Risk stratification based on these factors may help to identify patients suitable for organ preserving therapy and should be validated in appropriately selected populations.ДЄims: The enzymatic activity of dihydropyrimidine dehydrogenase (DPD) and thymidylate synthase (TS) are important for the tolerability and efficacy of the fluoropyrimidine drugs.

An algorithm combining these factors stratified patients adequately according to LNM risk, independently of ypT category.Д¬onclusions: Clinical nodal involvement, high-grade histopathology and RTD в‰Ґ10 mm are strong and independent predictors of residual nodal disease in rectal cancer patients with ypT0-2 tumours after CRT. Independent predictors of LNM were clinical nodal involvement (cN ), high-grade histopathology assessed in the post-CRT resection specimen (OR: 6.46, 95% CI: 1.23-34.02, P = 0.028) and residual tumour diameter (RTD) в‰Ґ10 mm (OR: 2.54, 95% CI: 1.06-6.09, P = 0.036). Residual nodal disease was found in 44 cases (21.0%). Of 657 consecutive CRT-treated rectal cancer patients 210 with ypT0-2 disease were included. Clinicopathological characteristics and their association with residual LNM were investigated. Methods And Results: Rectal cancer patients with ypT0-2 tumours after CRT and radical resection from five centres treated between June 1999 and February 2012 were included. These risk factors may help to select patients who can be spared radical surgery without compromising oncological outcomes. Our aim is to identify clinicopathological factors predicting the presence of residual LNM in rectal cancer patients with ypT0-2 tumours after neoadjuvant CRT. Local excision after chemoradiotherapy (CRT) for rectal cancer with excellent clinical response reduces morbidity and mortality compared to total mesorectal excision, although residual lymph node metastases (LNM) may cause local recurrence. Aims: Changes in rectal cancer treatment include increasing emphasis on organ preservation.

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