Laparoscopic Versus Open Pre-Treatment Loop Colostomy for Fecal Diversion in Rectal Cancer Patients: Is Laparoscopic Colostomy Better?

479 Background: CD133 has been described as a stem cell marker in colorectal cancer and is associated with higher tumorigenic potential and resistance to radiochemotherapy (RCT). In this study the expression of CD133 was evaluated in pre-treatment tumor biopsies and corresponding post-treatment surgical specimens of locally advanced rectal cancer patients undergoing multimodal therapy and was correlated to histopathological features and clinical follow-up. Methods: 97 patients with UICC II/III rectal cancer treated with preoperative 5-FU based RCT within the German Rectal Cancer Trials were investigated. Pre- and post-treatment CD133 expression levels were determined using immunhistochemistry and correlated with histopathologic parameters, tumor regression, tumor recurrence and disease-free survival (DFS). Results: As compared to pre-treatment biopsies we observed a significantly higher CD133 expression in post-treatment tumor specimens (p=0.01). There was, however, no correlation for both biopsies and tumor specimens between CD133 expression levels, pathological characteristics and survival. In matched analyses of corresponding biopsy/tumor pairs, patients with a decreased number of CD133 positive cells after preoperative RCT showed significantly lower post-treatment tumor stages (p=0.03) and higher histopathological tumor regression (p<0.01). Moreover, these patients had a significantly improved DFS in uni- (p<0.001) and multivariate analyses (p=0.001). Conclusions: CD133 expression displays a marker with prognostic and monitoring validity in rectal cancer patients. A decrease of the CD133 positive cell fraction in post-treatment tumor tissue is associated with a more favorable outcome after preoperative RCT.

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AB023. 209. Assessment of tumour budding in pre-treatment biopsies and its impact on outcomes in locally advanced rectal cancer patients

Mesentery and Peritoneum ◽

10.21037/map.2018.ab023 ◽

2018 ◽

Vol 2 ◽

pp. AB023-AB023

Author(s):

Ben Creavin ◽

Eanna Ryan ◽

Aoife McCarthy ◽

David Gibbons ◽

Kieran Sheahan ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Patients ◽

Locally Advanced ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Pre Treatment ◽

Tumour Budding

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Fecal Diversion in Rectal Cancer Patients Undergoing Sphincter Saving Resection is Associated with a Higher Morbidity and Readmission Rate but a Lower Reoperation Rate vs Non-Diverted Patients

Gastroenterology ◽

10.1016/s0016-5085(17)34330-5 ◽

2017 ◽

Vol 152 (5) ◽

pp. S1298

Author(s):

Hiromichi Miyagaki ◽

Chandana Herath Mudiyanselage ◽

Erica Pettke ◽

Abhinit Shah ◽

Xiaohong Yan ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Patients ◽

Readmission Rate ◽

Reoperation Rate ◽

Fecal Diversion ◽

Sphincter Saving Resection ◽

Sphincter Saving

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A panel of tumor biomarkers to predict complete pathological response to neo-adjuvant treatment in Locally Advanced Rectal Cancer

Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics ◽

10.3727/096504021x16232280278813 ◽

2021 ◽

Author(s):

Chiara Dalle Fratte ◽

Silvia Mezzalira ◽

Jerry Polesel ◽

Elena De Mattia ◽

Antonio Palumbo ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Patients ◽

Pathological Complete Response ◽

Locally Advanced ◽

Neoadjuvant Chemoradiotherapy ◽

Complete Response ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Classification And Regression Tree ◽

Pre Treatment

Pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients is related to a favorable prognosis. The identification of early biomarkers predictive of pathological complete response would help to optimize the multimodality management of the patients. A panel of 11 tumor-related proteins was investigated by immunohistochemistry in the pre-treatment biopsy of a group of locally advanced rectal cancer patients, to identify early biomarkers of pathological complete response to neoadjuvant chemoradiotherapy. A mono-institutional retrospective cohort of 95 stage II/III locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy and surgery was selected based on clinical-pathological characteristics and the availability of a pre-treatment tumor biopsy. Eleven selected protein markers expression (MLH1, GLUT1, Ki67, CA-IX, CXCR4, COX2, CXCL12, HIF1, VEGF, CD44, and RAD51) was investigated. The optimal cut-off values were calculated by receiver operating characteristic curve analysis. Classification and regression tree analysis was performed to investigate the biomarkers interaction. Patients presenting either Ki67, HIF1 or RAD51 below the cut-off value, or CXCR4 or COX2 above the cut-off value, were more likely to get a pathological complete response. Classification and regression tree analysis identified three groups of patients resulting from the combination of Ki67 and CXCR4 expression. Patients with high expression of Ki67 had the lowest chance to get a pathological complete response (18%), as compared to patients with low expression of both Ki67 and CXCR4 (29%), and patients with low Ki67 and high CXCR4 expression (70%). Pre-treatment Ki67, CXCR4, COX2, HIF1, RAD51 in tumor biopsies are associated with pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. A combined evaluation of Ki67 and CXCR4 would increase their predictive potential. If validated, their optimal cut-off could be used to select patients for a tailored multi-modality treatment.

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