Assessing the predictive value of clinical factors to pathological complete response for locally advanced rectal cancer: An analysis of 124 patients

Frontiers in Oncology

Oncology

Chaoxi Zhou¹  Kanghua Wang²  Xiaoxiao Zhang³  Xuan Wang⁴  Ming Liu⁴  Linlin Xiao⁴  Yuting Xiao⁴  Congrong Yang⁴  Jun Wang⁴  Fengpeng Wu⁴  Chao Gao⁴  Fuyin Qu⁴ 

[1] Department of General Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China;Department of Medical Oncology, Affiliated Hospital Of Hebei University, Baoding, China;Department of Radiotherapy, Fourth Hospital of Hebei Medical University, Shijiazhuang, China;Department of Radiation Oncology, Hebei Cancer Hospital Chinese Academy of Medical Sciences, Langfang, China;Department of Radiotherapy, Fourth Hospital of Hebei Medical University, Shijiazhuang, China;

关键词: locally advanced rectal cancer;    neoadjuvant chemoradiotherapy;    extramural vascular invasion;    carcino-embryonic antigen (CEA);    pathological complete response (PCR);   

DOI  :  10.3389/fonc.2023.1125470

 received in 2023-01-16, accepted in 2023-03-21,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeTo investigate the clinical factors affecting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC).MethodsClinical data of 124 LARC patients treated with nCRT and surgery in the fourth Hospital of Hebei Medical University from 2014 to 2019 were retrospectively analyzed. In this study, univariate analysis and logistic dichotomous multivariate regression analysis were used to study the clinical factors affecting pCR, and the receiver operator characteristic curve (ROC) analysis was used to further verify the accuracy of partial indexes in predicting pCR.ResultsOf the 124 enrolled patients, 19 patients (15.32%) achieved pCR. Univariate analysis showed that the number of cycles of consolidation chemotherapy, serum carcino-embryonic antigen (CEA) level before treatment, MRI longitudinal length of tumor, and extramural vascular invasion (EMVI) were statistically correlated with pCR. ROC analysis of the longitudinal length of tumor measured by MRI showed that the area under the curve (AUC) value, sensitivity and specificity were 0.735, 89.47% and 48.57% respectively, and the optimal cut-off value was 5.5cm. The ROC analysis showed that the AUC value, sensitivity and specificity of pCR prediction using CEA were 0.741, 63.16% and 90.48%, respectively, and the optimal cut-off value was 3.1ng/ml. Multivariate results showed that the number of cycles of consolidation chemotherapy, serum CEA level before treatment, and EMVI were independent predictors of pCR.ConclusionThe number of cycles of consolidation chemotherapy, serum CEA level before treatment, and EMVI may be important determinants of LARC patients to reach pCR after nCRT.

【 授权许可】

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Copyright © 2023 Zhou, Wang, Zhang, Xiao, Yang, Wang, Qu, Wang, Liu, Gao, Xiao and Wu