Induction Chemotherapy Leads to Increased Pathologic Downstaging in Locally Advanced Rectal Cancer Patients treated with Total Neoadjuvant Therapy

Increased utilization of induction chemotherapy in total neoadjuvant therapy for locally advanced rectal cancer led to higher pathologic downstaging rates compared to consolidation chemotherapy. From 2006 to 2017, 46.7% of patients experienced downstaging, with induction chemotherapy resulting in a higher rate of pathologic downstaging (58% vs. 44.7%). These findings suggest that induction chemotherapy may be preferable for achieving downstaging prior to surgery in this patient population.