Mean Corpuscular Volume as a Predictive Factor of Response to Preoperative Chemoradiotherapy in Locally Advanced Rectal Cancer

Abstract

Background. The aim of this study was to identify if blood routine parameters and serum tumor marker are potential predictive factors for tumor response to preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer. Materials and Methods. 55 locally advanced rectal cancer patients were treated with preoperative CRT in this study. The total dose of preoperative radiotherapy was 45 Gy in 25 fractions of 1.8 in 5 weeks. All patients concurrently received 825 mg/m2 capecitabine orally twice daily on days 1 to 14 and 22 to 35. Total mesorectal excision (TME) was performed 6 weeks after the end of preoperative CRT. Blood routine examination and serum tumor marker were checked before preoperative CRT. Tumor response to preoperative CRT was evaluated with the semiquantitative tumor regression grading (TRG) system proposed by Dworak criteria according to histopathological examination of the surgical specimens. Univariable and multivariable logistic regression analyses were used to test the association between blood routine parameters and serum tumor marker and tumor response to preoperative CRT. Results. Univariate logistic regression analysis revealed that differentiation, lymphocyte, LMR, MCV, PLR, and CEA have been significantly associated with tumor response to preoperative CRT. Multivariate logistic regression analysis revealed that differentiation, MCV, and CEA were the predictors of tumor response to preoperative CRT. According to the ROC analysis, the AUC of differentiation, MCV, and CEA was 0.794, 0.802, and 0.723, respectively. Optimal cutoff points for MCV and CEA were 87.65 fl and 4.05 ng/ml, respectively. Conclusion. MCV is a potential predictive factor for tumor response to preoperative chemoradiation in locally advanced rectal cancer.