{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T09:32:05Z","timestamp":1744191125746},"reference-count":29,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>ABSTRACT Background The approach of locally advanced extra-peritoneal rectal adenocarcinoma implies a treatment with neoadjuvant chemoradiotherapy associated with total mesorectal excision surgery. However, the tumors respond variably to this neoadjuvant therapy, and the mechanisms for response are not completely understood. Objective Evaluate the variables related to the complete tumor response and the outcomes of patients who underwent surgery, comparing those with partial tumor regression and those with total remission of rectal lesion, at the pathological examination. Methods Retrospective analysis of medical records of 212 patients operated between 2000 and 2010, in which 182 (85.9%) obtained partial remission at neoadjuvant therapy (Group 1) and 30 (14.1%), total remission (Group 2). Results No difference was found between the groups in relation to gender, ethnicity, age, tumor distance from the anal verge, occurrence of metastases and synchronous lesions on preoperative staging, dose of radiotherapy and performed surgery. In Group 2, was verified high rate of complete remission when the time to surgery after neoadjuvant therapy was equal or less than 8 weeks (P=0.027), and a tendency of lower levels of pretreatment carcinoembryonic antigen (P=0.067). In pathological analysis, the Group 1 presented in relation to Group 2, more affected lymph nodes (average 1.9 and 0.5 respectively; P=0.003), more angiolymphatic (19.2% and 3.3%; P=0.032) and perineural involvement (15.4% and 0%; P=0.017) and greater number of lymph nodes examined (16.3 and 13.6; P=0.023). In the late follow-up, Group 1 also had lower overall survival than Group 2 (94.1 months and 136.4 months respectively; P=0.02) and disease-free survival (85.5 months and 134.6 months; P=0.004). There was no statistical difference between Group 2 and Group 1 in local recurrence (15% and 3.4%, respectively) and distant metastasis (28% and 13.8%, respectively). Conclusion In this study, the only factor associated with complete remission of rectal adenocarcinoma was the time between neoadjuvant therapy and surgery. This group of patients had less affected lymph nodes, less angiolymphatic and perineural involvement, a longer overall and disease-free survival, but no significant statistical difference was observed in local recurrence and distant metastasis. Although the complete pathologic remission was associated with better prognosis, this not implied in the cure of the disease for all patients.<\/jats:p>","DOI":"10.1590\/s0004-28032016000300008","type":"journal-article","created":{"date-parts":[[2016,7,16]],"date-time":"2016-07-16T13:30:58Z","timestamp":1468675858000},"page":"163-168","source":"Crossref","is-referenced-by-count":9,"title":["NEOADJUVANT THERAPY AND SURGERY FOR RECTAL CANCER. Comparative study between partial and complete pathological response"],"prefix":"10.1590","volume":"53","author":[{"given":"Vitor Augusto de","family":"ANDRADE","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio Saddy Rodrigues","family":"COY","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel Franco","family":"LEAL","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Jos\u00e9","family":"FAGUNDES","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Augusto Real","family":"MARTINEZ","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria de Lourdes Setsuko","family":"AYRIZONO","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jcol.2013.08.008","article-title":"Neoadjuvant therapy and surgery in rectal adenocarcinoma Analysis of patients with complete tumor remission","volume":"33","author":"Andrade VA","year":"2013","journal-title":"J Coloproctol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1463-1318.2010.02321.x","article-title":"Controversial aspects of rectal cancer surgery","volume":"12","author":"Artioukh DY","year":"2010","journal-title":"Colorectal Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"5432","DOI":"10.1002\/cncr.24622","article-title":"Lymph Node Status After 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