Farahat, R., Habba, M., Elserafy, A., Gomaa, A., Noureldin, R. (2023). Downstaging of Rectal Cancer Following Neoadjuvant Chemoradiotherapy; How Far Could Functional MRI Support Organ Preservation Approach. The Egyptian Journal of Hospital Medicine, 90(1), 99-106. doi: 10.21608/ejhm.2023.279204
Roaa Farahat; Mohamed Habba; Ahmed Elserafy; Ahmed Mohamed Gomaa; Radwa Noureldin. "Downstaging of Rectal Cancer Following Neoadjuvant Chemoradiotherapy; How Far Could Functional MRI Support Organ Preservation Approach". The Egyptian Journal of Hospital Medicine, 90, 1, 2023, 99-106. doi: 10.21608/ejhm.2023.279204
Farahat, R., Habba, M., Elserafy, A., Gomaa, A., Noureldin, R. (2023). 'Downstaging of Rectal Cancer Following Neoadjuvant Chemoradiotherapy; How Far Could Functional MRI Support Organ Preservation Approach', The Egyptian Journal of Hospital Medicine, 90(1), pp. 99-106. doi: 10.21608/ejhm.2023.279204
Farahat, R., Habba, M., Elserafy, A., Gomaa, A., Noureldin, R. Downstaging of Rectal Cancer Following Neoadjuvant Chemoradiotherapy; How Far Could Functional MRI Support Organ Preservation Approach. The Egyptian Journal of Hospital Medicine, 2023; 90(1): 99-106. doi: 10.21608/ejhm.2023.279204
Downstaging of Rectal Cancer Following Neoadjuvant Chemoradiotherapy; How Far Could Functional MRI Support Organ Preservation Approach
1Department of Radiodiagnosis, Ismailia Medical Complex
2Department of Radiodiagnosis, Faculty of Medicine, Suez Canal University
3Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Abstract
Background: Rectal cancer constitutes a distinct subset of colorectal carcinoma necessitating a dedicated multidisciplinary approach through the journey of diagnosis and treatment. Neoadjuvant chemoradiotherapy (CRT) has the advantage of tumor down staging, with a chance of pathologic complete response (pCR) with reflection on locoregional recurrence rates, and increased overall survival. In this study we aim to assess the response to neoadjuvant chemoradiotherapy offered to patients with locally advanced rectal cancer using functional MRI then to be validated through final pathological result following standard surgical management. Patients and Methods: This study included 29 patients with rectal cancer eligible for neoadjuvant therapy. Patients had their MRI before and after neoadjuvant CRT, then they underwent surgical intervention in the form of anterior resection with total mesorectal excision (TME) or abdominoperineal resection (APR). Final pathological results were compared to post CRT functional MRI results. Results: We found that neoadjuvant CRT downstaged our patients to the extent that rendered around 15 percent of patients with complete pathological response could have made benefit from organ preservation approach with either ‘watch-and-wait’ or local excision, a chance could be offered in regards to good standardized functional multiparametric MRI assessment. Conclusion: Response to neoadjuvant treatment in locally advanced rectal cancer could be assessed with multiparametric functional MRI giving the patient good chances regarding the best tailored surgical options that influence disease control and overall survival.
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