Abstract
Objective: To investigate whether the locally advanced rectal cancer patients who got a pathological complete response after neo-adjuvant chemoradiotherapy have a better survival. Methods: From January 1 2014 to January 1 2018, the clinical information of locally advanced rectal cancer patients who underwent neo-adjuvant chemoradiotherapy were collected for a retrospective analysis. Then a telephone follow-up visit was done to get the patients’ survival information of progression-free survival and overall survival. At last the information was analyzed by Kaplan-Meier analysis, log-rank test and cox-regression analysis. Results: The clinical information of 246 locally advanced rectal cancer patients were collected and analyzed, which shows that the PCR rate after chemoradiotherapy was 20.3% in these patients. There were correlations between pathological grade(grade III-IV Vs. I-II, P=0.001), CRM invasion(positive Vs. negative, P=0.001), clinical T stage(T4 Vs. T1-3, P=0.000), PCR status(PCR Vs. Non-PCR, P=0.027), downstage after preoperative therapy(yes Vs. not, P=0.009) and PFS. Similarly, age(≤60 Vs. >60, P=0.000), pathological grade(grade III-IV Vs. I-II, P=0.016), EMVI status(positive Vs. negative, P=0.005), CRM invasion(positive Vs. negative, P=0.000), clinical T stage(T4 Vs. T1-3, P=0.000), clinical N stage(N0-1 Vs. N2, P=0.013), PCR status(PCR Vs. Non-PCR, P=0.010), downstage after preoperative therapy(yes Vs. not, P=0.002) were associated with the OS. After the Cox-regression analyses, the responses after preoperative therapy or T4 tumors were identified as the prognostic factors that affected PFS and OS. Conclusions: The PCR rate after chemoradiotherapy was 20.3% in locally advanced rectal patients. Stage T1-3, better response after chemoradiotherapy tumors (PCR or downstage) might have a better survival outcome.