Resultados clínico-oncológicos de la respuesta patológica completa en el cáncer de recto después de tratamiento neoadyuvante

Introduction: Neoadjuvant chemo-radiotherapy is the treatment of choice for rectal cancer in order to reduce local recurrence. Patients with a pathological complete response (PCR) have a better prognosis. The aim of this study was to determine the influence of PCR on the oncological outcomes in our patients. Methods: All patients with stage II/III rectal cancer treated with neoadjuvant chemo-radiotherapy and radical resection between 2007 and 2011were identified from a prospective database, and grouped based on whether they achieved PCR or not (non-PCR). Clinical, histological and oncological outcome data were compared. Results: A total of 162 patients were included (62% men), with a mean age of 65 years. In terms of pre-operative TNM staging, 82 patients (50%) were T2, 75 (46%) were T3, and 5 (3%) were T4. Forty-two patients (25%) were N1, and 87 (53%) were N2. Low anterior resection and abdominoperineal resection were performed in 125 (77%) and 25 (15%) patients. Forty-three patients (26.5%) had postoperative morbidity. PCR was achieved in 19 patients (11.7%). After a median follow-up of 26 months, there are no recurrences in the PCR group, and in the non-PCR group, local recurrence was 1.4% (P = .78), and distant metastasis was 8.4% (P = .21). Overall survival (P = .39) and survival free of diseases (P = .23) were better in the PCR group, but the differences were not significant. Conclusion: Patients with pathological complete response have better oncological outcome. (C) 2012 AEC. Published by Elsevier Espana, S. L. All rights reserved.