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Neoadjuvant chemotherapy in rectal cancer

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https://www.readbyqxmd.com/read/29035999/effects-on-18f-fdg-pet-ct-brain-glucose-metabolism-in-rectal-cancer-patients-undergoing-neoadjuvant-chemotherapy
#1
Alexei M C Machado, Theara C Fagundes, Arnoldo Mafra, Rodrigo G Silva, Ana Carolina G Castro, Marcelo Mamede
PURPOSE: Retrospective study of the effects of anticancer treatment on the brain metabolism of patients diagnosed with rectal cancer based on a large and homogeneous sample of 40 paired F-FDG PET/CT volumes taken from 20 patients. The results are compared to the ones presented by related works to help elucidating the mechanisms of neurotoxicity associated to a decrease in memory, learning and motor skills. PATIENTS AND METHODS: Twenty patients with rectal adenocarcinoma were scanned before and after neoadjuvant chemoradiation based exclusively on 5-fluorouracil and leucovorin...
October 13, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29022795/local-recurrence-after-standard-abdominoperineal-resection-do-we-really-need-elape
#2
A Xanthis, D Greenberg, B Jha, O Olafimihan, R Miller, N Fearnhead, J Davies, N Hall
Introduction Low rectal cancers requiring abdominoperineal resection tend to have a worse prognosis than higher tumours, which may be treated by anterior resection. One of the reasons for this may be inadequate local surgery, in particular the narrow waist of the resection specimen of a standard abdominoperineal resection may be associated with a high positive circumferential resection margin. The extralevator abdominoperineal excision (ELAPE) aims to improve the R0 resection rate but carries significant morbidity...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28982208/comparing-pathological-complete-response-rate-using-oral-capecitabine-versus-infusional-5-fluorouracil-with-preoperative-radiotherapy-in-rectal-cancer-treatment
#3
Narotam Jootun, Tess Evans, Jackie Mak, Greg Makin, Cameron Platell
BACKGROUND: Infusional 5-fluorouracil (5-FU) has been the standard radiation sensitizer in patients undergoing preoperative long-course chemoradiotherapy (CRT) for locally advanced rectal cancer in Australia. Capecitabine (Xeloda) is an oral 5-FU prodrug of comparable pharmacodynamic activity, currently preferred in place of 5-FU infusion, its established counterpart in neoadjuvant CRT for rectal cancer. The few studies quantifying pathological complete response (pCR) of Xeloda versus 5-FU have produced inconsistent results...
October 5, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28974244/multiple-rapidly-growing-desmoid-tumors-that-were-difficult-to-distinguish-from-recurrence-of-rectal-cancer
#4
Koki Nakanishi, Dai Shida, Shunsuke Tsukamoto, Hiroki Ochiai, Junichi Mazaki, Hirokazu Taniguchi, Yukihide Kanemitsu
BACKGROUND: Intra-abdominal desmoid tumors are usually slow growing and solitary, but multifocal desmoid tumors develop on rare occasions. Diagnosing desmoid tumors before histological examination of a surgical biopsy is often difficult. In particular, if a patient has a prior history of malignancy, it may be difficult to differentiate between these lesions and disease recurrence or metastasis. CASE PRESENTATION: We present a rare case of multiple rapidly growing intra-abdominal desmoid tumors after surgical trauma, without familial adenomatous polyposis...
October 3, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28963744/factors-associated-with-low-anterior-resection-syndrome-after-surgical-treatment-of-rectal-cancer
#5
Luis Miguel Jimenez-Gomez, Eloy Espin-Basany, Loris Trenti, Marc Martí-Gallostra, José Luis Sánchez-García, Francesc Vallribera-Valls, Esther Kreisler, Sebastiano Biondo, Manuel Armengol-Carrasco
AIM: To assess factors independently associated with low anterior resection syndrome (LARS) following resection or rectal cancer. METHOD: Cross-sectional study carried out in two acute-care teaching hospitals in Barcelona, Spain. Patients who had undergone sphincter preserving low anterior resection with curative intent, with total or partial mesorectal excision (with and without protective ileostomy) between January 2001 and December 2009 completed a self-administered questionnaire to assess bowel dysfunction after rectal cancer surgery...
September 29, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28900999/-study-on-the-relationship-between-tumor-regression-grade-and-lymph-node-regression-grade
#6
Quanquan Zhao, Chuangang Fu, Enda Yu, Wei Zhang, Ronggui Meng, Hantao Wang, Liqiang Hao, Hao Wang
OBJECTIVE: To investigate the relationship between tumor regression grade (TRG) and lymph node regression grade (LRG) after neoadjuvant chemoradiotherapy (CRT) for rectal cancer and its clinical implication. METHODS: Clinicopathological data of 176 rectal cancer patients undergoing radical excision after neoadjuvant CRT from January 2005 to December 2013 in our department were retrospectively analyzed. INCLUSION CRITERIA: (1) Radiology indicated locally advanced low rectal cancer and patients had strong desire to preserve the sphincter before neoadjuvant CRT; (2) there was no definite metastatic lesion before neoadjuvant CRT; (3) patients received whole course of neoadjuvant CRT (regular radiotherapy plus synchronous fluorouracil-like drugs chemotherapy); (4) patients underwent radical operation after neoadjuvant CRT...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28891848/adjuvant-chemotherapy-after-preoperative-chemoradiation-improves-survival-in-patients-with-locally-advanced-rectal-cancer
#7
Zhifei Sun, Brian Gilmore, Mohamed A Adam, Jina Kim, Shiao-Wen D Hsu, John Migaly, Christopher R Mantyh
BACKGROUND: Practice guidelines differ in their support of adjuvant chemotherapy use in patients who received preoperative chemoradiation for rectal cancer. OBJECTIVE: The purpose of this study was to evaluate the impact of adjuvant chemotherapy among patients with locally advanced rectal cancer who received neoadjuvant chemoradiation and surgery. DESIGN: This was a retrospective study. Multivariable Cox proportional hazard modeling was used to evaluate the adjusted survival differences...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28890815/the-role-of-neoadjuvant-radiotherapy-for-locally-advanced-rectal-cancer-with-resectable-synchronous-metastasis
#8
Croix C Fossum, Jasim Y Alabbad, Lindsay B Romak, Christopher L Hallemeier, Michael G Haddock, Marianne Huebner, Eric J Dozois, David W Larson
BACKGROUND: Although neoadjuvant radiotherapy is typically administered for locally-advanced rectal cancer to reduce local recurrence (LR), its role for patients who present with synchronous resectable liver and/or lung metastasis is not well defined. The aim of this study was to evaluate the role of neoadjuvant radiotherapy for patients with stage IV rectal cancer undergoing curative-intent surgery. METHODS: This study is a retrospective review of a prospectively maintained surgical registry of all consecutive adult patients who underwent curative-intent resection at Mayo Clinic in Rochester, MN, from January 1990 until December 2014 with a median follow-up time of 43 (IQR 16-67) months...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28876659/abdominoperineal-resection-in-the-prone-position-early-outcomes-at-a-tertiary-institution-in-the-western-cape-south-africa
#9
N Stevenson, A V V Lambrechts
BACKGROUND: Abdominoperineal resection (APR) in the prone position is a new technique in the developing world, where colorectal cancer incidence is rising fast and the patient population is different from those in the developed world. Literature is lacking on the outcomes of this technique under these conditions. METHOD: All patients who underwent APR in the prone position for rectal adenocarcinoma from February 2011 to February 2017 were reviewed. Main endpoints were stage at presentation, neoadjuvant treatment, circumferential resection margin involvement, perineal wound complications, length of intensive care unit (ICU) stay and days discharged after surgery...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871992/improved-metastasis-and-disease-free-survival-with-preoperative-sequential-short-course-radiation-therapy-and-folfox-chemotherapy-for-rectal-cancer-compared-with-neoadjuvant-long-course-chemoradiotherapy-results-of-a-matched-pair-analysis
#10
MULTICENTER STUDY
Stephanie Markovina, Fady Youssef, Amit Roy, Sonya Aggarwal, Shariq Khwaja, Todd DeWees, Benjamin Tan, Steven Hunt, Robert J Myerson, Daniel T Chang, Parag J Parikh, Jeffrey R Olsen
PURPOSE: To compare treatment and toxicity outcomes between a phase 2 institutional trial of near total neoadjuvant therapy (nTNT) for locally advanced rectal cancer and a similar historical control cohort treated at Washington University in St. Louis with the current US standard of care, defined as neoadjuvant chemoradiotherapy (NCRT), total mesorectal excision (TME), and adjuvant FOLFOX chemotherapy; to expand the comparison to an additional institution, patients treated with similar NCRT at Stanford University were included...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28835750/adjuvant-second-dose-chemotherapy-before-surgery-for-patients-with-locally-advanced-rectal-malignancy-is-not-beneficial-a-systematic-review-and-meta-analysis
#11
REVIEW
Min Chen, Xue Song, Liang-Zhou Chen, Lin Xu, Yi-Pu Lu, Jin-Song Zhang
BACKGROUND: Preoperative chemoradiotherapy is the standard treatment for patients with locally advanced rectal cancer, although tumor responses vary widely; some patients may achieve a pathologic complete response rate (pCR) after chemoradiotherapy. Controversy exists with regard to the efficacy of different preoperative combination chemotherapy regimens and neoadjuvant chemoradiotherapy, compared with chemoradiotherapy alone. METHODS: PubMed, the Cochrane Library, and Embase databases were searched for comparative studies of patients with locally advanced rectal cancer that were published between January 1991 and January 2016...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#12
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28756493/impact-of-adjuvant-chemotherapy-after-neoadjuvant-radio-or-radiochemotherapy-for-patients-with-locally-advanced-rectal-cancer
#13
Sven Lichthardt, Lisa Zenorini, Johanna Wagner, Johannes Baur, Alexander Kerscher, Niels Matthes, Caroline Kastner, Jörg Pelz, Volker Kunzmann, Christoph-Thomas Germer, Armin Wiegering
BACKGROUND: Due to its primarily extraperitoneal location, potential affection of the anorectal continence and different metastatic behavior the rectal carcinoma (RC) is classified and treated as an independent disease. Over the past few decades various trials have led to improved multimodal therapies (including radiation, chemotherapy and surgery) for locally advanced rectal cancer and significant changes in the management of this disease whereas the benefit of adjuvant chemotherapy remains unclear...
November 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28755256/rectal-sparing-approach-after-preoperative-radio-and-or-chemotherapy-resarch-in-patients-with-rectal-cancer-a-multicentre-observational-study
#14
A Barina, A De Paoli, P Delrio, M Guerrieri, A Muratore, F Bianco, D Vespa, C Asteria, E Morpurgo, A Restivo, C Coco, U Pace, C Belluco, C Aschele, S Lonardi, V Valentini, G Mantello, I Maretto, P Del Bianco, A Perin, S Pucciarelli
BACKGROUND: Rectum-sparing approaches appear to be appropriate in rectal cancer patients with a major (mCR) or complete clinical response (cCR) after neoadjuvant therapy. The aim of the present study is to evaluate the effectiveness of rectum-sparing approaches at 2 years after the completion of neoadjuvant treatment. STUDY DESIGN: Patients with rectal adenocarcinoma eligible to receive neoadjuvant therapy will be prospectively enrolled. Patients will be restaged 7-8 weeks after the completion of neoadjuvant therapy and those with mCR (defined as absence of mass, small mucosal irregularity no more than 2 cm in diameter at endoscopy and no metastatic nodes at MRI) or cCR will be enrolled in the trial...
July 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28742703/organ-preservation-in-ct2n0-rectal-cancer-after-neoadjuvant-chemoradiation-therapy-the-impact-of-radiation-therapy-dose-escalation-and-consolidation-chemotherapy
#15
Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Jorge Sabbaga, Patricia Bailão Aguilar, Laura Melina Fernandez, Sergio Eduardo Alonso Araújo, Rodrigo Oliva Perez
OBJECTIVE: To demonstrate the difference in organ-preservation rates and avoidance of definitive surgery among cT2N0 rectal cancer patients undergoing 2 different chemoradiation (CRT) regimens. BACKGROUND: Patients with cT2N0 rectal cancer are more likely to develop complete response to neoadjuvant CRT. Organ preservation has been considered an alternative treatment strategy for selected patients. Radiation dose-escalation and consolidation chemotherapy have been associated with increased rates of response and may improve chances of organ preservation among these patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742692/oncologic-outcome-and-morbidity-in-the-elderly-rectal-cancer-patients-after-preoperative-chemoradiotherapy-and-total-mesorectal-excision-a-multi-institutional-and-case-matched-control-study
#16
Soo-Y Sung, Hong S Jang, Sung H Kim, Jae U Jeong, Songmi Jeong, Jin H Song, Mi J Chung, Hyeon M Cho, Hyung J Kim, Jun-Gi Kim, In K Lee, Jong H Lee
OBJECTIVE: To determine the toxicity and oncologic outcome of neoadjuvant chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME) in the elderly (≥70 yrs) and younger (<70 yrs) rectal cancer patients. BACKGROUND: Sufficient data for elderly rectal cancer patients who received definitive trimodality have not been accumulated yet. PATIENTS AND METHODS: A total of 1232 rectal cancer patients who received neoadjuvant CRT and TME were enrolled in this study...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28736641/bone-marrow-tolerance-during-postoperative-chemotherapy-in-colorectal-carcinomas
#17
Neil B Newman, Rebecca A Moss, Nell Maloney-Patel, Kristen Donohue, Teresa V Brown, Michael J Nissenblatt, Shou-En Lu, Salma K Jabbour
BACKGROUND: This study seeks to quantify and compare bone marrow tolerance during postoperative chemotherapy therapy between rectal cancer vs. colon cancer patients. During rectal cancer treatment, patients receive neoadjuvant chemoradiation (CRT) irradiation which can exacerbate the hematologic toxicity (HT) via incidental irradiation of the pelvic bone marrow (PBM) during myelosuppressive postoperative chemotherapy. In contrast, colon cancer patients receive the same postoperative myelosuppressive chemotherapy but do not routinely receive preoperative chemoradiation therapy...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28728302/-clinical-efficacy-of-ladder-neoadjuvant-therapy-in-treatment-of-advanced-mid-low-rectal-cancer
#18
Y X Zhang, H B Wang, Y J Lu, H Y Liu
Objective: To explore the clinical efficacy of ladder neoadjuvant therapy in treatment of advanced mid-low rectal cancer. Methods: We performed a retrospective study of one hundred and eighty mid and low rectal cancer patients who underwent ladder neoadjuvant therapy(neoadjuvant chemotherapy followed by surgery if neoadjuvant chemotherapy was effective; neoadjuvant chemotherapy followed by neoadjuvant chemoradiotherapy if neoadjuvant chemotherapy was ineffective)(n=90) or neoadjuvant chemoradiotherapy (n=90)...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28685354/a-multicenter-phase-2-study-on-the-feasibility-and-efficacy-of-neoadjuvant-chemotherapy-without-radiotherapy-for-locally-advanced-rectal-cancer
#19
Suguru Hasegawa, Saori Goto, Takuya Matsumoto, Koya Hida, Kenji Kawada, Ryo Matsusue, Takashi Yamaguchi, Ryuta Nishitai, Dai Manaka, Shigeru Kato, Yoshio Kadokawa, Satoshi Yamanokuchi, Junichiro Kawamura, Masazumi Zaima, Takahisa Kyogoku, Akiyoshi Kanazawa, Yukiko Mori, Masashi Kanai, Shigemi Matsumoto, Yoshiharu Sakai
BACKGROUND: This prospective multicenter phase 2 study aimed to evaluate the feasibility and efficacy of neoadjuvant chemotherapy (NAC) without radiotherapy for locally advanced rectal cancer (LARC). METHODS: Patients with LARC (cStage II and III) were included in the study. Those with cT4b tumor were excluded. Six cycles of modified FOLFOX6 (mFOLFOX6) plus either bevacizumab or cetuximab, depending on KRAS status, were administered before surgery. The primary end point of the study was the R0 resection rate...
July 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28674583/-scrotal-fistulas-revealing-mucinous-adenocarcinoma-of-the-scrotum-about-a-case
#20
Abdelilah El Alaoui, Hicham El Boté, Oussama Ziouani, Oussman Dembele, Hachem El Sayegh, Ali Iken, Lounis Benslimane, Yassine Nouini
Scrotales fistulas are rare and often represent secondary lesions of tuberculosis. Mucinous adenocarcinomas are tumors containing at least 50% of extracellular mucus. They occur most commonly in the rectosigmoid; scrotal location is rare. We report the case of a 54-year old patient, with no particular past medical history, with secondary mucinous adenocarcinoma of the scrotum revealed by scrotal fistulas. The patient had suffered from recurrent scrotal fistulas for two years, with no other associated signs...
2017: Pan African Medical Journal
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