title: Predictive Response Value of Pre- and Postchemoradiotherapy Variables in Rectal Cancer: An Analysis of Histological Data.
abstract: Background. Neoadjuvant chemoradiotherapy (nCRT) followed by curative surgery in locally advanced rectal cancer (LARC) improves pelvic disease control. Survival improvement is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. Potential predictive factors for Mandard response are analyzed. Materials and Methods. 167 patients with LARC were treated with nCRT and curative surgery. Tumor biopsies and surgical specimens were reviewed and analyzed regarding mitotic count, necrosis, desmoplastic reaction, and inflammatory infiltration grade. Surgical specimens were classified according to Mandard TRG. The patients were divided as "good responders" (Mandard TRG1-2) and "bad responders" (Mandard TRG3-5). According to results from our previous data, good responders have better prognosis than bad responders. We examined predictive factors for Mandard response and performed statistical analysis. Results. In univariate analysis, distance from anal verge and ten other postoperative variables related with nCRT tumor response had predictive value for Mandard response. In multivariable analysis only mitotic count, necrosis, and differentiation grade in surgical specimen had predictive value. Conclusions. There is a lack of clinical and pathological preoperative variables able to predict Mandard response. Only postoperative pathological parameters related with nCRT response have predictive value.
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Marisa D
authors.initials: MD
authors.lastname: Santos
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Silva
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Rocha
authors.affiliation: Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Abel Salazar, 4099-003 Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Nogueira
authors.affiliation: Department of Community Health, Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge Viterbo Ferreira, No. 228, 4050-313 Porto, Portugal.
authors.forename: Eduarda
authors.initials: E
authors.lastname: Matos
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