Abstract 91P
Background
Neoadjuvant chemoradiotherapy (NCRT) is one of the standard treatments for locally advanced rectal cancer (LARC), where pathological complete response (ypCR) has been traditionally used as a surrogate survival endpoint. A relatively new biomarker known as the Neoadjuvant Rectal (NAR) score has been consistently shown to correlate with survival in clinical studies. NAR score is a composite endpoint combining clinical and pathological staging information obtained before and after NCRT which warrants validation in local population. The main objective of this study is to investigate the factors that may influence the achievement of ypCR, such as age, sex, tumour stage and location, presence of threatened CRM and extramural vascular invasion (EMVI) as well as tumour down-staging. Other objectives are to validate the prognostic significance of NAR score and to investigate any factors that are associated with a lower score.
Methods
The data of patients with LARC who received NCRT at the Prince of Wales Hospital between August 2006 to October 2018 were retrospectively analyzed. Chi-square or Fisher’s Exact Test was used to determine any correlation between categorical variables and logistic regression for continuous variables. Cox regression was used to determine any interactions between covariates and Kaplan-Meier method for survival analysis.
Results
Of the 193 patients who had optimal response to NCRT and surgery, the mean age was 62 and the male-to-female ratio was 2.94: 1. Tumour down-staging was the only independent prognostic factor which predicted ypCR (p<0.0001). NAR score was associated with overall survival (OS) (hazard ratio, HR=1.042, 95% confidence interval, CI: 1.021-1.064, p<0.0001), disease-free survival (DFS) (HR=1.042, 95% CI: 1.022-1.062, p<0.0001), locoregional recurrence-free survival (LRFS) (HR=1.070, 95% CI:1.039-1.102, p<0.0001) and distant recurrence-free survival (DRFS) (HR=1.034, 95%CI: 1.012-1.056, p=0.002). Patients who had ypCR to NCRT was associated with a lower NAR score (p<0.0001), but ypCR was not associated with survival.
Conclusions
NAR score (but not ypCR) is an independent prognostic marker of survival and disease recurrence in a cohort of Chinese patients who underwent NCRT for LARC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
224P - Associations of pre-existing cardiovascular disease (CVD) with treatment patterns and survival outcomes in patients with localized prostate cancer: A real-world, population-based study
Presenter: Atul Batra
Session: e-Poster Display Session
225P - Prostate cancer treatments and outcomes in the elderly: A retrospective analysis of an Australian real-world cohort
Presenter: Michael Fernando
Session: e-Poster Display Session
226P - Use of PSMA PET in metastatic castration-resistant prostate cancer (mCRPC)
Presenter: Andrew Jensen
Session: e-Poster Display Session
227P - Phase II study of pembrolizumab (pembro) plus enzalutamide for enzalutamide (enza)-resistant metastatic castration-resistant prostate cancer (mCRPC): Cohorts (C) 4 and 5 update from KEYNOTE-199
Presenter: Ulka Vaishampayan
Session: e-Poster Display Session
228P - Symptoms and impacts of metastatic castration-resistant prostate cancer (mCRPC) among Japanese patients designated to receive Ra-223
Presenter: Hiroji Uemura
Session: e-Poster Display Session
229P - Expanding the role of supervised exercise on fatigue in prostate cancer patient receiving androgen deprivation therapy: A meta-analysis of randomized controlled trial
Presenter: Niwanda Yogiswara
Session: e-Poster Display Session
230P - Molecular profiling and clinical characteristics of Chinese patients with prostate cancer
Presenter: Ranlu Liu
Session: e-Poster Display Session
231P - Phase II study of pembrolizumab in docetaxel-pretreated patients with metastatic castration-resistant prostate cancer (mCRPC): Updated follow-up of cohorts (C) 1-3 from KEYNOTE-199
Presenter: Jeffrey Goh
Session: e-Poster Display Session
232P - Real-world data on metastatic castration-resistant prostate cancer patients treated with abiraterone or enzalutamide: A regional experience
Presenter: Rachel Raju
Session: e-Poster Display Session
243P - Target sequencing of 508 genes in Chinese epithelial ovarian cancer patients
Presenter: Li Lei
Session: e-Poster Display Session