Density and distribution of lymphocytes in pretherapeutic rectal cancer and response to neoadjuvant therapy

Abstract Background Lymphocytic density in rectal cancer has been reported to be associated with therapeutic response, but the role of the lymphocytic distribution pattern remains to be determined. This study aimed to evaluate the association between the distribution and density of lymphocytes in rectal-cancer tissue with tumor response to neoadjuvant therapy. Methods We retrospectively analysed 134 patients with rectal cancer receiving neoadjuvant therapy within a prospectively maintained cohort. Pretherapeutic biopsy samples were stained with immunohistochemistry (CD4 and CD8). Densities of intratumoral periglandular lymphocytes (IPLs) and tumor-infiltrating lymphocytes (TILs) were assessed separately. Logistic-regression analysis was used to assess associations of lymphocyte densities with tumor regression grade (TRG), controlling for clinicopathological, molecular, and regimen features. Results Compared with cases in the lowest quartile of CD8+ TILs, those in the highest quartile were significantly associated with better TRG (multivariate odds ratio, 0.23; 95% confidence interval, 0.07 to 0.76; P < 0.001). In contrast, CD8+ IPLs, CD4+ IPLs, and CD4+ TILs were not significantly associated with TRG (P = 0.033, 0.156, and 0.170, respectively). Sensitivity analyses detected no interaction between CD8+ TILs and regimen of neoadjuvant radiation (Pinteraction = 0.831) or chemotherapy (Pinteraction = 0.879) on TRG. Conclusions Our data suggest that CD8+ TILs, but not IPLs, are independently associated with response to neoadjuvant therapy, regardless of the regimen of radiation or chemotherapy.

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Rectal cancer – current treatment strategy and the tumor regression grade evaluation after neoadjuvant therapy in patients who underwent surgery at the I. Department of Surgery, General University Hospital in Prague between 2012 and 2016

10.33699/pis.2021.100.2.74-82 ◽

2021 ◽

Vol 100 (2) ◽

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Tumor Regression ◽

Neoadjuvant Treatment ◽

Neoadjuvant Chemoradiotherapy ◽

Current Treatment ◽

University Hospital ◽

Tumor Regression Grade ◽

Oncological Treatment ◽

Regression Grade

Introduction: The article contains a summary of the issues of staging and therapy with an emphasis on the neoadjuvant treatment and associated tumor regression grade with the analysis of our own group of patients. Methods: Retrospective analysis of patients with rectal cancer who underwent a surgery at the 1st Department of Surgery – Thoratic, Abdominal and Injury Surgery; First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic, focusing on those who underwent neoadjuvant chemoradiotherapy and their pathologists evaluated tumor regression grade after the resection. Results: The group consists of 161 patients operated on between 2012 and 2016. 47 patients underwent neoadjuvant oncological treatment with further evaluation of the tumor regression grade by a pathologist, a scoring system according to Ryan was used. A complete pathological response was elicited in 10.4% of patients, no response in 35.4% of patients, and partial tumor regression in 54.2%. Conclusion: Although there is a difference in our results compared to foreign publications, the proportion of patients remains comparable. Studies evaluating the advantages versus disadvantages of neoadjuvant therapy will certainly follow, and the question of the suitability of surgical treatment as the only curative solution is partially raised.

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New tumor regression grade for rectal cancer after neoadjuvant therapy and radical surgery

Oncotarget ◽

10.18632/oncotarget.6008 ◽

2015 ◽

Vol 6 (39) ◽

pp. 42222-42231 ◽

Cited By ~ 3

Author(s):

Jun Li ◽

Hao Liu ◽

Junjie Hu ◽

Sai Liu ◽

Jie Yin ◽

...

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Radical Surgery ◽

Tumor Regression ◽

Tumor Regression Grade ◽

Regression Grade

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PO-1115: What's the role of tumor regression grade (TRG) in rectal cancer: an istututional experience

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)01132-4 ◽

2020 ◽

Vol 152 ◽

pp. S589-S590

Author(s):

A. Guaineri ◽

L. Triggiani ◽

F. Frassine ◽

J. Imbrescia ◽

F. Barbera ◽

...

Keyword(s):

Rectal Cancer ◽

Tumor Regression ◽

Tumor Regression Grade ◽

Regression Grade

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Role of neoadjuvant therapy(chemotherapy and/or radiotherapy) in lymph node and primary rectal tumor regression and prognosis (Preprint)

10.2196/preprints.35762 ◽

2021 ◽

Author(s):

Mahshid Kashkoulibehroozi ◽

Shirin Tahereh Haghighi ◽

Zhale Mohsenifar

Keyword(s):

Lymph Node ◽

Neoadjuvant Therapy ◽

Tumor Regression ◽

Rectal Tumor ◽

Tumor Regression Grade ◽

Rectal Tumors ◽

N Stage ◽

Prediction Of Prognosis ◽

Regression Grade

UNSTRUCTURED Background: Rectal tumors are important malignancies and prediction of prognosis after neoadjuvant therapy is important to improve the prognosis process. The purpose of this study was to determine therole ofneoadjuvant therapy in lymph node regression and primary rectal tumor as well as its association with prognosis. Methods and materials: In this descriptive study, 40 consecutive patients with rectal tumor who were referred toTaleghani Hospital for surgery from 2011 to 2018 were enrolled. Moreover, theneoadjuvant therapy role in lymph node regression and primary rectal tumor was determined as well as its association with prognosis. Results: The results of this study demonstrate that there was no tumor regression in 20% of patients and it wasalso less than 25%, 25-50%, 50-75%, and complete in 22.5%, 35%, 20%, and 2.5% of the patients,respectively. The lymph node regression was complete in 5% of the patients and it wasalso less than 25% in 20% and more than 25% in 50% of them. In addition, it was with no regression in 25% of the patients. The lymph node regression was related to N stage (P=0.018), primary tumor regression grade (P=0.001), yPT (P=0.008), and yPN (P=0.020); however, it was not related to prognosis (P > 0.05). Conclusions: Totally, according to the obtained results, it can be concluded thatneoadjuvant therapy plays a good role in lymph node regression and primary rectal tumor, but it has no association with prognosis. Keywords:Neoadjuvant therapy, Lymph node regression, Primary rectal tumor, Prognosis

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Neoadjuvant Therapy of Metformin is Associated with Good Tumor Response After Preoperative Concurrent Chemoradiotherapy for Rectal Cancer

10.21203/rs.3.rs-967810/v1 ◽

2021 ◽

Author(s):

Jeonghee Han ◽

Jong Ho kim ◽

Jin-Won Lee ◽

Sang Hyup Han ◽

Hae-sung kim

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Concurrent Chemoradiotherapy ◽

Tumor Response ◽

Tumor Regression ◽

Multivariate Logistic Regression Analysis ◽

Tumor Regression Grade ◽

Before And After ◽

Tumor Downstaging ◽

Regression Grade

Abstract Metformin is associated with good tumor response in preoperative concurrent chemoradiotherapy (CCRT) for rectal cancer. This study aims to demonstrate that the timing of metformin is related to the tumor response on preoperative CCRT for rectal cancer. From January 2010 to December 2017, 232 patients who underwent curative resection after preoperative CCRT were reviewed. Patients were divided into groups with or without diabetes or metformin. The timing of metformin administration was divided based on before and after initiation of chemoradiotherapy. Multivariate logistic regression analysis was used to identify predictors for tumor response. Tumor downstaging (p = 0.02) and good response rates of tumor regression grade (TRG) (p = 0.008) were significantly higher in the group administered metformin before CCRT than other groups. In the multivariate analysis, metformin administration before CCRT was a significant factor in predicting tumor downstaging (odds ratio [OR] 10.31, 95% confidence interval [CI]: 1.76 - 102.08, p = 0.02) and good TRG (OR 12.55, 95% CI: 2.38 - 80.24, p = 0.004). In patients with rectal cancer who underwent preoperative CCRT, neoadjuvant therapy of metformin before CCRT was significantly associated with good tumor response and tumor downstaging.

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