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Neoadjuvant rectal cancer

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https://www.readbyqxmd.com/read/28338156/-pay-attention-to-the-selective-lateral-pelvic-lymph-node-dissection-in-mid-low-rectal-cancer
#1
Wenjian Meng, Ziqiang Wang
Lateral pelvic lymph node metastasis is an important metastatic mode and a major cause of locoregional recurrence of mid-low rectal cancer. Recently, there is an East-West discrepancy in regard to the diagnosis, clinical significance, treatment and prognosis of lateral pelvic lymph node metastasis. In the West, lateral nodal involvement may represent systemic disease and preoperative chemoradiotherapy can sterilize clinically suspected lateral nodes. Thus, in many Western countries, the standard therapy for lower rectal cancer is total mesorectal excision with chemoradiotherapy, and pelvic sidewall dissection is rarely performed...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28334436/impact-of-neoadjuvant-chemoradiation-on-perioperative-outcomes-in-patients-with-rectal-cancer
#2
Brandon C Chapman, Patrick Hosokawa, William Henderson, Alessandro Paniccia, Douglas M Overbey, Wells Messersmith, Christopher Lieu, Greg V Stiegmann, Richard D Schulick, Csaba Gajdos
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation for rectal cancer is associated with lower local recurrence rates. The objective of this study is to assess the impact of neoadjuvant therapy on perioperative complications in patients with rectal cancer. METHODS: Using the ACS-NSQIP database (2005-2012), a propensity score was used to match 3592 patients with rectal cancer receiving neoadjuvant therapy to 3592 patients undergoing surgery alone. The association between neoadjuvant chemoradiation and perioperative outcomes was evaluated...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28333014/single-nucleotide-polymorphism-tgf%C3%AE-1-r25p-correlates-with-acute-toxicity-during-neoadjuvant-chemoradiotherapy-in-rectal-cancer-patients
#3
J Joshua Smith, Isaac Wasserman, Sarah A Milgrom, Oliver S Chow, Chin-Tung Chen, Sujata Patil, Karyn A Goodman, Julio Garcia-Aguilar
PURPOSE: To validate the finding of an association between single nucleotide polymorphisms (SNPs) and toxicity during chemoradiotherapy (CRT) in rectal cancer patients, in an independent population. METHODS AND MATERIALS: The cohort consisted of 165 patients who received CRT for rectal cancer from 2006 to 2012. Prospectively recorded toxicity information, graded according to the Common Terminology Criteria for Adverse Events version 3.0, was retrieved from the medical record...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28327898/adherence-to-capecitabine-in-preoperative-treatment-of-stage-ii-and-iii-rectal-cancer-do-we-need-to-worry
#4
R Font, J A Espinas, L Layos, M Martinez Villacampa, J Capdevila, M Tobeña, A Pisa, C Pericay, C Lezcano, E Fort, I Cardona, N Berga, J Solà, J M Borras
Background: : Preoperative oral capecitabine plus radiotherapy has been progressively adopted in oncology units to provide more convenient care to patients with rectal cancer, but little is known about adherence to this therapy. Patients and methods: : Prospective, multicentre observational study in six hospitals in metropolitan Barcelona (Spain), in patients with stage II and III rectal cancer. Assessment of adherence was based on the medical report in the clinical history, a patient questionnaire and a pill count in the pharmacy service upon finalization of treatment...
March 6, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28326100/immunohistochemical-markers-as-predictors-of-histopathologic-response-and-prognosis-in-rectal-cancer-treated-with-preoperative-adjuvant-therapy-state-of-the-art
#5
REVIEW
Alessandro Del Gobbo, Stefano Ferrero
We explain the state of the art of the immunohistochemical markers of response in rectal cancers treated with neoadjuvant medical therapies and its implication with prognosis. Neoadjuvant chemoradiotherapy is widely used to improve the outcome of patients with locally advanced rectal cancer, and the evaluation of the effects of medical therapy is to date based on histomorphological examination by applying four grading systems of response to therapy (tumor regression grade (TRG)). The need to identify immunohistochemical markers that could ensure a better assessment of response and possibly provide additional prognostic information has emerged...
2017: Gastroenterology Research and Practice
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
#6
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/28316153/-assessment-of-predictive-factors-for-survival-in-patients-with-locally-advanced-rectal-cancer-after-neoadjuvant-chemoradiotherapy
#7
G J Wu, T Yu, W W Jia, Q An, G Xiao, X Wang
Objective: To evaluate the clinical predictive factors for survival prognosis in patients with locally advanced rectal cancer after neoadjuvant chemoradiotheraphy. Methods: The study included 87 patients with middle and lower locally advanced rectal cancer, who underwent neoadjuvant chemoradiotheraphy followed by radical surgery between April 2007 and May 2015. The clinical factors associated with 3-year disease-free survival (DFS) and overall survival (OS) were analyzed.Kaplan-Meier analysis of disease-free survival and overall survival was performed for all patients...
March 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#8
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/28304143/anal-function-after-endoluminal-loco-regional-resection-by-transanal-endoscopic-microsurgery-and-radiotherapy-for-rectal-cancer
#9
Ivano Biviano, Andrea Balla, Danilo Badiali, Silvia Quaresima, Giancarlo D'Ambrosio, Emanuele Lezoche, Enrico Corazziari, Alessandro M Paganini
AIM: In patients with rectal cancer, surgery and chemo-radiotherapy may affect the anal sphincter function. Few studies evaluated the ano-rectal function after neoadjuvant chemo-radiotherapy (n-CRT) and/or Transanal Endoscopic Microsurgery (TEM). The aim of this study was to evaluate the effects of n-CRT and TEM on ano-rectal function. METHOD: Thirty-seven patients with rectal cancer underwent ano-rectal manometry and Wexner score for faecal incontinence at baseline, after n-CRT (cT2-T3N0 cancer) and at 4 and 12 months after surgery...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28295220/total-neoadjuvant-therapy-for-rectal-cancer-an-emerging-option
#10
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
#11
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/28293088/do-pathological-variables-have-prognostic-significance-in-rectal-adenocarcinoma-treated-with-neoadjuvant-chemoradiotherapy-and-surgery
#12
Luca Reggiani Bonetti, Simona Lionti, Federica Domati, Valeria Barresi
AIM: To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and surgery. METHODS: Tumor regression grade (TRG) according to the Dworak system and yTNM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced (cTNM stage II and III) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival (DFS) and cancer specific survival (CSS) was analyzed by Kaplan Meier and Cox-regression analyses...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28291773/comprehensive-molecular-exploration-identified-promoter-dna-methylation-of-the-crbp1-gene-as-a-determinant-of-radiation-sensitivity-in-rectal-cancer
#13
K Yokoi, K Yamashita, S Ishii, T Tanaka, N Nishizawa, A Tsutsui, H Miura, H Katoh, T Yamanashi, M Naito, T Sato, T Nakamura, M Watanabe
BACKGROUND: Neoadjuvant chemoradiotherapy (NCRT) for advanced rectal cancer (RC) is a well-evidenced therapy; however, some RC patients have no therapeutic response. Patient selection for NCRT so that non-responsive patients are excluded has been subjective. To date, no molecular markers indicating radiation sensitivity have been reported. METHODS: We irradiated six colorectal cancer (CRC) cell lines and identified HCT116 cells as radiation-sensitive and HCT15 and DLD-1 cells as radiation resistant...
March 14, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28284574/comparison-of-5-fu-based-and-capecitabine-based-neoadjuvant-chemoradiotherapy-in-patients-with-rectal-cancer-a-meta-analysis
#14
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
#15
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/28280623/rectal-cancer-restaging-after-neoadjuvant-chemoradiation-towards-a-down-staging-score-system
#16
Antonio Manenti, Luca Roncati, Massimiliano Salati, Emilio Simonini, Maurizio Zizzo, Alberto Farinetti
No abstract text is available yet for this article.
February 2017: Journal of Gastrointestinal 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
#17
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/28273303/association-between-incomplete-neoadjuvant-radiotherapy-and-survival-for-patients-with-locally-advanced-rectal-cancer
#18
Kyle Freischlag, Zhifei Sun, Mohamed A Adam, Jina Kim, Manisha Palta, Brian G Czito, John Migaly, Christopher R Mantyh
Importance: Failing to complete chemotherapy adversely affects survival in patients with colorectal cancer. However, the effect of incomplete delivery of neoadjuvant radiotherapy is unclear. Objective: To determine whether incomplete radiotherapy delivery is associated with worse clinical outcomes and survival. Design, Setting, and Participants: Data on 17 600 patients with stage II to III rectal adenocarcinoma from the 2006-2012 National Cancer Database who received neoadjuvant chemoradiotherapy followed by surgical resection were included...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28272347/predictive-and-prognostic-molecular-biomarkers-for-response-to-neoadjuvant-chemoradiation-in-rectal-cancer
#19
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/28270729/pre-and-post-surgery-treatments-in-rectal-cancer-a-long-term-single-centre-experience
#20
H Ozyurt, A S Ozden, Z Ozgen, C Gemici, G Yaprak
BACKGROUND: Our study evaluated long-term survival outcomes in rectal cancer patients treated with preoperative radiotherapy, and the impact on survival of concomitant and postoperative adjuvant chemotherapy (ctx), among other prognostic factors. METHODS: The study included 196 patients [median age: 58 years (range: 20-86 years); 63.0% men] with locally advanced rectal carcinoma and, in some cases, resectable liver metastasis. Rates of distant metastasis and local recurrence and of 5-year distant metastasis-free survival (dmfs) and overall survival (os) were determined...
February 2017: Current Oncology
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