Nomogram Predicting Long-Term Survival After TME Surgery for Locally Advanced Rectal Cancer Based on 1798 Patients Treated in a Single Institution Between 2000 and 2010

2014 ◽  
Vol 90 (1) ◽  
pp. S23 ◽  
Author(s):  
W. Liu ◽  
N. Dinapoli ◽  
J. Jin ◽  
V. Valentini ◽  
E. Meldolesi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Single Institution ◽  
Term Survival ◽  
Long Term Survival

scholarly journals The Oncologic Efficacy and Long-term Survival Outcomes of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Systemic Review and Meta-Analysis

2021 ◽  
Author(s):  
Gan Bin Li ◽  
Yu Tao ◽  
Zhen Jun Wang ◽  
Zhai Wei Zhai ◽  
Jia-Gang Han
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Term Survival ◽  
Long Term Survival ◽  
Total Neoadjuvant Therapy

Abstract Purpose To evaluate the pooled oncologic efficacy of total neoadjuvant therapy for locally advanced rectal cancer patients using meta-analysis method.Method To evaluate the pooled effects of total neoadjuvant therapy in terms of exact oncologic efficacy and long-term survival outcomes, a systemic literature search of PubMed, Embase, China Biology Medicine and WanFang Database was performed.Results A total of 15 studies including 4091 patients were finally identified. The pooled analysis revealed that total neoadjuvant therapy significantly increased the rates of T-downstaging (OR=2.16, 95% CI:1.63~2.87, P<0.00001), pathologic complete response (OR=1.90, 95% CI:1.60~2.27, P<0.00001) and R0 resection (OR=1.44, 95% CI: 1.07~1.93, P=0.01) with a comparable safety profile. Most importantly, patients received total neoadjuvant therapy had a superior overall survival rate compared to standard neoadjuvant chemoradiotherapy (HR=0.74, 95% CI: 0.62~0.89, P=0.001).Conclusion Patients with locally advanced rectal cancer can be managed with total neoadjuvant therapy with a superior short-term oncologic efficacy and long-term survival benefits.

scholarly journals Prognostic significance of tumor regression in locally advanced rectal cancer after preoperative radiochemotherapy

2017 ◽  
Vol 52 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Mirko Omejc ◽  
Maja Potisek
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Tumor Regression ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Preoperative Radiochemotherapy ◽  
Term Survival

AbstractBackgroundThe 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 methodsPatients with rectal cancer stage II or III, treated between 2006 and 2010, were included in a retrospective study. Clinical and pathohistologic data were acquired from computer databases and information about survival from Cancer Registry. Survival was estimated according to Kaplan-Meier method. Significance of prognostic factors was evaluated in univariate analysis; comparison was carried out with log-rank test. The multivariate analysis was performed according to the Cox regression model; statistically significant variables from univariate analysis were included.ResultsTwo hundred and two patients met inclusion criteria. Median follow-up was 53.2 months. Stage ypT0N0 (pathologic complete response, pCR) was observed in 14.8% of patients. Pathohistologic stage had statistically significant impact on survival (p = 0.001). 5-year survival in patients with pCR was>90%. Postoperative T and N status were also found to be statistically significant (p = 0.011 for ypT and p < 0.001 for ypN). According to multivariate analysis, tumor response to neoadjuvant therapy was the only independent prognostic factor (p = 0.003).ConclusionsPathologic response of tumor to preoperative radiochemotherapy is an important prognostic factor for prediction of long-term survival of patients with locally advanced rectal cancer.

scholarly journals Do the Locally Advanced Rectal Cancer Patients Enjoy Long-term Survival Benefit From the Radiation-based Neoadjuvant Treatments in the Total Mesorectal Excision Era: a Population-based Analysis

2021 ◽  
Author(s):  
Lei Wang ◽  
Xiaohong Zhong ◽  
Huaqin Lin ◽  
Xueqing Zhang ◽  
Lingdong Shao ◽  
...  
Keyword(s):  
Preoperative Radiotherapy ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Population Based ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision ◽  
Training Set ◽  
Term Survival ◽  
Long Term Survival

Abstract Background: Radiation-based neoadjuvant therapy followed by radical surgery is the standard treatment for locally advanced rectal cancer (LARC), but things might have changed with the advent of total mesorectal excision (TME). This study re-evaluated the clinical efficacy of preoperative radiotherapy for LARC patients in the TME era by population-based analysis to identify any long-term survival benefits. Methods: LARC patients receiving preoperative radiotherapy or not followed by surgery between 2011 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was analyzed by Kaplan-Meier curves, and potential candidates for preoperative radiotherapy were identified by nomogram. Results: There were 7582 eligible patients; 6066 received preoperative radiotherapy, and 1516 received non-preoperative radiotherapy. The initial result showed that the pooled hazard ratio (HR) for OS was in favor of preoperative radiotherapy compared with non-preoperative radiotherapy group (HR = 0.86, 95% confidence interval (CI) = 0.75-0.98, P <0.05). The cases were randomly divided into training and validation datasets, and multivariate Cox regression analysis of the training set determined that age, sex, carcinoembryonic antigen level, tumor stage, node stage, tumor differentiation, perineural invasion, and the number of dissected lymph nodes were independent risk factors for OS in the training set (all P <0.05). A nomogram was established based on the risk factors to predict the OS (concordance index, training set: 0.70, validation set: 0.67). Further analysis showed that the long-term survival of high-risk patients was better with preoperative radiotherapy (HR = 0.71, 95% CI = 0.56-0.91, P <0.05). Conclusions: Preoperative radiotherapy has long-term survival benefits for LARC patients, especially those with high risk.

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