Prognostic significance of clinicopathological and molecular features after neoadjuvant chemoradiotherapy in rectal cancer patients

Background/Aim: This study evaluated clinicopathological and molecular features and their prognostic impact on patients with locally advanced rectal cancer (LARC) who received preoperative chemoradiotherapy (CRT). Patients and Methods: We retrospectively gathered data from 284 patients with LARC who underwent total mesorectal excision (TME) after CRT. Results: In the univariate analysis, lower yield pathologic T (ypT) category, yield pathologic N (ypN) category, yield pathologic TNM (ypTNM) stage, as well as the absence of lymphovascular invasion (LVI) and perineural invasion (PNI), were significantly associated with better disease-free survival (DFS) and overall survival (OS). Meanwhile, the expression of Ki-67, p53, and the mismatch repair (MMR) status showed no association with clinical outcomes. A multivariate survival analysis revealed that ypT category and LVI were independent prognostic factors of a worse DFS (HR=3.081, p-value=0.001; HR=2.818, p-value=0.030) and OS (HR=3.158, p-value=0.006; HR=3.837, p-value=0.014). Conclusion: The ypT category and the presence of LVI were found to be prognostic factors for patients with LARC after CRT followed by TME.