Post-induction MRI response is associated with complete response and recurrence-free survival in rectal cancer treated with total neoadjuvant therapy.

Authors

Yu Shen, Xiaoling Gong, Tianxiang Jiang, Yazhou He, Hanjiang Zeng, Tinghan Yang, Mingtian Wei, Xiangbing Deng, Ziqiang Wang

Published in

American journal of surgery. Volume 262. Pages 117229. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

To evaluate the association between post-induction MRI response after induction chemotherapy and final treatment response in locally advanced rectal cancer (LARC) patients undergoing total neoadjuvant therapy.
This retrospective study included LARC patients who underwent induction chemotherapy-based total neoadjuvant therapy followed by total mesorectal excision (TME). MRI tumor regression grade and tumor longitudinal length reduction rate (TLLR) were used to assess post-induction response. MRI tumor regression grade and diffusion-weighted imaging were used to determine preoperative MRI complete response (mriCR). The primary outcome was the pathological complete response (pCR).
The current study included 224 patients (56 [IQR 49-65] years). Good responders at post-induction evaluation were associated with higher mriCR (OR 3.78, p < 0.001), higher pCR (OR 4.41, p < 0.001), and better recurrence-free survival (p < 0.001).
Post-induction evaluation was associated with later mriCR, pCR, and recurrence-free survival in LARC patients undergoing total neoadjuvant therapy, supporting future study on response-adapted neoadjuvant strategies.

PMID:
42710280
Bibliographic data and abstract were imported from PubMed on 09 Sep 2026.

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