73. changing patterns of recurrent disease in colorectal cancer

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  • 754 ABSTRACTSTumour response to neoadjuvant therapy ranges from complete response to

    little or no response at all and is related with outcomes. The aim of this

    study was to determine the correlation between clinical, pathological pa-

    rameters and molecular biomarkers in diagnostic endoscopic biopsies

    with tumour regression grading in the resected specimens.

    Materials and methods: Ninety five patients with mid (56%) and low

    (44%) locally advanced rectal adenocarcinoma who received neoadjuvant

    radiotherapy with or without chemotherapy followed by radical surgical

    resection were included in the study. Mean age was 68 years. Sixty four

    (67%) were males and 31 (33%) females. Several clinical and pathological

    parameters were collected. Paraffin-embedded sections obtained in diag-

    nostic biopsies before therapy were assessed by immunohistochemical

    staining for p53, her-2, VEGFr, bcl-2, beta-catenin, COX-2, APAF-1 and

    Ki-67. These stains were correlated with T-downstaging and tumour re-

    gression grade (TRG) using Mandards scoring system on surgical speci-

    mens. Data were analyzed with chi-square and Spearmans correlation

    tests.

    Results: Pathologic complete response was seen in 17% and T down-

    staging in 48.2%. There was correlation between TRG and pretreatment

    expression of bcl-2 (p0.04), beta-catenin (p0.03) and VEGFr(p0.04). T-downstaging was significantly associated with expression ofAPAF-1 (p0.04) and VEGFr (p0.03). We did not find any correlationwith any other molecular marker (p53, her-2, COX-2, Ki-67), clinical

    and pathological parameters (age, gender, tumour location, pretreatment

    CEA level, interval to surgery), excepting histologic grade (p