Consequence of restaging after neoadjuvant treatment for locally advanced rectal cancer.

Cees Bisschop, J. J. J. Tjalma, G. A. P. Hospers, D. Van Geldere, J.W.B. de Groot, E. M. Wiegman, M. Van't Veer-ten Kate, M. G. Havenith, J. Vecht, J. C. Beukema, G. Kats-Ugurlu, S V K Mahesh, B. van Etten, Klaas Havenga, J. G. M. Burgerhof, D. J. A. de Groot, W. H. de Vos Tot Nederveen Cappel

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Abstract

Locally advanced rectal cancer is customarily treated with neoadjuvant chemoradiotherapy (CRT) followed by a total mesorectal excision. During the course of CRT, previously non-detectable distant metastases can appear. Therefore, a restaging CT scan of the chest and abdomen was performed prior to surgery. The aim of this study was to determine the frequency of a change in treatment strategy after this restaging CT scan.

Patients treated with neoadjuvant CRT for locally advanced rectal cancer between January 2003 and July 2013 were included retrospectively. To determine the value of the restaging CT scan, the surgical treatment as planned before CRT was compared with the treatment ultimately received.

A total of 153 patients (91 male) were eligible, and median age was 62 (32-82) years. The restaging CT scan revealed the presence of distant metastases in 19 patients (12.4, 95 % confidence interval [CI] 7.0-17.8). In 17 patients (11.1, 95 % CI 6.1-16.1), a change in treatment strategy occurred due to the detection of metastases with a restaging CT scan.

A restaging CT scan after completion of neoadjuvant CRT may detect newly developed metastases and consequently alter the initial treatment strategy. This study demonstrated the added value of the restaging CT scan prior to surgery.

Original languageEnglish
Pages (from-to)552-556
Number of pages5
JournalAnnals of Surgical Oncology
Volume22
Issue number2
DOIs
Publication statusPublished - Feb-2015

Keywords

  • COLORECTAL-CANCER
  • PREOPERATIVE RADIOTHERAPY
  • PULMONARY METASTASES
  • CHEMORADIOTHERAPY
  • MANAGEMENT
  • GUIDELINES
  • CT

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