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III stage rectal cancer

Xin Yu, Qiao-Xuan Wang, Wei-Wei Xiao, Hui Chang, Zhi-Fan Zeng, Zhen-Hai Lu, Xiao-Jun Wu, Gong Chen, Zhi-Zhong Pan, De-Sen Wan, Pei-Rong Ding, Yuan-Hong Gao
BACKGROUND: Neoadjuvant chemoradiotherapy followed by surgery is recommended as the standard of care for locally advanced rectal cancer, reducing local recurrence but not distant metastasis. Intensified systemic therapy is warranted to reduce the risk of distant metastasis. The present study aimed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine (XELOX) combined with bevacizumab plus radiotherapy for locally advanced rectal cancer. METHODS: Patients with stages II to III rectal cancer received one cycle of induction chemotherapy and concurrent chemoradiotherapy with XELOX plus bevacizumab...
May 21, 2018: Cancer communications
Xiangyang Wang, Weilan Cao, Chenguo Zheng, Wanle Hu, Changbao Liu
BACKGROUND: Marital status has been validated as an independent prognostic factor for survival in several cancer types, but is controversial in rectal cancer (RC). The objective of this study was to investigate the impact of marital status on the survival outcomes of patients with RC. METHODS: We extracted data of 27,498 eligible patients diagnosed with RC between 2004 and 2009 from the Surveillance, Epidemiology and End Results (SEER) database. Patients were categorized into married, never married, divorced/separated and widowed groups...
May 1, 2018: Cancer Epidemiology
Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Akinobu Furutani, Shoichi Manabe, Yusuke Yamaoka, Hitoshi Hino
BACKGROUND: The long-term outcomes of robotic-assisted laparoscopic lateral lymph node dissection (RALLD) have not been fully investigated. This study aimed to assess the oncological and long-term outcomes of RALLD for rectal cancer through comparison with those of open lateral lymph node dissection (OLLD) in a retrospective study. METHODS: Between September 2002 and October 2014, the medical data of 426 patients who underwent total mesorectal excision with lateral lymph node dissection for primary rectal cancer were collected...
May 2, 2018: Surgical Endoscopy
Kang Hong Lee, Bo-Kyeong Kang, Byung Kyu Ahn
PURPOSE: Obesity is thought to influence postoperative complications and recurrence of mid and low rectal cancer (MLRC) because of intraoperative technical difficulties. However, few reports have described the relationship between obesity indices and the clinical outcomes of MLRC. This study aimed to investigate the association between visceral obesity on computed tomography (CT) and oncolofical outcomes after surgery for MLRC and identify the obesity index that most accurately reflects clinical outcomes...
April 30, 2018: International Journal of Colorectal Disease
Patricio M Polanco, Ali A Mokdad, Hong Zhu, Michael A Choti, Sergio Huerta
Importance: Adjuvant chemotherapy (AC) in patients with rectal cancer with pathologic complete response following neoadjuvant chemoradiotherapy (nCRT) and resection is recommended by treatment guidelines. However, its role in this setting is equivocal because data supporting benefits are lacking. Objective: To compare the overall survival (OS) between AC and postoperative observation (OB) in patients with rectal cancer with pathologic complete response following nCRT and resection...
April 19, 2018: JAMA Oncology
Yvonne H Sada, Hop S Tran Cao, George J Chang, Avo Artinyan, Benjamin L Musher, Brandon G Smaglo, Nader N Massarweh
BACKGROUND: For locally advanced rectal cancer, response to neoadjuvant radiation has been associated with improved outcomes but has not been well characterized in general practice. The goals of this study were to describe disease response rates after neoadjuvant treatment and to evaluate the association between disease response and survival. MATERIALS AND METHODS: Retrospective cohort study of patients aged 18-80 y with clinical stage II and III rectal adenocarcinoma in the National Cancer Database (2006-2012)...
June 2018: Journal of Surgical Research
Andrzej Rutkowski, Lucyna Pietrzak, Jacek Kryński, Leszek Zając, Mariusz Bednarczyk, Tomasz Olesiński, Marek Szpakowski, Piotr Saramak, Ireneusz Pierzankowski, Piotr Hevelke, Piotr Surowski, Krzysztof Bujko
PURPOSE: A previous randomized study conducted by our group showed that application of gentamicin-collagen implant (GCI) into the pelvic cavity after total mesorectal excision (TME) reduced the incidence of distant metastases. Therefore, we decided to conduct a confirmatory study. METHODS: Patients with rectal cancer were included in the study if they met the following criteria: adenocarcinoma of the rectum, preoperative short-term radiotherapy (5 × 5 Gy), and WHO performance score 0-1...
April 15, 2018: International Journal of Colorectal Disease
Tomokazu Tokoro, Keishi Nakamura, Atsushi Hirose, Shinichi Nakanuma, Kohichi Okamoto, Jun Kinoshita, Isamu Makino, Hironori Hayashi, Katsunobu Oyama, Tomoharu Miyashita, Hidehiro Tajima, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
The patient was a 57-year-old woman. Preclinical examination of malignant lymphoma revealed 0-I sp type of early rectal cancer in the upper rectum, 20 cm from the anal margin. Endoscopic mucosal resection was performed and positive deep margins were pathologically diagnosed. Additional intestinal resection with lymph node dissection was deemed necessary, but ABVD therapy was initiated because the clinical stage of the malignant lymphoma was Stage III b or higher. Two months after detecting elevated CEA, S8 liver metastasis was pointed out, and examination of weakness of the right upper limb revealed nodular, multifocal brain metastasis...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sieske Hoendervangers, Alice M Couwenberg, Martijn P W Intven, Wilhelmina M U van Grevenstein, Helena M Verkooijen
INTRODUCTION: Patients with locally advanced rectal cancer (LARC) who are unfit for chemoradiation (CRT), are often offered short-course radiotherapy followed by delayed surgery (SCRT-delay). This entails a lower radiation dose, no chemotherapy and a shorter treatment period. This may lower their chances for complete tumor response and, as such, organ-sparing approaches. The purpose of this study was to compare the pathological complete response (pCR) rates between neoadjuvant CRT and SCRT-delay in patients with LARC in a nationwide database from the Netherlands...
March 23, 2018: European Journal of Surgical Oncology
Marina Baretti, Lorenza Rimassa, Nicola Personeni, Laura Giordano, Maria Chiara Tronconi, Tiziana Pressiani, Silvia Bozzarelli, Armando Santoro
BACKGROUND: Comorbidity has a detrimental effect on cancer survival, however, it is difficult to disentangle its direct effect from its influence on treatment choice. In this study we assessed the effect of comorbidity on survival in patients who received standard treatment for resected stage II and III colorectal cancer (CRC). PATIENTS AND METHODS: In total, 230 CRC patients, 68 rectal (29.6%) and 162 colon cancer (70.4%) treated with surgical resection and neoadjuvant/adjuvant chemotherapy from December 2002 to December 2009 at Humanitas Cancer Center were retrospectively reviewed...
March 21, 2018: Clinical Colorectal Cancer
Olusegun Isaac Alatise, Omobolaji O Ayandipo, Ademola Adeyeye, Ken Seier, Akinwunmi O Komolafe, Matthew O Bojuwoye, Oludapo O Afuwape, Ann Zauber, Adeleye Omisore, Samuel Olatoke, Adegboyega Akere, Olusola Famurewa, Mithat Gonen, David O Irabor, T Peter Kingham
BACKGROUND: Colorectal cancer (CRC) rates in low-resource countries, which typically lack CRC screening programs, are rising. This study determined whether a risk model for patients with rectal bleeding could identify patients with curable CRC. METHODS: This prospective, cross-sectional study evaluated a model constructed from data from 1 hospital and validated at 2 other hospitals. The primary endpoint was the ability of the model to predict CRC, as diagnosed by colonoscopy, from clinical characteristics...
April 12, 2018: Cancer
Andrew Martella, Christopher Willett, Manisha Palta, Brian Czito
PURPOSE OF REVIEW: Colorectal cancer has a high global incidence, and standard treatment employs a multimodality approach. In addition to cure, minimizing treatment-related toxicity and improving the therapeutic ratio is a common goal. The following article addresses the potential of omitting radiotherapy in select rectal cancer patients. RECENT FINDINGS: Omission of radiotherapy in rectal cancer is analyzed in the context of historical findings, as well as more recent data describing risk stratification of stage II-III disease, surgical optimization, imaging limitations, improvement in systemic chemotherapeutic agents, and contemporary studies evaluating selective omission of radiotherapy...
April 11, 2018: Current Oncology Reports
Amit Merchea, Shahzad M Ali, Scott R Kelley, Emilie Duchalais, Jasim Y Alabbad, Eric J Dozois, David W Larson
BACKGROUND: Long-term oncologic outcomes after minimally invasive surgery (MIS) for rectal adenocarcinoma compared to open surgery continue to be debated. We aimed to review our high-volume single-institution outcomes in MIS rectal cancer surgery. METHODS: A retrospective review of a prospectively collected database was completed of all consecutive adult patients with rectal adenocarcinoma treated from January 2005 through December 2011. Stage IV or recurrent disease was excluded...
March 28, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Gabriella Macchia, Maria Antonietta Gambacorta, Carlotta Masciocchi, Giuditta Chiloiro, Giovanna Mantello, Maika di Benedetto, Marco Lupattelli, Elisa Palazzari, Liliana Belgioia, Almalina Bacigalupo, Aldo Sainato, Sabrina Montrone, Lucia Turri, Angela Caroli, Antonino De Paoli, Fabio Matrone, Carlo Capirci, Giampaolo Montesi, Rita Marina Niespolo, Mattia Falchetto Osti, Luciana Caravatta, Alessandra Galardi, Domenico Genovesi, Maria Elena Rosetto, Caterina Boso, Piera Sciacero, Lucia Giaccherini, Salvatore Parisi, Antonella Fontana, Francesco Romeo Filippone, Vincenzo Picardi, Alessio Giuseppe Morganti, Vincenzo Valentini
Background: To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods: A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT...
June 2017: Clinical and Translational Radiation Oncology
Ming-Yii Huang, Hsin-Hua Lee, Hsiang-Lin Tsai, Ching-Wen Huang, Yung-Sung Yeh, Cheng-Jen Ma, Chun-Ming Huang, Chiao-Yun Chen, Joh-Jong Huang, Jaw-Yuan Wang
BACKGROUND: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemoradiation (NACRT) in locally advanced rectal cancer (LARC) in upper rectum versus middle/lower rectum. METHODS: The study included 173 patients with stage II or III (T2-4b, N0-2b) LARC who underwent NACRT followed by total mesorectal excision (TME) between January 2011 and October 2016. Cox regression, log-rank test, and Kaplan-Meier curves were calculated. RESULTS: Among the 173 patients, 58 had lesions in the upper rectum and 115 patients had lesions in middle/lower rectum...
March 27, 2018: Radiation Oncology
Joseph C Kong, Glen R Guerra, Satish K Warrier, A Craig Lynch, Michael Michael, Samuel Y Ngan, Wayne Phillips, G Ramsay, Alexander G Heriot
BACKGROUND: The current standard of care for locally advanced rectal cancer involves neo-adjuvant chemo-radiotherapy followed by total mesorectal excision. There is a spectrum of response to neo-adjuvant therapy, however the prognostic value of tumour regression grade(TRG) in predicting disease-free survival (DFS) or overall survival (OS) is inconsistent in the literature. METHODS: This study was performed in accordance with the PRISMA guidelines. A systematic search was undertaken using Ovid Medline, Embase and Google Scholar...
March 27, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Yufeng Ren, Jinning Ye, Yan Wang, Weixin Xiong, Jianbo Xu, Yulong He, Shirong Cai, Min Tan, Yujie Yuan
Background: Transrectal ultrasound (TRUS) is a cost-effective test for preoperative assessment of rectal cancer. However, whether the accuracy of TRUS staging is correlated with tumor location remains obscured. This study is designed to explore their relationship and confirm an optimal application of TRUS in rectal cancer restaging. Methods: From 2005 to 2011, rectal cancer patients with TRUS data were retrospectively reviewed. Patients were divided into five groups according to tumor-involved rectal segment (SEG) above the anal verge: SEG I 1-3cm, II 3-6cm, III 6-9cm, IV 9-12cm, and V 12-16cm...
2018: Journal of Cancer
Eng-Yen Huang, Jen-Chieh Chang, Hong-Hwa Chen, Chieh-Ying Hsu, Hsuan-Chih Hsu, Keng-Liang Wu
BACKGROUND: We sought to identify the carcinoembryonic antigen (CEA) as a marker of radioresistance in rectal cancer. METHODS: From July 1997 to January 2008, 104 patients with stage II or III rectal cancer who were treated with post-operative radiotherapy (PORT) were included in this study. The doses of radiotherapy ranged from 45 to 54.6 Gy. The CEA levels were measured before surgery. We analyzed the actuarial rates of overall survival (OS), distant metastasis (DM), and local recurrence (LR) using Kaplan-Meier curves...
March 27, 2018: BMC Cancer
Wei Wang, Zhengchun Kang, Chenglong Wang, Junjie Xing, Xiaodong Xu, Enda Yu
OBJECTIVE: To compare the surgical safety and short-term efficacy of minilaparotomy and laparoscopic approach for curative resection of rectal cancer. METHODS: The retrospective cohort study was adopted. A review of patients scheduled to undergo a curative resection of rectal cancer via minilaparotomy or laparoscopic approach at Department of Colorectal Surgery of Changhai Hospital from June 2016 to May 2017 was carried out. All the patients were confirmed as rectal cancer by postoperative pathology...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Virginia Sun, Tracy E Crane, Samantha D Slack, Angela Yung, Sarah Wright, Stephen Sentovich, Kurt Melstrom, Marwan Fakih, Robert S Krouse, Cynthia A Thomson
PURPOSE: Bowel dysfunction is a common, persistent long-term effect of treatment for rectal cancer survivors. Survivors often use dietary modifications to maintain bowel control. There are few evidence-based interventions to guide survivors on appropriate diet modifications for bowel symptom management. The purpose of this paper is to describe the development and design of the Altering Intake, Managing Symptoms (AIMS) intervention to support bowel dysfunction management in rectal cancer survivors...
March 19, 2018: Contemporary Clinical Trials
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