scholarly journals Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Shu-Biao Ye ◽  
Yi-Kan Cheng ◽  
Lin Zhang ◽  
Yi-Feng Zou ◽  
Ping Chen ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Mismatch Repair ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Neoadjuvant Radiotherapy ◽  
Radio Therapy ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Prior reports have indicated that defective mismatch repair (MMR) has a favorable impact on outcome in colorectal cancer patients treated with surgery, immunotherapy, or adjuvant chemotherapy. However, the impact of MMR status on response to neoadjuvant radiotherapy in rectal cancer is not well understood. Here we report that dMMR was associated with improved disease-free survival (DFS) (P = 0.034) in patients receiving neoadjuvant chemotherapy (NCT). Patients with dMMR tumors who received neoadjuvant chemoradiotherapy (NCRT) achieved significantly worse DFS (P = 0.026) than those treated with NCT. Conversely, NCRT improved DFS (P = 0.043) in patients with pMMR tumors, especially for stage III disease with improved DFS (P = 0.02). The presence of dMMR was associated with better prognosis in rectal cancer patients treated with NCT. NCT benefited patients with dMMR tumors; while NCRT benefited patients with stage III disease and pMMR tumors. Patients stratified by MMR status may provide a more tailored approach to rectal cancer neoadjuvant therapy.

scholarly journals Elevated Platelet Count as Predictor of Recurrence in Rectal Cancer Patients Undergoing Preoperative Chemoradiotherapy Followed by Surgery

2015 ◽  
Vol 100 (2) ◽  
pp. 199-207 ◽  
Author(s):  
Yuji Toiyama ◽  
Yasuhiro Inoue ◽  
Mikio Kawamura ◽  
Aya Kawamoto ◽  
Yoshinaga Okugawa ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Poor Overall Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Impact

The impact of systemic inflammatory response (SIR) on prognostic and predictive outcome in rectal cancer after neoadjuvant chemoradiotherapy (CRT) has not been fully investigated. This retrospective study enrolled 89 patients with locally advanced rectal cancer who underwent neoadjuvant CRT and for whom platelet (PLT) counts and SIR status [neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR)] were available. Both clinical values of PLT and SIR status in rectal cancer patients were investigated. Elevated PLT, NLR, PLR, and pathologic TNM stage III [ypN(+)] were associated with significantly poor overall survival (OS). Elevated PLT, NLR, and ypN(+) were shown to independently predict OS. Elevated PLT and ypN(+) significantly predicted poor disease-free survival (DFS). Elevated PLT was identified as the only independent predictor of DFS. PLT counts are a promising pre-CRT biomarker for predicting recurrence and poor prognosis in rectal cancer.

The Impact of the Lymph Node Ratio is Greater than Traditional Lymph Node Status in Stage III Colorectal Cancer Patients

2013 ◽  
Vol 37 (8) ◽  
pp. 1927-1933 ◽  
Author(s):  
Yen-Jung Lu ◽  
Pei-Ching Lin ◽  
Chun-Chi Lin ◽  
Huann-Sheng Wang ◽  
Shung-Haur Yang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Ratio ◽  
Stage Iii ◽  
Lymph Node Status ◽  
Node Status ◽  
Node Ratio ◽  
Colorectal Cancer Patients ◽  
The Impact

scholarly journals The impact of COVID-19 pandemic on colorectal cancer patients: a single-center retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Xu ◽  
Zong-Hao Huang ◽  
Charlie Zhi-Lin Zheng ◽  
Cong Li ◽  
Yu-Qin Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Major Complication ◽  
Control Group ◽  
Endoscopic Polypectomy ◽  
Curative Surgery ◽  
Neoadjuvant Radiotherapy ◽  
Number Of Patients ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Background Since December 2019, China has experienced a public health emergency from the coronavirus disease, which has become a pandemic and is impacting the care of cancer patients worldwide. This study evaluated the impact of the pandemic on colorectal cancer (CRC) patients at our center and aimed to share the lessons we learned with clinics currently experiencing this impact. Methods We retrospectively collected data on CRC patients admitted between January 1, 2020 and May 3, 2020; the control group comprised patients admitted between January 1, 2019 and May 3, 2019. Results During the pandemic, outpatient volumes decreased significantly, especially those of nonlocal and elderly patients, whereas the number of patients who received chemotherapy and surgery remained the same. During the pandemic, 710 CRC patients underwent curative resection. The proportion of patients who received laparoscopic surgeries was 49.4%, significantly higher than the 39.5% during the same period in 2019. The proportion of major complication during the pandemic was not significantly different from that of the control group. The mean hospital stay was significantly longer than that of the control group. Conclusions CRC patients confirmed to be infection-free can receive routine treatment. Using online medical counseling and appropriate identification, treatment and follow-up can be effectively maintained. Adjuvant and palliative chemotherapy should not be discontinued. Endoscopic polypectomy, elective, palliative, and multidisciplinary surgeries can be postponed, while curative surgery should proceed as usual. For elderly CRC patients, endoscopic surgery and neoadjuvant radiotherapy are recommended.

scholarly journals Folate pathway genes linked to mitochondrial biogenesis and respiration are associated with outcome of patients with stage III colorectal cancer

Tumor Biology ◽  
2019 ◽  
Vol 41 (6) ◽  
pp. 101042831984623 ◽  
Author(s):  
Elisabeth Odin ◽  
Arvid Sondén ◽  
Göran Carlsson ◽  
Bengt Gustavsson ◽  
Yvonne Wettergren
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Mitochondrial Biogenesis ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Free Survival ◽  
Folate Pathway ◽  
Colorectal Cancer Patients ◽  
Disease Free

5-fluorouracil in combination with the folate leucovorin is the cornerstone in treatment of colorectal cancer. Transport of leucovorin into cells, and subsequent metabolic action, require expression of several genes. The aim was to analyze if tumoral expression of genes putatively involved in leucovorin transport, polyglutamation, or metabolism was associated with outcome of patients with stage III colorectal cancer treated with adjuvant chemotherapy. A total of 363 stage III colorectal cancer patients who received adjuvant bolus 5-fluorouracil + leucovorin alone, or in combination with oxaliplatin according to Nordic bolus regimes were included. Expression of 11 folate pathway genes was determined in tumors using quantitative real-time polymerase chain reaction and related to disease-free survival. The median follow-up time was 5 years. During follow-up, 114 (31%) patients suffered from recurrent disease. A high tumoral expression of the genes SLC46A1/PCFT, SLC19A1/RFC-1, ABCC3/MRP3, GGH, and MTHFD1L, which are involved in folate transport, polyglutamation, or metabolism, was associated with longer disease-free survival of the patients. Each of these genes either encodes mitochondrial enzymes or is being regulated by mitochondrial transcription factors. Expression of the SLC46A1/PCFT gene was most strongly associated with disease-free survival, regardless of treatment regimen. In conclusion, the results show that expression of folate pathway genes are associated with outcome of colorectal cancer patients treated with adjuvant 5-fluorouracil in combination with leucovorin. A prospective study needs to be conducted to determine if expression of these genes can be used to predict response to leucovorin and other folates that are now being tested in clinical studies. Moreover, there seems to be a link between folate metabolism and mitochondrial biogenesis and respiration that deserves further exploration.

Adjuvant treatment for resected rectal cancer: Effect of postoperative oxaliplatin added to 5-FU in the neoadjuvant era.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 672-672
Author(s):  
Benjamin Garlipp ◽  
Patrick Stuebs ◽  
Hans Lippert ◽  
Karsten Ridwelski ◽  
Henry Ptok ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Data Set ◽  
Cox Regression Analysis ◽  
The Impact

672 Background: Oxaliplatin (Ox) added to postoperative 5-fluorouracil (5FU) based adjuvant treatment has shown a survival benefit in colon cancer. For rectal cancer, the impact of Ox on survival has almost exclusively been tested in studies using 5FU +/- Ox both as a component of preoperative chemoradiotherapy (CRT) and as adjuvant treatment. Only one study (NCT00807911) investigated adjuvant 5FU +/- Ox in patients undergoing preop 5FU based CRT without Ox. Thus, the evidence for the benefit of adding Ox to adjuvant 5FU in patients treated with preop 5FU based CRT is limited. Methods: Data from the prospective German multicenter Quality Assurance in Rectal Cancer observational trial involving more than 300 hospitals of all levels of care throughout Germany were retrospectively analyzed. Patients undergoing R0 total mesorectal excision (TME) for rectal cancer following neoadjuvant 5FU based treatment without oxaliplatin between 01/01/2008 and 12/31/2010 were included. Disease-free survival (DFS) in patients receiving adjuvant treatment with or without Ox was compared using the Kaplan Meier method. The impact of adjuvant treatment with 5FU with or without Ox on DFS was investigated in a Cox regression analysis including open vs. laparoscopic approach, pT stage, pN stage, tumor grading, TME quality grade, and presence of anastomotic leakage as potential confounding factors. Results: The entire data set included 1,861 patients. Data for all variables investigated were available for 599 patients of whom 512 (85%) and 89 (15%) received 5FU based adjuvant treatment without and with Ox, respectively. Mean DFS was not different in patients receiving 5FU only vs. 5FU with Ox (p=0.103). Cox regression analysis revealed no significant impact of adding Ox to adjuvant 5FU on DFS. Of all factors analyzed, only pN2 (vs. pN0) status had an independent adverse effect on DFS (Hazard ratio 4.22, p<0.001). Conclusions: These data indicate that adjuvant Ox added to 5FU does not provide a DFS benefit in rectal cancer patients treated with preoperative 5FU based CRT under routine care conditions. Rectal cancer patients may be different from patients with colon cancer with respect to benefit from adjuvant Ox.

The relationship between Pim-3 expression and chemoradiotherapy resistance in locally advanced rectal cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15112-e15112
Author(s):  
Rong-xin Zhang ◽  
Zhongguo Zhou ◽  
Shi-xun Lu ◽  
Zhen-hai LU ◽  
Desen Wan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Rectal Cancer Patient ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tissue Bank ◽  
Disease Free Survival ◽  
Significant Factors

e15112 Background: It is difficult for clinical oncologists to predict which types of rectal cancer patient would respond to neoadjuvant chemoradiotherapy. About 30% of rectal cancer patients who could not benefit from chemoradiotherapy, and about 10% of patients even suffered from disease progression. It is of considerable importance to identify a bio-marker to identify patients who would benefit from neoadjuvant treatment. Methods: This study enrolled 175 rectal cancer patients who underwent neoadjuvant treatment. Tissue samples from all the patients were deposited in the tissue bank of Sun Yat-sen University Cancer Center prior to neoadjuvant treatment. We compared the expression of Pim-3 in rectal tumors and investigated correlations with the response to chemoradiotherapy and with survival. Results: The Pim-3-negative patients were more likely to achieve a pathological complete response to chemoradiotherapy (P = 0.001, RR = 5.132, 95% CI: 2.442–10.787). Cox multivariate analysis in 137 patients with at least 24 months follow-up showed that the expression of Pim-3 (P = 0.041, RR = 1.209, 95% CI = 1.007–1.452) and cycles of neoadjuvant chemotherapy cycles (P = 0.006, RR = 0.557, 95% CI = 0.367–0.845) were significant factors affecting the survival status of patients. Cox multivariate analysis of disease-free survival showed that Pim-3 expression (P = 0.012, RR = 1.180, 95% CI: 1.037–1.344) and adjuvant chemotherapy cycles (P = 0.003, RR = 0.745, 95% CI: 0.615–0.902) were statistically significant factors. Conclusions: Pim-3 could be a potential predictive bio-marker of the response to chemoradiotherapy.

Adjuvant treatment in extreme elderly patients with colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 784-784
Author(s):  
Marta Llopis Cuquerella ◽  
Maria del Carmen Ors Castaño ◽  
María Ballester Espinosa ◽  
Alejandra Magdaleno Cremades ◽  
Vicente Boix Aracil ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Stage Ii ◽  
Stage Iii ◽  
Complementary Treatment ◽  
Colorectal Cancer Patients

784 Background: Surgical and adjuvant treatment in extreme elderly ( > 80 years) patients with localized colorectal cancer is an unresolved issue. Owing to the lack of available neither clinical practice nor investigational data in this field we present our experience in this scenario. Methods: We retrospectively reviewed data regarding surgical and complementary treatment for colorectal cancer patients aged more than 80 consecutively attended by General Surgery Department in Vega Baja Hospital between 2008 and 2013. Results: A total number of 115 colorectal cancer patients were registered. 95 patients diagnosed of localized disease were selected for analysis. Colon vs rectal cancer ratio was 4:1. Median age was 83.6 years (80-94). Male sex was predominant (60 patients, 63.2%). Emergency surgery was performed in 15 patients (15.8%). Complementary treatment to surgery was advised, according to international guidelines, in 53 patients (55.8%). 10 patients (18.9%) with an advise of adjuvant treatment finally received it. More patients with rectal cancer received recommended treatment (41.7% rectal vs 12.2% colon cancer). Patients with stage III disease were more frequently finally treated according to guidelines (22.2 % stage III vs 11.8% stage II). More patients with stage II rectal cancer were advised and received treatment (recommendation: 66.7% rectal vs 36.1% colon cancer; administration: 25% rectal vs 7.7% colon cancer). Treatment was also more frequently administered to stage III rectal cancer (50% rectal vs 14.3% rectal cancer) (Table). Conclusions: Our experience in localized colorectal cancer in extreme elderly patients ( > 80 years) showed that, although advised according to guidelines, most of them did not receive adjuvant treatment to surgery. Complementary treatment administration was more common in rectal cancer patients and with more advanced disease. [Table: see text]

scholarly journals Oncologic results in rectal cancer patients with a subcentimeter distal margin after laparoscopic-assisted sphincter-preserving surgery: a propensity-score matched cohort analysis

2020 ◽  
Author(s):  
Chenghai Zhang ◽  
Hong Yang ◽  
Ming Cui ◽  
Jiadi Xing ◽  
Zhendan Yao ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Cohort Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Distal Margin ◽  
Rectal Cancers ◽  
Laparoscopic Assisted ◽  
The Impact

Abstract Background: Distal resection margin (DRM) is closely associated with sphincter-preserving surgery and oncologic safety for patients with mid-low rectal cancers. However, the optimal DRM has not been determined. The purpose of this study to assess the impact of a DRM of ≤ 1 cm on oncologic safetyMethods: Data of 378 rectal cancer patients who underwent laparoscopic-assisted sphincter-preserving surgery from 2009 to 2015 were retrospectively analyzed. Patients were divided into two groups based on DRM: ≤ 1 cm (n=74) and >1 cm (n=304). To minimize the differences between the two groups, propensity-score matching on baseline features was performed. Stratified analysis was performed according to neoadjuvant chemoradiotherapy.Results: Before propensity-score matching, no significant differences in 5-year disease-free survival (DFS) (92.8 vs. 81.3%; P=0.128) and 5-year overall survival (OS) (83.7 vs. 82.2%; p=0.892) were observed in patients with DRMs of ≤1(n=74) and >1cm (n=304), respectively. After propensity-score matching (1:1), there were also no significant differences in DFS (88.1 vs. 78.2%; P=0.162) and OS (84.5vs. 84.9%; P=0.420) between the DRM of ≤1 cm group (n=65) and >1 cm group (n=65), respectively. A total of 44 patients received preoperative chemoradiotherapy. In this cohort, the 5-year local recurrence (LR) rates ( p=0.118) and the 5-year DFS rates ( p=0.298) were not significantly different between two groups. A total of 334 patients received surgery without neoadjuvant chemoradiotherapy. There were also no significant differences in the 5-year LR rates ( p=0.150) and 5-year DFS rates ( p=0.172) between two groups.Conclusions: No matter whether patients with rectal cancers receiving neoadjuvant therapy or not, sphincter-preserving surgery with a DRM of ≤1 cm may be acceptable in mid-low rectal cancer without jeopardizing oncologic safety.

Decreased PLK1 expression denotes therapy resistance and unfavourable disease-free survival in rectal cancer patients receiving neoadjuvant chemoradiotherapy

2016 ◽  
Vol 212 (12) ◽  
pp. 1133-1137 ◽  
Author(s):  
Arancha Cebrián ◽  
Teresa Gómez del Pulgar ◽  
Maria Jesús Fernández-Aceñero ◽  
Aurea Borrero-Palacios ◽  
Laura del Puerto-Nevado ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Therapy Resistance ◽  
Free Survival ◽  
Disease Free ◽  
Plk1 Expression

Watch and wait approach following neoadjuvant chemoradiotherapy for rectal cancer patients: A single-centre experience.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 681-681
Author(s):  
Ji Zhu ◽  
Jingwen Wang
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Preoperative Treatment ◽  
Watch And Wait

681 Background: A watch-and-wait approach for patients with clinical complete response to neoadjuvant chemoradiation could avoid the morbidity of conventional surgery for rectal cancer. Here, we report the survival outcome of patients with this strategy in our center. Methods: We retrospectively analyzed the rectal cancer patients who received neoadjuvant chemoradiotherapy since 2015 in our center. Preoperative regimen included long-course radiotherapy (50 Gy / 25 Fx) combined fluoropyrimidin–based chemotherapy concurrently. MRI and endoscopic evaluation were performed after preoperative treatment. Patients with complete tumor response were referred to the “watch-and-wait” approach and omitted the surgery. Four to six cycles of consolidation chemotherapy were performed. Patients were followed up clinically, endoscopically, and radiologically to assess for local recurrence or disease progression. Results: From January 2015 to March 2018, a total of 47 patients with rectal cancer in our center received conservative treatment following neoadjuvant therapy. The median age of the patients is 58 (53-66). The proportions of stages I to IV are 4.3%, 12.8%, 70.2%, 8.5%, respectively. After a median follow-up of 20 month, tumor regrowth occurred in five out of 47 (10.6%) patients. All local regrowth was diagnosed in the first two years, and four out of five (80%) of local regrowth was located in the bowel wall. All patients underwent salvage surgery. Distant metastasis was diagnosed in four of 47 patients (8.5%). two-year overall survival was 89.9%, and two-year disease-free survival was 76.5%. Conclusions: Organ preservation for locally advanced rectal cancer is feasible for selected patients who achieve a complete response to individualized neoadjuvant CRT. The survival of patients is not impaired with “watch-and-wait” strategy.

Sign in / Sign up

Export Citation Format

Share Document