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Rectal Cancer and complete response

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https://www.readbyqxmd.com/read/28324284/nonoperative-management-or-watch-and-wait-for-rectal-cancer-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy-a-critical-appraisal
#1
Tarik Sammour, Brandee A Price, Kate J Krause, George J Chang
BACKGROUND: There is increasing interest in nonoperative management (NOM) for rectal cancer with complete clinical response (cCR) after neoadjuvant chemoradiation (nCRT). OBJECTIVE: The aim of this systematic review was to summarize the available data on NOM, with the intention of formulating standardized protocols on which to base future investigations. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted...
March 21, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28314318/systemic-inflammatory-response-after-preoperative-chemoradiotherapy-can-affect-oncologic-outcomes-in-locally-advanced-rectal-cancer
#2
In Hee Lee, Soyoon Hwang, Soo Jung Lee, Byung Woog Kang, Dongwon Baek, Hye Jin Kim, Su Yeon Park, Jun Seok Park, Gyu Seog Choi, Jae Chul Kim, Seung Hyun Cho, Jong Gwang Kim
AIM: Systemic inflammatory response (SIR) has been reported to be an important determinant of disease progression and survival in patients with colorectal cancer. This study investigated the prognostic relevance of changes in the platelet count on survival and the predictive value of changes in platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) on the pathological tumor response to preoperative chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC)...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#3
Reena Engineer, Vikas Ostwal, Supreeta Arya, Priyamvada Gupta, Supriya Chopra, Prachi Patil, Sudhir Jatal, Avanish Saklani
AIM: A proportion of locally advanced rectal cancer patients who receive neoadjuvant chemoradiotherapy (NACRT) are still unresectable. This study was undertaken to assess the outcomes of giving additional chemotherapy to rectal cancer patients with unresectable disease after NACRT. METHODS: Patients with poor response to NACRT where mesorectal fascia was still involved on MRI and R0 resection was doubtful, received additional four cycles of chemotherapy with either CAPOX or FOLFIRINOX regimen, and the response was reevaluated with MRI and reassessed for surgical resection...
March 17, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28301974/folfox-and-intensified-split-course-chemoradiation-as-initial-treatment-for-rectal-cancer-with-synchronous-metastases
#4
T Bird, M Michael, M Bressel, J Chu, S Chander, P Cooray, J McKendrick, M Jefford, A Heriot, M Steel, T Leong, S Ngan
BACKGROUND: Optimal initial management of rectal carcinoma with synchronous metastases (RCSM) is controversial - both for patients being treated with curative and palliative intent. This study aims to evaluate the use of an upfront treatment strategy combining FOLFOX chemotherapy with split-course pelvic chemoradiation (FOLFOX + CRT) for patients with RCSM. MATERIAL AND METHODS: An analysis of all patients who commenced treatment with FOLFOX + CRT at our institutions between January 2009 and June 2014 was performed...
March 16, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28295220/total-neoadjuvant-therapy-for-rectal-cancer-an-emerging-option
#5
REVIEW
Ethan B Ludmir, Manisha Palta, Christopher G Willett, Brian G Czito
The treatment of locally advanced rectal cancer (LARC) has benefited from improved surgical techniques and from the implementation of neoadjuvant chemoradiotherapy (CRT), which have markedly decreased the rates of local recurrence. However, distant metastatic disease remains the most significant cause of death for these patients. Although adjuvant chemotherapy (ChT) after neoadjuvant CRT and definitive surgery is commonly recommended, the value of adjuvant systemic therapy remains less clear. Trials evaluating adjuvant ChT for rectal cancer have been handicapped by poor compliance rates and inconsistent survival results...
March 10, 2017: Cancer
https://www.readbyqxmd.com/read/28294676/-treatment-results-of-patients-with-rectum-tumor-in-a-city-hospital
#6
Zoltán Banai, Béla Lestár, Lajos Berczi, József Földi, Zsigmond Harkai, Tibor Karácsony
INTRODUCTION: Two hundred and three patients were operated on with rectal malignancy between 2007 and 2014 in our surgical department. METHODS: Of these, patients who had cancer within 16 cm of the anal verge were included. 73 patients received neoadjuvant treatment and 130 patients were treated with primary resection. The specimens were graded by the Dworak and the Rödel regression score system. RESULTS: We found strong response in 45 patients and pathologic complete remission in three patients...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28284574/comparison-of-5-fu-based-and-capecitabine-based-neoadjuvant-chemoradiotherapy-in-patients-with-rectal-cancer-a-meta-analysis
#7
Xiang-Cai Zou, Qiwen Wang, Jimin Zhang
INTRODUCTION: The inconvenience of using infusion therapies resulted in the development of capecitabine (CA), an oral fluoropyrimidine. In this meta-analysis, we evaluated 10 studies that compared the efficacy and safety of an oral CA-based regimen with those of a continuous infusion 5-fluorouracil (5-FU) regimen for neoadjuvant chemoradiotherapy in patients with rectal cancer. MATERIALS AND METHODS: The databases searched included Medline, Cochrane, EMBASE, and Google Scholar (until August 31, 2016)...
January 25, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28281215/neoadjuvant-treatment-for-locally-advanced-rectal-cancer-new-concepts-in-clinical-trial-design
#8
REVIEW
Nitesh Rana, A Bapsi Chakravarthy, Lisa A Kachnic
Treatment for locally advanced rectal cancer has evolved from surgery alone to surgery plus adjuvant therapy. Preoperative 5-fluorouracil- or capecitabine-based chemoradiation with standard fractionated radiation, surgery utilizing total mesorectal excision, and further chemotherapy has become the standard of care in the USA. Preoperative adjuvant chemoradiation treatment sequencing has allowed for decreased toxicity, more sphincter-sparing surgery, and improved local control rates as compared to delivering the chemoradiation postoperatively...
February 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28280607/pathologic-complete-response-and-disease-free-survival-are-not-surrogate-endpoints-for-5-year-survival-in-rectal-cancer-an-analysis-of-22-randomized-trials
#9
Fausto Petrelli, Karen Borgonovo, Mary Cabiddu, Mara Ghilardi, Veronica Lonati, Sandro Barni
BACKGROUND: We performed a literature-based analysis of randomized clinical trials to assess the pathologic complete response (pCR) (ypT0N0 after neoadjuvant therapy) and 3-year disease-free survival (DFS) as potential surrogate endpoints for 5-year overall survival (OS) in rectal cancer treated with neoadjuvant (chemo)radiotherapy (CT)RT. METHODS: A systematic literature search of PubMed, EMBASE, the Web of Science, SCOPUS, CINAHL, and the Cochrane Library was performed...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28277833/capecitabine-in-locally-advanced-anal-cancer-do-we-need-randomised-evidence
#10
Li Chia Chong, Tabitha Healey, Tony Michele, Timothy J Price
Standard treatment for locally advanced anal cancer is chemoradiotherapy with mitomycin C and fluorouracil. However, infusional fluorouracil requires central venous catheter placement potentiating risk of infection and thrombosis. Capecitabine which is an oral tumor activated fluoropyrimidine carbamate is an established treatment alternative to infusional fluorouracil for patients with gastrointestinal cancers. Areas covered: This review examines and discusses the current evidence for substitution of Capecitabine for infusional fluorouracil in locally advanced anal cancer...
March 13, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28272347/predictive-and-prognostic-molecular-biomarkers-for-response-to-neoadjuvant-chemoradiation-in-rectal-cancer
#11
REVIEW
Delphine Dayde, Ichidai Tanaka, Rekha Jain, Mei Chee Tai, Ayumu Taguchi
The standard of care in locally advanced rectal cancer is neoadjuvant chemoradiation (nCRT) followed by radical surgery. Response to nCRT varies among patients and pathological complete response is associated with better outcome. However, there is a lack of effective methods to select rectal cancer patients who would or would not have a benefit from nCRT. The utility of clinicopathological and radiological features are limited due to lack of adequate sensitivity and specificity. Molecular biomarkers have the potential to predict response to nCRT at an early time point, but none have currently reached the clinic...
March 7, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28267003/prediction-of-pathological-complete-response-using-endoscopic-findings-and-outcomes-of-patients-who-underwent-watchful-waiting-after-chemoradiotherapy-for-rectal-cancer
#12
Kazushige Kawai, Soichiro Ishihara, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Teppei Morikawa, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. OBJECTIVE: This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28266969/pathologic-complete-response-of-primary-tumor-following-preoperative-chemoradiotherapy-for-locally-advanced-rectal-cancer-long-term-outcomes-and-prognostic-significance-of-pathologic-nodal-status-krog-09-01
#13
https://www.readbyqxmd.com/read/28256956/on-a-prolonged-interval-between-rectal-cancer-chemo-radiotherapy-and-surgery
#14
Bengt Glimelius
Preoperative radiotherapy (RT) or chemoradiotherapy (CRT) is often required before rectal cancer surgery to obtain low local recurrence rates or, in locally advanced tumours, to radically remove the tumour. RT/CRT in tumours responding completely can allow an organ-preserving strategy. The time from the end of the RT/CRT to surgery or to the decision not to operate has been prolonged during recent years. After a brief review of the literature, the relevance of the time interval to surgery is discussed depending upon the indication for RT/CRT...
March 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28241904/participation-in-activities-associated-with-quality-of-life-for-long-term-survivors-of-rectal-cancer
#15
Carmit Mcmullen, Liyan Liu, Joanna E Bulkley, Mark C Hornbrook, Christopher Wendel, Marcia Grant, Andrea Altschuler, Larissa Kf Temple, Robert S Krouse, Lisa Herrinton
CONTEXT: Cancer patients' participation in social, recreational, and civic activities is strongly associated with quality of life (QOL), but these activities are not well integrated into cancer survivorship research or interventions. OBJECTIVE: Test the hypothesis that for long-term (≥ 5 years) survivors of rectal cancer, clinical factors (type of surgery and bowel function) are associated with long-term participation in activities and that participation in activities is associated with long-term QOL...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28214167/psychometric-evaluation-and-design-of-patient-centered-communication-measures-for-cancer-care-settings
#16
Bryce B Reeve, David M Thissen, Carla M Bann, Nicole Mack, Katherine Treiman, Hanna K Sanoff, Nancy Roach, Brooke E Magnus, Jason He, Laura K Wagner, Rebecca Moultrie, Kathryn D Jackson, Courtney Mann, Lauren A McCormack
OBJECTIVE: To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). METHODS: Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28203168/a-complete-response-case-in-a-patient-with-multiple-lung-metastases-of-rectal-cancer-treated-with-bevacizumab-plus-xeliri-therapy
#17
Hiroki Hashida, Hironaga Satake, Satoshi Kaihara
It has been reported that many patients with lung metastasis of colorectal cancer (CRC) underwent chemotherapy with fluorouracil, folinic acid, oxaliplatin, irinotecan, or capecitabine. There is a small number of reports about the capecitabine and irinotecan (XELIRI) plus bevacizumab (BV) therapy for patients with metastatic CRC in Japan. We report a case of successful BV+XELIRI therapy for rectal cancer with multiple lung metastases as first-line chemotherapy. A 53-year-old female presented with advanced rectal cancer and metastatic lung tumors...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28181384/resection-of-synchronous-liver-metastases-between-radiotherapy-and-definitive-surgery-for-locally-advanced-rectal-cancer-short-term-surgical-outcomes-overall-and-recurrence-free-survivals
#18
K J Labori, M G Guren, K W Brudvik, B I Røsok, A Waage, A Nesbakken, S Larsen, S Dueland, B Edwin, B A Bjørnbeth
AIM: There is debate as to the correct treatment algorithm sequence for patients with locally advanced rectal cancer with liver metastases. The aim of the study was to assess safety, resectability, and survival after a modified "liver-first" approach. METHOD: This was retrospective study of patients undergoing preoperative adjuvant radiotherapy for the primary rectal tumour, followed by liver resection and finally, resection of the primary tumour. Short-term surgical outcome, overall survival (OS) and recurrence-free survival (RFS) are reported...
February 9, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28177997/outcome-and-salvage-surgery-following-watch-and-wait-for-rectal-cancer-after-neoadjuvant-therapy-a-systematic-review
#19
REVIEW
Joseph C Kong, Glen R Guerra, Satish K Warrier, Robert G Ramsay, Alexander G Heriot
BACKGROUND: Currently there is no reliable test to predict pathological complete response following neoadjuvant chemoradiotherapy for rectal cancer. However, there is increasing interest in using clinical complete response as a surrogate marker, allowing a subset of patients with locally advanced rectal cancer to be allocated into a "watch and wait" pathway. Little is known about the oncological safety of the "watch and wait" approach or the rate of salvage surgery in cases of tumor regrowth...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28156480/effect-of-red-blood-cell-transfusions-on-patient-reported-outcomes-in-an-ambulatory-oncology-population
#20
Kimberly D Moeller, Lawrence David Wagman
78 Background: The standard transfusion (Tf) trigger in the hospitalized patient is hemoglobin (Hgb) level driven. Triggers in the ambulatory oncology population are often symptom based. The symptoms of exercise intolerance (EI), fatigue (F), and shortness of breath (SOB) were identified from a hospital quality review. The purpose of this study was to evaluate patient reported symptom (SX) changes following red blood cell (RBC) Tf. METHODS: Standardized Tf orders required symptom indication(s) which include EI, F, SOB and Other...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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