Acta Oncol Tur.. Ahead of Print: AOT-89664 | DOI: 10.5505/aot.2023.89664

The Relationship Between the Response to Neoadjuvant Chemoradiotherapy and Mesorectum Volume in Rectum Cancer

Ramazan Saygýn Kerimoðlu¹, Ebru Esen², Mustafa Saraçoðlu¹, Ýbrahim Babalioglu³, Bekir Turgut⁴, Ilknur Küçükosmanoðlu⁵, Osman Doðru^6
1University Of Health Sciences, Konya City Hospital, Department Of Gastrointestinal Surgery, Konya
²University Of Health Sciences, Gulhane Research And Training Hospital, Department Of Surgical Oncology, Ankara
³University Of Health Sciences, Konya City Hospital, Department Of Radiation Oncology, Konya
⁴Necmettin Erbakan University Meram Faculty Of Medicine, Department Of Radiology, Konya
⁵University Of Health Sciences, Konya City Hospital, Department Of Pathology, Konya
⁶University Of Health Sciences, Konya City Hospital, Department Of General Surgery, Konya

INTRODUCTION: To investigate the relationship of changes in the mesorectum volume (MRV) associated with neoadjuvant chemoradiotherapy (nCRT) with pathological and clinical response in patients with locally advanced rectum cancer (LARC).
METHODS: The study included 39 patients who received nCRT because of LARC and underwent surgery between January 2016 and April 2019. The MRV values were measured on magnetic resonance imaging (MRI) before and after nCRT. The patients were separated into two groups as those with an increase or decrease in MRV following nCRT. The relationships were examined between the 2 groups and the pathological T and N statuses, pre and post-nCRT T and N statuses, and the degree of MRI regression and pathological regression.
RESULTS: Retrospective analysis was made of 39 patients comprising 19 males and 20 females with a mean age of 59.3 years (range, 27-80 years). The mean MRV value was 116.8 mm3 (range, 49.9-253.9) before nCRT and 115.5 mm3 (50.9-196.7) after nCRT. There was determined to be an increase in MRV in 21 patients, and a decrease in 18 patients. In the MRI evaluation there was no response to nCRT in 4 patients, and in the pathological evaluation, a response could not be determined in 9 patients.
DISCUSSION AND CONCLUSION: Since this study is one of the first studies in the literature to investigate the relationship between changes in MRV and response to nCRT, further studies are needed to reach more meaningful results.

Keywords: Rectum cancer, Neoadjuvant treatment, Mesorectum volume

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Rektum Kanserinde Neoadjuvan Kemoradyoterapi Yanýtý Ýle Mezorektum Hacmi Arasýndaki Ýliþki

Ramazan Saygýn Kerimoðlu¹, Ebru Esen², Mustafa Saraçoðlu¹, Ýbrahim Babalioglu³, Bekir Turgut⁴, Ilknur Küçükosmanoðlu⁵, Osman Doðru^6
1Saðlýk Bilimleri Üniversitesi, Konya Þehir Hastanesi, Gastrointestinal Cerrahi Kliniði, Konya
²Saðlýk Bilimleri Üniversitesi Gülhane Eðitim Ve Araþtýrma Hastanesi, Cerrahi Onkoloji Kliniði, Ankara
³Saðlýk Bilimleri Üniversitesi, Konya Þehir Hastanesi, Radyasyon Onkolojisi Kliniði, Konya
⁴Necmettin Erbakan Üniversitesi Meram Týp Fakültesi, Radyoloji Kliniði, Konya
⁵Saðlýk Bilimleri Üniversitesi, Konya Þehir Hastanesi, Patoloji Kliniði, Konya
⁶Saðlýk Bilimleri Üniversitesi, Konya Þehir Hastanesi, Genel Cerrahi Kliniði, Konya

GÝRÝÞ ve AMAÇ: Lokal ileri rektum kanserli (LARC) hastalarda neoadjuvan kemoradyoterapi (nCRT) ile iliþkili mezorektum hacmindeki (MRV) deðiþikliklerin patolojik ve klinik yanýtla iliþkisini araþtýrmak.
YÖNTEM ve GEREÇLER: Çalýþmaya Ocak 2016-Nisan 2019 tarihleri arasýnda LARC nedeniyle nKRT alan ve ameliyat edilen 39 hasta dahil edildi. MRV deðerleri nKRT öncesi ve sonrasý manyetik rezonans görüntüleme (MRG) ile ölçüldü. Hastalar nCRT sonrasý MRV'de artýþ veya azalma olanlar olarak iki gruba ayrýldý. 2 grup ile patolojik T ve N durumlarý, nCRT öncesi ve sonrasý T ve N durumlarý ve MRG gerilemesi ve patolojik gerileme derecesi arasýndaki iliþkiler incelendi.
BULGULAR: Yaþ ortalamasý 59,3 (27-80 yýl) olan 19 erkek, 20 kadýn toplam 39 hastanýn retrospektif analizi yapýldý. nCRT öncesi ortalama MRV deðeri 116,8 mm3 (aralýk, 49,9-253,9), nCRT sonrasý 115,5 mm3 (50,9-196,7) idi. 21 hastada MRV'de artýþ, 18 hastada azalma saptandý. MRG deðerlendirmesinde 4 hastada nCRT'ye yanýt alýnamadý, patolojik deðerlendirmede 9 hastada yanýt saptanamadý.
TARTIÞMA ve SONUÇ: Bu çalýþma literatürde MRV'deki deðiþiklikler ile nCRT'ye yanýt arasýndaki iliþkiyi araþtýran ilk çalýþmalardan biri olduðundan, daha anlamlý sonuçlara ulaþabilmek için daha ileri çalýþmalara ihtiyaç vardýr.

Anahtar Kelimeler: Rektum kanseri, Neoadjuvan tedavi, Mezorektum hacmi

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