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Rectal Cancer and complete response

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https://www.readbyqxmd.com/read/28089690/mri-evaluation-of-rectal-cancer-staging-and-restaging
#1
REVIEW
Courtney C Moreno, Patrick S Sullivan, Pardeep K Mittal
Magnetic resonance imaging (MRI) plays an important role in the staging and restaging of rectal cancer. Multiplanar high-resolution (≤3-mm section thickness) T2-weighted images are the primary sequences used for rectal cancer staging. No preprocedural bowel cleansing regimen, intravenous contrast material, nor endorectal coil is necessary. MRI is highly accurate for differentiating T1-T2 disease from T3 and T4 disease, an important distinction as patients with T3 and T4 tumors typically undergo preoperative neoadjuvant chemoradiation before resection...
November 21, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28078118/less-than-12-lymph-nodes-in-the-surgical-specimen-after-neoadjuvant-chemo-radiotherapy-an-indicator-of-tumor-regression-in-locally-advanced-rectal-cancer
#2
Jaiprakash Gurawalia, Kapil Dev, Sandeep P Nayak, Vishnu Kurpad, Arun Pandey
BACKGROUND: The number of lymph node retrieved in the surgical specimen is important for tumor staging and has paramount impact on prognosis in colorectal cancer and imitates the adequacy of lymph node surgical clearance. The paucity of lymph node yields in patients undergoing resection after preoperative chemo radiotherapy (CRT) in rectal cancer has seen. Lower total number of lymph nodes in the total mesoractal excision (TME) specimen after CRT, could a marker of better tumor response...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28060889/sequential-pet-ct-with-18f-fdg-predicts-pathological-tumor-response-to-preoperative-short-course-radiotherapy-with-delayed-surgery-in-patients-with-locally-advanced-rectal-cancer-using-logistic-regression-analysis
#3
Biagio Pecori, Secondo Lastoria, Corradina Caracò, Marco Celentani, Fabiana Tatangelo, Antonio Avallone, Daniela Rega, Giampaolo De Palma, Maria Mormile, Alfredo Budillon, Paolo Muto, Francesco Bianco, Luigi Aloj, Antonella Petrillo, Paolo Delrio
: Previous studies indicate that FDG PET/CT may predict pathological response in patients undergoing neoadjuvant chemo-radiotherapy for locally advanced rectal cancer (LARC). Aim of the current study is evaluate if pathological response can be similarly predicted in LARC patients after short course radiation therapy alone. METHODS: Thirty-three patients with cT2-3, N0-2, M0 rectal adenocarcinoma treated with hypo fractionated short course neoadjuvant RT (5x5 Gy) with delayed surgery (SCRTDS) were prospectively studied...
2017: PloS One
https://www.readbyqxmd.com/read/28059911/transanal-endoscopic-microsurgery-for-early-rectal-cancer-a-single-center-experience
#4
Conor H O'Neill, Joseph Platz, Jesse S Moore, Peter W Callas, Peter A Cataldo
BACKGROUND: There is debate regarding the appropriate use of transanal endoscopic microsurgery for rectal cancer. OBJECTIVE: This study analyzed our single-center experience with transanal endoscopic microsurgery for early rectal cancer. DESIGN: Medical charts of patients who underwent transanal endoscopic microsurgery were reviewed to determine lesion characteristics, as well as operative and treatment characteristics. Complications and recurrences were recorded...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28047611/su-f-r-48-early-prediction-of-pathological-response-of-locally-advanced-rectal-cancer-using-perfusion-ct-a-prospective-clinical-study
#5
K Nie, L Shi, N Yue, S Jabbour, S Kim, T Mao, L Qian, X Hu, X Sun, T Niu
PURPOSE: To prospectively evaluate the tumor vascularity assessed by perfusion CT for prediction of chemo-radiation treatment (CRT) response in locally advanced rectal cancer (LARC). METHODS: Eighteen consecutive patients (61.9±8.8 years, from March-June 2015) diagnosed with LARC who underwent 6-8 weeks CRT followed by surgery were included. The pre-treatment perfusion CT was acquired after a 5s delay of contrast agent injection for 45s with 1s interval. A total of 7-cm craniocaudal range covered the tumor region with 3-mm slice thickness...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042958/standardized-index-of-shape-dce-mri-and-standardized-uptake-value-pet-ct-two-quantitative-approaches-to-discriminate-chemo-radiotherapy-locally-advanced-rectal-cancer-responders-under-a-functional-profile
#6
Antonella Petrillo, Roberta Fusco, Mario Petrillo, Vincenza Granata, Paolo Delrio, Francesco Bianco, Biagio Pecori, Gerardo Botti, Fabiana Tatangelo, Corradina Caracò, Luigi Aloj, Antonio Avallone, Secondo Lastoria
PURPOSE: To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS: 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS)...
December 22, 2016: Oncotarget
https://www.readbyqxmd.com/read/28027515/organ-or-sphincter-preservation-for-rectal-cancer-the-role-of-contact-x-ray-brachytherapy-in-a-monocentric-series-of-112-patients
#7
Anne Claire Frin, Ludovic Evesque, Jocelyn Gal, Karène Benezery, Eric François, Jean Gugenheim, Emmanuel Benizri, Yan Château, Serge Marcié, Jérome Doyen, Jean-Pierre Gérard
BACKGROUND: Contact X-ray brachytherapy (CXB) has been used at Centre Antoine Lacassagne since 2002 to increase the chance of conservative treatment (organ or sphincter preservation) in rectal cancer. A consecutive series of 112 patients (pts) is reported. METHODS: Three protocols were used in selected rectal adenocarcinomas. Group 1: T1 N0 treated with local excision (LE) followed by adjuvant CXB. Group 2: T2 or 'early' T3 N0 treated with CXB combined with chemoradiotherapy (CRT) followed by surveillance or LE...
December 24, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/28008455/perfusion-ct-measurements-predict-tumor-response-in-rectal-carcinoma
#8
Aya Kino, Jenny Shaffer, Katherine E Maturen, Heiko Schmiedeskamp, Albert C Koong, Daniel T Chang, Dominik Fleischmann, Aya Kamaya
PURPOSE: To evaluate the capacity of perfusion CT imaging to distinguish between complete and incomplete responders after neoadjuvant chemoradiation therapy for rectal carcinoma, with particular attention to segmentation technique. MATERIALS AND METHODS: 17 patients were evaluated in this prospective IRB-approved study. For each patient, a perfusion CT acquisition was obtained prior to the initiation of chemoradiation, at 1-2 weeks after the start of chemoradiation, and at 12 weeks after the start of chemoradiation therapy...
December 23, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/28004138/investigation-of-volumetric-apparent-diffusion-coefficient-histogram-analysis-for-assessing-complete-response-and-clinical-outcomes-following-pre-operative-chemoradiation-treatment-for-rectal-carcinoma
#9
Vijay Chidambaram, James D Brierley, Bernard Cummings, Rajesh Bhayana, Ravi J Menezes, Erin D Kennedy, Richard Kirsch, Kartik S Jhaveri
PURPOSE: To investigate the relationship of pre-treatment volumetric apparent diffusion coefficient (ADC) histogram parameters with post-operative histopathologic treatment response and clinical outcomes following pre-operative chemoradiation treatment (CRT) in rectal cancer. MATERIALS AND METHODS: In a Health Insurance Portability and Accountability Act compliant retrospective study, 78 rectal cancer patients treated with pre-operative CRT and rectal MRI were included...
December 21, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/28002822/the-vegfr-inhibitor-cediranib-improves-the-efficacy-of-fractionated-radiotherapy-in-a-colorectal-cancer-xenograft-model
#10
Elodie Melsens, Bert Verberckmoes, Natacha Rosseel, Christian Vanhove, Benedicte Descamps, Piet Pattyn, Wim Ceelen
BACKGROUND/PURPOSE: Radiotherapy (RT) increases local tumor control in locally advanced rectal cancer, but complete histological response is seen in only a minority of cases. Antiangiogenic therapy has been proposed to improve RT efficacy by "normalizing" the tumor microvasculature. Here, we examined whether cediranib, a pan-vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor, improves microvascular function and tumor control in combination with RT in a mouse colorectal cancer (CRC) model...
December 22, 2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/27997526/organ-preservation-with-local-excision-or-active-surveillance-following-chemoradiotherapy-for-rectal-cancer
#11
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
January 17, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/27995323/mucosa-associated-lymphoid-tissue-malt-variant-of-primary-rectal-lymphoma-a-review-of-the-english-literature
#12
REVIEW
Scott R Kelley
PURPOSE: Primary rectal lymphoma (PRL) is the third most common cause of rectal cancer following adenocarcinoma (90-95 %) and carcinoid (5 %). The most common variant of PRL is the mucosa-associated lymphoid tissue (MALT) type. To date, no study has been able to recommend an optimal treatment algorithm for this rare disease. The aim of our study was to review the English literature on primary rectal MALT lymphoma. METHODS: A review of the English literature was conducted to identify articles describing the MALT variant of PRL...
December 19, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27981667/assessment-of-pathological-complete-response-to-preoperative-chemoradiotherapy-by-means-of-multiple-mathematical-models-of-diffusion-weighted-mri-in-locally-advanced-rectal-cancer-a-prospective-single-center-study
#13
Hai-Bin Zhu, Xiao-Yan Zhang, Xiao-Hong Zhou, Xiao-Ting Li, Yu-Liang Liu, Shuai Wang, Ying-Shi Sun
PURPOSE: To assess stretched-exponential, mono-exponential and intravoxel incoherent motion (IVIM) models of diffusion-weighted MRI(DWI) in predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) in rectal cancer patients. MATERIALS AND METHODS: This prospective study recruited 98 consecutive patients with locally advanced rectal cancer who underwent 3 Tesla MR examination before, during and after CRT. The apparent diffusion coefficient (ADC), IVIM-derived parameters (D, f, and D*), and stretched-exponential model-derived parameters (DDC and α) were measured...
December 16, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27978776/short-course-preoperative-radiotherapy-combined-with-chemotherapy-delayed-surgery-and-local-hyperthermia-for-rectal-cancer-a-phase-ii-study
#14
A O Rasulov, S S Gordeyev, Yu A Barsukov, S I Tkachev, A G Malikhov, S S Balyasnikova, M Yu Fedyanin
PURPOSE: The aim of this study was to investigate the feasibility of short-course radiotherapy with oral capecitabine, hyperthermia and delayed surgery for neoadjuvant treatment of rectal cancer. METHODS: Patients with clinically staged T2-3N0-2M0 primary rectal cancer were included. All patients received short-course 25 Gy in 5 Gy fractions radiotherapy with capecitabine, local hyperthermia and metronidazole. Capecitabine 1000 mg/m2 twice a day was given on days 1-14...
December 15, 2016: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/27974702/tumor-compactness-improves-the-preoperative-volumetry-based-prediction-of-the-pathological-complete-response-of-rectal-cancer-after-preoperative-concurrent-chemoradiotherapy
#15
Che-Yu Hsu, Chun-Wei Wang, Chia-Chun Kuo, Yu-Hsuan Chen, Keng-Hsueh Lan, Ann-Lii Cheng, Sung-Hsin Kuo
In addition to clinical factors (tumor and node stage) and treatment factors (equivalent radiotherapy dose and chemotherapy regimen), we assessed whether different performances of various tumor volume measurements help predict the pathological complete response (pCR) of locally advanced rectal cancer (LARC) after preoperative concurrent chemoradiotherapy (CCRT). A total of 122 patients with LARC treated with a long course of CCRT, between December 2009 and March 2015, were enrolled in this bi-institutional study...
December 10, 2016: Oncotarget
https://www.readbyqxmd.com/read/27959450/chemoradiotherapy-and-concurrent-radiofrequency-thermal-therapy-to-treat-primary-rectal-cancer-and-prediction-of-treatment-responses
#16
Hisanori Shoji, Masahiko Motegi, Yosuke Takakusagi, Takayuki Asao, Hiroyuki Kuwano, Takeo Takahashi, Kyoji Ogoshi
The present study aimed to evaluate a previously reported predictive formula of output-limiting symptoms induced by radiofrequency (RF) to determine the efficacy of this neoadjuvant chemoradiation (NACR) and concurrent RF thermal therapy. The present study included 81 consecutive patients with confirmed diagnoses of rectal adenocarcinoma that was localized in the mid-low rectum (up to 12 cm from the anal verge) who received NACR [intensity-modulated radiotherapy (IMRT), 50 Gy/25 fractions, capecitabine 1,700 mg/m2/day for 5 days/week)] with concurrent thermal therapy (Thermotron-RF8, once a week for 5 weeks with 50 min irradiation)...
February 2017: Oncology Reports
https://www.readbyqxmd.com/read/27939008/is-routine-use-of-adjuvant-chemotherapy-for-rectal-cancer-with-complete-pathological-response-justified
#17
Maysoon Gamaleldin, James M Church, Luca Stocchi, Mathew Kalady, David Liska, Emre Gorgun
BACKGROUND: Patients with locally advanced rectal cancer (LARC) receiving neoadjuvant chemoradiation (nCRT) can have a complete pathologic response (pCR), and are given postoperative adjuvant chemotherapy (ACT). METHODS: A prospectively maintained outcomes database was queried for patients who had pCR to nCRT for LARC from 2000 to 2012. Local recurrence and survival were analyzed according to whether patients received ACT. RESULTS: We identified 139 patients and excluded 9 due to lack of follow-up...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27935051/the-survival-impact-of-delayed-surgery-and-adjuvant-chemotherapy-on-stage-ii-iii-rectal-cancer-with-pathological-complete-response-after-neoadjuvant-chemoradiation
#18
Feng-Che Kuan, Chia-Hsuan Lai, Hsiu-Ying Ku, Chun-Feng Wu, Meng-Chiao Hsieh, Tsang-Wu Liu, Chien-Yuh Yeh, Kuan-Der Lee
Neoadjuvant concurrent chemoradiation (CCRT) is standard treatment for clinical stage II/III rectal cancers. However, whether patients with pathological complete response (pT0N0, pCR) should receive adjuvant chemotherapy and whether delayed surgery will influence the pCR rate remains controversial. A nationwide population study was conducted using the Taiwan Cancer Registry Database from January 2007 to December 2013. Kaplan-Meier survival analysis was performed. Cox proportional hazards models were used to estimate multivariate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI)...
December 9, 2016: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/27927012/nodal-tumor-response-according-to-the-count-of-peripheral-blood-lymphocyte-subpopulations-during-preoperative-chemoradiotherapy-in-locally-advanced-rectal-cancer
#19
Jaesung Heo, Young-Taek Oh, O Kyu Noh, Mison Chun, Jun-Eun Park, Sung-Ran Cho
PURPOSE: The objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer. MATERIALS AND METHODS: From August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy...
December 2016: Radiation Oncology Journal
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#20
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
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