Pathological Complete Response Predicts Outcomes in Advanced Rectal Cancer
Among patients with locally advanced rectal cancer, a complete disappearance of detectable cancer (pathological complete response) after preoperative chemoradiation therapy is linked with better long-term outcomes. These findings were recently published in the journal The Lancet Oncology.
Rectal cancer is a disease in which malignant cells arise from the cells of the rectum. The rectum is part of the digestive system and is the final 6 inches of the large intestine. Current treatments for rectal cancer include surgery, chemotherapy, and radiation. Some of the factors that influence the choice of treatment include the likelihood of cancer recurrence, the extent of the cancer, and the general health of the patient. Compared with surgery alone, chemotherapy and radiation given before surgery (neoadjuvant) has been shown to improve patient outcomes in patients with locally advanced rectal cancer.
In the current study, researchers reviewed data from 17 studies to determine whether pathological complete response following preoperative chemoradiation therapy predicted better long-term outcomes in patients with locally advanced rectal cancer. Of the 3,105 patients in the reviewed studies, 484 had a pathological complete response following chemoradiation therapy. Approximate five-year disease-free survival was 83.3% for patients with a pathological complete response compared with 65.6% for those who did not achieve a pathological complete response. Disease-free survival was also improved in pathological complete responders.
The researchers concluded that this pooled analysis of multiple datasets indicates that pathological complete response following chemoradiation therapy appears to be a predictor for better long-term outcome in patients with locally advanced rectal cancer.
 Maas M, Nelemans PJ, Valentini V, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. The Lancet Oncology [early online publication]. August 9, 2010.
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