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Neoadjuvant rectal cancer

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https://www.readbyqxmd.com/read/28635312/predictors-of-adherence-to-aerobic-exercise-in-rectal-cancer-patients-during-and-after-neoadjuvant-chemoradiotherapy
#1
Andria R Morielli, Normand G Boulé, Nawaid Usmani, Kurian Joseph, Keith Tankel, Diane Severin, Kerry S Courneya
This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = -.62; P = ...
June 21, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28634627/influence-of-multiple-stapler-firings-used-for-rectal-division-on-colorectal-anastomotic-leak-rate
#2
Tamara Braunschmid, Nikolaus Hartig, Lukas Baumann, Bernhard Dauser, Friedrich Herbst
BACKGROUND: Anastomotic leakage following colorectal resection remains one of the most significant complications with relevant morbidity and mortality. There is evidence that a higher number of stapler firings for rectal division can affect the leak rate in double stapling anastomosis. However, there are no data concerning compression anastomosis. We present our institutional experience addressing this issue. DESIGN: This is a retrospective review of a prospective institutional database of patients undergoing colonic and rectal resection for benign and malignant indications between January 2008 and December 2014 at the surgical department of the St...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28633587/sarcomatoid-carcinoma-manifesting-as-recurrent-rectal-cancer-and-mimicking-radiation-induced-extraskeletal-osteosarcoma-a-case-report
#3
MiJo Lee, Hyun-Jin Son, Je-Ho Jang, Hyun-Young Han, Moon Hyang Park
Here, we report an unusual case of sarcomatoid carcinoma mimicking extraskeletal osteosarcoma that manifested as recurrent rectal cancer. Five years earlier, a 76-year-old male patient had undergone neoadjuvant chemoradiotherapy followed by a laparoscopic low anterior resection due to adenocarcinoma of the rectum. He was admitted because of pain in the anus and left hip. He underwent abdominal computed tomography that revealed a newly developed left perirectal mass with gluteus maximus invasion measuring up to 8 cm, and therefore, an abdominoperineal resection was performed...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28627602/molecular-profiling-of-locally-advanced-rectal-adenocarcinoma-using-microrna-expression-review
#4
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/28621181/-advantages-of-transanal-approach-in-low-rectal-cancer-resections
#5
Géza Papp, István Besznyák, Balázs Pörneczi, György Saftics, Attila Bursics
Laparoscopic surgery is proven equal technique to open rectal surgery. Despite advantages, some problems in case of low rectal surgery are existing: visualization of the pelvis, securing safe distal resection margin, preparing single stapled rectal stump with safe conjunction to the colorectal anastomosis. Approximately 500 procedures have been performed worldwide until today by applying Transanal Total Mesorectal Excision (TaTME) technique, which evolved from a combination of laparoscopy and transanal approach...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28620675/sphincter-preserving-surgery-for-low-rectal-cancers-incidence-and-risk-factors-for-permanent-stoma
#6
Joanna Chung Kiu Mak, Dominic Chi Chung Foo, Rockson Wei, Wai Lun Law
BACKGROUND: Advances in surgical techniques and paradigm changes in rectal cancer treatment have led to a drastic decline in the abdominoperineal resection rate, and sphincter-preserving operation is possible in distal rectal cancer. OBJECTIVE: The aim of this study is to evaluate the long-term incidence of permanent stoma after sphincter-preserving surgery for low rectal cancer and its corresponding risk factors. METHOD: From 2000 to 2014, patients who underwent sphincter-preserving low anterior resection for low rectal cancer (within 5 cm from the anal verge) were included...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28620444/clinical-utility-of-pretreatment-prediction-of-chemoradiotherapy-response-in-rectal-cancer-a-review
#7
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/28615639/population-based-study-of-effectiveness-of-neoadjuvant-radiotherapy-on-survival-in-us-rectal-cancer-patients-according-to-age
#8
Leilei Wu, Shichao Pang, Qianlan Yao, Chen Jian, Ping Lin, Fangyoumin Feng, Hong Li, Yixue Li
Recent cancer researches pay more attention to younger patients due to the variable treatment response among different age groups. Here we investigated the effectiveness of neoadjuvant radiation on the survival of younger and older patients in stage II/III rectal cancer. Data was obtained from Surveillance, Epidemiology, and End Results (SEER) database (n = 12801). Propensity score matching was used to balance baseline covariates according to the status of neoadjuvant radiation. Our results showed that neoadjuvant radiation had better survival benefit (Log-rank P = 3...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28607594/high-expression-of-aldolase-b-confers-a-poor-prognosis-for-rectal-cancer-patients-receiving-neoadjuvant-chemoradiotherapy
#9
Yu-Feng Tian, Pei-Ling Hsieh, Ching-Yih Lin, Ding-Ping Sun, Ming-Jen Sheu, Ching-Chieh Yang, Li-Ching Lin, Hong-Lin He, Julia Solórzano, Chien-Feng Li, I-Wei Chang
Background : Colorectal cancer is the third most common cancer in both sex worldwide and it is also the fourth most common cause of cancer mortality. For rectal cancer, neoadjuvant concurrent chemoradiotherapy (CCRT) followed by radical proctectomy is gold standard treatment for patients with stage II/III rectal cancer. By data mining a documented database of rectal cancer transcriptome (GSE35452) from Gene Expression Omnibus, National Center of Biotechnology Information, we recognized that ALDOB was the most significantly up-regulated transcript among those related to glycolysis (GO: 0006096)...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28603932/prognostic-significance-of-tumour-regression-grade-after-neoadjuvant-chemoradiotherapy-for-a-cohort-of-locally-advanced-rectal-cancer-patients-an-8-year-retrospective-single-institutional-study
#10
Lai Xu, Songhua Cai, Tixian Xiao, Yanyu Chen, Huizhong Qiu, Bin Wu, Guole Lin, Xiyu Sun, Junyang Lu, Weixun Zhou, Yi Xiao
AIM: Locally advanced rectal cancer (LARC) is frequently treated with neoadjuvant chemoradiotherapy (NACRT) to reduce the risk of local recurrence and improve survival. Tumour response to NACRT is variable and may influence the prognosis after subsequent surgery. This study compared the prognostic values of tumour regression grade (TRG) and neoadjuvant pathologic (ypTNM) downstaging in stage II and III rectal cancer patients treated with NACRT followed by curative surgery. METHOD: This study included 185 LARC patients treated with long-course radiotherapy (45 Gy in 25 fractions) plus 5-fluorouracil over 5 weeks between 2005 and 2013...
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28602545/what-is-the-impact-of-neoadjuvant-chemoradiation-on-outcomes-in-gastro-intestinal-cancer
#11
C Mariette, A Brouquet, D Tzanis, A Laurenzi, A de la Rochefordière, P Mariani, G Piessen, A Sa Cunha, C Penna
Multimodal therapeutic strategies combining chemotherapy, radiation therapy and surgery have been shown to be feasible and to have a positive impact on outcomes by decreasing the risk of locoregional recurrence and often by increasing overall survival. The advantages of neoadjuvant chemo(radio)therapy include optimal tumor control combined with better tolerance and compliance to treatment while also increasing the number of candidates for surgery. Whereas indications for neoadjuvant therapy are increasing, its impact on surgical treatment and postoperative outcomes are not well-known...
June 8, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28601342/organ-preservation-for-rectal-cancer-greccar-2-a-prospective-randomised-open-label-multicentre-phase-3-trial
#12
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/28595169/the-addition-of-target-therapy-to-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer-a-review
#13
Ilaria Benevento, Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Currently, neoadjuvant fluoropyrimidine-based chemoradiotherapy (CRT) is standard practice in the management of locally advanced rectal cancer (LARC). In the last decade there has been a lively interest in the improvement of clinical outcomes by modifying this standard regimen by the addition of further agents. We review combinations of targeted therapies and conventional CRT currently under investigation in LARC patients.
June 9, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28594720/clinical-relevance-of-a-grading-system-for-anastomotic-leakage-after-low-anterior-resection-analysis-from-a-national-cohort-database
#14
Martine A Frouws, Heleen S Snijders, Steve H Malm, Gerrit-Jan Liefers, Cornelis J H Van de Velde, Peter A Neijenhuis, Hidde M Kroon
BACKGROUND: Anastomotic leakage is a severe complication after low anterior resection for rectal cancer. With a global increase in registration initiatives, adapting uniform definitions and grading systems is highly relevant. OBJECTIVE: This study aimed to provide clinical parameters to categorize anastomotic leakage into subcategories according to the International Study Group of Rectal Cancer. DESIGN: All of the patients who underwent a low anterior resection in the Netherlands with primary anastomosis were included using the population-based Dutch Surgical Colorectal Audit...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28594719/bowel-dysfunction-after-low-anterior-resection-with-neoadjuvant-chemoradiotherapy-or-chemotherapy-alone-for-rectal-cancer-a-cross-sectional-study-from-china
#15
Qiyuan Qin, Binjie Huang, Wuteng Cao, Jie Zhou, Tenghui Ma, Zhiyang Zhou, Jianping Wang, Lei Wang
BACKGROUND: Neoadjuvant therapy plays a vital role in the treatment of locally advanced rectal cancer but impairs bowel function after restorative surgery. Optimal decision making requires adequate information of functional outcomes. OBJECTIVE: This study aimed to assess postoperative bowel function and to identify predictors for severe dysfunction. DESIGN: The study included a cross-sectional cohort and retrospective assessments of pelvic anatomic features...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28586509/association-between-neoadjuvant-chemoradiation-and-survival-for-patients-with-locally-advanced-rectal-cancer
#16
Zhifei Sun, Mohamed A Adam, Jina Kim, Megan C Turner, Deborah A Fisher, Kingshuk Roy Choudhury, Brian G Czito, John Migaly, Christopher R Mantyh
AIM: To examine the overall survival differences of neoadjuvant therapy modalities: no therapy, chemotherapy alone, radiation alone, and chemoradiation in a large cohort of patients with locally advanced rectal cancer. METHOD: Adults with clinical stage II and III rectal adenocarcinoma were selected from the National Cancer Database and grouped by type of neoadjuvant therapies received: no therapy, chemotherapy only, radiotherapy only, or chemoradiation. Multivariable regression methods were used to compare adjusted differences in perioperative outcomes and overall survival...
June 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28583894/local-recurrence-after-five-years-is-associated-with-preoperative-chemoradiotherapy-treatment-in-patients-diagnosed-with-stage-ii-and-iii-rectal-cancer
#17
Gabriel Marin, Javier Suárez, Ruth Vera, Enrique Balén, Antonio Viudez, Elena Mata
AIM: To asses the moment of local recurrence and its influence on the appraisal of the results of neoadjuvant chemoradiotherapy (CRT). METHODS: We evaluated 317 patients with a preoperative diagnosis of stage II or III rectal cancer who underwent rectal resection. Gender, age, neoadjuvant treatment, circumferencial resection margin, adjuvant treatment, pretreatment carcinoembryonic antigen level, tumor location, TNM stage, lymph node retrieval, abdominoperineal resection, and lymphatic or vascular infiltration were registered prospectively...
June 3, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28583790/transanal-endoscopic-microsurgery-after-neoadjuvant-radiochemotherapy-for-locally-advanced-extraperitoneal-rectal-cancer
#18
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/28583651/dual-energy-ct-can-detect-malignant-lymph-nodes-in-rectal-cancer
#19
I Al-Najami, M J Lahaye, R G H Beets-Tan, G Baatrup
BACKGROUND: There is a need for an accurate and operator independent method to assess the lymph node status to provide the most optimal personalized treatment for rectal cancer patients. This study evaluates whether Dual Energy Computed Tomography (DECT) could contribute to the preoperative lymph node assessment, and compared it to Magnetic Resonance Imaging (MRI). The objective of this prospective observational feasibility study was to determine the clinical value of the DECT for the detection of metastases in the pelvic lymph nodes of rectal cancer patients and compare the findings to MRI and histopathology...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28581407/continuous-effect-of-radial-resection-margin-on-recurrence-and-survival-in-rectal-cancer-patients-who-receive-preoperative-chemoradiation-and-curative-surgery-a-multicenter-retrospective-analysis
#20
SooYoon Sung, Sung Hwan Kim, Joo Hwan Lee, Taek Keun Nam, Songmi Jeong, Hong Seok Jang, Jin Ho Song, Jeong Won Lee, Jung Min Bae, Jong Hoon Lee
PURPOSE: To elucidate the proper length and prognostic value of resection margins in rectal cancer patients who received preoperative chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME). METHODS AND MATERIALS: A total of 1476 rectal cancer patients staging cT3-4N0-2M0 were analyzed. All patients received radiation dose of 50.4 Gy in 28 fractions with concurrent 5-fluorouracil or capecitabine. Total mesorectal excision was performed 4 to 8 weeks after radiation therapy...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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