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Session: ePoster: Rectal Cancer 6 (Mon8)

EP664 - How lateral Pelvic nodes respond to neoadjuvant therapies in rectal cancer

Monday, May 12, 2025
8:16 AM – 8:21 AM PT
Location: Monitor 9, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Tejas P. Vispute, MCh

    Assistant professor
    Mahamana Pandit Madan Mohan Malviya Cancer Center, Varanasi
    Tata Memorial Center and Homi Bhabha National Institute, Mumbai
    Mumbai, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai

    Professor
    Division of colorectal Surgeon, Department of Surgical oncology
    Tata Memorial hospital , Mumbai
    Mumbai, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MK

    MUFADDAL K. KAZI, MBBS, MS, MCH

    Associate Professor
    Tata memorial hospital, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

  • AD

    ASHWIN DESOUZA, MBBS, MS, MCh

    Professor
    Tata Memorial Center, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

  • AS

    ANKIT SHARMA, MBBS, MS, MCH

    ASSISTANT PROFESSOR
    TATA MEMORIAL HOSPITAL, MUMBAI
    Tata Memorial Hospital, Mumbai
    MUMBAI, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • SUBHATHIRA MANOHKARAN, MS

    General surgeon and collorectal fellow
    Tata Memorial Cancer Centre
    Mumbai,, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • MN

    MITHUN NARIAMPALLI KARTHYARTH, MBBS, MS, DNB, MCH

    FELLOW
    DIVISION OF COLORECTAL SURGERY, DEPARTMENT OF SURGICAL ONCOLOGY, TATA MEMORIAL HOSPITAL, MUMBAI< MAHARASHTRA, INDIA
    MUMBAI, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Tejas P. Vispute, MCh: This individual has no financial relationships with ineligible companies.
Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai: This individual has no financial relationships with ineligible companies.
ANKIT SHARMA, MBBS, MS, MCH: This individual has no financial relationships with ineligible companies.
SUBHATHIRA MANOHKARAN, MS: This individual has no financial relationships with ineligible companies.
MITHUN NARIAMPALLI KARTHYARTH, MBBS, MS, DNB, MCH: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The response of lateral pelvic lymph nodes (LPLN) to various neoadjuvant treatments has not been previously investigated. The RAPIDO, PRODIGE 23, and OPRA trials incorporated total neoadjuvant treatment (TNT) in cases with LPLN involvement; however, they did not address the management or outcomes regarding these nodes.

Methods/Interventions: Design - Retrospective cohort study derived from a prospectively maintained database.To compare the response of LPLN to TNT (short course radiotherapy and chemotherapy) versus long-course radiotherapy (LCRT). Secondary outcomes include the pathological positive rate of LPLN dissection post-neoadjuvant treatment.
Setting - A single tertiary-care center.
Patients - Rectal cancer patients registered in between January 2020 to December 2021 with radiologically positive LPLN.
Intervention - Neoadjuvant Radiation and TNT
Main Outcome Measures - LPLN size reduction

Results/Outcomes: Of 1200 cases of rectal cancer registered, 160 had positive LPLN and 142 patients were included in the analysis. Sixty-one patients (43%) received LCRT, while 81 (57%) underwent TNT. No significant differences in T and N staging were detected between the groups. However, the TNT cohort had a notably higher percentages of metastatic patients (p < 0.001), patients with palliative intent (p < 0.001), poorly differentiated tumors (p=0.021) and extramural venous invasion (p=0.002).Baseline mean nodal sizes were comparable; 11mm in the LCRT group and 10.8mm in the TNT group. Post-neoadjuvant nodal sizes were 5.3mm for LCRT and 6.2mm for TNT, with mean reductions of 5.7mm and 4.6mm, respectively (p=0.136 & 0.54). Surge ry was conducted in 77% from the LCRT group and 59% from the TNT group, with 22 (48.9%) and 26 (55.3%) undergoing LPLN dissection in their respective groups. The pathological positivity rates for LPLN showed no significant difference (23.1% vs. 19.4%; p=0.731).

Conclusion/Discussion: Limitation - Retrospective study. There are no advantages of SCRT with consolidation chemotherapy over long course chemoradiation.