Predictive factors of disease-free survival after complete pathological response to neoadjuvant radiotherapy for rectal adenocarcinoma: retrospective case series
Amine Souadka,
Mohammed Anass Majbar,
Amine Benkabbou,
Badr Serji,
Tarik Souiki,
Sidi Mohammed Bouchentouf,
Mourad Abid,
Basma El Khannousi,
Tijani El Harroudi,
Hadj Omar El Malki,
Mohammed Raiss,
Lahsen Ifrine,
Khalid Mazaz,
Aziz Zentar,
Raouf Mohsine,
Abdelilah Souadka,
Abdelkader Belkouchi,
Mohammed Ahallat,
Abdelmalek Hrora,
on behalf of the Moroccan Society of Surgery
Affiliations
Amine Souadka
Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School
Mohammed Anass Majbar
Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School
Amine Benkabbou
Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School
Badr Serji
Surgical Oncology, Hospital El Farabi, Mohammed Ist University
Tarik Souiki
Surgery Department, Sidi Mohammed Ben Abdellah University
Sidi Mohammed Bouchentouf
Surgery Department, Military Hospital
Mourad Abid
Batna Anticancer Center Alger
Basma El Khannousi
Anatomopathology Department, National Institute of Oncology
Tijani El Harroudi
Surgical Oncology, Hospital El Farabi, Mohammed Ist University
Hadj Omar El Malki
Surgical Department “A”, Ibn Sina Hospital
Mohammed Raiss
Anatomopathology Department, National Institute of Oncology
Lahsen Ifrine
Surgical Department “A”, Ibn Sina Hospital
Khalid Mazaz
Surgery Department, Sidi Mohammed Ben Abdellah University
Aziz Zentar
Surgery Department, Military Hospital
Raouf Mohsine
Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School
Abdelilah Souadka
Private surgical oncology center
Abdelkader Belkouchi
Surgical Department “A”, Ibn Sina Hospital
Mohammed Ahallat
Abdelmalek Hrora
Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School
Abstract Background Many data suggest that patients with low rectal adenocarcinoma who achieved ypT0N0 status have improved survival and disease-free survival (DFS) compared to all other stages however only few data are available regarding the specific prognosis factors of this subgroup. This study aimed to evaluate predictive factors for disease free survival after complete pathological response (CPR) in cases of low rectal adenocarcinoma. Materials and methods From January 2005 to December 2013, all patients with low rectal adenocarcinoma who underwent neoadjuvant chemoradiotherapy followed by total mesorectal excision and achieved CPR were included at 7 Moroccan and 1 Algerian centres. Predictive factors for disease-free survival were analysed by uni and multivariate analysis. Results Eigthy-four (12.1%) patients achieved a CPR (ypT0N0). Multivariate analysis revealed that both poorly differentiated tumors (OR, 9.23; 95 CI 1.35–62.82; P = 0.023) and the occurrence of perineal sepsis (OR, 13.51; 95 CI 1.96–93.12; P = 0.008) were independently associated with impaired DFS. Conclusions Patients with low rectal cancer who exhibited a CPR after neoadjuvant therapy have good prognoses; however, the occurrence of perineal sepsis and/or poor initial differentiation may be associated with impaired DFS in these patients. Trial registration: The study was retrospectively registered the 28th July 2018 in ClinicalTrials.gov register with the reference NCT03601689.
