Complete Clinical Response After Neoadjuvant Chemoradiation Therapy for Distal Rectal Cancer: Characterization of Clinical and Endoscopic Findings for Standardization

• DOI: 10.1007/dcr.0b013e3181f42b89
• Publication Date: 2011-04-07T19:27:12Z
• Authors: Angelita Habr-Gama; Rodrigo O. Perez; Gregory Wynn; John Marks; Hermann Kessler; Joaquim Gama-Rodr...
• Keywords: Neoadjuvant Therapy; Complete response; Concomitant; Chemoradiotherapy

BACKGROUND: Complete tumor regression may develop after neoadjuvant chemoradiation therapy for distal rectal cancer. Studies have suggested that selected patients with complete clinical response avoid radical surgery and close surveillance provide good outcomes no oncologic compromise. However, definition of is often imprecise vary between different studies. The aim this study to a clear in cancer addition actual endoscopic videos from managed nonoperatively. METHODS: Patients nonmetastatic treated by therapy, including 50.4 Gy concomitant 5-fluorouracil leucovorin, were assessed at least 8 weeks completion. incomplete responses defined based on findings. not immediately operated closely followed. Early late findings recorded. RESULTS: Definition should be very strict criteria. finding any residual superficial ulceration, irregularity, or nodule prompt surgical attention, transanal full-thickness excision even resection total mesorectal excision. Standard incisional biopsies avoided setting. responders harbor more than whitening the mucosa, teleangiectasia mucosal integrity considered nonoperative approach. In presence these findings, regularly scheduled reassessments safe alternative early detection recurrent disease. CONCLUSION: Strict experiencing useful tool understanding immediate allowing standardization classifications comparison experiences institutions.