Efficacy of preoperative chemoradiotherapy in downstaging rectal cancer and its impact on the long-term outcome

INTRODUCTION: Response to preoperative chemoradiation (PRTCT) for rectal cancer predicts the long-term outcome. CONTEXT: Tertiary care hospital. AIMS: The aim is to study the factors affecting the response to chemoradiation. SETTINGS AND DESIGN: Retrospective. MATERIALS AND METHODS: Twenty-three patients of rectal cancer undergoing PRTCT followed by surgery and adjuvant chemotherapy were followed up for 20–56 months. Postoperative response, tumor downstaging and nodal downstaging were correlated with the disease status. RESULTS: Tumor downstaging was seen in 11 (50%) and nodal downstaging in 12 (63.15%) patients. Nodal downstaging was statistically significant with P = 0.004. Pathological complete response (PCR) was seen in one patient and partial response (PR) in 17 patients. Thirteen (72.2% of patients) were alive and disease free and the negative nodal status correlated with long-term control with P = 0.04. CONCLUSION: Most patients of rectal cancer show PR to PRTCT, and the benefit is more for node-positive patients. Nodal PCR is associated with a higher chance of long-term disease control.