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Rectal Cancer and complete response

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https://www.readbyqxmd.com/read/28627602/molecular-profiling-of-locally-advanced-rectal-adenocarcinoma-using-microrna-expression-review
#1
Cory Pettit, Steve Walston, Patrick Wald, Amy Webb, Terence M Williams
Treatment for locally-advanced rectal cancer (LARC) typically consists of neoadjuvant chemoradiation followed by total mesorectal excision. Recently, there has been growing interest in non-operative management for patients who are medically-inoperable or wish to avoid surgical morbidity and permanent colostomy. Approximately 50% of patients who receive pre-operative neoadjuvant chemoradiation develop some degree of pathologic response. Approximately 10-20% of patients are found to have a complete pathologic response, a finding which has frequently been shown to predict better clinical outcomes, including local-regional control, distant metastasis and survival...
June 14, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28621318/natural-killer-like-signature-observed-post-therapy-in-locally-advanced-rectal-cancer-is-a-determinant-of-pathological-response-and-improved-survival
#2
Matthew Alderdice, Philip D Dunne, Aidan J Cole, Paul G O'Reilly, Darragh G McArt, Vicky Bingham, Marc-Aurel Fuchs, Stephen McQuaid, Maurice B Loughrey, Graeme I Murray, Leslie M Samuel, Mark Lawler, Richard H Wilson, Manuel Salto-Tellez, Vicky M Coyle
Around 12-15% of patients with locally advanced rectal cancer undergo a pathologically complete response (tumor regression grade 4) to long-course preoperative chemoradiotherapy; the remainder exhibit a spectrum of tumor regression (tumor regression grade 1-3). Understanding therapy-related transcriptional alterations may enable better prediction of response as measured by progression-free and overall survival, in addition to aiding the development of improved strategies based on the underlying biology of the disease...
June 16, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28620444/clinical-utility-of-pretreatment-prediction-of-chemoradiotherapy-response-in-rectal-cancer-a-review
#3
REVIEW
Byong Chul Yoo, Seung-Gu Yeo
Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organ-sparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations...
March 2017: EPMA Journal
https://www.readbyqxmd.com/read/28601342/organ-preservation-for-rectal-cancer-greccar-2-a-prospective-randomised-open-label-multicentre-phase-3-trial
#4
Eric Rullier, Philippe Rouanet, Jean-Jacques Tuech, Alain Valverde, Bernard Lelong, Michel Rivoire, Jean-Luc Faucheron, Mehrdad Jafari, Guillaume Portier, Bernard Meunier, Igor Sileznieff, Michel Prudhomme, Frédéric Marchal, Marc Pocard, Denis Pezet, Anne Rullier, Véronique Vendrely, Quentin Denost, Julien Asselineau, Adélaïde Doussau
BACKGROUND: Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. METHODS: We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28594714/tailored-treatment-strategy-for-locally-advanced-rectal-carcinoma-based-on-the-tumor-response-to-induction-chemotherapy-preliminary-results-of-the-french-phase-ii-multicenter-greccar4-trial
#5
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stéphanie Nougaret
BACKGROUND: Preoperative radiochemotherapy and total mesorectal excision are the standard-of-care for locally advanced rectal carcinoma, but some patients could be over- or undertreated. OBJECTIVE: This study aimed to assess the feasibility of radiochemotherapy tailored based on the tumor response to induction chemotherapy (FOLFIRINOX) to obtain a minimum R0 resection rate of 90% in the 4 arms of the study. DESIGN: This study is a multicenter randomized trial (NCT01333709)...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28583790/transanal-endoscopic-microsurgery-after-neoadjuvant-radiochemotherapy-for-locally-advanced-extraperitoneal-rectal-cancer
#6
G Rizzo, G Zaccone, M Magnocavallo, C Mattana, D P Pafundi, M A Gambacorta, V Valentini, C Coco
PURPOSE: The aim of this study is to provide a prospective analysis of post-operative and oncological outcomes in patients affected by locally advanced rectal cancer (LARC), who obtained a major/complete clinical response after pre-operative radio-chemotherapy (RCT) and were treated with local excision (LE) by trans-anal endoscopic microsurgery (TEM) to confirm a pathological complete response (pCR) after to neo-adjuvant RCT. METHODS: All patients with LARC treated by pre-operative RCT and full-thickness LE by TEM (2000-2014) were included in the study...
May 25, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28583726/results-of-short-term-radiotherapy-followed-by-radical-surgery-for-rectal-cancer-a-long-term-unicenter-observational-study
#7
Yolanda Saralegui, José M Enríquez-Navascués, Juan Pablo Ciria, Mikel Osorio, Adelaida Lacasta, Garazi Elorza, Maddi Garmendia, Carlos Placer
INTRODUCTION: Short-term radiotherapy (STR) for rectal cancer (RC) has rarely been used in Spain. The aim of the present study is to describe oncological results after RTC and surgery for RC. METHODS: This is a retrospective analysis of a consecutive series of patients treated with STR and surgery for RC (1999-2012). Epidemiological data, staging, complications of STR, STR-surgery interval, surgical approach, rate of anastomotic/perineal wound dehiscence, and pathological data (regression degree and staging) were collected...
May 2017: Cirugía Española
https://www.readbyqxmd.com/read/28576182/evolving-role-of-radiotherapy-in-the-management-of-rectal-carcinoma
#8
REVIEW
Clayton A Smith, Lisa A Kachnic
Management of locally advanced rectal cancer has evolved over time from surgical resection alone to multimodality therapy with preoperative radiation, chemotherapy, and total mesorectal excision resulting in excellent local control rates. Refinements in neoadjuvant therapies and their sequencing have improved pathologic complete response rates such that consideration of selective radiation and nonoperative management are now active clinical trial questions. Advances in radiation treatment planning and delivery techniques may allow for further reduction in acute treatment-related toxicity in select patient populations...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28571778/long-term-outcomes-in-ypt0-rectal-cancers-an-international-multi-centric-investigation-on-behalf-of-italian-society-of-surgical-oncology-young-board-ysico
#9
L Lorenzon, D Parini, D Rega, A Mellano, V Vigorita, A Biondi, R Jaminez-Rosellon, M Scheiterle, I Giannini, G Gallo, G Marino, L Turati, P Marsanic, L De Franco, L Marano, R De Luca
AIM: To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. METHODS: Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes...
May 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28567185/extramural-vascular-invasion-and-response-to-neoadjuvant-chemoradiotherapy-in-rectal-cancer-influence-of-the-cpg-island-methylator-phenotype
#10
Jeremy Stuart Williamson, Huw Geraint Jones, Namor Williams, Anthony Paul Griffiths, Gareth Jenkins, John Beynon, Dean Anthony Harris
AIM: To identify whether CpG island methylator phenotype (CIMP) is predictive of response to neoadjuvant chemoradiotherapy (NACRT) and outcomes in rectal cancer. METHODS: Patients undergoing NACRT and surgical resection for rectal cancer in a tertiary referral centre between 2002-2011 were identified. Pre-treatment tumour biopsies were analysed for CIMP status (high, intermediate or low) using methylation specific PCR. KRAS and BRAF status were also determined using pyrosequencing analysis...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28566093/efficacy-and-short-term-outcomes-of-preoperative-chemoradiotherapy-with-intermittent-oral-tegafur-uracil-plus-leucovorin-in-japanese-rectal-cancer-patients-a-single-center-experience-retrospective-analysis
#11
Ryosuke Nakagawa, Yuji Inoue, Takeshi Ohki, Yuka Kaneko, Fumi Maeda, Masakazu Yamamoto
BACKGROUND: Various types of preoperative chemoradiotherapy (CRT) have been established for rectal cancer; thus, Physicians will need to refine the selection of appropriate preoperative CRT for different patients since there are various treatment regimens. Oral tegafur-uracil (UFT) plus leucovorin (LV) is commonly used to treat rectal cancer in Japan. Oral chemotherapy offers patients many potential advantages. Since 2008, we have been performing preoperative CRT with intermittent oral UFT plus LV in locally advanced rectal cancer patients to prevent postoperative local recurrence...
May 31, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28551665/the-role-of-concomitant-radiation-boost-in-neoadjuvant-chemoradiotherapy-for-locally-advanced-rectal-cancer
#12
Harun Badakhshi, Mahmoud Ismail, Christos Boskos, Kuaile Zhao, David Kaul
BACKGROUND/AIM: This study analyzed the impact of concomitant boost on long-term clinical outcomes in locally advanced rectal cancer. PATIENTS AND METHODS: A total of 141 patients (median age=61 years) were treated with neoadjuvant chemoradiotherapy. Median total dose was 50.4 Gy. Forty-three patients received a concomitant boost. Concurrent chemotherapy consisted of 5-fluorouracil (5-FU), given as a 24-h continuous infusion. Mean follow-up was 83.7 months. RESULTS: The 3, 5-, and 10-year overall survival (OS) rates were 91...
June 2017: Anticancer Research
https://www.readbyqxmd.com/read/28534328/-predictive-value-of-serum-carcinoembryonic-antigen-level-in-efficacy-and-prognosis-for-patients-with-rectal-cancer-following-preoperative-radiochemotherapy
#13
Dakui Zhang, Tiancheng Zhan, Ming Li, Jin Gu
OBJECTIVE: To examine the association of preoperative carcinoembryonic antigen (CEA) level with the efficacy of neoadjuvant radiochemotherapy and postoperative metastasis and relapse in patients with rectal cancer. METHODS: Between January 2011 and January 2014, 325 patients with local advanced rectal cancer underwent preoperative radiochemotherapy and radical operation in Department of Colorectal Cancer Surgery, Beijing University Cancer Hospital, including 194 males and 131 females...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534322/-value-of-functional-magnetic-resonance-imaging-in-predicting-outcomes-of-neoadjuvant-chemoradiotherapy-in-rectal-cancer
#14
Yishan Yu, Jinbo Yue, Jinming Yu
Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534080/pathologic-complete-response-rates-after-neoadjuvant-treatment-in-rectal-cancer-an-analysis-of-the-national-cancer-database
#15
Patrick D Lorimer, Benjamin M Motz, Russell C Kirks, Danielle M Boselli, Kendall K Walsh, Roshan S Prabhu, Joshua S Hill, Jonathan C Salo
BACKGROUND: Pathologic complete response (pCR) of rectal cancer following neoadjuvant therapy is associated with decreased local recurrence and increased overall survival. This study utilizes a national dataset to identify predictors of pCR in patients with rectal cancer. METHODS: The National Cancer Database was queried for patients with nonmetastatic rectal cancer (2004-2014) who underwent neoadjuvant therapy and surgical resection. Unadjusted associations were assessed using rank-sum tests and χ (2) tests where appropriate...
May 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28524777/can-a-longer-waiting-period-after-neoadjuvant-chemoradiotherapy-improve-the-pathologic-complete-response-rate-in-patients-with-rectal-cancer
#16
Jun Li, Jian Li
No abstract text is available yet for this article.
May 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28514763/the-value-of-diffusion-kurtosis-imaging-in-assessing-pathological-complete-response-to-neoadjuvant-chemoradiation-therapy-in-rectal-cancer-a-comparison-with-conventional-diffusion-weighted-imaging
#17
Feixiang Hu, Wei Tang, Yiqun Sun, Dang Wan, Sanjun Cai, Zhen Zhang, Robert Grimm, Xu Yan, Caixia Fu, Tong Tong, Weijun Peng
OBJECTIVES: The aim of this study is to comprehensively evaluate the advantage of diffusion kurtosis imaging (DKI) in distinguishing pathological complete response (pCR) from non-pCR patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiation therapy (CRT) in comparison to conventional diffusion-weighted imaging (DWI). MATERIAL AND METHODS: Fifty-six consecutive patients diagnosed with LARC were prospectively enrolled and underwent pre- and post-CRT MRI on a 3...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28503826/prospective-randomised-trial-of-neoadjuvant-chemotherapy-during-the-wait-period-following-pre-operative-chemoradiotherapy-for-rectal-cancer-results-of-the-wait-trial
#18
James Moore, Tim Price, Scott Carruthers, Sudarsha Selva-Nayagam, Andrew Luck, Michelle Thomas, Peter Hewett
AIMS: To determine whether the addition of additional cycles of chemotherapy during the "wait "period following neoadjuvant chemo-radiotherapy for rectal cancer improves the pathologic complete response rate (pCR). METHODS: Rectal cancer patients were randomly allocated to either a standard 10 week wait period before surgery (standard chemo-radiotherapy, SCRT) or to receive 3 cycles of 5FU based chemotherapy following chemo-radiotherapy during a similar 10 week wait (extended chemo-radiotherapy, XCRT)...
May 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28503516/transanal-minimally-invasive-surgery-for-treating-patients-with-regressed-rectal-cancer-after-preoperative-chemoradiotherapy
#19
Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
PURPOSE: Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT. METHODS: From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS...
April 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28497757/safety-and-tolerability-of-veliparib-combined-with-capecitabine-plus-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-a-phase-1b-study
#20
Brian G Czito, Dustin A Deming, Gayle S Jameson, Mary F Mulcahy, Houman Vaghefi, Matthew W Dudley, Kyle D Holen, Angela DeLuca, Rajendar K Mittapalli, Wijith Munasinghe, Lei He, John R Zalcberg, Samuel Y Ngan, Philip Komarnitsky, Michael Michael
BACKGROUND: Further optimisation of present standard chemoradiation is needed in patients with locally advanced rectal cancer. Veliparib, an oral poly(ADP-ribose) polymerase inhibitor, has been shown to enhance the antitumour activity of chemotherapy and radiotherapy in preclinical models. We aimed to establish the maximum tolerated dose and establish the recommended phase 2 dose of veliparib combined with neoadjuvant capecitabine and radiotherapy. METHODS: This phase 1b, open-label, multicentre, dose-escalation study was done at six hospitals (one in Australia and five in the USA)...
June 2017: Lancet. Gastroenterology & Hepatology
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