Background: In Panama, and the rest of Latin America, there are few publications on chemoradioresistance, it leads to poor prognosis and represents the main reason for failure of therapy, ultimately it can lead to tumor recurrence and metastasis. Objective: Identify factors associated with chemoradioresistance in the neoadjuvant treatment of locally advanced rectal cancer at the Instituto Oncológico Nacional de Panamá, period 2016-2020. Methodology: This retrospective study included 71 patients with LARC who received neoadjuvant chemoradiotherapy and surgery. Chemoradioresistant patients were those who did not reach a higher pathological stage of ypT2NO and the results were compared. Results: Of the 71 patients, pathological complete response (pCR) was achieved in 34 patients (48%). 49% of patients met chemoradioresistance criteria. In this group, the median CEA was 136 ng/ml, the median hemoglobin was 12 g/dl, and the median BMI was 26 kg/m2. The median radiation dose was 5000Gy. The time between completion of chemoradiotherapy and surgery was 110 days (16 weeks). Depending on the type of surgery, 65% who underwent low anterior resection were chemoradioresistant. The variables with statistical significance were the CEA value >5 ng/mL (OR=1.81, p=0.026) prior to the start of neoadjuvant treatment, with a lower pCR rate. Likewise, the ECOG scale (OR=2.51, p=0.015) was a risk factor related to chemoradioresistance, the lower the ECOG, the lower the risk of chemoradioresistance. The median overall survival and median recurrence-free survival was not reached in both groups and there was no statistically significant difference. Conclusions: Significant interactions were identified between CEA levels prior to the start of neoadjuvant treatment with the pathological complete response rate and the ECOG score with chemoradioresistance. Therefore, these factors can be used to predict patient outcomes, will help optimize personalized treatment strategies and improve patient outcomes.
| Published in | Cancer Research Journal (Volume 12, Issue 2) |
| DOI | 10.11648/j.crj.20241202.11 |
| Page(s) | 21-26 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Locally Advanced Rectal Cancer, Chemoradiotherapy, Pathological Complete Response, Chemoradioresistance
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APA Style
Jerez, D. A., Luz, C. E. L., Llerena, J. P., Arauz, R. (2024). Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama. Cancer Research Journal, 12(2), 21-26. https://doi.org/10.11648/j.crj.20241202.11
ACS Style
Jerez, D. A.; Luz, C. E. L.; Llerena, J. P.; Arauz, R. Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama. Cancer Res. J. 2024, 12(2), 21-26. doi: 10.11648/j.crj.20241202.11
AMA Style
Jerez DA, Luz CEL, Llerena JP, Arauz R. Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama. Cancer Res J. 2024;12(2):21-26. doi: 10.11648/j.crj.20241202.11
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Download@article{10.11648/j.crj.20241202.11,
author = {Daliana Alcantara Jerez and Carla Eloy La Luz and Jose Pinto Llerena and Rafael Arauz},
title = {Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama
},
journal = {Cancer Research Journal},
volume = {12},
number = {2},
pages = {21-26},
doi = {10.11648/j.crj.20241202.11},
url = {https://doi.org/10.11648/j.crj.20241202.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20241202.11},
abstract = {Background: In Panama, and the rest of Latin America, there are few publications on chemoradioresistance, it leads to poor prognosis and represents the main reason for failure of therapy, ultimately it can lead to tumor recurrence and metastasis. Objective: Identify factors associated with chemoradioresistance in the neoadjuvant treatment of locally advanced rectal cancer at the Instituto Oncológico Nacional de Panamá, period 2016-2020. Methodology: This retrospective study included 71 patients with LARC who received neoadjuvant chemoradiotherapy and surgery. Chemoradioresistant patients were those who did not reach a higher pathological stage of ypT2NO and the results were compared. Results: Of the 71 patients, pathological complete response (pCR) was achieved in 34 patients (48%). 49% of patients met chemoradioresistance criteria. In this group, the median CEA was 136 ng/ml, the median hemoglobin was 12 g/dl, and the median BMI was 26 kg/m2. The median radiation dose was 5000Gy. The time between completion of chemoradiotherapy and surgery was 110 days (16 weeks). Depending on the type of surgery, 65% who underwent low anterior resection were chemoradioresistant. The variables with statistical significance were the CEA value >5 ng/mL (OR=1.81, p=0.026) prior to the start of neoadjuvant treatment, with a lower pCR rate. Likewise, the ECOG scale (OR=2.51, p=0.015) was a risk factor related to chemoradioresistance, the lower the ECOG, the lower the risk of chemoradioresistance. The median overall survival and median recurrence-free survival was not reached in both groups and there was no statistically significant difference. Conclusions: Significant interactions were identified between CEA levels prior to the start of neoadjuvant treatment with the pathological complete response rate and the ECOG score with chemoradioresistance. Therefore, these factors can be used to predict patient outcomes, will help optimize personalized treatment strategies and improve patient outcomes.
},
year = {2024}
}
TY - JOUR T1 - Predictive and Prognostic Factors Related to Chemoradioresistance in Neoadjuvant Treatment of Locally Advanced Rectal Cancer at Panama AU - Daliana Alcantara Jerez AU - Carla Eloy La Luz AU - Jose Pinto Llerena AU - Rafael Arauz Y1 - 2024/04/12 PY - 2024 N1 - https://doi.org/10.11648/j.crj.20241202.11 DO - 10.11648/j.crj.20241202.11 T2 - Cancer Research Journal JF - Cancer Research Journal JO - Cancer Research Journal SP - 21 EP - 26 PB - Science Publishing Group SN - 2330-8214 UR - https://doi.org/10.11648/j.crj.20241202.11 AB - Background: In Panama, and the rest of Latin America, there are few publications on chemoradioresistance, it leads to poor prognosis and represents the main reason for failure of therapy, ultimately it can lead to tumor recurrence and metastasis. Objective: Identify factors associated with chemoradioresistance in the neoadjuvant treatment of locally advanced rectal cancer at the Instituto Oncológico Nacional de Panamá, period 2016-2020. Methodology: This retrospective study included 71 patients with LARC who received neoadjuvant chemoradiotherapy and surgery. Chemoradioresistant patients were those who did not reach a higher pathological stage of ypT2NO and the results were compared. Results: Of the 71 patients, pathological complete response (pCR) was achieved in 34 patients (48%). 49% of patients met chemoradioresistance criteria. In this group, the median CEA was 136 ng/ml, the median hemoglobin was 12 g/dl, and the median BMI was 26 kg/m2. The median radiation dose was 5000Gy. The time between completion of chemoradiotherapy and surgery was 110 days (16 weeks). Depending on the type of surgery, 65% who underwent low anterior resection were chemoradioresistant. The variables with statistical significance were the CEA value >5 ng/mL (OR=1.81, p=0.026) prior to the start of neoadjuvant treatment, with a lower pCR rate. Likewise, the ECOG scale (OR=2.51, p=0.015) was a risk factor related to chemoradioresistance, the lower the ECOG, the lower the risk of chemoradioresistance. The median overall survival and median recurrence-free survival was not reached in both groups and there was no statistically significant difference. Conclusions: Significant interactions were identified between CEA levels prior to the start of neoadjuvant treatment with the pathological complete response rate and the ECOG score with chemoradioresistance. Therefore, these factors can be used to predict patient outcomes, will help optimize personalized treatment strategies and improve patient outcomes. VL - 12 IS - 2 ER -
Department of Gastrointestinal Medical Oncology, Instituto Oncologico Nacional, Panama City, Panama
Department of Gastrointestinal Medical Oncology, Instituto Oncologico Nacional, Panama City, Panama
Department of Gastrointestinal Medical Oncology, Instituto Oncologico Nacional, Panama City, Panama
Department of Radiation Oncology, Instituto Oncologico Nacional, Panama City, Panama
