Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : November | Volume : 11 | Issue : 11 | Page : PC09 - PC10

Complete Response after Neoadjuvant Therapy in Rectal Cancer- Does T0 Mean N0?

Rajat Raghunath, Dipti Masih, Rajesh Joseph Selvakumar, Bharat Shankar, Mark Ranjan Jesudason

1. Assistant Professor, Department of Surgery, Unit II, CMC, Vellore, Tamil Nadu, India. 2. Associate Professor, Department of Pathology, CMC, Vellore, Tamil Nadu, India. 3. Assistant Professor, Department of Surgery, Unit II, CMC, Vellore, Tamil Nadu, India. 4. Colorectal Fellow, Department of Surgery, Unit II, CMC, Vellore, Tamil Nadu, India. 5. Professor, Department of Surgery, Unit II, CMC, Vellore, Tamil Nadu, India.

Correspondence Address :
Dr. Rajat Raghunath,
Assistant Professor, Department of Surgery, Unit II, CMC, Vellore-632004, Tamil Nadu, India.
E-mail: rajatraghunath@gmail.com

Abstract

Introduction: Rectal resection after neoadjuvant chemoradiotherapy is the standard of care for rectal cancer. Non-operative management of rectal cancer is the new frontier. Selection of these patients is based on the absence of mucosal disease after neoadjuvant therapy. The question that is quintessential is whether absence of mucosal disease means absence of nodal disease.

Aim: To see the correlation between absence of mucosal disease and mesorectal disease in rectal resections after neoadjuvant therapy for rectal cancer.

Materials and Methods: A retrospective study was done on 479 patients of locally advanced carcinoma rectum from 2008 to 2015. All patients received neoadjuvant therapy which was mainly long course radiation therapy with 5040cGy over duration of 28 days with concurrent chemotherapy. Some patients underwent neoadjuvant chemotherapy. After an interval of approximately 6 weeks they underwent curative surgery. The patients who had complete pathological response were analysed in this study.

Results: Out of the 479 patients, 76 patients were found to have no disease in the rectal wall. Only 1 patient (1.3%) had node positive disease without having any rectal disease (T0N1). The rest had no tumour either in the rectum or the mesorectal nodes. Thus, 75 patients had a pathological complete response (15.6%).

Conclusion: In patients with rectal cancer undergoing neoadjuvant chemoradiotherapy followed by radical resection, absence of tumour in the rectum correlates well with absence of disease in the mesorectum and absence of nodal disease. Thus, absence of mucosal disease can be taken as marker of complete response to neoadjuvant therapy.

Keywords

Chemoradiotherapy, Mucosal disease, Nodal disease

How to cite this article :

Rajat Raghunath, Dipti Masih, Rajesh Joseph Selvakumar, Bharat Shankar, Mark Ranjan Jesudason. COMPLETE RESPONSE AFTER NEOADJUVANT THERAPY IN RECTAL CANCER- DOES T0 MEAN N0?. Journal of Clinical and Diagnostic Research [serial online] 2017 November [cited: 2018 Jan 23 ]; 11:PC09-PC10. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=November&volume=11&issue=11&page=PC09-PC10&id=10842

DOI and Others

DOI: 10.7860/JCDR/2017/30848.10842

Date of Submission: Jun 12, 2017
Date of Peer Review: Jul 17, 2017
Date of Acceptance: Oct 06, 2017
Date of Publishing: Nov 01, 2017

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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