Real-world Dataanalysis Of 52 Cases Of Local Advanced Rectal Cancer Neoadjuvant Therapy

OBJECTIVE: To observe the pathologic complete response rate(pCR),tumor downturn and surgical complications after neoadjuvant therapy for locally advanced rectal cancer.Methods:The clinical data of 52 patients with second stage and third stage rectal carcinoma from January 2015 to December 2017 were retrospectively analyzed.Neoadjuvant radiotherapy and chemotherapy combined with total mesorectal resection(TME)was used.The pCR,the declining condition,and the surgical complications were observed in this group of patients.RESULTS: The post-operative PCR rate was 19.2%(10/52)in 50 patients,the rate of decline was 36.5%(19/52)(in this paper,the descending period was defined as ypT0-2N0M0).The R0 resection rate was 100% in all patients,the postoperative complication rate was 23.1%,the postoperative hospital stay was 14.16±18.89 days,the amount of blood loss during the operation was 117.24±124.77 ml,and the operation duration was 4.78±1.49 hours.As of March 20,2019,two of all patients lost follow-up.Of the 46 patients who survived,1 patient found pulmonary metastases 11 months after diagnosis,2 patient found liver metastasis after 11 months of diagnosis,and liver metastasis was found in 1 case 10 months after diagnosis.One patient found local recurrence after 15 months of diagnosis.Four patients died,two patient died 2 years after diagnosis,cause of death unknown.One patient died after one year of diagnosis,cause of death unknown.One case died 3 years and 3 months after diagnosis.The reason of death was respiratory failure.No tumor recurrence and metastasis were found at the time of death.The overall survival rate was 92.0%(46/50)in 50 patients and 84.0%(42/50)in DFS(disease free survival).Three patients with unknown causes of death were excluded,the local control rate was 97.9%(46/47).The distant metastasis rate was 8.5%(4/47).Conclusion: Neoadjuvant radiotherapy and chemotherapy can reduce the tumor stage in patients with locally advanced rectal cancer,and some patients can achieve pCR.The risk of distant metastasis during neoadjuvant radiotherapy and chemotherapy is low,and postoperative complications are within acceptable limits and deserve further investigation.