ANALYSIS OF PATIENTS OPERATED ON FOR RECTAL CANCER AFTER NEOADJUVANT THERAPY WITH NO RESIDUAL TUMOR IN THE PATHOLOGICAL EXAMINATION

Introduction Around 10-25% of patients who undergo surgery for rectal cancer (RC) after neoadjuvant therapy show a complete pathological response in the surgical specimen. However, it is difficult to predict this response with certainty based on the available exams, such as colonoscopy, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT).

Objective To evaluate patients with rectal cancer who underwent neoadjuvant treatment followed by surgery for incomplete response, and who did not present viable tumor in the pathological examination.

Method Retrospective analysis of medical records of patients operated between 2015 and 2023 at the Hospital das Clínicas, Unicamp, who had a complete pathological response after surgery.

Results During this period, 227 patients with rectal cancer were operated after neoadjuvant treatment, with 20 of them showing no viable tumor in the pathological examination. Half received the Mayo regimen, and the other half received Xelox and radiotherapy. The average age was 56.8 years, with 70% being male. Of the 18 patients who underwent PET-CT, 9 (50%) showed residual neoplasia; of the 15 colonoscopies, 11 (73.33%), and of the 17 MRIs, 12 (70.50%). The average interval between the end of radiotherapy and surgery was 29.8 weeks.

Conclusion Identifying patients with a complete pathological response after neoadjuvant therapy remains a challenge, and there is currently no exam capable of precisely determining this condition.

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Artikel online veröffentlicht:
25. April 2025