First report on clinicopathological characteristics, histological response to neoadjuvant therapy and survival outcomes of patients with locally advanced rectal cancer in north-est of Morocco

In this study, our aim was to provide a global overview of locally advanced rectal cancer (RC) epidemiology and its clinicopathologic characteristics as well as to identify predictive factors that may influence response to neoadjuvant therapy of a Moroccan population. Enrolled RC patients underwent neoadjuvant therapy, followed by surgery between 2011 and 2018 at the university hospital of Fez, Morocco. 250 patients were included in this observational retro-prospective cross-sectional study. 50.8% were women and 49.2% were men with a female to male ratio of 1.03. The average age at diagnosis was 56 years. Most of patients presented rectal bleeding as a revealing symptom (75.9 %). 84.8% were responders to neoadjuvant therapy and 51.2% were non responders. In univariate analysis, the responders group was found significantly associated with resection status, absence of perineural and vascular invasion, yp TNM, less metastasis, recurrence and long-term survival. In multivariate analysis, circumferential resection margins (HR: 3.154; 95% CI: 1.265-7.861; p=0.014), resection status (HR: 0.190; 95% CI: 0.042-0.849; p=0.030), ratio of positive lymph nodes (HR: 0.030; 95% CI: 0.002-0.391;p=007), and ypUICC stages (II: HR: 0.142; 95% CI: 0.021-0.974;p=0.047, III: HR: 0.050; 95% CI: 0.007-0.329;p=0.002, IV: HR: 0.172; 95% CI: 0.030-0.969; p=0.046) were found to be independent predictors of response to neoadjuvant therapy in RC.