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Rectal Cancer and complete response

E B Thorgersen, M A Goscinski, M Spasojevic, A M Solbakken, A B Mariathasan, K Boye, S G Larsen, K Flatmark
BACKGROUND: High morbidity, increased mortality, and impaired long-term oncologic outcome have been reported after deep surgical site infection (SSI) in rectal cancer surgery. The rate, risk factors and consequences of deep SSI after (chemo)radiotherapy [(C)RT], and surgery for locally advanced rectal cancer (LARC) in a tertiary university hospital single centre cohort of 540 patients are presented. METHODS: Patients with LARC, operated between January 1, 2007 and December 31, 2015, were identified in the institutional prospective database...
October 20, 2016: Annals of Surgical Oncology
Matthew D Hall, Timothy E Schultheiss, David D Smith, Marwan G Fakih, Jeffrey Y C Wong, Yi-Jen Chen
BACKGROUND: Neoadjuvant chemoradiation therapy (CRT) increases pathological complete response (pCR) rates compared to radiotherapy alone in patients with stage II-III rectal cancer. Limited evidence addresses whether radiotherapy dose escalation further improves pCR rates. Our purpose is to measure the effects of radiotherapy dose and other factors on post-therapy pathologic tumor (ypT) and nodal stage in rectal cancer patients treated with neoadjuvant CRT followed by mesorectal excision...
October 20, 2016: Acta Oncologica
Filippo Landi, Eloy Espín, Victor Rodrigues, Francesc Vallribera, Aleix Martinez, Cecile Charpy, Francesco Brunetti, Daniel Azoulay, Nicola de'Angelis
PURPOSE: Patients with locally advanced rectal cancer and pathologic complete response to neoadjuvant chemoradiation therapy have lower rates of recurrence compared to those who do not. However, the influences of the pathologic response on surgical complications and survival remain unclear. This study aimed to investigate the influence of neoadjuvant therapy for rectal cancer on postoperative morbidity and long-term survival. METHODS: This was a comparative study of consecutive patients who underwent laparoscopic total mesorectal excision for rectal cancer in two European tertiary hospitals between 2004 and 2014...
October 19, 2016: International Journal of Colorectal Disease
Kyung Ha Lee, Jin Soo Kim, Ji Yeon Kim
PURPOSE: Oral capecitabine has demonstrated to be safe and efficient as neoadjuvant concurrent chemoradiotherapy (NCRT) for locally advanced rectal cancers. The aim of this study was to evaluate the long-term oncologic outcomes of NCRT with capecitabine and radical surgery. METHODS: From January 2000 to June 2010, 238 patients were treated at our center for locally advanced rectal cancers using conventional NCRT with capecitabine and radical surgery. Univariate and multivariate analyses were used to evaluate the factors associated with oncologic outcomes with log rank and Cox regression tests...
October 2016: Annals of Surgical Treatment and Research
Glenwood Goss, Chun-Ming Tsai, Frances A Shepherd, Lyudmila Bazhenova, Jong Seok Lee, Gee-Chen Chang, Lucio Crino, Miyako Satouchi, Quincy Chu, Toyoaki Hida, Ji-Youn Han, Oscar Juan, Frank Dunphy, Makoto Nishio, Jin-Hyoung Kang, Margarita Majem, Helen Mann, Mireille Cantarini, Serban Ghiorghiu, Tetsuya Mitsudomi
BACKGROUND: Osimertinib (AZD9291) is an oral, potent, irreversible EGFR tyrosine-kinase inhibitor selective for EGFR tyrosine-kinase inhibitor sensitising mutations, and the EGFR Thr790Met resistance mutation. We assessed the efficacy and safety of osimertinib in patients with EGFR Thr790Met-positive non-small-cell lung cancer (NSCLC), who had progressed after previous therapy with an approved EGFR tyrosine-kinase inhibitor. METHODS: In this phase 2, open-label, single-arm study (AURA2), patients aged at least 18 years with centrally confirmed EGFR Thr790Met-positive mutations, locally advanced or metastatic (stage IIIB/IV) NSCLC who progressed on previous EGFR tyrosine-kinase inhibitor therapy received osimertinib 80 mg orally once daily; treatment could continue beyond progression if the investigator observed a clinical benefit...
October 14, 2016: Lancet Oncology
Min-Jeong Kim, Eun Seok Kim, Seung-Gu Yeo
BACKGROUND: Standard management for locally advanced rectal cancer (LARC) involves preoperative chemoradiotherapy (CRT) and radical surgery. However, this level of treatment may be unnecessary for a subgroup of LARC patients. Previous reports have shown that approximately 20% of LARC patients experience a complete tumor response to preoperative CRT. Post-CRT nonoperative management of these patients may prevent morbidities associated with radical surgery. To our knowledge, this case report firstly presents the favorable long-term outcomes of a LARC patient who underwent definitive aim CRT...
October 2016: Medicine (Baltimore)
Carmit K McMullen, Joanna E Bulkley, Andrea Altschuler, Christopher S Wendel, Marcia Grant, Mark C Hornbrook, Virginia Sun, Robert S Krouse
BACKGROUND: Eliciting the priorities of cancer survivors is essential to address the specific needs of cancer survivor subgroups. OBJECTIVE: The purpose of this study was to describe the greatest challenges related to treatment for long-term rectal cancer survivors. DESIGN: This was an observational study with a cross-sectional survey. SETTINGS: The study included members of Kaiser Permanente Northern California and Northwest health plans...
November 2016: Diseases of the Colon and Rectum
Finn Ole Larsen, Alice Markussen, Benny V Jensen, Anne L Fromm, Kirsten K Vistisen, Vibeke K Parner, Dorte Linnemann, Rasmus H Hansen, Helle H Johannesen, Jakob V Schou
PURPOSE: To evaluate the effect of capecitabine and oxaliplatin before, during, and after radiotherapy for high-risk rectal cancer. PATIENTS AND METHODS: Patients with rectum cancer T4 or T3 involving the mesorectal fascia was included in a prospective phase 2 trial. Liver or lung metastases were accepted if the surgeons found them resectable. The patients received 6 weeks of capecitabine and oxaliplatin before chemoradiotherapy (CRT), continued capecitabine and oxaliplatin during radiotherapy, and received 4 weeks of capecitabine and oxaliplatin after CRT...
September 14, 2016: Clinical Colorectal Cancer
Yulia Kundel, Nicola J Nasser, Lea Rath-Wolfson, Ofer Purim, Natalia Yanichkin, Ronen Brenner, Tanya Zehavi, Yuval Nardi, Eyal Fenig, Aaron Sulkes, Baruch Brenner
OBJECTIVES: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. METHODS: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011...
October 12, 2016: American Journal of Clinical Oncology
Kittinut Timudom, Natthawut Phothong, Thawatchai Akaraviputh, Vitoon Chinswangwatanakul, Ananya Pongpaibul, Janjira Petsuksiri, Suthinee Ithimakin, Atthaphorn Trakarnsanga
Background. Traditionally, rectal cancer surgery is recommended 6 to 8 weeks after completing neoadjuvant chemoradiation. Extending the waiting time may increase the tumor response rate. However, the perioperative complication rate may increase. The purpose of this study was to determine the association between extending the waiting time of surgery after neoadjuvant chemoradiation and perioperative outcomes. Methods. Sixty patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation followed by radical resection at Siriraj hospital between June 2012 and January 2015 were retrospectively analyzed...
2016: Gastroenterology Research and Practice
Chun-Ming Huang, Ming-Yii Huang, Hsiang-Lin Tsai, Ching-Wen Huang, Cheng-Jen Ma, Chih-Hung Lin, Chih-Jen Huang, Jaw-Yuan Wang
The aim of the study was to compare clinical outcomes and toxicity between 3D conformal radiotherapy (3DCRT) and image-guided intensity-modulated radiotherapy (IG-IMRT) administered through helical tomotherapy in locally advanced rectal cancer (LARC) patients receiving preoperative chemoradiotherapy. We reviewed 144 patients with Stage II-III rectal cancer receiving preoperative fluoropyrimidine-based chemoradiotherapy followed by radical resection. Tumor responses following chemoradiotherapy were evaluated using the Dworak tumor regression grade (TRG)...
October 13, 2016: Journal of Radiation Research
Young Seob Shin, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Heung Moon Chang, Jin-Hong Park, Seung Do Ahn, Sang-Wook Lee, Eun Kyung Choi, Jin Cheon Kim, Jong Hoon Kim
PURPOSE: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. MATERIALS AND METHODS: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months...
September 2016: Radiation Oncology Journal
Jasna But-Hadzic, Franc Anderluh, Erik Brecelj, Ibrahim Edhemovic, Ajra Secerov-Ermenc, Rihard Hudej, Ana Jeromen, Miran Kozelj, Bojan Krebs, Irena Oblak, Mirko Omejc, Andrej Vogrin, Vaneja Velenik
BACKGROUND AND PURPOSE: This phase 2 study investigated the efficacy and safety of preoperative intensity modulated radiation therapy with a simultaneous integrated boost (IMRT-SIB) without dose escalation, concomitant with standard capecitabine chemotherapy in locally advanced rectal cancer. METHODS AND MATERIALS: Between January 2014 and March 2015, 51 patients with operable stage II-III rectal adenocarcinoma received preoperative IMRT with pelvic dose of 41.8 Gy and simultaneously delivered 46...
August 31, 2016: International Journal of Radiation Oncology, Biology, Physics
Lin Xiao, Xin Yu, Wenjing Deng, Huixia Feng, Hui Chang, Weiwei Xiao, Huizhong Zhang, Shaoyan Xi, Mengzhong Liu, Yujia Zhu, Yuanhong Gao
We investigated the distribution of residual cancer cells (RCCs) within different layers of the bowel wall in surgical specimens and the value of biopsies of primary rectal lesion after preoperative volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients with rectal cancer. Between April 2011 and April 2013, 178 patients with rectal cancer who received preoperative VMAT, concurrent chemotherapy, and surgery were evaluated; 79 of the patients received a biopsy of the primary lesion after chemoradiotherapy and prior to surgery...
October 10, 2016: Scientific Reports
Leonardo S Lino-Silva, Rosa A Salcedo-Hernández, Erika B Ruiz-García, Leticia García-Pérez, Ángel Herrera-Gómez
BACKGROUND: Several studies have reported that an elevation in neutrophils/lymphocyte ratio (NLR) is correlated with poor survival in patients with colorectal cancer, but in rectal cancer (RC), it has been reported only in a few studies. It is necessary to separate colon cancer and rectal cancer to clarify the prognostic significance of NLR, especially in patients who received chemoradiotherapy. METHODS: It is a comparative, observational retrospective study of a cohort of 175 patients...
July 27, 2016: Medical Archives
A McBrearty, K McCallion, R J Moorehead, I McAllister, K Mulholland, R Gilliland, W J Campbell
BACKGROUND: In patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management.(1) The need for restaging afterwards has been questioned as it may be difficult to interpret imaging due to local tissue effects of chemoradiotherapy. The purpose of this study was to determine if restaging affected the management of patients receiving long-course chemoradiotherapy for rectal cancer. METHODS: A retrospective review of patients with rectal cancer discussed at the South Eastern Health and Social Care Trust Lower Gastrointestinal Multi-Disciplinary Team Meeting (LGIMDT) in 2013 who had received long-course chemoradiotherapy was performed...
September 2016: Ulster Medical Journal
Ryosuke Arata, Toshiyuki Itamoto, Satoshi Ikeda, Hideki Nakahara, Akihiko Oshita, Katsunori Shinozaki, Takashi Nishisaka
BACKGROUND: Systemic chemotherapy for stage IV colorectal cancer has advanced markedly in the recent years. We report an unusual case of 13 synchronous liver metastases for which a pathological complete response was achieved with neoadjuvant chemotherapy (NAC) consisting of a combination of 5-fluorouracil (5-FU), oxaliplatin, leucovorin (mFOLFOX6), and bevacizumab. CASE PRESENTATION: A 44-year-old man was diagnosed with colorectal cancer with synchronous liver metastases...
December 2016: Surgical Case Reports
L Dover, C Dulaney, A McDonald, R Jacob
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
A Roy, J R Olsen, R J Myerson, S Markovina, T A DeWees, P J Parikh
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
C Y J Hsu, C W Wang, C C Kuo, H K Liang, S F Lai, Y H Chen, S H Kuo
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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