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Rectal Cancer and complete response

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https://www.readbyqxmd.com/read/29136328/organ-preservation-in-rectal-cancer-a-synopsis-of-current-guidelines
#1
W A A Borstlap, S E van Oostendorp, C E L Klaver, D Hahnloser, C Cunningham, E Rullier, W A Bemelman, J B Tuynman, P J Tanis
BACKGROUND: The high morbidity associated with radical resection for rectal cancer is an incentive for surgeons to adopt strategies aimed at organ preservation, particularly for early disease. There are a number of different approaches to achieve this. In this study we have collated current national and international guidelines to produce a synopsis to support this changing practice. METHODS: The databases PubMed, Embase, Trip database, national guideline clearinghouse, BMJ Best practice were interrogated...
November 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29134378/organ-preservation-in-rectal-cancer-after-chemoradiation-should-we-extend-the-observation-period-in-patients-with-a-clinical-near-complete-response
#2
Britt J P Hupkens, Monique Maas, Milou H Martens, Marit E van der Sande, Doenja M J Lambregts, Stéphanie O Breukink, Jarno Melenhorst, Janneke B Houwers, Christiaan Hoff, Meindert N Sosef, Jeroen W A Leijtens, Maaike Berbee, Regina G H Beets-Tan, Geerard L Beets
BACKGROUND: To assess whether extending the observation period in patients with a near clinical complete response (near cCR) after chemoradiation (CRT) leads to an impaired oncological outcome. METHODS: Patients who had a clinical complete response (cCR) 8-10 weeks after CRT restaging with magnetic resonance imaging and endoscopy were offered a watch-and-wait strategy (W&W1), while patients with a near cCR were offered to undergo local excision or a second restaging 6-12 weeks later...
November 13, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29134362/selecting-patients-for-hyperthermia-combined-with-preoperative-chemoradiotherapy-for-locally-advanced-rectal-cancer
#3
Sang-Won Kim, Ji Woon Yea, Jae Hwang Kim, Mi Jin Gu, Min Kyu Kang
BACKGROUND: This study investigated the role of hyperthermia combined with preoperative concurrent chemoradiotherapy (CCRT) for locally advanced rectal cancer (LARC) according to hypoxic marker expression. METHODS: One hundred and nine LARC patients with tissue blocks available for immunohistochemical assessment of carbonic anhydrase 9 (CA9) expression were reviewed. CA9 expression was considered positive when the staining percentage of tumor cells was >25% (n = 31)...
November 13, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29132485/prognostic-role-of-acellular-mucin-pools-in-patients-with-rectal-cancer-after-pathological-complete-response-to-preoperative-chemoradiation-systematic-review-and-meta-analysis
#4
Abu Bakar Hafeez Bhatti, Sidra Zaheer, Kashif Shafique
The prognostic implication of acellular mucin pools (AMP) in rectal cancer is controversial. There is no Level-I evidence regarding their prognostic impact. This systematic review was performed to determine the impact of AMPon survival in patients with rectal cancer, who demonstrate pathological complete response (PCR) to preoperative chemoradiation (CRT). Asystematic literature review was performed by searching MEDLINE and EMBASE database. For overall survival, the overall random effect model favored mucin negative tumors (HR=2, 95% CI=0...
November 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29127435/intensified-preoperative-chemoradiation-by-adding-oxaliplatin-in-locally-advanced-primary-operable-ct3nxm0-rectal-cancer-impact-on-long-term-outcome-results-of-the-phase%C3%A2-ii-tako-05-abcsg-r%C3%A2-02-trial
#5
P Kogler, A F DeVries, W Eisterer, J Thaler, L Sölkner, D Öfner
PURPOSE: The major goals of preoperative treatment for locally advanced rectal cancers (LARCs) are improvement of local tumor control, tumor downsizing, and downstaging. Modifications with respect to standardized chemoradiation protocol, e. g., integrating oxaliplatin, are realized with the aim of improving primary tumor response and patient outcome. PATIENTS AND METHODS: In this phase II multicenter study, patients with LARC of the mid- or lower rectum, cT3cNxcM0 as staged by MRI, were included and treated preoperatively with a combination of capecitabine and oxaliplatin following a standardized protocol during radiation...
November 10, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29114614/preoperative-radiation-dose-escalation-for-rectal-cancer-using-a-concomitant-boost-strategy-improves-tumor-downstaging-without-increasing-toxicity-a-matched-pair-analysis
#6
Jillian R Gunther, Awalpreet S Chadha, Ui Sup Shin, In Ja Park, Kiran V Kattepogu, Jonathan D Grant, David C Weksberg, Cathy Eng, Scott E Kopetz, Prajnan Das, Marc E Delclos, Harmeet Kaur, Dipen M Maru, John M Skibber, Miguel A Rodriguez-Bigas, Y Nancy You, Sunil Krishnan, George J Chang
Purpose: Pathologic complete response to neoadjuvant chemoradiation therapy (CRT) is associated with improved outcomes for patients with locally advanced rectal cancer (LARC). Increased response rates have been reported with higher radiation doses, but these studies often lack long-term outcome and/or toxicity data. We conducted a case-control analysis of patients with LARC who underwent definitive CRT to determine the efficacy and safety of intensified treatment with a concomitant boost (CB) approach...
July 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29113729/intensified-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer-in-elderly-patients-toxicity-disease-control-and-survival-outcomes
#7
Francesca De Felice, Karen Llange, Filippo Rubini, Nadia Bulzonetti, Rossella Caiazzo, Daniela Musio, Vincenzo Tombolini
INTRODUCTION: We report the treatment compliance, toxicity rates, and long-term clinical outcomes of elderly patients who received intensified neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). PATIENTS AND METHODS: We identified a retrospective cohort of patients aged ≥ 70 years with LARC who received intensified neoadjuvant CRT, followed by surgery and adjuvant chemotherapy, from 2007 to 2014. Intensified neoadjuvant CRT consisted of radiotherapy (total dose, 50...
October 16, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29112561/nodal-disease-in-rectal-cancer-patients-with-complete-tumor-response-after-neoadjuvant-chemoradiation-danger-below-calm-waters
#8
Rebeccah B Baucom, Lillias H Maguire, Sandra L Kavalukas, Timothy M Geiger, Molly M Ford, Roberta L Muldoon, M Benjamin Hopkins, Alexander T Hawkins
BACKGROUND: A subset of patients with rectal cancer who undergo neoadjuvant chemoradiation therapy will develop a complete pathologic tumor response. Complete nodal response is not universal in these patients and is difficult to assess clinically. Quantifying the risk of nodal disease would allow for targeted therapy with either radical resection or "watchful waiting." OBJECTIVE: This study aimed to identify risk factors for residual nodal disease in ypT0 rectal adenocarcinoma...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29108299/serum-mir-143-levels-predict-the-pathological-response-to-neoadjuvant-chemoradiotherapy-in-patients-with-locally-advanced-rectal-cancer
#9
Yukiharu Hiyoshi, Takashi Akiyoshi, Ramu Inoue, Keiko Murofushi, Noriko Yamamoto, Yosuke Fukunaga, Masashi Ueno, Hideo Baba, Seiichi Mori, Toshiharu Yamaguchi
Recently, several circulating miRNAs have been reported as promising, minimally invasive biomarkers for the diagnosis or prediction of the prognosis in various types of cancer. However, the utility of circulating miRNAs as predictive markers of the cancer response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer is still unclear. To identify circulating serum miRNAs useful for predicting a pathological good response to nCRT, total 18 serum miRNAs of interest were analyzed by real-time polymerase chain reaction in 94 rectal cancer patients treated with nCRT and surgery...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29102233/rectal-perfusion-parameters-normalised-to-tumour-free-rectal-wall-can-predict-response-to-neoadjuvant-chemoradiotherapy
#10
S Krishan, A Patel, R Sud, R Puri, A Vaid, L Lipi, T Kataria
AIMS: To evaluate absolute changes in quantitative and semi-quantitative perfusion parameters using a newer approach of comparing these parameters with tumour-free normal rectal wall (i.e., relative/normalised change) in predicting complete pathological response to chemoradiotherapy. MATERIALS AND METHODS: Perfusion parameters measured before and after treatment of 10 patients with histopathologically proven rectal cancer that showed complete treatment response (Group 1) were compared with 10 patients with residual tumour on histopathology following treatment (Group 2)...
October 25, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/29100742/outcome-of-neoadjuvant-chemoradiation-in-mri-staged-locally-advanced-rectal-cancer-retrospective-analysis-of-123-chinese-patients
#11
Shing Fung Lee, Chi Leung Chiang, Francis Ann Shing Lee, Yiu Wah Wong, Chi Ming Poon, Frank Chi Sing Wong, Stewart Yuk Tung
BACKGROUND: For advanced rectal cancer with involved or threatened mesorectal fascia (MRF), current standard is pre-operative long course chemoradiotherapy (PLCRT) with either capecitabine or 5-fluorouracil (5-FU). However, few Chinese data on its clinical outcome are available, especially for those with pelvic MRI staging. METHODS: Between Jan-2009 and Oct-2014, 123 consecutive patients with biopsy proven adenocarcinoma of rectum, all with pelvic MRI staging, selected for PLCRT after multi-disciplinary team discussion were recruited...
November 1, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29083469/nonoperative-management-of-rectal-cancer-a-modern-perspective
#12
REVIEW
Yushen Qian, Alexander L Chin, Diego A S Toesca, Albert C Koong, Daniel T Chang
Nonoperative management of rectal cancer is an emerging treatment approach that aims to enable carefully selected patients to avoid the morbidity of radical surgical resection, while benefiting from the same excellent rates of tumor control achieved with radical surgery-based combined-modality therapy. The success of nonoperative management in this setting is based on the accurate assessment of tumor eradication after chemoradiotherapy, without pathologic verification. Therefore, clinical evidence of complete response-based on physical examination, endoscopic procedures, and imaging-must be utilized as a marker to predict for pathologic complete response and thus help select the patients who are most appropriate for nonoperative management...
October 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/29066704/-two-cases-of-unresectable-advanced-rectal-cancer-with-a-long-term-survival-for-which-pathological-complete-response-was-achieved-through-neoadjuvant-effective-chemotherapy
#13
Kenji Gonda, Yosuke Tachiya, Yuichi Hatakeyama, Masahiko Shibata, Koji Kono, Yuichi Rokkaku
We report 2 unusual cases of Stage IV rectal cancer for which pathological complete response was achieved with neoadjuvant chemotherapy(NAC)consisting of a combination of 5-fluorouracil(5-FU), oxaliplatin, Leucovorin(mFOLFOX6)or irinotecan(FOLFIRI), and bevacizumab, without radiotherapy. Case 1: A 65-year-old man was diagnosed as having rectal cancer with an invasive carcinoma of the prostate and lymph node metastasis. He refused to undergo surgery and received NAC instead. After NAC with mFOLFOX6 and FOLFIRI was performed, CT scan and colonoscopy revealed no evidence of disease...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29066682/-a-case-of-bilateral-lymph-node-metastases-of-rectal-cancer-treated-with-chemotherapy-and-surgery
#14
Tomohiro Tate, Yudai Fukui, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Shuichiro Matoba, Hiroya Kuroyanagi
We present a case of bilateral lymph node metastases of rectal cancer treated with chemotherapy and surgery. The patient was a 65-year-old man with upper rectal cancer. Laparoscopic low anterior resection(LAR)was performed. Pathological findings were tub2>por>muc, pT3, ly2, v3, pN2, pM0. Six months after surgery, the CEA level was elevated. CT and PET-CT confirmed bilateral metastasis to the lymph nodes. Five courses of FOLFOX4 plus bevacizumab were administered, and then, we performed laparoscopic bilateral lymph node dissection...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29054345/the-effect-of-formal-robotic-residency-training-on-the-adoption-of-minimally-invasive-surgery-by-young-colorectal-surgeons
#15
David E Disbrow, Stephanie M Pannell, Beth-Ann Shanker, Jeremy Albright, Juan Wu, Amir Bastawrous, Mark Soliman, Jane Ferraro, Robert K Cleary
OBJECTIVE: The minimally invasive approach to colorectal surgery is still underused. Only 50% to 60% of colectomies and 10% to 20% of rectal resections for cancer are performed laparoscopically. The increasing adoption of the robotic platform for colorectal surgery warrants re-evaluation of minimally invasive surgery (MIS) training techniques. Although considering lessons learned from past laparoscopic training, a standardized national robotic training program for colon and rectal surgery residents was developed and implemented in 2011...
October 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29046927/fdg-pet-ct-radiomics-for-predicting-the-outcome-of-locally-advanced-rectal-cancer
#16
Pierre Lovinfosse, Marc Polus, Daniel Van Daele, Philippe Martinive, Frédéric Daenen, Mathieu Hatt, Dimitris Visvikis, Benjamin Koopmansch, Frédéric Lambert, Carla Coimbra, Laurence Seidel, Adelin Albert, Philippe Delvenne, Roland Hustinx
PURPOSE: The aim of this study was to investigate the prognostic value of baseline (18)F-FDG PET/CT textural analysis in locally-advanced rectal cancer (LARC). METHODS: Eighty-six patients with LARC underwent (18)F-FDG PET/CT before treatment. Maximum and mean standard uptake values (SUVmax and SUVmean), metabolic tumoral volume (MTV), total lesion glycolysis (TLG), histogram-intensity features, as well as 11 local and regional textural features, were evaluated...
October 18, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29037023/simultaneous-integrated-boost-intensity-modulated-radiotherapy-versus-3-dimensional-conformal-radiotherapy-in-preoperative-concurrent-chemoradiotherapy-for-locally-advanced-rectal-cancer
#17
Bong Kyung Bae, Min Kyu Kang, Jae-Chul Kim, Mi Young Kim, Gyu-Seog Choi, Jong Gwang Kim, Byung Woog Kang, Hye Jin Kim, Soo Yeun Park
PURPOSE: To evaluate the feasibility of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for preoperative concurrent chemoradiotherapy (PCRT) in locally advanced rectal cancer (LARC), by comparing with 3-dimensional conformal radiotherapy (3D-CRT). MATERIALS AND METHODS: Patients who were treated with PCRT for LARC from 2015 January to 2016 December were retrospectively enrolled. Total doses of 45 Gy to 50.4 Gy with 3D-CRT or SIB-IMRT were administered concomitantly with 5-fluorouracil plus leucovorin or capecitabine...
September 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/29025456/a-finger-or-not-prostate-examinations-by-non-urologists-at-a-south-african-academic-institution
#18
Kalli Spencer
BACKGROUND: According to the South African (SA) National Cancer Registry 2009, prostate cancer is the most commonly diagnosed solid-organ cancer in SA men: the incidence increases at ~3% every year, with 1/26 men developing prostate cancer in their lifetime and five men dying every day. Screening for prostate cancer by performing a digital rectal examination (DRE) adds to the sensitivity and specificity of serum prostate-specific antigen (PSA) testing and is an important component of the assessment for the early detection of prostate cancer...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28987662/value-of-dce-mri-for-staging-and-response-evaluation-in-rectal-cancer-a-systematic-review
#19
REVIEW
Rebecca A P Dijkhoff, Regina G H Beets-Tan, Doenja M J Lambregts, Geerard L Beets, Monique Maas
PURPOSE: Aim was to perform a systematic review to evaluate the clinical value of dynamic contrast-enhanced (DCE) MRI in rectal cancer. METHODS AND MATERIALS: A systematic search was performed on Pubmed, Embase and the Cochrane library. Studies that evaluated DCE-MRI for tumour aggressiveness, primary staging and restaging after chemoradiation (CRT) were included. Information on population, DCE technique, DCE parameters and outcome (angiogenesis, staging and response) were extracted...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28982515/robotic-total-pelvic-exenteration-with-intracorporeal-sigmoid-conduit-and-colostomy-step-by-step-technique
#20
Matthew J Maurice, Daniel Ramirez, Emre Gorgun, Georges-Pascal Haber
OBJECTIVE: To describe our technique for robotic total pelvic exenteration with intracorporeal sigmoid conduit and colostomy using the da Vinci Si robot. METHODS: Three 8-mm robotic ports and two 12-mm laparoscopic ports are placed in a "W" configuration, approximately 2-3 cm more cephalad than for radical prostatectomy (Fig. 1). The robot is docked between the legs with the patient in steep Trendelenburg. The ureters are dissected out from the iliac vessels to the rectovesical pouch, where they are clipped and transected...
July 2017: Urology
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