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MR prediction of pathologic complete response and early-stage rectal cancer after neoadjuvant chemoradiation in patients with clinical T1/T2 rectal cancer for organ saving strategy

 Heejin Bae  ;  Nieun Seo  ;  Kyunghwa Han  ;  Woong Sub Koom  ;  Myeong-Jin Kim  ;  Nam Kyu Kim  ;  Joon Seok Lim 
 MEDICINE, Vol.99(42) : e22746, 2020-10 
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Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy ; Early Detection of Cancer ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Neoadjuvant Therapy ; Organ Sparing Treatments ; Predictive Value of Tests ; Rectal Neoplasms / diagnostic imaging* ; Rectal Neoplasms / pathology ; Rectal Neoplasms / therapy* ; Remission Induction*
To evaluate the ability of magnetic resonance imaging (MRI) to predict pathologic complete response (pCR) after neoadjuvant chemoradiation therapy (CRT) in patients with clinical T1/T2 rectal cancer to indicate candidates for organ-saving strategies.Between 2012 and 2016, 38 patients with clinical T1/T2 rectal cancer received neoadjuvant CRT. Radiologic complete response (rCR) was assigned when dense fibrotic tissue without tumor signal intensity was observed on post-CRT MRI. Surgical pathologic assessment was used to evaluate tumor regression. The association between rCR and the mural extent of the primary tumor, pCR, and pathologic T stage were analyzed.In rCR patients, the pCR rate was higher; the odds of achieving pCR were 8.00 times higher than for non-rCR patients (P = .02). rCR patients were also more likely to have early-stage cancer than non-rCR patients (P = 0.01). Patients with partial extent of the primary tumor on post-CRT MRI were more likely to be diagnosed with early-stage cancer than those with transmural extent (P = .01).rCR indicated by post-CRT MRI can be used as a supportive factor to predict pCR after neoadjuvant CRT in patients with clinical T1/T2 rectal cancer and can guide management decisions around organ-saving treatments.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Bae, Heejin(배희진) ORCID logo https://orcid.org/0000-0002-1227-8646
Seo, Nieun(서니은) ORCID logo https://orcid.org/0000-0001-8745-6454
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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