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Neoadjuvant chemotherapy in local advanced rectal cancer

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https://www.readbyqxmd.com/read/29745478/laparoscopic-abdominoperineal-resection-with-lateral-lymph-node-dissection-for-advanced-rectal-and-prostate-cancer-with-synchronous-lateral-lymph-node-metastases
#1
Takahisa Ishikawa, Shigenori Homma, Makoto Nishikawa, Hiroki Nakamoto, Ryoji Yokoyama, Akinobu Taketomi
Here we report a case of advanced rectal and prostate cancer with synchronous lateral lymph node (LLN) metastases that was treated with laparoscopic surgery. A 71-year-old man presented with fecal occult blood and was diagnosed with rectal cancer. A metastatic right LLN was suspected after CT examination of a 19-mm lymph node (proximal internal iliac artery region) and a 13-mm lymph node (distal internal iliac artery region) in the right lateral region. We planned neoadjuvant chemotherapy to suppress local and distant recurrence...
May 10, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29741977/laparoscopic-pelvic-exenteration-for-locally-advanced-rectal-cancer-technique-and-short-term-outcomes
#2
Ashish Pokharkar, Praveen Kammar, Ashwin D'souza, Rahul Bhamre, Pavan Sugoor, Avanish Saklani
BACKGROUND: Since last two decades minimally invasive techniques have revolutionized surgical field. In 2003 Pomel first described laparoscopic pelvic exenteration, since then very few reports have described minimally invasive approaches for total pelvic exenteration. METHODS: We report the 10 cases of locally advanced rectal adenocarcinoma which were operated between the periods from March 1, 2017 to November 11, 2017 at the Tata Memorial Hospital, Mumbai. All male patients had lower rectal cancer with prostate involvement on magnetic resonance imaging (MRI)...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29739356/korean-society-of-coloproctology-kscp-trial-of-consolidation-chemotherapy-for-locally-advanced-mid-or-low-rectal-cancer-after-neoadjuvant-concurrent-chemoradiotherapy-a-multicenter-randomized-controlled-trial-konclude
#3
Chang Woo Kim, Byung Mo Kang, Ik Yong Kim, Ji Yeon Kim, Sun Jin Park, Won Cheol Park, Ki Beom Bae, Byung-Noe Bae, Seong Kyu Baek, Seung Hyuk Baik, Gyung Mo Son, Yoon Suk Lee, Suk-Hwan Lee
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) has been a standard treatment option for locally advanced rectal cancer with improved local control. However, systemic recurrence despite neoadjuvant CRT remained unchanged. The only significant prognostic factor proven to be important was pathologic complete response (pCR) after neoadjuvant CRT. Several efforts have been tried to improve survival of patients who treated with neoadjuvant CRT and to achieve more pCR including adding cytotoxic chemotherapeutic agents, chronologic modification of chemotherapy schedule or adding chemotherapy during the perioperative period...
May 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29721045/long-term-outcome-of-oxaliplatin-and-capecitabine-xelox-concomitant-with-neoadjuvant-radiotherapy-and-extended-to-the-resting-period-in-high-risk-locally-advanced-rectal-cancer
#4
Jinghua Tang, Xiaojun Wu, Yanfang Bai, Yuanhong Gao, Wu Jiang, Lingheng Kong, Junzhong Lin, Desen Wan, Zhizhong Pan, Peirong Ding
Purpose: This study aimed at investigating the long-term outcomes of oxaliplatin and capecitabine (XELOX) administered concurrently with preoperative radiation and extended to the resting period in patients with high-risk locally advanced rectal cancer (LARC). Methods: From January 2010 to December 2013, 45 patients were recruited. Study treatment consisted two cycles of XELOX regimen concomitant with preoperative radiation and then followed by an additional cycle of XELOX regimen between completion of neoadjuvant radiotherapy and surgery...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29714663/assessment-of-bowel-and-anal-sphincter-function-after-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#5
Consuelo Rosa, Monica Di Tommaso, Luciana Caravatta, Annamaria Vinciguerra, Antonietta Augurio, Francesca Perrotti, Albina Allajbej, Marco Regoli, Isaia Al Zecca, Marta Di Nicola, Domenico Genovesi
PURPOSE: To report long-term effects on anorectal function and bowel disorders and late toxicity rate of preoperative chemoradiotherapy in patients with locally advanced rectal cancer. METHODS: Between 2000 and 2016, 201 patients treated with different neoadjuvant schedules of chemotherapy and radiotherapy doses were retrospectively analyzed. The Memorial Sloan-Kettering Cancer Center score was used for the evaluation of anal sphincter function. RESULTS: The median follow-up time was 68 months (interquartile range 35-113 months)...
April 1, 2018: Tumori
https://www.readbyqxmd.com/read/29710274/association-between-adjuvant-chemotherapy-and-overall-survival-in-patients-with-rectal-cancer-and-pathological-complete-response-after-neoadjuvant-chemotherapy-and-resection
#6
Fahima Dossa, Sergio A Acuna, Aaron S Rickles, Mariana Berho, Steven D Wexner, Fayez A Quereshy, Nancy N Baxter, Sami A Chadi
Importance: Although American guidelines recommend use of adjuvant chemotherapy in patients with locally advanced rectal cancer, individuals who achieve a pathological complete response (pCR) following neoadjuvant chemoradiotherapy are less likely to receive adjuvant treatment than incomplete responders. The association and resection of adjuvant chemotherapy with survival in patients with pCR is unclear. Objective: To determine whether patients with locally advanced rectal cancer who achieve pCR after neoadjuvant chemoradiation therapy and resection benefit from the administration of adjuvant chemotherapy...
April 19, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29710272/association-of-adjuvant-chemotherapy-with-overall-survival-in-patients-with-rectal-cancer-and-pathologic-complete-response-following-neoadjuvant-chemotherapy-and-resection
#7
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
https://www.readbyqxmd.com/read/29681787/the-response-to-neoadjuvant-chemoradiotherapy-with-5-fluorouracil-in-locally-advanced-rectal-cancer-patients-a-predictive-proteomic-signature
#8
Anaïs Chauvin, Chang-Shu Wang, Sameh Geha, Perrine Garde-Granger, Alex-Ane Mathieu, Vincent Lacasse, François-Michel Boisvert
Background: Colorectal cancer is the third most common and the fourth most lethal cancer in the world. In the majority of cases, patients are diagnosed at an advanced stage or even metastatic, thus explaining the high mortality. The standard treatment for patients with locally advanced non-metastatic rectal cancer is neoadjuvant radio-chemotherapy (NRCT) with 5-fluorouracil (5-FU) followed by surgery, but the resistance rate to this treatment remains high with approximately 30% of non-responders...
2018: Clinical Proteomics
https://www.readbyqxmd.com/read/29661280/prognostic-value-of-neoadjuvant-treatment-response-in-locally-advanced-rectal-cancer
#9
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
https://www.readbyqxmd.com/read/29650419/comparison-of-pathological-complete-response-rates-after-neoadjuvant-short-course-radiotherapy-or-chemoradiation-followed-by-delayed-surgery-in-locally-advanced-rectal-cancer
#10
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
https://www.readbyqxmd.com/read/29594202/time-to-surgery-and-pathologic-complete-response-after-neoadjuvant-chemoradiation-in-rectal-cancer-a-population-study-on-2094-patients
#11
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
https://www.readbyqxmd.com/read/29566109/adoption-of-total-neoadjuvant-therapy-for-locally-advanced-rectal-cancer
#12
Andrea Cercek, Campbell S D Roxburgh, Paul Strombom, J Joshua Smith, Larissa K F Temple, Garrett M Nash, Jose G Guillem, Philip B Paty, Rona Yaeger, Zsofia K Stadler, Kenneth Seier, Mithat Gonen, Neil H Segal, Diane L Reidy, Anna Varghese, Jinru Shia, Efsevia Vakiani, Abraham J Wu, Christopher H Crane, Marc J Gollub, Julio Garcia-Aguilar, Leonard B Saltz, Martin R Weiser
Importance: Treatment of locally advanced rectal (LARC) cancer involves chemoradiation, surgery, and chemotherapy. The concept of total neoadjuvant therapy (TNT), in which chemoradiation and chemotherapy are administered prior to surgery, has been developed to optimize delivery of effective systemic therapy aimed at micrometastases. Objective: To compare the traditional approach of preoperative chemoradiation (chemoRT) followed by postoperative adjuvant chemotherapy with the more recent TNT approach for LARC...
March 22, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29558294/mr-imaging-with-apparent-diffusion-coefficient-histogram-analysis-evaluation-of-locally-advanced-rectal-cancer-after-chemotherapy-and-radiation-therapy
#13
Nandin-Erdene Enkhbaatar, Shigeaki Inoue, Hiroshi Yamamuro, Shuichi Kawada, Masashi Miyaoka, Naoya Nakamura, Sotaro Sadahiro, Yutaka Imai
Purpose To determine response to neoadjuvant chemotherapy and radiation therapy in patients with locally advanced rectal cancer (LARC) by using magnetic resonance (MR) apparent diffusion coefficient (ADC) histogram analysis. Materials and Methods Ninety-two patients with LARC underwent MR imaging with rectal barium before and after chemotherapy and radiation therapy (CRT). Rectal expansion with barium expanded the lumen, provided similar imaging geometry before and after CRT, and eliminated fecal matter, air, and residual fluid...
March 20, 2018: Radiology
https://www.readbyqxmd.com/read/29545727/contemporary-management-of-locally-advanced-rectal-cancer-resolving-issues-controversies-and-shifting-paradigms
#14
Aeris Jane D Nacion, Youn Young Park, Nam Kyu Kim
Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/29520203/prognostic-significance-of-tumor-regression-in-locally-advanced-rectal-cancer-after-preoperative-radiochemotherapy
#15
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
https://www.readbyqxmd.com/read/29514017/mr-imaging-of-rectal-cancer-radiomics-analysis-to-assess-treatment-response-after-neoadjuvant-therapy
#16
Natally Horvat, Harini Veeraraghavan, Monika Khan, Ivana Blazic, Junting Zheng, Marinela Capanu, Evis Sala, Julio Garcia-Aguilar, Marc J Gollub, Iva Petkovska
Purpose To investigate the value of T2-weighted-based radiomics compared with qualitative assessment at T2-weighted imaging and diffusion-weighted (DW) imaging for diagnosis of clinical complete response in patients with rectal cancer after neoadjuvant chemotherapy-radiation therapy (CRT). Materials and Methods This retrospective study included 114 patients with rectal cancer who underwent magnetic resonance (MR) imaging after CRT between March 2012 and February 2016. Median age among women (47 of 114, 41%) was 55...
March 7, 2018: Radiology
https://www.readbyqxmd.com/read/29506843/pathologic-response-following-treatment-for-locally-advanced-rectal-cancer-does-location-matter
#17
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
https://www.readbyqxmd.com/read/29478127/impact-of-ras-braf-mutation-status-in-locally-advanced-rectal-cancer-treated-with-preoperative-chemotherapy
#18
Taihei Oshiro, Keisuke Uehara, Toshisada Aiba, Toshiki Mukai, Tomoki Ebata, Masato Nagino
PURPOSE: Our sincere hope is to establish the predictive factors of neoadjuvant chemotherapy (NAC) response and provide patients with greater certainty regarding treatment outcomes. The aim of this study was to assess the response to NAC and survival in patients with locally advanced rectal cancer (LARC) according to their RAS/BRAF mutation status. METHODS: Data on 57 patients with LARC who received NAC between 2009 and 2016 were analyzed retrospectively. The patients were classified into two groups based on their mutation status: wild-type in both RAS and BRAF (WT) or mutant-type in either RAS or BRAF (MT)...
February 24, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29464828/significance-of-tumor-infiltrating-lymphocytes-before-and-after-neoadjuvant-therapy-for-rectal-cancer
#19
Shinji Matsutani, Masatsune Shibutani, Kiyoshi Maeda, Hisashi Nagahara, Tatsunari Fukuoka, Shigetomi Nakao, Kosei Hirakawa, Masaichi Ohira
Neoadjuvant therapy for locally advanced rectal cancer is becoming increasingly common. However, biomarkers predicting the response to neoadjuvant therapy have not been established. Tumor-infiltrating lymphocytes (TILs) have a crucial effect on tumor progression and survival outcome as the primary host immune response, and an antitumor immune effect has been reported to contribute to the response to radiotherapy and chemotherapy. We investigated the significance of TILs before and after neoadjuvant treatment and the change in the density of those TILs...
April 2018: Cancer Science
https://www.readbyqxmd.com/read/29432076/neoadjuvant-chemotherapy-followed-by-radical-surgery-versus-concomitant-chemotherapy-and-radiotherapy-in-patients-with-stage-ib2-iia-or-iib-squamous-cervical-cancer-a-randomized-controlled-trial
#20
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 ( ClinicalTrials.gov 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
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