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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/28078118/less-than-12-lymph-nodes-in-the-surgical-specimen-after-neoadjuvant-chemo-radiotherapy-an-indicator-of-tumor-regression-in-locally-advanced-rectal-cancer
#1
Jaiprakash Gurawalia, Kapil Dev, Sandeep P Nayak, Vishnu Kurpad, Arun Pandey
BACKGROUND: The number of lymph node retrieved in the surgical specimen is important for tumor staging and has paramount impact on prognosis in colorectal cancer and imitates the adequacy of lymph node surgical clearance. The paucity of lymph node yields in patients undergoing resection after preoperative chemo radiotherapy (CRT) in rectal cancer has seen. Lower total number of lymph nodes in the total mesoractal excision (TME) specimen after CRT, could a marker of better tumor response...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28044949/sphincter-sparing-surgery-in-patients-with-mid-and-low-rectal-cancer-risk-factors-for-local-recurrence-and-anastomotic-leakage
#2
Denis Aslan, Florin Grama, Daniel Cristian, Adrian Bordea, Traean Burcoş
: Background: Rectal cancer is a major health problem. The current treatment of distal rectal cancer involves a multimodality approach aimed at achieving an optimal oncologic control and an increased quality of life. PURPOSE: The purpose of this article is to identify the risk factors for local recurrence and anastomotic leakage after sphincter-sparing surgery for low and mid rectal cancer. Material and Methods: We prospectively analyzed a group of 38 patients with low and middle rectal cancer who underwent sphincter-sparing surgery...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/27984651/neoadjuvant-long-course-chemoradiation-remains-strongly-favored-over-short-course-radiotherapy-by-radiation-oncologists-in-the-united-states
#3
Yvonne M Mowery, Joseph K Salama, S Yousuf Zafar, Harvey G Moore, Christopher G Willett, Brian G Czito, M Benjamin Hopkins, Manisha Palta
BACKGROUND: Short-course radiotherapy (SC-RT) and long-course chemoradiotherapy (LC-CRT) are accepted neoadjuvant treatments of rectal cancer. In the current study, the authors surveyed US radiation oncologists to assess practice patterns and attitudes regarding SC-RT and LC-CRT for patients with rectal cancer. METHODS: The authors distributed a survey to 1701 radiation oncologists regarding treatment of neoadjuvant rectal cancer. Respondents were asked questions regarding the number of patients with rectal cancer treated, preference for SC-RT versus LC-CRT, and factors influencing regimen choice...
December 16, 2016: Cancer
https://www.readbyqxmd.com/read/27978776/short-course-preoperative-radiotherapy-combined-with-chemotherapy-delayed-surgery-and-local-hyperthermia-for-rectal-cancer-a-phase-ii-study
#4
A O Rasulov, S S Gordeyev, Yu A Barsukov, S I Tkachev, A G Malikhov, S S Balyasnikova, M Yu Fedyanin
PURPOSE: The aim of this study was to investigate the feasibility of short-course radiotherapy with oral capecitabine, hyperthermia and delayed surgery for neoadjuvant treatment of rectal cancer. METHODS: Patients with clinically staged T2-3N0-2M0 primary rectal cancer were included. All patients received short-course 25 Gy in 5 Gy fractions radiotherapy with capecitabine, local hyperthermia and metronidazole. Capecitabine 1000 mg/m2 twice a day was given on days 1-14...
December 15, 2016: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/27956537/neoadjuvant-therapy-for-rectal-cancer-affects-lymph-node-yield-and-status-without-clear-implications-on-outcome-the-case-for-eliminating-a-metric-and-using-preoperative-staging-to-guide-therapy
#5
Sherif R Z Abdel-Misih, Lai Wei, Al B Benson, Steven Cohen, Lily Lai, John Skibber, Neal Wilkinson, Martin Weiser, Deborah Schrag, Tanios Bekaii-Saab
BACKGROUND: Nodal status has long been considered pivotal to oncologic care, staging, and management. This has resulted in the establishment of rudimentary metrics regarding adequate lymph node yield in colon and rectal cancers for accurate cancer staging. In the era of neoadjuvant treatment, the implications of lymph node yield and status on patient outcomes remains unclear. PATIENT AND METHODS: This study included 1,680 patients with locally advanced rectal cancer from the NCCN prospective oncology database stratified into 3 groups based on preoperative therapy received: no neoadjuvant therapy, neoadjuvant chemoradiation, and neoadjuvant chemotherapy...
December 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27939008/is-routine-use-of-adjuvant-chemotherapy-for-rectal-cancer-with-complete-pathological-response-justified
#6
Maysoon Gamaleldin, James M Church, Luca Stocchi, Mathew Kalady, David Liska, Emre Gorgun
BACKGROUND: Patients with locally advanced rectal cancer (LARC) receiving neoadjuvant chemoradiation (nCRT) can have a complete pathologic response (pCR), and are given postoperative adjuvant chemotherapy (ACT). METHODS: A prospectively maintained outcomes database was queried for patients who had pCR to nCRT for LARC from 2000 to 2012. Local recurrence and survival were analyzed according to whether patients received ACT. RESULTS: We identified 139 patients and excluded 9 due to lack of follow-up...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27935051/the-survival-impact-of-delayed-surgery-and-adjuvant-chemotherapy-on-stage-ii-iii-rectal-cancer-with-pathological-complete-response-after-neoadjuvant-chemoradiation
#7
Feng-Che Kuan, Chia-Hsuan Lai, Hsiu-Ying Ku, Chun-Feng Wu, Meng-Chiao Hsieh, Tsang-Wu Liu, Chien-Yuh Yeh, Kuan-Der Lee
Neoadjuvant concurrent chemoradiation (CCRT) is standard treatment for clinical stage II/III rectal cancers. However, whether patients with pathological complete response (pT0N0, pCR) should receive adjuvant chemotherapy and whether delayed surgery will influence the pCR rate remains controversial. A nationwide population study was conducted using the Taiwan Cancer Registry Database from January 2007 to December 2013. Kaplan-Meier survival analysis was performed. Cox proportional hazards models were used to estimate multivariate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI)...
December 9, 2016: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/27872117/protocol-for-a-multicentre-randomised-feasibility-trial-evaluating-early-surgery-alone-in-low-rectal-cancer-sailor
#8
Dean A Harris, Kymberley Thorne, Hayley Hutchings, Saiful Islam, Gail Holland, Olivia Hatcher, Sarah Gwynne, Ian Jenkins, Peter Coyne, Michael Duff, Melanie Feldman, Des C Winter, Simon Gollins, Phil Quirke, Nick West, Gina Brown, Deborah Fitzsimmons, Alan Brown, John Beynon
INTRODUCTION: There are 11 500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment, there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High-quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in MRI-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27864695/adjuvant-chemotherapy-improves-overall-survival-of-rectal-cancer-patients-treated-with-neoadjuvant-chemoradiotherapy-regardless-of-pathologic-nodal-status
#9
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: After neoadjuvant chemoradiotherapy for rectal cancer, the interpretation of surgical pathology poses difficulties in deciding the need for adjuvant chemotherapy (AC). The aim of this study was to determine whether there is a survival benefit to providing AC in patients with node-negative disease on surgical pathology. METHODS: Patients with clinical stage II and III rectal adenocarcinoma who received neoadjuvant chemoradiation and definitive surgical resection from 2006 to 2012 were identified in the National Cancer Data Base...
November 18, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27837319/functional-outcomes-after-tem-in-patients-with-complete-clinical-response-after-neoadjuvant-chemoradiotherapy
#10
Roberto Ghiselli, Monica Ortenzi, Luca Cardinali, Edlira Skrami, Rosaria Gesuita, Mario Guerrieri
BACKGROUND: In patients who exhibit a complete clinical response after radio-chemotherapy for rectal cancer, the standard surgical approach might constitute overtreatment. The aim of this study is to analyse the outcomes of anorectal function and quality of life after transanal endoscopic microsurgery (TEM) in irradiated patients with complete clinical response. PATIENTS AND METHODS: Between 2007 and 2014, 84 patients who were diagnosed with stage T2-T3-T4 N0 rectal cancer before chemoradiotherapy showed a complete clinical response to neoadjuvant therapy and underwent TEM...
November 11, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27830368/adjuvant-treatment-for-resected-rectal-cancer-impact-of-standard-and-intensified-postoperative-chemotherapy-on-disease-free-survival-in-patients-undergoing-preoperative-chemoradiation-a-propensity-score-matched-analysis-of-an-observational-database
#11
Benjamin Garlipp, Henry Ptok, Frank Benedix, Ronny Otto, Felix Popp, Karsten Ridwelski, Ingo Gastinger, Christoph Benckert, Hans Lippert, Christiane Bruns
AIMS: Adjuvant chemotherapy for resected rectal cancer is widely used. However, studies on adjuvant treatment following neoadjuvant chemoradiotherapy (CRT) and total mesorectal excision (TME) have yielded conflicting results. Recent studies have focused on adding oxaliplatin to both preoperative and postoperative therapy, making it difficult to assess the impact of adjuvant oxaliplatin alone. This study was aimed at determining the impact of (i) any adjuvant treatment and (ii) oxaliplatin-containing adjuvant treatment on disease-free survival in CRT-pretreated, R0-resected rectal cancer patients...
December 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27819876/impact-of-postoperative-adjuvant-chemotherapy-following-long-course-chemoradiotherapy-in-stage-ii-rectal-cancer
#12
Jonathan M Loree, Hagen F Kennecke, Richard M Lee-Ying, Rachel A Goodwin, Erin D Powell, Patricia A Tang, Julie A Price Hiller, Michael M Vickers, Winson Y Cheung
OBJECTIVES: Use of adjuvant chemotherapy (AC) following neoadjuvant chemoradiation (nCRT) is controversial in rectal cancer (RC). We assessed a multi-institutional database to determine if there was benefit from AC for pathologic stage II RC patients and whether the addition of oxaliplatin to fluoropyrimidine (OXAC) therapy impacted outcomes. MATERIALS AND METHODS: We included patients who underwent nCRT and had pathologic stage II (ypT3/4 ypN0) tumors. Disease-free survival and overall survival were assessed...
November 4, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27819639/therapy-of-stenosing-rectal-cancer
#13
Violeta Deaconescu, Eugen Brătucu, Bogdan Mastalier, Cristian Botezatu, Marian Marincaş
Develop a rectal cancer management aims to establish an algorithm diagnostic, surgical treatment strategy implementation, strategy and neoadjuvant and adjuvant treatment response and optimal methods for assessing response to specific treatment. In trying to track this management, we studied the issues listed above, we conducted a retrospective clinical study, descriptive and included the analysis of data obtained on a sample selected 90 patients diagnosed with stenosing rectal cancer between January 2008 and December 2012 treated on the General Surgery Clinic I of "Prof...
2016: Chirurgia
https://www.readbyqxmd.com/read/27796635/clinically-node-negative-pathologically-node-positive-rectal-cancer-patients-who-did-not-receive-neoadjuvant-therapy
#14
Nouf Akeel, Nan Lan, Luca Stocchi, Meagan M Costedio, David W Dietz, Emre Gorgun, Matthew F Kalady, Georgios Karagkounis, Hermann Kessler, Feza H Remzi
PURPOSE: Neoadjuvant chemoradiotherapy is the preferred standard of care for clinical stages II-III rectal cancer. It is uncertain whether clinically node negative (cN-) tumors found to be pathologically stage III could be optimally treated with surgery alone and avoid adjuvant treatments. The aim of our study was to define the outcomes of such patients. METHODS: Patients undergoing radical surgery using total mesorectal excision (TME) techniques for rectal cancer (≤12 cm from the anal verge) with curative intent during 2000-2012 and found to have stage III disease on final pathology were identified from a prospectively maintained database...
January 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27795447/clinical-outcome-of-neoadjuvant-chemoradiation-in-locally-advanced-rectal-cancer-at-a-tertiary-hospital
#15
W Wk Yeung, B By Ma, J Fy Lee, S Sm Ng, M Hy Cheung, W M Ho, M Wk Tsang, S Chu, D Cm Lam, F Kf Mo
OBJECTIVES: To review the clinical outcome of locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by definitive surgery with or without adjuvant chemotherapy and to elucidate the prognostic factors for treatment outcome. METHODS: This historical cohort study was conducted at a tertiary public hospital in Hong Kong. All patients who had undergone neoadjuvant chemoradiation for locally advanced rectal cancer in our department from November 2005 to October 2014 were recruited...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27793945/a-comparative-effectiveness-study-of-two-oral-chemotherapy-drugs-uft-vs-capecitabine-in-neoadjuvant-concurrent-chemoradiotherapy-for-patients-with-locally-advanced-rectal-cancer
#16
Chun-Ru Chien, William Tzu-Liang Chen, Hwei-Min Wang, Tao-Wei Ke, Hua-Che Chiang, Sheng-Chi Chang, Yu-Chun Huang, Che-Hung Lin, Chun-Lin Huang, Ying-Chun Lin, Tsung-Wei Chen, Chia-Chin Li, K S Clifford Chao
BACKGROUND/AIM: Capecitabine is the current standard oral chemotherapy used in neoadjuvant concurrent chemoradiotherapy (NCCRT) for locally advanced rectal cancer (LARC) in North America. We compared the effectiveness of another oral chemotherapy agent, UFT (an oral combination of uracil and tegafur), to that of capecitabine. MATERIALS AND METHODS: We identified LARC patients diagnosed from 2007 to 2011 using a population-based registry in Taiwan (Health and Welfare Data Science Center, HWDC) and constructed a propensity score matched cohort to balance observable potential confounders...
2016: Anticancer Research
https://www.readbyqxmd.com/read/27784746/crlx101-a-nanoparticle-drug-conjugate-containing-camptothecin-improves-rectal-cancer-chemoradiotherapy-by-inhibiting-dna-repair-and-hif1%C3%AE
#17
Xi Tian, Minh Nguyen, Henry P Foote, Joseph M Caster, Kyle C Roche, Christian G Peters, Pauline Wu, Lata Jayaraman, Edward G Garmey, Joel E Tepper, Scott Eliasof, Andrew Z Wang
Novel agents are needed to improve chemoradiotherapy for locally advanced rectal cancer. In this study, we assessed the ability of CRLX101, an investigational nanoparticle-drug conjugate containing the payload camptothecin (CPT), to improve therapeutic responses as compared with standard chemotherapy. CRLX101 was evaluated as a radiosensitizer in colorectal cancer cell lines and murine xenograft models. CRLX101 was as potent as CPT in vitro in its ability to radiosensitize cancer cells. Evaluations in vivo demonstrated that the addition of CRLX101 to standard chemoradiotherapy significantly increased therapeutic efficacy by inhibiting DNA repair and HIF1α pathway activation in tumor cells...
January 1, 2017: Cancer Research
https://www.readbyqxmd.com/read/27780316/can-we-eliminate-neoadjuvant-chemoradiotherapy-in-favor-of-neoadjuvant-multiagent-chemotherapy-for-select-stage-ii-iii-rectal-adenocarcinomas-analysis-of-the-national-cancer-database
#18
Richard J Cassidy, Yuan Liu, Kirtesh Patel, Jim Zhong, Conor E Steuer, David A Kooby, Maria C Russell, Theresa W Gillespie, Jerome C Landry
BACKGROUND: Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers...
October 25, 2016: Cancer
https://www.readbyqxmd.com/read/27766558/racial-and-socioeconomic-treatment-disparities-in-adolescents-and-young-adults-with-stage-ii-iii-rectal-cancer
#19
David Y Lee, Annabelle Teng, Rose C Pedersen, Farees R Tavangari, Vikram Attaluri, Elisabeth C McLemore, Stacey L Stern, Anton J Bilchik, Melanie R Goldfarb
INTRODUCTION: Stage II-III rectal cancer requires multidisciplinary cancer care, and adolescents and young adults (AYA, ages 15-39 years) often do not receive optimal cancer therapy. METHODS: Overall, 3295 AYAs with clinical stage II-III rectal cancer were identified in the National Cancer Database. Factors associated with the receipt of adjuvant and surgical therapies, as well as overall survival (OS), were examined. RESULTS: The majority of patients were non-Hispanic White (72...
October 20, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27762654/effect-of-increasing-radiation-dose-on-pathologic-complete-response-in-rectal-cancer-patients-treated-with-neoadjuvant-chemoradiation-therapy
#20
Matthew D Hall, Timothy E Schultheiss, David D Smith, Marwan G Fakih, Jeffrey Y C Wong, Yi-Jen Chen
BACKGROUND: Neoadjuvant chemoradiation therapy (CRT) increases pathological complete response (pCR) rates compared to radiotherapy alone in patients with stage II-III rectal cancer. Limited evidence addresses whether radiotherapy dose escalation further improves pCR rates. Our purpose is to measure the effects of radiotherapy dose and other factors on post-therapy pathologic tumor (ypT) and nodal stage in rectal cancer patients treated with neoadjuvant CRT followed by mesorectal excision...
December 2016: Acta Oncologica
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