Factors associated with pathological complete response and construction of scoring system in patients with rectal cancer after neoadjuvant chemoradiotherapy
10.3760/cma.j.cn113855-20210713-00427
- VernacularTitle:直肠癌新辅助放化疗后病理完全缓解相关因素分析及评分系统构建
- Author:
Xin CHEN
1
;
Yao LIN
;
Xiong SUN
;
Xin TONG
;
Chenggang ZHANG
;
Qi JIANG
;
Chengguo LI
;
Peng ZHANG
;
Zheng WANG
;
Kaixiong TAO
Author Information
1. 华中科技大学同济医学院附属协和医院胃肠外科，武汉 430022
- Keywords:
Rectal neoplasms;
Chemoradiotherapy;
Lymphocytes;
Forecasting
- From:
Chinese Journal of General Surgery
2022;37(5):325-329
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the clinical factors associated with pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced middle and low rectal cancer and establish a scoring system.Methods:In this retrospective analysis the clinical data of patients with locally advanced middle and low rectal cancer treated with nCRT combined with surgery at Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from Jan 2016 to Jan 2020 were studied. Patients were divided into pCR group and non-pCR group. Single factor analysis and Logistic multivariate regression analysis were performed to explore pCR related factors after nCRT, and a pCR prediction scoring system was established.Results:The pCR was achieved in 33 patients (20.8%). Univariate analysis showed that the maximum thickness of the tumor≤25mm before nCRT ( P=0.046), concurrent oxaliplatin-combined intensive chemotherapy ( P=0.013), the NLR≤1.65 before nCRT ( P=0.004) and the serum CEA≤5 ng/ml before nCRT ( P=0.016) were significantly associated with pCR. In multivariate analysis, concurrent oxaliplatin-combined intensive chemotherapy, the NLR before nCRT and serum CEA before nCRT were independent related factors of pCR. The probability of pCR for patients with score of 0, 1, 2, and 3 was 42% (10/24), 30% (19/63), 5% (3/57) and 7% (1/15), respectively. The probability of pCR in patients with score≤1 point was 33% (29/87), and 6% (4/72) for score?1 point ( P?0.001). The area under the curve of the scoring system is 0.729 (95% CI: 0.638-0.820, P?0.001). Conclusions:Concurrent oxaliplatin-combined intensive chemotherapy, NLR≤1.65 before nCRT and serum CEA≤5 ng/ml before nCRT are independent predictors of pCR in locally advanced middle and low rectal cancer and the scoring system constructed in combination with above indicators can effectively predict pCR.
