Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial

Xiao, Jian; Cai, Zerong; Li, Wenyun; Yang, Zuli; Gong, Jiaying; Huang, Yan; Deng, Yanhong; Wu, Xiaojian; Wang, Lei; Peng, Junsheng; Ren, Donglin; Lan, Ping; Wang, Jianping

doi:10.7150/jca.11738

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J Cancer 2015; 6(7):636-642. doi:10.7150/jca.11738 This issue Cite

Research Paper

Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial

Jian Xiao^1†, Zerong Cai^2†, Wenyun Li^3†, Zuli Yang², Jiaying Gong⁴, Yan Huang⁵, Yanhong Deng¹, Xiaojian Wu², Lei Wang², Junsheng Peng², Donglin Ren², Ping Lan², Jianping Wang^2✉

1. Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, P.R. China
2. Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, P.R. China
3. Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, National University of Singapore, 169856, Singapore
4. Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, P.R. China
5. Department of Pathology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, P.R. China
† Co-first authors: Jian Xiao, Zerong Cai and Wenyun Li contributed equally to this study.

Citation:

Xiao J, Cai Z, Li W, Yang Z, Gong J, Huang Y, Deng Y, Wu X, Wang L, Peng J, Ren D, Lan P, Wang J. Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial. J Cancer 2015; 6(7):636-642. doi:10.7150/jca.11738. https://www.jcancer.org/v06p0636.htm

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Abstract

Purpose: To evaluate tumor volume reduction rate (TVRR) measured by three-dimensional region-of-interest (3D-ROI) magnetic resonance (MR) volumetry in predicting pathological tumor response of preoperative chemotherapy alone for locally advanced rectal cancer (LARC).

Methods: LARC patients who received neoadjuvant chemotherapy only from a prospective and randomized trial were recruited. Tumor volumes were measured with 3D-ROI MR volumetry. TVRR was determined using the equation TVRR = (V_Pre-Therapy - V_{Post-Therapy)} / V_Pre-Therapy ×100%. Correlation between TVRR and clinical or pathological characteristics and predictive value of TVRR for pathological tumor response in terms of Tumor Regression Grade (TRG), T downstage, N downstage and overall downstage were analyzed.

Results: 80 eligible cases of LARC were included in our study with TVRR of (51.7±25.1) %. TVRR was higher in well-differentiated tumors compared with poor-differentiated tumors (P=0.040). TVRR was found to be related with TRG (P<0.001), T downstage (P<0.001) and overall downstage (P<0.001). Risk of achieving TRG 2/3 decreased to 57.5% (P=0.002) and odds of achieving overall downstage increase to 179.3% (P<0.001) when TVRR increased by every 10%. A sensitivity of 0.704 and specificity of 0.804 were calculated when ROC curve was constructed to predict TRG using TVRR with a cutoff of 65%.

Conclusion: TVRR is correlated with TRG and overall downstage significantly in LARC patients treated with preoperative chemotherapy alone and shows great value in predicting favorable TRG and overall downstage with good sensitivity and specificity. It could be considered as a promising parameter candidate for efficacy evaluation.

Keywords: Rectal Cancer, Neoadjuvant Chemotherapy, Chemotherapeutic Efficacy, TVRR

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APA

Xiao, J., Cai, Z., Li, W., Yang, Z., Gong, J., Huang, Y., Deng, Y., Wu, X., Wang, L., Peng, J., Ren, D., Lan, P., Wang, J. (2015). Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial. Journal of Cancer, 6(7), 636-642. https://doi.org/10.7150/jca.11738.

ACS

Xiao, J.; Cai, Z.; Li, W.; Yang, Z.; Gong, J.; Huang, Y.; Deng, Y.; Wu, X.; Wang, L.; Peng, J.; Ren, D.; Lan, P.; Wang, J. Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial. J. Cancer 2015, 6 (7), 636-642. DOI: 10.7150/jca.11738.

NLM

CSE

Xiao J, Cai Z, Li W, Yang Z, Gong J, Huang Y, Deng Y, Wu X, Wang L, Peng J, Ren D, Lan P, Wang J. 2015. Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial. J Cancer. 6(7):636-642.

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