Value of ypTNM stage in patients with rectal cancer

Abstract In the current NCCN guidelines, the prognosis and adjuvant chemotherapy regimen of patients who underwent neoadjuvant chemoradiotherapy, which are based on pre-radiotherapy clinical TNM stage or neoadjuvant pathologic TNM stage, are not clearly described. This retrospective study investigated the significance of neoadjuvant pathologic TNM stage and the value of the adjuvant chemotherapy regimens in different neoadjuvant pathologic TNM stages. Between 2010 and 2015, a total of 316 rectal cancer patients who underwent neoadjuvant chemoradiotherapy, followed by radical resection, were included for analysis. Our findings revealed that neoadjuvant pathologic TNM stage was a more important prognostic factor than clinical TNM stage. In different neoadjuvant pathologic TNM stages, adjuvant chemotherapy played important roles in stage-II and -III disease, but played no significant role in pCR and stage-I disease. We concluded that neoadjuvant pathologic TNM stage, rather than clinical TNM stage, was a more important prognostic factor. The intensity of adjuvant chemotherapy might need to be strengthened with the increase of ypTNM stage.