17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response

Neoadjuvant chemoradiation (CRT) followed by curative surgery still remains the standard of care for locally advanced rectal cancer (LARC). The main purpose of this multimodal treatment is to achieve a complete pathological tumor response (ypCR), with better survival. The surgery delay after CRT com...

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Main Authors: Marisa D. Santos, Manuel T. Gomes, Filipa Moreno, Anabela Rocha, Carlos Lopes
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2015/816491
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author Marisa D. Santos
Manuel T. Gomes
Filipa Moreno
Anabela Rocha
Carlos Lopes
author_facet Marisa D. Santos
Manuel T. Gomes
Filipa Moreno
Anabela Rocha
Carlos Lopes
author_sort Marisa D. Santos
collection DOAJ
description Neoadjuvant chemoradiation (CRT) followed by curative surgery still remains the standard of care for locally advanced rectal cancer (LARC). The main purpose of this multimodal treatment is to achieve a complete pathological tumor response (ypCR), with better survival. The surgery delay after CRT completion seems to increase tumor response and ypCR rate. Usually, time intervals range from 8 to 12 weeks, but the maximum tumor regression may not be seen in rectal adenocarcinomas until several months after CRT. About this issue, we report a case of a 52-year-old man with LARC treated with neoadjuvant CRT who developed, one month after RT completion, an acute myocardial infarction. The need to increase the interval between CRT and surgery for 17 weeks allowed a curative surgery without morbidity and an unexpected complete tumor response in the resected specimen (given the parameters presented in pelvic magnetic resonance imaging (MRI) performed 11 weeks after radiotherapy completion).
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institution Kabale University
issn 2090-6900
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language English
publishDate 2015-01-01
publisher Wiley
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series Case Reports in Surgery
spelling doaj-art-0eb7eda32ab6450f955dd97f7d53d4c02025-02-03T01:23:23ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/81649181649117-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological ResponseMarisa D. Santos0Manuel T. Gomes1Filipa Moreno2Anabela Rocha3Carlos Lopes4Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, PortugalDepartment of Medical Imaging, Radiology Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, PortugalDepartment of Pathology, Pathological Anatomy Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, PortugalDepartment of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, PortugalDepartment of Pathology, Pathological Anatomy Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, PortugalNeoadjuvant chemoradiation (CRT) followed by curative surgery still remains the standard of care for locally advanced rectal cancer (LARC). The main purpose of this multimodal treatment is to achieve a complete pathological tumor response (ypCR), with better survival. The surgery delay after CRT completion seems to increase tumor response and ypCR rate. Usually, time intervals range from 8 to 12 weeks, but the maximum tumor regression may not be seen in rectal adenocarcinomas until several months after CRT. About this issue, we report a case of a 52-year-old man with LARC treated with neoadjuvant CRT who developed, one month after RT completion, an acute myocardial infarction. The need to increase the interval between CRT and surgery for 17 weeks allowed a curative surgery without morbidity and an unexpected complete tumor response in the resected specimen (given the parameters presented in pelvic magnetic resonance imaging (MRI) performed 11 weeks after radiotherapy completion).http://dx.doi.org/10.1155/2015/816491
spellingShingle Marisa D. Santos
Manuel T. Gomes
Filipa Moreno
Anabela Rocha
Carlos Lopes
17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
Case Reports in Surgery
title 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
title_full 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
title_fullStr 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
title_full_unstemmed 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
title_short 17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response
title_sort 17 week delay surgery after chemoradiation in rectal cancer with complete pathological response
url http://dx.doi.org/10.1155/2015/816491
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AT manueltgomes 17weekdelaysurgeryafterchemoradiationinrectalcancerwithcompletepathologicalresponse
AT filipamoreno 17weekdelaysurgeryafterchemoradiationinrectalcancerwithcompletepathologicalresponse
AT anabelarocha 17weekdelaysurgeryafterchemoradiationinrectalcancerwithcompletepathologicalresponse
AT carloslopes 17weekdelaysurgeryafterchemoradiationinrectalcancerwithcompletepathologicalresponse