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III stage rectal cancer

Sohyun Kim
Purpose: Most patients with rectal cancer undergo a total mesorectal excision and a partial resection of the sigmoid colon to improve oncologic outcomes. The aim of this study was to assess the distribution of lymph nodes (LNs) in rectal cancer. Methods: The records of 54 patients with mid and low rectal cancer between April 2015 and March 2017 were reviewed, and 49 patients were enrolled in this study. All harvested LNs were analyzed according to the harvested area: the mesorectum area (MA), the vascular pedicle area (VA), and the sigmoid area (SA)...
February 2018: Annals of Coloproctology
Peter C Ambe, Daniel Gödde, Stephan Störkel, Hubert Zirngibl, Lars Bönicke
BACKGROUND: Colorectal cancer (CRC) is the second leading cause for cancer-related death in industrialized nations. Nodal involvement has been identified as a relevant prognostic feature in CRC. Extra nodal metastasis (ENM) describes the spread of malignant cells beyond the nodal capsule. ENM is thought to be an independent risk factor for poor survival. This study examined ENM as an independent risk factor for poor overall survival in patients with node-positive CRC. MATERIALS AND METHODS: Data from a prospectively maintained CRC database was retrospectively analyzed...
March 8, 2018: International Journal of Colorectal Disease
Mirko Omejc, Maja Potisek
Background: The majority of rectal cancers are discovered in locally advanced forms (UICC stage II, III). Treatment consists of preoperative radiochemotherapy, followed by surgery 6-8 weeks later and finally by postoperative chemotherapy. The aim of this study was to find out if tumor regression affected long-term survival in patients with localy advanced rectal cancer, treated with neoadjuvant radiochemotherapy. Patients and methods: Patients with rectal cancer stage II or III, treated between 2006 and 2010, were included in a retrospective study...
March 2018: Radiology and Oncology
Jasna But-Hadzic, Vaneja Velenik
Background: The aim of the study was to investigate the feasibility and safety of experimental fractionation using intensity modulated radiation therapy with a simultaneous integrated boost (IMRT-SIB) to shorten the overall treatment time without dose escalation in preoperative radiochemotherapy of locally advanced rectal cancer. Patients and methods: Between January 2014 and November 2015, a total of 51 patients with operable stage II-III rectal adenocarcinoma were treated...
March 2018: Radiology and Oncology
Carl Pontus Gustafsson, Ulf Gunnarsson, Ursula Dahlstrand, Ulrik Lindforss
PURPOSE: To identify factors associated with timing of stoma reversal after rectal cancer surgery in a large Swedish register-based cohort. METHODS: Three thousand five hundred sixty-four patients with rectal cancer who received a protective stoma during surgery in 2007-2013 were identified in the Swedish colorectal cancer register. Time to stoma reversal was evaluated over a follow-up period of one and a half years. Factors associated with timing of stoma reversal were analysed using Cox regression analysis...
March 5, 2018: International Journal of Colorectal Disease
William H Ward, Elin R Sigurdson, Andrew C Esposito, Karen J Ruth, Samuel M Manstein, Eric C Sorenson, Brian D Wernick, Jeffrey M Farma
BACKGROUND: Despite advances in the treatment of rectal adenocarcinoma, the management of locally advanced disease remains a challenge. The standard of care for patients with stages II and III rectal cancer includes neoadjuvant chemoradiation followed by total mesorectal excision and postoperative chemotherapy. Much effort has been dedicated to the identification of predictive factors associated with pathologic complete response (pCR). The aim of our study was to examine our institutional experience and determine whether any association exists between anatomic tumor location and the rate of pCR...
April 2018: Journal of Surgical Research
David W Borowski, Sarah Cawkwell, Syed M Amir Zaidi, Matthew Toward, Nicola Maguire, Dharmendra K Garg, Talvinder S Gill
Purpose The NHS Bowel cancer screening programme (NHSBCSP) aims to reduce colorectal cancer (CRC) cumulative mortality by up to 23 per cent; long-term outcomes at national level are not yet known. The purpose of this paper is to examine a local population of CRC patients of screening age for their characteristics and long-term survival in relation to their presentation, including through the NHSBCSP. Design/methodology/approach Retrospective analysis of a prospectively maintained CRC database for the years 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services...
March 12, 2018: International Journal of Health Care Quality Assurance
Kozo Yoshikawa, Mitsuo Shimada, Jun Higashijima, Toshihiro Nakao, Masaaki Nishi, Chie Takasu, Hideya Kashihara, Syohei Eto, Yoshimi Bando
AIM: To evaluate the usefulness of Ki-67 index and survivin as predictive prognostic factors for rectal cancer treated with preoperative chemoradiotherapy. PATIENTS AND METHODS: The Ki-67 index and survivin expression were examined in patients with stage II/III rectal cancer (n=46) by immunohistochemistry. Patients were divided into a high-group and a low-group for the Ki-67 index, and positive and negative groups for survivin expression. Overall and disease-free survival were compared between the groups, and the correlation between Ki-67 index and survivin expression was assessed...
March 2018: Anticancer Research
Thomas G Bird, Samuel Y Ngan, Julie Chu, René Kroon, Andrew C Lynch, Alexander G Heriot
PURPOSE: Radical management of locally recurrent rectal cancer (LRRC) can lead to prolonged survival. This study aims to assess outcomes and identify prognostic factors for patients with LRRC treated using a multimodality treatment protocol. METHODS: An analysis of a prospectively maintained institutional database of consecutive patients who underwent radical surgical resection for LRRC was performed. Potential prognostic factors were investigated using a Cox proportional hazards model...
February 21, 2018: International Journal of Colorectal Disease
Georgios Karagkounis, Leo Thai, Adam G Mace, Homer Wiland, Rish K Pai, Scott R Steele, James M Church, Matthew F Kalady
OBJECTIVE: To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND: Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in rectal cancer. AJCC regression scores have been shown to correlate with prognosis. METHODS: Patient demographics, tumor characteristics, and AJCC scores (0 = complete response; 1 = isolated tumor cells remaining; 2 = residual cancer outgrown by fibrosis; 3 = extensive residual cancer) were assessed from 545 rectal cancer patients treated by nCRT followed by surgery at a single institution...
February 20, 2018: Annals of Surgery
Sudeep Gupta, Amita Maheshwari, Pallavi Parab, Umesh Mahantshetty, Rohini Hawaldar, Supriya Sastri Chopra, Rajendra Kerkar, Reena Engineer, Hemant Tongaonkar, Jaya Ghosh, Seema Gulia, Neha Kumar, T Surappa Shylasree, Renuka Gawade, Yogesh Kembhavi, Madhuri Gaikar, Santosh Menon, Meenakshi Thakur, Shyam Shrivastava, Rajendra Badwe
Purpose We compared the efficacy and toxicity of neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin-based chemoradiation in patients with locally advanced squamous cervical cancer. Patients and Methods This was a single-center, phase III, randomized controlled trial ( identifier: NCT00193739). Eligible patients were between 18 and 65 years old and had stage IB2, IIA, or IIB squamous cervical cancer. They were randomly assigned, after stratification by stage, to receive either three cycles of neoadjuvant chemotherapy using paclitaxel and carboplatin once every 3 weeks followed by radical hysterectomy or standard radiotherapy with concomitant cisplatin once every week for 5 weeks...
February 12, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Masaaki Ito, Akihiro Kobayashi, Shin Fujita, Junki Mizusawa, Yukihide Kanemitsu, Yusuke Kinugasa, Koji Komori, Masayuki Ohue, Mitsuyoshi Ota, Yoshihiro Akazai, Manabu Shiozawa, Takashi Yamaguchi, Takayuki Akasu, Yoshihiro Moriya
BACKGROUND: Postoperative urinary dysfunction is a major complication of rectal cancer surgery. A randomized controlled trial (JCOG0212) concluded that the noninferiority of mesorectal excision alone to mesorectal excision with lateral lymph node dissection was not confirmed in terms of relapse-free survival. METHODS: Eligibility criteria included histologically proven clinical stage II/III rectal cancer, a main lesion located in the rectum with the lower margin below the peritoneal reflection, and the absence of lateral lymph node enlargement...
January 17, 2018: European Journal of Surgical Oncology
A M Dinaux, L G J Leijssen, L G Bordeianou, H Kunitake, D L Berger
BACKGROUND: Screening for colorectal cancer has resulted in declining incidence rates of both colon and rectal cancer and it may influence stage at presentation and improve survival. The aim of this study was to assess the impact of screening on patients diagnosed with locally advanced rectal cancer. METHODS: A retrospective analysis of a consecutive series of patients who underwent neoadjuvant therapy and had an R0-resection for clinical AJCC stage II or stage III disease...
February 9, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Matthew Alderdice, Susan D Richman, Simon Gollins, Peter Stewart, Chris Hurt, Richard Adams, Amy McCorry, Aideen Roddy, Dale Vimalachandran, Claudio Isella, Enzo Medico, Tim Maughan, Darragh G McArt, Mark Lawler, Philip D Dunne
Colorectal cancer (CRC) biopsies underpin accurate diagnosis, but are also relevant for patient stratification in molecularly-guided clinical trials. The consensus molecular subtypes (CMS) and colorectal cancer intrinsic subtypes (CRIS) transcriptional signatures have potential clinical utility for improving prognostic/predictive patient assignment. However, their ability to provide robust classification, particularly in pre-treatment biopsies from multiple regions or at different time points remains untested...
February 7, 2018: Journal of Pathology
Susana Roselló, Federica Papaccio, Desamparados Roda, Noelia Tarazona, Andrés Cervantes
Curative treatment of rectal cancer depends on an optimal surgical resection, with the addition of neoadjuvant radiotherapy (RT) with or without concomitant chemotherapy (ChT) in more advanced tumors. The role of adjuvant ChT is controversial and a more intensified neoadjuvant approach with the addition of ChT before or after RT, or even as single modality, is currently being explored in trials. A systematic review selecting randomised phase II and III trials on the role of ChT in localized rectal cancer was performed...
February 2018: Cancer Treatment Reviews
Takashi Noma, Hajime Hirose, Yoshito Ide, Hiroki Imamura, Yuriko Yagi, Yukako Mokutani, Yasuji Hashimoto, Kenichi Nagai, Jin Matsuyama, Masaru Kubota, Yukio Fukushima, Shigeyuki Tamura, Yo Sasaki
A 70's woman with a history of abdominal surgery for gastric cancer visited our hospital for the evaluation of bleeding during defecation.We diagnosed her with advanced rectal cancer and performed laparoscopic low anterior resection.As postoperative pathological staging was pT3N2M0, pStage III b, we included CapeOx therapy as adjuvant chemotherapy.One year and 4 months after the surgery, lung and liver metastases were revealed by CT and PET-CT scans.At the same time, dilatation of the main pancreatic duct(intraductal papillary mucinous neoplasm: IPMN)was detected...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Motoi Koyama, Keigo Okada, Kenta Kitamura, Tomonori Matsumura, Eishi Totsuka, Kazuhiro Karikomi, Hiroyuki Suzuki, Shigeru Masamura, Tatsushi Suwa, Tomomi Arai, Akemi Komiya, Yuriko Yoshioka
The aim of this study was to evaluate the long-term sexual function and risk factors of dysfunction after the autonomic nerve preserving operation for lower rectal cancer. METHODS: We evaluated postoperative sexual function assessed by IIEF5 in 91 patients who responded to the questionnaire by mail. RESULTS: After a median follow-up of 5.5 years, univariate analysis identified 4 risk factors associated with poor sexual function: the elder, over 3 years after surgery, pathological stage III , and lateral lymph node dissection(both side)...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kiyoshi Uchiyama, Yu Katarao, Yu Kimura, Ryoichi Tanaka, Takashi Fuse, Manabu Takemura, Yoshiki Yamamoto, Yoshihiro Shimizu
A 60-year-old man underwent low anterior resection for rectal cancer. Histological findings indicated well-differentiated adenocarcinoma(T3[SS]N1M0, ly3, v2, Stage III a). Two years and 1 month later, right adrenalectomy was performed for solitary adrenal metastasis. Three months thereafter, left partial pulmonary resection was performed for a metastatic lung tumor. All resected specimens showed metastatic adenocarcinoma derived from the rectal cancer. The patient is alive and well without recurrence for more than 10years after lung resection...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Keishi Hakoda, Masanori Yoshimitsu, Manabu Emi, Yuya Hirai, Atsushi Kamigaichi, Manato Osawa, Norimasa Kuraoka, Toshiaki Komo, Norifumi Tsubokawa, Ichiko Yamakita, Masashi Miguchi, Yoshiro Aoki, Akira Nakashima, Mikihiro Kano, Koichi Oishi, Toshihiko Kohashi, Mayumi Kaneko, Mahito Funakoshi, Jun Hihara, Hidenori Mukaida, Naoki Hirabayashi
Anal metastasis of colorectal cancer is rare, and no standardized effective therapeutic strategy exists. We report a case of abdominoperineal resection for anal metastasis of rectal cancer. A 65-year-old man underwent laparoscopic low anterior resection for rectal cancer in August 2013. Histopathological examination revealed a moderately differentiated adenocarcinoma( tub2, pSS, ly3, v2, pN1, H0, P0, M0, Stage III a, Cur A). In February 2015, he complained of anal discomfort, and tumor markers were elevated...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Naoki Sakuyama, Motohiro Kojima, Shingo Kawano, Yoko Matsuda, Mari Mino-Kenudson, Atsushi Ochiai, Masaaki Ito
The aim of this study was to elucidate differences in the histological features of rectal cancer between patients treated with preoperative chemoradiotherapy and those treated with preoperative chemotherapy. Area of residual tumor (ART) was also evaluated for its utility as a potential prognostic marker between them. Sixty-eight patients with rectal cancer who underwent sphincter-saving surgery were enrolled in this study. Of these, 39 patients received preoperative chemoradiotherapy (CRT group) and 29 patients received preoperative (neoadjuvant) chemotherapy (NAC group)...
February 1, 2018: Cancer Science
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