AI Article Synopsis
- - The study investigates whether early restaging with endoscopy and MRI after induction therapy in rectal cancer patients influences the final treatment outcome.
- - Analyzed data from 107 patients showed that those with better interim responses had significantly higher chances of achieving complete final responses, highlighting a potential link between early assessment and ultimate success.
- - Limitations of the study include its retrospective nature and small sample size, which might affect the reliability of the findings, particularly regarding the implications of partial responses.
Article Abstract
Background: Among patients with rectal cancer treated with total neoadjuvant therapy, it is unclear whether early, postinduction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making.
Objective: To determine whether postinduction restaging with endoscopy and MRI is associated with final tumor response.
Design: Retrospective cohort study.
Settings: US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer.
Patients: Patients with biopsy-proven rectal cancer who underwent total neoadjuvant therapy with interim (postinduction) restaging.
Main Outcome Measures: Association between response assessment on postinduction restaging and final treatment response.
Results: One hundred seven patients were analyzed. Patients with postinduction magnetic resonance tumor response grade 1 and 2 or complete endoscopic response were significantly more likely (OR 5.4, p < 0.01 and OR 3.7, p = 0.03, respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with postinduction composite partial (OR 4.1, p < 0.01) or minimal (OR 12.0, p < 0.01) responses.
Limitations: Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of these data. The limited sample size may also have biased these conclusions.
Conclusions: Tumor response to induction therapy is associated with the ultimate treatment response to total neoadjuvant therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract .
Est Asociada La Reestadificacin Temprana Postinduccin Del Cancer De Recto Sometido A Terapia Neoadyuvante Total Con La Respuesta Teraputica Final: ANTECEDENTES:Entre los pacientes con cáncer de recto tratados con terapia neoadyuvante total, no está claro si la re-estadificación temprana posterior a la inducción está asociada con la respuesta tumoral final. De ser así, la re-estadificación provisoria podría alterar la toma de decisiones sobre el cáncer rectal.OBJETIVO:Determinar si la re-estadificación posterior a la inducción con endoscopia y resonancia magnética están asociadas con la respuesta tumoral final.DISEÑO:Estudio de cohorte retrospectivoESCENARIO:Institución de atención terciaria de Estados Unidos, certificada por el Programa Nacional de Acreditación para el Cáncer de Recto.PACIENTES:Pacientes con cáncer rectal confirmado por biopsia que fueron sometidos a terapia neoadyuvante total con re-estadificación provisoria (posterior a la inducción).PRINCIPALES MEDIDAS DE RESULTADOS:La asociación entre la evaluación de la respuesta en la re-estadificación posterior a la inducción y la respuesta al final del tratamiento.RESULTADOS:Se estudiaron 107 pacientes. Aquellos que presentaban respuesta tumoral a la resonancia magnética post-inducción grado 1-2 o respuesta endoscópica completa tuvieron significativamente más probabilidades (OR (odds ratio) 5,4 [ p < 0,01] y OR: 3,7 [ p = 0,03], respectivamente) de lograr finalmente una respuesta completa final. Asimismo, las probabilidades de una respuesta incompleta final fueron significativamente mayores para los pacientes con respuestas parciales compuestas post-inducción (OR: 4,1, p < 0,01) o mínimas (OR: 12,0, p < 0,01).LIMITACIONES:El análisis retrospectivo y la falta de una subclasificación detallada de la respuesta endoscópica parcial pueden haber limitado las conclusiones de estos datos. El tamaño limitado de la muestra también puede haber sesgado las conclusiones mencionadas.CONCLUSIÓN:La respuesta tumoral a la terapia de inducción está asociada con la respuesta final al tratamiento con terapia neoadyuvante total entre los respondedores completos o mínimos; la importancia de una respuesta parcial provisional sigue sin estar clara. (Traducción-Dr. Xavier Delgadillo ).
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Article Synopsis
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