Reggiani Bonetti L, Lionti S, Domati F, Barresi V. Do pathological variables have prognostic significance in rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy and surgery? World J Gastroenterol 2017; 23(8): 1412-1423 [PMID: 28293088 DOI: 10.3748/wjg.v23.i8.1412]
Corresponding Author of This Article
Dr. Valeria Barresi, Department of Pathology in Evolutive Age and Adulthood, “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 98125 Messina, Italy. vbarresi@unime.it
Research Domain of This Article
Pathology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Luca Reggiani Bonetti, Federica Domati, Department of Laboratory Integrated Activities, Anatomic Pathology and Legal Medicine, Section of Pathology, University of Modena and Reggio Emilia, 41124 Modena, Italy
Simona Lionti, Valeria Barresi, Department of Pathology in Evolutive Age and Adulthood, “Gaetano Barresi”, University of Messina, 98125 Messina, Italy
Author contributions: Reggiani Bonetti L designed the study, revised the histological slides, analyzed the results and wrote the paper; Lionti S designed the study, performed the statistical analyses and supervised the report; Domati F designed the study, collected the clinical data and supervised the report; Barresi V designed the study, revised the histological slides, analyzed the results and supervised the report.
Institutional review board statement: Ethical issues were discussed with the local ethics committee. Since the study was retrospective, no approval was needed to revise the histological slides.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Valeria Barresi, Department of Pathology in Evolutive Age and Adulthood, “Gaetano Barresi”, University of Messina, Via Consolare Valeria, 98125 Messina, Italy. vbarresi@unime.it
Telephone: +39-90-2212537
Received: October 22, 2016 Peer-review started: October 25, 2016 First decision: December 19, 2016 Revised: December 29, 2016 Accepted: January 17, 2017 Article in press: January 17, 2017 Published online: February 28, 2017 Processing time: 127 Days and 12.7 Hours
Core Tip
Core tip: This study evaluates the prognostic significance of clinico-pathological variables in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemo-radiotherapy (CRT) and surgery. Our data show that tumors with cN+ status, extensive/lower involvement of the rectum, mucinous histotype and poor differentiation have a lower response to pre-operative CRT. Dworak tumor regression grade was prognostically informative; however, a simplified two-tiered system was more reproducible and prognostically significant. Acellular mucin pools were found in a percentage of cases with excellent outcomes. Although acellular mucin pools should be considered as complete pathological responses, careful histological examination is mandatory to exclude residual mucinous carcinoma.
