The role of serum adipokines in predicting response to neoadjuvant therapy in patients with locally advanced rectal cancer.

OBJECTIVE: The response to neoadjuvant therapy in patients with locally advanced rectal cancer varies considerably among individuals. While some patients achieve a complete pathological response, others may even experience disease progression during treatment. The aim of the study was to investigate the predictive value of serum adipokines in determining the response to neoadjuvant therapy. METHODS: This prospective study included patients diagnosed with rectal cancer and scheduled for neoadjuvant therapy at our institution between September 2020 and September 2022. Before the treatment, blood samples were collected from the patients, and levels of serum adipokines (adiponectin, leptin, resistin, and adipsin) were measured. Following surgical resection, the Modified Ryan Scoring System was used to assess the response to neoadjuvant chemoradiotherapy. Patients were then divided into two groups according to the response to the treatment (Group 1: tumor regression grade 0; Group 2: tumor regression grade 1-3). RESULTS: In the 58 patients included, no significant differences were observed in terms of demographics, tumor characteristics, or serum biochemical parameters. However, levels of adiponectin (p=0.039) and resistin (p=0.017) were significantly lower in the pathologic complete response group. CONCLUSION: Adiponectin and resistin might contribute to anticipating response to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. The incorporation of these markers into personalized therapy approaches has the potential to improve correct decision-making in the management of locally advanced rectal cancer.