Current status in the treatment of rectal cancer in the Czech republic regarding to the appearance of complete pathologic response after neoadjuvant therapy - PATOD C20 study
Abstract
The primary rectal resection is indicated in early stages, while locally advanced tumors should be pretreated by one of the modes of neoadjuvant (chemo)radiotherapy. The main goal of this study was to explore the therapeutic strategy in patients with rectal cancer in the Czech Republic.
The second aim was to determine incidence of the pathologic complete response after neoadjuvant therapy. Material and methods: This is a retrospective multicenter clinical study, which includes data from all patients with rectal cancer who were treated at participating centers in the period from 1. 1. 2011 to 31. 12. 2012.
The required data has been passed into the online registry PATOD C20. There have been set up three issues: 1. characteristics of the center and cooperation with oncological department; 2. characteristics of the treatment of patients with rectal cancer; 3. detailed analysis of group of patients with complete pathological response.
Analysis was performed with regard to the character of the individual departments, ie. departments of surgery in university hospitals with complex oncological centres, departments of surgery within complex oncologic center and departments of surgery without complex oncologic center. Results Totally 21 departments of surgery in the Czech Republic, provided data of 1860 patients with rectal cancer into study.
Treatment strategy for rectal cancer was determined at multidisciplinary seminars in 19 (90.5 %). Statistically significant differences between the centers were found in the indication for neoadjuvant treatment (p0,001), rectal resection with anastomosis (p = 0.048) and resection without anastomosis (p = 0.022).
Pathologic complete response was found in 61 (8.7 %) patients. Positivity of the mesorectal lymph nodes (ypN+) was found in the case of ypT0 stage in 7 (9.7 %) patients.
Conclusion PATOD study showed that therapy of the rectal cancer in the Czech Republic is highly heterogeneous.