Pre-operative neoadjuvant therapy for rectal cancer (RC): review of currentpractice: P120


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Abstract

Aim:Magnetic Resonance imaging (MRI) is gold standard for RC staging. This study evaluates correlation between signal intensity (SI) and tumour/nodal size, and efficacy of neoadjuvant therapy in down-staging RC.Method:All RC patients (January 2008-2009) wereprospectively included. Information relating topre-treatment, post-neoadjuvant and post-operative staging were tabulated. Significance was assessed by two-tailed t-test and Wilcoxon ranked-test.Results:Thirty-seven patients(10F:27M) were identified. Age ranged 49-92(median = 68). One did not receive MRI due to having a metallic valve. Twenty-six requiredpre-operative neoadjuvant therapy, 17 underwent post-neoadjuvant MRI. Four were inoperable. The tables illustrate MRI/histology findings.There was left shift betweenpre-neoadjuvant MRI and histological TNM staging suggestive of downstaging (P < 0.05). Mean nodal yield and size was 13.72 (6-31) and 4.8 mm (1.5-10 mm) respectively. No 30-day operative mortality was observed.Conclusion:Reported SI correlated with nodal/tumour sizes. Neoadjuvant therapy significantly down-staged RC. The total mesorectal excision nodal yield was adequate.

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