Peritumoral immune microenvironment markers as predictors of recurrence after adjuvant therapy in locally advanced rectal cancer

Rectal cancer (RC) is a high prevalence disease and the second most common cancer in the large intestine, which leads every year to numerous deaths worldwide and can drastically change the quality of life of the patients who manage to survive it. Currently the staging of the RC is based on the TNM classification, but its limitations due to the lack of markers beyond TNM make the prognosis unreliable. In recent years, evidence is increasingly highlighting the fundamental role the peritumoral immune microenvironment (PIMM) is playing in this disease, in its progression, metastasis and recurrence. The immune microenvironment of RC is complex, different from colon cancer, and consisting of different types of immune cells, such as regulatory T cells and epithelial cells, which were here primarily analysed. In this study we aim to investigate how the markers associated with the PIMM can be used to assess the efficacy of the adjuvant therapy in locally advanced rectal cancer (LARC) and to predict the recurrence of the disease after such therapy, potentially leading in the near future to a more accurate RC staging and better prognosis.