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Tumor regression grading in rectal cancer

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https://www.readbyqxmd.com/read/28918544/tumor-regression-grading-of-gastrointestinal-cancers-after-neoadjuvant-therapy
#1
REVIEW
Rupert Langer, Karen Becker
Neoadjuvant therapy has been successfully introduced in the treatment of locally advanced gastrointestinal malignancies, particularly esophageal, gastric, and rectal cancers. The effects of preoperative chemo- or radiochemotherapy can be determined by histopathological investigation of the resection specimen following this treatment. Frequent histological findings after neoadjuvant therapy include various amounts of residual tumor, inflammation, resorptive changes with infiltrates of foamy histiocytes, foreign body reactions, and scarry fibrosis...
September 16, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28900999/-study-on-the-relationship-between-tumor-regression-grade-and-lymph-node-regression-grade
#2
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/28888798/impact-of-body-mass-index-on-treatment-outcome-of-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#3
REVIEW
Y Sun, Z Xu, H Lin, X Lu, Y Huang, S Huang, X Wang, P Chi
AIM: To determine the effect of obesity, measured by body mass index (BMI), on tumor response and surgical outcome in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT) and radical surgery. METHOD: LARC patients undergoing nCRT and radical surgery from 2008 to 2014 were included and divided into three groups: non-obese (BMI < 25.0 kg/m(2)), obese I (BMI 25.0-29.9 kg/m(2)), and obese II (BMI ≥ 30.0 kg/m(2))...
August 10, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28884049/potential-predictive-factors-for-pathologic-complete-response-after-the-neoadjuvant-treatment-of-rectal-adenocarcinoma-a-single-center-experience
#4
Feryel Letaief, Meher Nasri, Mouna Ayadi, Khedija Meddeb, Amina Mokrani, Yosra Yahyaoui, Nesrine Chraiet, Henda Raies, Amel Mezlini
OBJECTIVE: : To assess the response rate of patients with rectal adenocarcinoma to neoadjuvant therapy and to identify the predictors of histological regression after neoadjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). METHODS: : This study recruited 64 patients. The patients had resectable cancer of the lower and the middle rectum (T3/T4 and/or N+) without distant metastasis and received neoadjuvant RT or CCRT followed by radical surgery with total mesorectal excision (TME) between January 2006 and December 2011...
August 2017: Cancer Biology & Medicine
https://www.readbyqxmd.com/read/28870789/panitumumab-in-combination-with-preoperative-radiation-therapy-in-patients-with-locally-advanced-ras-wild-type-rectal-cancer-results-of-the-multicenter-explorative-single-arm-phase-2-study-neorit
#5
Kirsten Merx, Uwe M Martens, Melanie Kripp, Thomas Hoehler, Michael Geissler, Timo Gaiser, Sabine Mai, Peter Kienle, Sebastian Belle, Christoph Plöger, Udo Hieber, Frederik Wenz, Stefan Post, Ralf D Hofheinz
PURPOSE: Studies investigating combinations of anti-epidermal growth factor receptor monoclonal antibodies such as panitumumab or cetuximab with standard chemoradiation therapy protocols in rectal cancer have yielded disappointing results. Because of the supposed negative interaction of epidermal growth factor receptor inhibition and chemoradiation therapy, we conducted a phase 2 study using single-agent panitumumab in combination with radiation therapy in patients with RAS wild-type locally advanced rectal cancer...
June 28, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28865674/tumor-regression-grade-after-neoadjuvant-chemoradiation-and-surgery-for-low-rectal-cancer-evaluated-by-multiple-correspondence-analysis-ten-years-as-minimum-follow-up
#6
Raffaello Mancini, Giada Pattaro, Maria Grazia Diodoro, Isabella Sperduti, Carlo Garufi, Vittoria Stigliano, Pasquale Perri, Gian Luca Grazi, Maurizio Cosimelli
BACKGROUND: The role of Mandard's tumor regression grade (TRG) classification is still controversial in defining the prognostic role of patients who have undergone neoadjuvant chemoradiation (CRT) and total mesorectal excision. The present study evaluated multiple correspondence analysis (MCA) as a tool to better cluster variables, including TRG, for a homogeneous prognosis. PATIENTS AND METHODS: A total of 174 patients with a minimum follow-up period of 10 years were stratified into 2 groups: group A (TRG 1-3) and group B (TRG 4-5) using Mandard's classification...
August 9, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28830475/preoperative-intensity-modulated-radiotherapy-with-a-simultaneous-integrated-boost-combined-with-capecitabine-in-locally-advanced-rectal-cancer-short-term-results-of-a-multicentric-study
#7
Marco Lupattelli, Fabio Matrone, Maria Antonietta Gambacorta, Mattia Osti, Gabriella Macchia, Elisa Palazzari, Luca Nicosia, Federico Navarria, Giuditta Chiloiro, Vincenzo Valentini, Cynthia Aristei, Antonino De Paoli
BACKGROUND: Preoperative radiotherapy (RT) in combination with fluoropyrimidine-based chemotherapy (CT) is the standard of care in patients with locally advanced, T3-T4 N0-2, rectal cancer (LARC). Given the correlation between RT dose-tumor response and the prognostic role of the tumor regression grade (TRG), treatment intensification represents an area of active investigation. The aim of the study was to analyze the role of RT dose-intensification in the preoperative treatment of LARC in terms of feasibility, efficacy and toxicity...
August 22, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28778099/predictive-clinical-model-of-tumor-response-after-chemoradiation-in-rectal-cancer
#8
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
Survival improvement in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT) is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. The ability to predict tumor response before treatment may significantly have impact the selection of patients for nCRT in rectal cancer. The aim is to identify potential predictive pretreatment factors for Mandard response and build a clinical predictive model design. 167 patients with locally advanced rectal cancer were treated with nCRT and curative surgery...
July 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28766076/multicenter-analysis-of-risk-factors-for-anastomotic-leakage-after-middle-and-low-rectal-cancer-resection-without-diverting-stoma-a-retrospective-study-of-319-consecutive-patients
#9
Wei Zhang, Zheng Lou, Qizhi Liu, Ronggui Meng, Haifeng Gong, Liqiang Hao, Peng Liu, Ge Sun, Jun Ma, Wei Zhang
PURPOSE: The purpose of this study was to evaluate the risk factors for anastomotic leakage (AL) after anterior resection for middle and low rectal cancer in order to help surgeons to decide which patients could benefit from a diverting stoma. METHODS: Data on 319 patients having a middle and low rectal cancer resection with anastomosis between May 2011 and October 2015 from two hospitals were included in the study. The analysis included the following variables: patient-related variables (gender, age, diabetes mellitus, ASA score, preoperative radiochemotherapy, body mass index, blood hemoglobin, and serum albumin level), tumor-related variables (K-ras status, distance of tumor from the anal verge, histopathologic grade, pathological T stage, pathological N stage, pathological M stage, TNM stage, and tumor size), and surgery-related variables (laparoscopic or open surgery, blood loss, and operative time)...
August 2, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28728151/a-modified-classification-of-prognostic-factors-based-on-pathological-stage-and-tumor-regression-grade-in-patients-with-rectal-cancer-who-receive-preoperative-chemoradiotherapy
#10
Toshiyuki Suzuki, Sotaro Sadahiro, Akira Tanaka, Kazutake Okada, Gota Saito, Hiroshi Miyakita, Takeshi Akiba, Hiroshi Yamamuro
OBJECTIVE: The histologic response to neoadjuvant chemoradiotherapy (CRT) has been intimately related to outcomes in locally advanced rectal cancer. However, reliable prognostic factors have yet to be established. SUBJECTS AND METHODS: The study group comprised 198 patients with locally advanced rectal cancer who received CRT. A modified classification based on the combination of ypStage and tumor regression grade (TRG) was developed. ypStage II with TRG 2 was classified as ypTRGstage IIA, and ypStage II with TRG 3 or 4 was classified as ypTRGstage IIB...
July 21, 2017: Oncology
https://www.readbyqxmd.com/read/28717704/significance-of-magnetic-resonance-imaging-assessed-tumor-response-for-locally-advanced-rectal-cancer-treated-with-preoperative-long-course-chemoradiation
#11
Mohamed Salah Fayaz, Gerges Attia Demian, Wael Moftah Fathallah, Heba El-Sayed Eissa, Mustafa Shawki El-Sherify, Sadeq Abozlouf, Thomas George, Suzanne Mona Samir
PURPOSE: To study the predictive and prognostic value of magnetic resonance imaging (MRI)-assessed tumor response after long-course neoadjuvant therapy for locally advanced rectal cancer. METHODS: This study included 79 patients who had T3 or T4 and/or N+ rectal cancer treated with long-course neoadjuvant chemoradiation. MRI-assessed tumor regression grade (mrTRG) was assessed in 64 patients. MRIs were reviewed by the study radiologist. Surgical and pathologic reports for those who underwent surgery were reviewed...
August 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28703886/dual-energy-ct-a-possible-new-method-to-assess-regression-of-rectal-cancers-after-neoadjuvant-treatment
#12
Issam Al-Najami, Henrik C Drue, Robert Steele, Gunnar Baatrup
BACKGROUND AND OBJECTIVES: The measurement of tumor regression after neoadjuvant oncological treatment has gained increasing interest because it has a prognostic value and because it may influence the method of treatment in rectal cancer. The assessment of tumor regression remains difficult and inaccurate with existing methods. Dual Energy Computed Tomography (DECT) enables qualitative tissue differentiation by simultaneous scanning with different levels of energy. We aimed to assess the feasibility of DECT in quantifying tumor response to neoadjuvant therapy in loco-advanced rectal cancer...
July 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28693154/association-between-the-expression-of-micrornas-and-the-response-of-patients-with-locally-advanced-rectal-cancer-to-preoperative-chemoradiotherapy
#13
Anne Haahr Mellergaard Eriksen, Flemming Brandt Sørensen, Rikke Fredslund Andersen, Anders Jakobsen, Torben Frøstrup Hansen
Preoperative chemoradiotherapy (CRT) followed by mesorectal excision is the standard treatment for patients with locally advanced rectal cancer (LARC). The balance between treatment efficacy and toxicity is a major issue in the clinical management of these patients. There is a requirement for the identification of predictive molecular biomarkers for the response of patients to CRT. The present study aimed to analyze the association between microRNA (miRNA/miR) expression and treatment efficacy in patients with LARC who were treated with preoperative CRT...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28682967/applicability-of-american-joint-committee-on-cancer-and-college-of-american-pathologists-regression-grading-system-in-rectal-cancer
#14
Tarkan Jäger, Daniel Neureiter, Romana Urbas, Eckhard Klieser, Wolfgang Hitzl, Klaus Emmanuel, Adam Dinnewitzer
BACKGROUND: Different tumor grading systems have been proposed to predict the association between tumor response and clinical outcome after preoperative chemoradiotherapy in patients with rectal cancer. The American Joint Committee on Cancer and College of American Pathologists regression grading system was recommended as the standard tumor regression grading system for rectal adenocarcinoma. OBJECTIVE: This study evaluated the clinical applicability of the American Joint Committee on Cancer and College of American Pathologists regression grading system in neoadjuvant-treated patients with rectal cancer...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28643307/-application-of-magnetic-resonance-in-non-operative-treatment-strategy-for-rectal-cancer
#15
Yi Wang, Gong Chen
The primary curative modality for localized rectal cancer is total mesorectal excision (TME). Local control rate of rectal cancer has been improved after neoadjuvant chemoradiotherapy and even pathological complete response (pCR) has been demonstrated in a significant minority. Patients who achieve pCR to neoadjuvant chemoradiotherapy have an excellent prognosis compared with those without pCR. If the patients with complete response to neoadjuvant chemoradiation can be demonstrated by clinical findings and medical imaging (cCR), a non-operative management (NOM) strategy may be pursued to preserve sphincter function and avoid complications induced by TME, which is a new tendency in the treatment of rectal cancer in recent years...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28638446/overexpression-of-transcobalamin-1-is-an-independent-negative-prognosticator-in-rectal-cancers-receiving-concurrent-chemoradiotherapy
#16
Yi-Ying Lee, Yu-Ching Wei, Yu-Feng Tian, Ding-Ping Sun, Ming-Jen Sheu, Ching-Chieh Yang, Li-Ching Lin, Chen-Yi Lin, Chung-Hsi Hsing, Wan-Shan Li, Chien-Feng Li, Pei-Ling Hsieh, Ching-Yih Lin
Objective: Neoadjuvant concurrent chemoradiotherapy (CCRT) is an increasingly common therapeutic strategy for locally advanced rectal cancer, but stratification of risk and final outcomes remain a major challenge. Transcobalamin 1 (TCN1), a vitamin B12 (cobalamin)-binding protein, regulates cobalamin homeostasis. High expression of TCN1 have been reported in neoplasms such as breast cancer and hepatocellular carcinoma. However, little is known about the relevance of TCN1 to rectal cancer receiving CCRT. This study examined the predictive and prognostic impact of TCN1 expression in patients with rectal cancer following neoadjuvant CCRT...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28628734/effect-of-abdominopelvic-sepsis-on-cancer-outcome-in-patients-undergoing-sphincter-saving-surgery-for-rectal-cancer
#17
Dirk Van de Putte, Elke Van Daele, Wouter Willaert, Piet Pattyn, Wim Ceelen, Yves Van Nieuwenhove
BACKGROUND: In rectal cancer, the significance of abdominopelvic sepsis (APS) on metastatic tumor growth remains uncertain. We aimed to analyze the effect of abdominopelvic sepsis on long-term survival in patients undergoing restorative rectal cancer surgery. METHODS: Data were used from the Belgian PROCARE rectal cancer registry. The effect of abdominopelvic infection on survival was assessed in uni- and multivariable Cox regression models. The effect of clinical and pathological covariates was controlled by propensity score-based matching of cases with controls...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28621318/natural-killer-like-signature-observed-post-therapy-in-locally-advanced-rectal-cancer-is-a-determinant-of-pathological-response-and-improved-survival
#18
Matthew Alderdice, Philip D Dunne, Aidan J Cole, Paul G O'Reilly, Darragh G McArt, Vicky Bingham, Marc-Aurel Fuchs, Stephen McQuaid, Maurice B Loughrey, Graeme I Murray, Leslie M Samuel, Mark Lawler, Richard H Wilson, Manuel Salto-Tellez, Vicky M Coyle
Around 12-15% of patients with locally advanced rectal cancer undergo a pathologically complete response (tumor regression grade 4) to long-course preoperative chemoradiotherapy; the remainder exhibit a spectrum of tumor regression (tumor regression grade 1-3). Understanding therapy-related transcriptional alterations may enable better prediction of response as measured by progression-free and overall survival, in addition to aiding the development of improved strategies based on the underlying biology of the disease...
September 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28608017/relationship-between-expression-of-proteins-ercc1-ercc2-and-xrcc1-and-clinical-outcomes-in-patients-with-rectal-cancer-treated-with-folfox-based-preoperative-chemoradiotherapy
#19
Ming-Yii Huang, Joh-Jong Huang, Chun-Ming Huang, Chih-Hung Lin, Hsiang-Lin Tsai, Ching-Wen Huang, Chee-Yin Chai, Chia-Yang Lin, Jaw-Yuan Wang
BACKGROUND: Platinum resistance enhances DNA damage repair through nucleotide excision repair mechanisms involving the excision repair cross-complementing group 1 (ERCC1), X-ray cross-complementing group 1 (XRCC1), and excision repair cross-complementing group 2 (ERCC2). We evaluated the correlation between the expression of these three DNA repair genes and clinical outcomes in patients with rectal cancer receiving FOLFOX-based preoperative chemoradiotherapy (CRT). METHODS: Using immunohistochemistry, we examined the expression of ERCC1, ERCC2, and XRCC1 in pre-CRT cancer tissues from 86 patients with rectal cancer who had undergone curative resection and preoperative CRT with FOLFOX-4 to identify potential predictors of clinical outcomes...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28534328/-predictive-value-of-serum-carcinoembryonic-antigen-level-in-efficacy-and-prognosis-for-patients-with-rectal-cancer-following-preoperative-radiochemotherapy
#20
Dakui Zhang, Tiancheng Zhan, Ming Li, Jin Gu
OBJECTIVE: To examine the association of preoperative carcinoembryonic antigen (CEA) level with the efficacy of neoadjuvant radiochemotherapy and postoperative metastasis and relapse in patients with rectal cancer. METHODS: Between January 2011 and January 2014, 325 patients with local advanced rectal cancer underwent preoperative radiochemotherapy and radical operation in Department of Colorectal Cancer Surgery, Beijing University Cancer Hospital, including 194 males and 131 females...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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