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Tumor regression grading in rectal cancer

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https://www.readbyqxmd.com/read/28326100/immunohistochemical-markers-as-predictors-of-histopathologic-response-and-prognosis-in-rectal-cancer-treated-with-preoperative-adjuvant-therapy-state-of-the-art
#1
REVIEW
Alessandro Del Gobbo, Stefano Ferrero
We explain the state of the art of the immunohistochemical markers of response in rectal cancers treated with neoadjuvant medical therapies and its implication with prognosis. Neoadjuvant chemoradiotherapy is widely used to improve the outcome of patients with locally advanced rectal cancer, and the evaluation of the effects of medical therapy is to date based on histomorphological examination by applying four grading systems of response to therapy (tumor regression grade (TRG)). The need to identify immunohistochemical markers that could ensure a better assessment of response and possibly provide additional prognostic information has emerged...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28294676/-treatment-results-of-patients-with-rectum-tumor-in-a-city-hospital
#2
Zoltán Banai, Béla Lestár, Lajos Berczi, József Földi, Zsigmond Harkai, Tibor Karácsony
INTRODUCTION: Two hundred and three patients were operated on with rectal malignancy between 2007 and 2014 in our surgical department. METHODS: Of these, patients who had cancer within 16 cm of the anal verge were included. 73 patients received neoadjuvant treatment and 130 patients were treated with primary resection. The specimens were graded by the Dworak and the Rödel regression score system. RESULTS: We found strong response in 45 patients and pathologic complete remission in three patients...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28293088/do-pathological-variables-have-prognostic-significance-in-rectal-adenocarcinoma-treated-with-neoadjuvant-chemoradiotherapy-and-surgery
#3
Luca Reggiani Bonetti, Simona Lionti, Federica Domati, Valeria Barresi
AIM: To clarify which factors may influence pathological tumor response and affect clinical outcomes in patients with locally advanced rectal carcinoma treated with neo-adjuvant chemoradiotherapy and surgery. METHODS: Tumor regression grade (TRG) according to the Dworak system and yTNM stage were assessed and correlated with pre-treatment clinico-pathological variables in 215 clinically locally advanced (cTNM stage II and III) rectal carcinomas. Prognostic value of all pathological and clinical factors on disease free survival (DFS) and cancer specific survival (CSS) was analyzed by Kaplan Meier and Cox-regression analyses...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28267003/prediction-of-pathological-complete-response-using-endoscopic-findings-and-outcomes-of-patients-who-underwent-watchful-waiting-after-chemoradiotherapy-for-rectal-cancer
#4
Kazushige Kawai, Soichiro Ishihara, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Teppei Morikawa, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. OBJECTIVE: This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28210855/lymph-node-retrieval-in-colorectal-cancer-determining-factors-and-prognostic-significance
#5
Johannes Betge, Lars Harbaum, Marion J Pollheimer, Richard A Lindtner, Peter Kornprat, Matthias P Ebert, Cord Langner
PURPOSE: The study aimed to analyze clinicopathological factors that determine the extent of lymph node retrieval and to evaluate its prognostic impact in patients with colorectal cancer (CRC). METHODS: The number of retrieved lymph nodes was analyzed in 381 CRC specimens. Lymph node count was related to different clinicopathological variables by binary logistic regression. Progression-free survival (PFS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method and Cox regression models...
February 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28177989/accuracy-of-mri-in-restaging-locally-advanced-rectal-cancer-after-preoperative-chemoradiation
#6
Joris J van den Broek, Floor S W van der Wolf, Max J Lahaye, Luc A Heijnen, Christof Meischl, Martin A Heitbrink, W Hermien Schreurs
BACKGROUND: Patients with a locally advanced rectal carcinoma benefit from preoperative chemoradiotherapy. MRI is considered the first choice imaging modality after preoperative chemoradiation, although its reliability for restaging is debatable. OBJECTIVE: The purpose of this study was to determine the accuracy of MRI in restaging locally advanced rectal cancer after preoperative chemoradiation. DESIGN: This was a retrospective study. SETTINGS: The study was conducted in a Dutch high-volume rectal cancer center...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28120325/predictive-factors-for-survival-in-neoadjuvant-radiochemotherapy-for-advanced-rectal-cancer
#7
A Reig Castillejo, I Membrive, P Foro, J Quera, X Sanz, N Rodriguez, E Fernández-Velilla, O Pera, A Ortiz, M Algara
INTRODUCTION: Neoadjuvant radiochemotherapy followed by radical surgery is the standard approach in advanced rectal carcinoma. Tumor response is determined in histological specimen. OBJECTIVE: To assess predictive factors for survival in 115 patients. PATIENTS AND METHOD: 115 patients treated with neoadjuvant radiochemotherapy followed by radical surgery with total mesorectal excision, in our hospital from January 2007 to December 2014. All patients received pelvic radiotherapy with concomitant chemotherapy, followed by radical surgery and in some adjuvant chemotherapy...
January 24, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28079398/feasibility-evaluation-of-diffusion-weighted-imaging-using-an-integrated-mri-radiotherapy-system-for-response-assessment-to-neoadjuvant-therapy-in-rectal-cancer
#8
Narek Shaverdian, Yingli Yang, Peng Hu, Steven Hart, Ke Sheng, James Lamb, Minsong Cao, Nzhde Agazaryan, David Thomas, Michael Steinberg, Daniel A Low, Percy Lee
OBJECTIVES: To evaluate the feasibility of on-board DWI with an integrated low-field MRI-radiotherapy system to assess responses to neoadjuvant chemoradiation (NAC) in rectal cancer. METHODS: A spin echo-based planar imaging diffusion sequence on a 0.35 T MRI-radiotherapy system was acquired over the course of NAC. The apparent diffusion coefficients (ADC) from the tumor region of interest (ROIs) were calculated. A functional diffusion map (fDM) was created showing a pixel-wise ADC analysis of the ROI over the course of treatment...
January 12, 2017: British Journal of Radiology
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
#9
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/28060748/is-the-pathological-regression-level-of-metastatic-lymph-nodes-associated-with-oncologic-outcomes-following-preoperative-chemoradiotherapy-in-rectal-cancer
#10
Jung Pil Choi, Sung Joo Kim, In Ja Park, Seung Mo Hong, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jung Bok Lee, Chang Sik Yu, Jin Cheon Kim
PURPOSE: The oncologic impact of the lymph node (LN) regression level after preoperative chemoradiotherapy (PCRT) has not been thoroughly evaluated. Hence, this study aimed to examine whether the regression level of metastatic LNs following PCRT is associated with oncologic outcomes in rectal cancer. RESULTS: The optimal number of cut points for LRG sum was determined to be three. The three LRG groups demonstrated different distributions according to the ypT and ypN stages (p < 0...
February 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28047611/su-f-r-48-early-prediction-of-pathological-response-of-locally-advanced-rectal-cancer-using-perfusion-ct-a-prospective-clinical-study
#11
K Nie, L Shi, N Yue, S Jabbour, S Kim, T Mao, L Qian, X Hu, X Sun, T Niu
PURPOSE: To prospectively evaluate the tumor vascularity assessed by perfusion CT for prediction of chemo-radiation treatment (CRT) response in locally advanced rectal cancer (LARC). METHODS: Eighteen consecutive patients (61.9±8.8 years, from March-June 2015) diagnosed with LARC who underwent 6-8 weeks CRT followed by surgery were included. The pre-treatment perfusion CT was acquired after a 5s delay of contrast agent injection for 45s with 1s interval. A total of 7-cm craniocaudal range covered the tumor region with 3-mm slice thickness...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042958/standardized-index-of-shape-dce-mri-and-standardized-uptake-value-pet-ct-two-quantitative-approaches-to-discriminate-chemo-radiotherapy-locally-advanced-rectal-cancer-responders-under-a-functional-profile
#12
Antonella Petrillo, Roberta Fusco, Mario Petrillo, Vincenza Granata, Paolo Delrio, Francesco Bianco, Biagio Pecori, Gerardo Botti, Fabiana Tatangelo, Corradina Caracò, Luigi Aloj, Antonio Avallone, Secondo Lastoria
PURPOSE: To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS: 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS)...
January 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/28035459/understanding-the-factors-associated-with-reduction-in-the-number-of-lymph-nodes-in-rectal-cancer-patients-treated-by-neoadjuvant-treatment
#13
L Bustamante-Lopez, C S Nahas, S C Nahas, U Ribeiro, C F Marques, G Cotti, A Rocco, I Cecconello
INTRODUCTION: Rectal cancer patients frequently present with locally advanced disease for which the standard of care includes neoadjuvant chemoradiotherapy followed by total mesorectal excision. Positive lymph nodes are one of the most powerful risk factors for recurrence and survival in colorectal cancer. In the absence of specific rectal guidelines, the literature recommends to the pathologist to optimize the number of rectal lymph nodes (LN) retrieved. We made a literature review in order to identify factors that could potentially affect the number of LN retrieved in specimens of patients with rectal cancer treated by chemoradiotherapy (CRT) followed by total mesorectal excision (TME)...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28011504/prognostic-and-therapeutic-potential-implications-of-genetic-variability-in-prostaglandin-e2-pathway-genes-in-rectal-cancer
#14
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
AIM: To evaluate the prognostic significance and potential therapeutic implication of genetic variability in prostaglandin E2 pathway genes in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery. MATERIALS AND METHODS: This cohort study included 167 patients with LARC, treated with nCRT followed by surgery. A total of 61 single nucleotide polymorphisms (SNPs) were characterized using the Sequenom platform through multiplex amplification followed by mass-spectometric product separation...
2017: Anticancer Research
https://www.readbyqxmd.com/read/27930716/mre11-and-atm-expression-levels-predict-rectal-cancer-survival-and-their-association-with-radiotherapy-response
#15
Vincent Ho, Liping Chung, Maxine Revoltar, Stephanie H Lim, Thein-Ga Tut, Askar Abubakar, Chris J Henderson, Wei Chua, Weng Ng, Mark Lee, Paul De Souza, Matthew Morgan, C Soon Lee, Joo-Shik Shin
BACKGROUND: Aberrant expression of DNA repair proteins is associated with poor survival in cancer patients. We investigated the combined expression of MRE11 and ATM as a predictive marker of response to radiotherapy in rectal cancer. METHODS: MRE11 and ATM expression were examined in tumor samples from 262 rectal cancer patients who underwent surgery for rectal cancer, including a sub-cohort of 54 patients who were treated with neoadjuvant radiotherapy. The relationship between expression of the two-protein panel and tumor regression grade (TRG) was assessed by Mann-Whitney U test and receiver operating characteristics area under curve (ROC-AUC) analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27824703/biomarker-based-scoring-system-for-prediction-of-tumor-response-after-preoperative-chemoradiotherapy-in-rectal-cancer-by-reverse-transcriptase-polymerase-chain-reaction-analysis
#16
Hyuk Hur, Inna Tulina, Min Soo Cho, Byung Soh Min, Woong Sub Koom, Joon Seok Lim, Joong Bae Ahn, Nam Kyu Kim
BACKGROUND: Numerous molecular markers have been investigated to predict tumor response after preoperative chemoradiotherapy for rectal cancer. OBJECTIVE: This study aimed to evaluate the predictive value of biomarkers for the prediction of tumor response after preoperative chemoradiotherapy. DESIGN & SETTING: Tumor specimens have been collected prospectively from 80 patients with rectal cancer who underwent curative resection at 8 weeks after completing preoperative chemoradiotherapy...
December 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27781400/comparison-of-outcomes-between-rectal-squamous-cell-carcinoma-and-adenocarcinoma
#17
Max S Chiu, Vivek Verma, Nathan R Bennion, Abhijeet R Bhirud, Jinluan Li, Mary E Charlton, Chandrakanth Are, Chi Lin
Large, population-based analyses of rectal squamous cell carcinoma (SCC) have not been previously conducted. We assessed patterns of care, prognostic factors, and outcomes of rectal SCC and adenocarcinoma (AC) in population-based cohorts. Surveillance, Epidemiology, and End Results (SEER) registry searches were performed (1998-2011), producing 42,308 nonmetastatic rectal cancer patients (999 SCC and 41,309 AC). Patient, tumor, and treatment characteristics were compared. Based on risk factors, SCC/AC groups were subdivided into low-, intermediate-, and high-risk groups...
December 2016: Cancer Medicine
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-data-base
#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...
March 1, 2017: Cancer
https://www.readbyqxmd.com/read/27740975/molecular-predictors-of-response-to-neoadjuvant-chemoradiation-for-rectal-cancer
#19
Yulia Kundel, Nicola J Nasser, Lea Rath-Wolfson, Ofer Purim, Natalia Yanichkin, Ronen Brenner, Tanya Zehavi, Yuval Nardi, Eyal Fenig, Aaron Sulkes, Baruch Brenner
OBJECTIVES: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. METHODS: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011...
October 12, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27740855/neutrophil-to-lymphocyte-ratio-nlr-and-derived-neutrophil-to-lymphocyte-ratio-d-nlr-predict-non-responders-and-postoperative-complications-in-patients-undergoing-radical-surgery-after-neo-adjuvant-radio-chemotherapy-for-rectal-adenocarcinoma
#20
Damiano Caputo, Marco Caricato, Alessandro Coppola, Vincenzo La Vaccara, Michele Fiore, Roberto Coppola
In order to evaluate neutrophil-to-lymphocyte ratio (NLR) and derived neutrophil-to-lymphocyte ratio (d-NLR) in predicting response and complications in rectal cancer patients who underwent surgery after neo-adjuvant radio-chemotherapy, 87 patients were evaluated. Cutoffs before and after radio-chemotherapy were respectively 2.8 and 3.8 for NLR, and 1.4 and 2.3 for d-NLR. They were analyzed in relation to clinical and pathological outcomes. Patients with preoperative NLR and d-NLR higher than cutoffs had significantly higher rates of tumor regression grade response (TRG ≥ 4) and postoperative complications...
October 14, 2016: Cancer Investigation
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