Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Surgery
Volume 2015 (2015), Article ID 816491, 5 pages
http://dx.doi.org/10.1155/2015/816491
Case Report

17-Week Delay Surgery after Chemoradiation in Rectal Cancer with Complete Pathological Response

1Department of Surgery, Digestive Surgery Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal
2Department of Medical Imaging, Radiology Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal
3Department of Pathology, Pathological Anatomy Service, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-003 Porto, Portugal
4Department of Pathology and Molecular Immunology, Instituto de Ciências Biomédicas Abel Salazar, Rua Jorge Viterbo Ferreira No. 228, 4050-313 Porto, Portugal

Received 21 April 2015; Accepted 27 September 2015

Academic Editor: Tsukasa Hotta

Copyright © 2015 Marisa D. Santos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neoadjuvant chemoradiation (CRT) followed by curative surgery still remains the standard of care for locally advanced rectal cancer (LARC). The main purpose of this multimodal treatment is to achieve a complete pathological tumor response (ypCR), with better survival. The surgery delay after CRT completion seems to increase tumor response and ypCR rate. Usually, time intervals range from 8 to 12 weeks, but the maximum tumor regression may not be seen in rectal adenocarcinomas until several months after CRT. About this issue, we report a case of a 52-year-old man with LARC treated with neoadjuvant CRT who developed, one month after RT completion, an acute myocardial infarction. The need to increase the interval between CRT and surgery for 17 weeks allowed a curative surgery without morbidity and an unexpected complete tumor response in the resected specimen (given the parameters presented in pelvic magnetic resonance imaging (MRI) performed 11 weeks after radiotherapy completion).