Understanding mucin pool formation after chemoradiotherapy
Understanding the role of mucin pool formation after patients with rectal cancer undergo chemoradiotherapy.
Mucin pools are a gel-like substance found extracellularly in some patients with rectal cancer following treatment with chemoradiotherapy.
There is uncertainty as to why some patients with rectal cancer form mucin pools following chemoradiotherapy, while others do not. There is increased uncertainty as to what this morphological response to treatment means for patients in regards to outcomes, including recurrence and survival.
In a recently published paper available here, RCSI researchers Ian Reynolds et al definitively answer the outstanding questions regarding mucin pool formation after neoadjuvant chemoradiotherapy for rectal cancer, confirming that they do not signify any particular patient health outcome.
Using meta-analytical techniques, the authors have pooled together all available published data on the topic. In total, 11 articles with pathological and survival data on 1,947 patients were included in the analysis.
Using a random-effects model, the authors compared the following outcomes between those who formed mucin pools and those who did not — T stage, N stage, pathological complete response, tumour regression, lymphovascular invasion, perineural invasion, tumour differentiation, margin status, local recurrence, distant recurrence, disease-free survival and overall survival.
The parameters that were analysed between those who formed and those who did not form mucin pools revealed no differences. This finding was unexpected as it has been previously felt that mucin pool formation represented a good response to neoadjuvant treatment, translating into a reduced risk of recurrence and a subsequently increased survival rate.
The study confirms that mucin pools simply represent a morphological response to treatment and do not correlate with better or indeed worse outcomes for the patient.
Journal Article Information:
Mucin Pools Following Neoadjuvant Chemoradiotherapy For Rectal Cancer: A Marker of Response or Epiphenomenon?
Am J Surg Path. 2019 Sep 17. [Epub ahead of print]
DOI: https://doi.org/10.1097/PAS.0000000000001373
