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First report on clinicopathological characteristics, histological response to neoadjuvant therapy and survival outcomes of patients with locally advanced rectal cancer in north-est of Morocco

Author: 
Ihsane El Otmani, Fatima El Agy, Nada Lahmidani, Dafr Allah Benajah, Mohammed El Abkari, Imane Toughrai, Oussaden Abdelmalek, Ibn Majdoub Hassani Karim, Khalid Mazaz, Ouadii Mouaqit, Bachir Benjelloun, Hicham El Bouhaddouti, Karima El Rhaz, Touria Bouha
Subject Area: 
Life Sciences
Abstract: 

In this study, our aim was to provide a global overview of locally advanced rectal cancer (RC) epidemiology and its clinicopathologic characteristics as well as to identify predictive factors that may influence response to neoadjuvant therapy of a Moroccan population. Enrolled RC patients underwent neoadjuvant therapy, followed by surgery between 2011 and 2018 at the university hospital of Fez, Morocco. 250 patients were included in this observational retro-prospective cross-sectional study. 50.8% were women and 49.2% were men with a female to male ratio of 1.03. The average age at diagnosis was 56 years. Most of patients presented rectal bleeding as a revealing symptom (75.9 %). 84.8% were responders to neoadjuvant therapy and 51.2% were non responders. In univariate analysis, the responders group was found significantly associated with resection status, absence of perineural and vascular invasion, yp TNM, less metastasis, recurrence and long-term survival. In multivariate analysis, circumferential resection margins (HR: 3.154; 95% CI: 1.265-7.861; p=0.014), resection status (HR: 0.190; 95% CI: 0.042-0.849; p=0.030), ratio of positive lymph nodes (HR: 0.030; 95% CI: 0.002-0.391;p=007), and ypUICC stages (II: HR: 0.142; 95% CI: 0.021-0.974;p=0.047, III: HR: 0.050; 95% CI: 0.007-0.329;p=0.002, IV: HR: 0.172; 95% CI: 0.030-0.969; p=0.046) were found to be independent predictors of response to neoadjuvant therapy in RC.

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