Onyekachi Ekowo
Darent Valley Hospital, United Kingdom
Title: MRI report post neoadjuvant chemoradiotherapy for advanced rectal cancer can help reduce the rate of surgery for locally advanced rectal cancer
Biography
Biography: Onyekachi Ekowo
Abstract
Aim: A study to investigate the tumour behaviour in the management of locally advanced rectal cancer (LARC) treated with neoadjuvant chemo-radiotherapy (NACRT) and definitive surgery to help guide decision on watchful wait versus surgery post NACRT.
Methods: T3 &T4 and/or positive nodal rectal cancer Patients treated for locally advanced low rectal cancer between the periods of 2017 – 2019 at our district general hospital were studied.
Results: A total of 30 patients met the criteria. The median age was 67 years (11 females and 19 males). All patients had neoadjuvant chemotherapy & surgery. 2 patients had complete clinical response on MRI post neoadjuvant chemotherapy. When the histological sample was analysed, we found cure in the same 2 patients (8.7%), down stage in 12(52%) and no effect in 9(39.1). These 2 patients who had cure before surgery had pathological complete response (pCR) post op. MRI (performed about 42 days post neoadjuvant chemotherapy) showed a concordance with histology of 12(70%).
Conclusion: MRI done as close to surgery as possible and about 6 to 8 weeks post NACRT could potentially pick those cancers showing complete response and would have obviated the need for surgery in 2 of the patients. MRI pre-op showed good concordance with pathology report post op and so can be relied upon for follow up with no surgery done.