Neoadjuvant treatment of rectal cancer

Objective: The aim of this work was to study the predictive factors of HR to neoadjuvant treatment of locally advanced CR in Tunisian patients.Methods: Retrospective study of patients with CR operated after neoadjuvant radiochemotherapy (RCT). HR was assessed according to Dworak's TRG whose five grades were subsequently grouped into two categories: Response Group (R) for TRG3 and 4 and No Response Group (PR) for TRG 0 1 and 2.Results: The study included 88 patients with a mean age of 60 years. The site of CR was the middle rectum in 63% of cases. Node invasion was noted in 52 patients (59%). The R group comprised 29 patients (33%) and the PR group 59 patients (67%). In multivariate analysis predictive factors for HR were age ≤ 60 years male gender and pre-therapeutic parietal infiltration of cT3.Conclusion: In locally advanced RC patients aged ≤ 60 years male gender with pre-therapeutic cT3 parietal infiltration would be the best candidates for a strategy of neoadjuvant RCT followed by surgical excision.