Republic of the Philippines

Department of Health
Davao Center for Health Development
SOUTHERN PHILIPPINES MEDICAL CENTER
DEPARTMENT OF SURGERY

A Research Paper Presented to the

Hospital Research Committee

In Partial Fulfillment of the Requirement for

Surgery Residency Training

Pathologic Complete Response after Neoadjuvant Chemoradiotherapy in Rectal

Carcinoma at Southern Philippines Medical Center

Noe Abraham G. Paez, MD

Principal Author

Sharmaine P. Paragas, MD, FPCS, FPSCRS

Maynard B. Hernal, MD, FPCS

2Co-Author
 Republic of the Philippines
Department of Health
Davao Center for Health Development
SOUTHERN PHILLIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City

RESEARCH PAPER

CERTIFICATE

In Partial Fulfilment of the Requirement Training for Residency Training in the

Department of Surgery - Southern Philippines Medical Center, this research paper entitled,
“Pathologic Complete Response after Neoadjuvant Chemoradiotherapy in Rectal
Carcinoma at Southern Philippines Medical Center” was submitted by,

NOE ABRAHAM G. PAEZ, MD

Department of Surgery
 In Partial Fulfilment of the Requirement Training for Residency Training
In the Department of Surgery, this research paper entitled,

Pathologic Complete Response after Neoadjuvant Chemoradiotherapy in Rectal Carcinoma at

Southern Philippines Medical Center

Has been prepared and submitted on June 29, 2023

By Dr.Noe Abraham G. Paez, MD

Sharmaine P. Paragas, MD, FPCS, FPSCRS

Maynard B. Hernal, MD, DPBS

Co-Author

Approved in partial fulfillment of the requirement for Residency Training

Mark Edward Anthony Maruya, MD, FPCS, FPATACSI

Department Chairperson

Shalimar C. Cortez, MD, FPCS, FPSGS, FSOSP

Department Training Officer

MA. ELINORE ALBA-CONCHA, MD, FPAFP

Chief Training Officer

FITZGERALD C. ARANCEL, MD, FPCS, FPSGS, MDM

Chief Medical Professional Staff

Accepted in partial fulfillment of the requirement for residency training

RICARDO B. AUDAN, MD, FPAFP

Medical Center Chief II
 Abstract

Background. The aim of this study was to identify the rate of pathologic complete response

after a completed neoadjuvant chemoradiotherapy in rectal carcinoma patients at Southern

Philippines Medical Center. Methods. This is a descriptive research design on the characteristics

of patients diagnosed with rectal adenocarcinoma who had a Pathologic Complete Response

(PCR) and the frequency and rate of PCR. The study was conducted from January 2018 to

December 2021. The section of colon and rectal cancer surgery database was used to identify

patients who underwent rectal surgery with circumferential resection margin. The main

outcome measure for the study will be the pathological complete response (PCR). Results. Of

the 370 patients, 50 (13.5%) achieved PCR, and ten (10) patients achieved a favorable response

to treatment. The overall survival and disease survival at 5 years was 100% and 92%

respectively for the non-operative group and 88% and 83%, respectively, for the operative

group. There were a total of 117 patients with biopsy-proven rectal tumors who received and

completed a full course of nasogastric chemotherapy followed by rectal surgeries with total

mesorectal excision. The median age of the patients in the nonoperative group was 58 years.

There was no significant difference in the overall survival between the two groups. Among

these patients, ten patients achieved pathologic response. Conclusion. This study reported a

pathologic completion response rate of 9.5% for patients with biopsied rectal malignancies who

were treated at Southern Philippine Medical Center which is comparable to pathologic

responses rates in other institutions internationally.