title: The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.
abstract: Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120 patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Jing-Hua
authors.initials: JH
authors.lastname: Tang
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Lin
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Gao
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Guo-Chen
authors.initials: GC
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Ling-Heng
authors.initials: LH
authors.lastname: Kong
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Zhi-Zhong
authors.initials: ZZ
authors.lastname: Pan
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|Departments of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Pei-Rong
authors.initials: PR
authors.lastname: Ding
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D062005:Biopsy, Large-Core Needle / Q000295:instrumentation / Q000379:methods*; D059248:Chemoradiotherapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D012074:Remission Induction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013525:Surgical Instruments
keywords: core needle biopsy; forceps biopsy; locally advanced rectal cancer; neoadjuvant chemoradiotherapy