European Journal of Biomedical and Pharmaceutical Sciences

EFFECT OF NEOADJUVANT THERAPY ON TUMOR SIZE AND SURGICAL MARGINS IN COLORECTAL CANCER

Mohammad Ahmad ABU'Alanaz MD*, Jafar Habis Alrfooh MD, Mu'ayyad Mohammad Khair Falah Mugdadi MD, Ibrahim Abdelrahman Alrawashdeh MD, Saif Yousef Hussein Al-Alwan MD, Muhanad Mohammad Ismail Al Rabee MD, Ghada Ali Khalaf Ramadneh MD, Doaa Nasri Ali Alsyoof MD, Ruba Shannaq MD and Ahmad Uraiqat MD

ABSTRACT

Background: The standard management approach for colorectal cancer (CRC) is surgical resection followed by adjuvant chemotherapy. The risk of cancer recurrence after adjuvant therapy reaches 20-30% in CRC. The existing literature suggests potential benefits of neoadjuvant chemotherapy over adjuvant chemotherapy in GI cancers by reducing tumor size prior to surgery which helps to avoid incomplete resection of tumor. Purpose: In this single-center, retrospective study, we aim to investigate the effects of neoadjuvant chemotherapy on CRC regression after surgical resection by evaluating tumor size and surgical margins in a Jordanian population of CRC patients. Methods: We will implement a retrospective design at King Hussein Medical Center (KHMC), Amman, Jordan for CRC patients who underwent surgical resection from 2016 to 2024. The cohort will include CRC patients who took neoadjuvant chemotherapy prior to surgery (Group A), and those who did not take neoadjuvant therapy (Group B). Demographic and clinical data will be retrieved for the following variables: patients’ ID, national number, age, gender, body-mass index (BMI), smoking history, tumor site, mode of surgery (Laparoscopic, or open), and presence of perforation. Outcome variable will include the proximal and distal tumor margins in centimeters (cm), and tumor diameter (cm). Continuous data will be reported as mean (standard deviation) and analyzed with the student’s t-test for normally distributed data and using median (Range) with the Mann-Whitney U test for non-normally distributed data. Categorical variables will be reported with frequencies and percentages and analyzed using the Chi-square test. A logistic regression model will be developed to assess the association between neoadjuvant chemotherapy and outcome variables (Tumor Size and Margins). All analyses will be conducted using R statistical software.

Keywords: Colorectal Cancer, Neoadjuvant chemotherapy, Tumor regression, Surgical resection, Jordan.