Distance to the anal verge is associated with pathologic complete response to neoadjuvant therapy in locally advanced rectal cancer Journal Article


Authors: Patel, S. V.; Roxburgh, C. S.; Vakiani, E.; Shia, J.; Smith, J. J.; Temple, L. K.; Paty, P.; Garcia-Aguilar, J.; Nash, G.; Guillem, J.; Wu, A.; Reyngold, M.; Weiser, M. R.
Article Title: Distance to the anal verge is associated with pathologic complete response to neoadjuvant therapy in locally advanced rectal cancer
Abstract: Background and Objectives: Achieving a pathologic complete response (pCR) after neoadjuvant therapy has been associated with better prognosis in rectal cancer patients. The objective of this study was to investigate the relationship between distance to the anal verge (DTAV) and pCR. Methods: Review of a prospectively maintained database of patients with locally advanced rectal cancer who received neoadjuvant treatment was completed. Uni- and multivariate analysis assessed the association between DTAV and pCR after neoadjuvant therapy. Results: Of 827 included patients, 20% had a pCR. We found that pCR rates were 11% for tumors <4 cm, 24% for tumors 4–6 cm, 30% for tumors at 6–8 cm, 17% for tumors 8–10 cm, and 14% for tumors >10 cm from the anal verge (P = 0.002). Multivariate analysis also showed a strong association between DTAV and pCR (P = 0.008). The bimodal distribution of pCR resulted in a lower odds ratio of pCR for tumors <4 and >8 cm from the anal verge. Conclusions: Patients with low tumors (<4 cm) and higher tumors (>8 cm), were less likely to have a pCR. Further investigation is warranted to determine if these observations are related to tumor biology or possibly differences in radiation technique. J. Surg. Oncol. 2016;114:637–641. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Keywords: neoadjuvant therapy; rectal cancer; pathologic complete response; distance to anal verge
Journal Title: Journal of Surgical Oncology
Volume: 114
Issue: 5
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2016-10-01
Start Page: 637
End Page: 641
Language: English
DOI: 10.1002/jso.24358
PROVIDER: scopus
PUBMED: 27641934
PMCID: PMC5516624
DOI/URL:
Notes: Article -- Export Date: 2 November 2016 -- Source: Scopus
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MSK Authors
  1. Philip B Paty
    373 Paty
  2. Jose Guillem
    373 Guillem
  3. Jinru Shia
    465 Shia
  4. Martin R Weiser
    346 Weiser
  5. Marsha Laufer
    26 Laufer
  6. Abraham Jing-Ching Wu
    202 Wu
  7. Garrett Nash
    136 Nash
  8. Larissa Temple
    179 Temple
  9. Efsevia Vakiani
    164 Vakiani
  10. Jesse Joshua Smith
    49 Smith
  11. Sunil V Patel
    3 Patel