Tumor Response to Neoadjuvant Long-Course Chemoradiotherapy Depends on the Rectal Cancer Patient Gender
Our study aimed to analyze the correlation of cancer-related parameters with tumor regression grade (TRG) and disease-free survival (DFS) by gender in 192 rectal cancer patients operated on after neoadjuvant long-course chemoradiotherapy (LCCRT). Preoperative diagnostics revealed no significant g...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2024-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/481883 |
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| Summary: | Our study aimed to analyze the correlation of cancer-related parameters with tumor
regression grade (TRG) and disease-free survival (DFS) by gender in 192 rectal cancer patients operated
on after neoadjuvant long-course chemoradiotherapy (LCCRT). Preoperative diagnostics revealed
no significant gender differences in any clinical parameters other than obesity (p=0.031). We found
that slightly overweight men had a lower incidence of distant metastases (p=0.042). The post-LCCRT
pathologic finding showed that women had more positive lymph nodes (ypN, p=0.002) while no other
pathologic parameter differed significantly between the genders. Overall, a poor response to therapy correlated
with a shorter time to disease progression (p=0.002). Women achieved ypN0 in 50% of cases, but
only 27% had a good TRG compared to 40.5% of men (p=0.073). Women had a worse DFS than men,
even when complete response to therapy was achieved (p=0.003), and greater depth of residual tumor
invasion (ypT, p=0.035) and higher ypN (p=0.002) correlated with shorter DFS. Positive resection margins
(p<0.001), higher ypN stage (p=0.003), and poor TRG (p=0.025) correlated with shorter DFS in
men. We conclude that women have a poorer response to LCCRT with the possibility that therapeutic
approach to the neoadjuvant treatment of rectal cancer may be gender-specific. |
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| ISSN: | 0353-9466 1333-9451 |