MULTIDISCIPLINARY TREATMENT OF RECTAL CANCER: THE ASSESSMENT OF CLINICAL AND PATHOLOGIC RESPONSE FOR LOCALLY ADVANCED RECTAL CANCER TREATED WITH NEOADJUVANT CHEMORADIOTHERAPY

Abstract

Preoperative staging by digital examination, endorectal ultrasound and magnetic resonance imaging (MRI) allows an assessment of the risk of local recurrence after surgery alone. The successful management of rectal cancer requires a multidisciplinary approach, with treatment decisions based on precise patient evaluations. Chemoradiotherapy (CRT) is associated with reduction of tumor size and downstaging.The aim of this study is to assess how often complete clinical response is achieved after eoadjuvant CRT and its concordance with pathologic complete response.Results. Patients with biopsy-proven, locally advanced rectal cancer (T3, T4) were treated by CRT followed by radical surgery. Tumors were re-assessed after 8 weeks from CRT completion using MRI and endoscopic examination. The results of examination were comparedwith the final histopathologic status.Conclusions. Neoadjuvant CRT leads to significant tumor regression and in some patients there is complete disappearance of neoplasm. MRI combining with colonoscopic findings is a useful tool to evaluate these features.

Keywords

• rectal cancer
• magnetic resonance imaging
• chemoradiotherapy
• complete clinical response