TY - JOUR
T1 - Is Early, Post-Induction Restaging of Rectal Cancer Undergoing Total Neoadjuvant Therapy Associated With Ultimate Treatment Response?
AU - Chapman, William C.
AU - Gorgun, Emre
AU - Yilmaz, Sumeyye
AU - Rosen, David R.
AU - Valente, Michael
AU - Sommovilla, Josh
AU - Kanters, Arielle
AU - Purysko, Andrei
AU - Khorana, Alok
AU - Krishnamurthi, Smitha
AU - Amarnath, Sudha
AU - Kessler, Hermann
AU - Steele, Scott
AU - Liska, David
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Among rectal cancer patients treated with Total Neoadjuvant Therapy, it is unclear whether early, post-induction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making. OBJECTIVE: To determine if post-induction restaging with endoscopy and magnetic resonance imaging is associated with final tumor response. DESIGN: Retrospective cohort study SETTINGS: US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer PATIENTS: Biopsy-proven rectal cancer patients who underwent Total Neoadjuvant Therapy with interim (post-induction) restaging. MAIN OUTCOME MEASURES: Association between response assessment on post-induction restaging and final treatment response. RESULTS: 107 patients were analyzed. Patients with post-induction magnetic resonance tumor response grade 1 - 2 or complete endoscopic response were significantly more likely (odds ratio 5.4 [p < 0.01] and odds ratio 3.7 [p = 0.03], respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with post-induction composite partial (odds ratio 4.1, p < 0.01) or minimal (odds ratio 12.0, p < 0.01) responses. LIMITATIONS: Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of this data. Limited sample size may also have biased these conclusions. CONCLUSION: Tumor response to induction therapy is associated with ultimate treatment response to Total Neoadjuvant Therapy among complete or minimal responders; the significance of a partial interim response remains unclear.
AB - BACKGROUND: Among rectal cancer patients treated with Total Neoadjuvant Therapy, it is unclear whether early, post-induction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making. OBJECTIVE: To determine if post-induction restaging with endoscopy and magnetic resonance imaging is associated with final tumor response. DESIGN: Retrospective cohort study SETTINGS: US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer PATIENTS: Biopsy-proven rectal cancer patients who underwent Total Neoadjuvant Therapy with interim (post-induction) restaging. MAIN OUTCOME MEASURES: Association between response assessment on post-induction restaging and final treatment response. RESULTS: 107 patients were analyzed. Patients with post-induction magnetic resonance tumor response grade 1 - 2 or complete endoscopic response were significantly more likely (odds ratio 5.4 [p < 0.01] and odds ratio 3.7 [p = 0.03], respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with post-induction composite partial (odds ratio 4.1, p < 0.01) or minimal (odds ratio 12.0, p < 0.01) responses. LIMITATIONS: Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of this data. Limited sample size may also have biased these conclusions. CONCLUSION: Tumor response to induction therapy is associated with ultimate treatment response to Total Neoadjuvant Therapy among complete or minimal responders; the significance of a partial interim response remains unclear.
KW - Complete response
KW - Nonoperative management
KW - Rectal cancer
KW - Total neoadjuvant therapy
KW - Watch-and-wait
UR - http://www.scopus.com/inward/record.url?scp=85209406959&partnerID=8YFLogxK
U2 - 10.1097/DCR.0000000000003485
DO - 10.1097/DCR.0000000000003485
M3 - Article
C2 - 39527827
AN - SCOPUS:85209406959
SN - 0012-3706
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
M1 - 10.1097/DCR.0000000000003485
ER -