title: 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response.
abstract: Neoadjuvant chemoradiation (CRT) followed by curative surgery still remains the standard of care for locally advanced rectal cancer (LARC). The main purpose of this multimodal treatment is to achieve a complete pathological tumor response (ypCR), with better survival. The surgery delay after CRT completion seems to increase tumor response and ypCR rate. Usually, time intervals range from 8 to 12 weeks, but the maximum tumor regression may not be seen in rectal adenocarcinomas until several months after CRT. About this issue, we report a case of a 52-year-old man with LARC treated with neoadjuvant CRT who developed, one month after RT completion, an acute myocardial infarction. The need to increase the interval between CRT and surgery for 17 weeks allowed a curative surgery without morbidity and an unexpected complete tumor response in the resected specimen (given the parameters presented in pelvic magnetic resonance imaging (MRI) performed 11 weeks after radiotherapy completion).
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Marisa D
authors.initials: MD
authors.lastname: Santos
authors.affiliation: Department of Medical Imaging, Radiology Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Manuel T
authors.initials: MT
authors.lastname: Gomes
authors.affiliation: Department of Pathology, Pathological Anatomy Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Moreno
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Rocha
authors.affiliation: Department of Pathology, Pathological Anatomy Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal ; Department of Pathology and Molecular Immunology, Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge Viterbo Ferreira No. 228, 4050-313 Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lopes