scholarly journals PROGNOSTIC SIGNIFICANCE OF TUMOUR BUDDING IN RECTAL CANCER BIOPSIES PRIOR TO NEOADJUVANT THERAPY

Gut ◽  
2013 ◽  
Vol 62 (Suppl 2) ◽  
pp. A2.2-A3
Author(s):  
A C Rogers ◽  
D Gibbons ◽  
A M Hanly ◽  
J M P Hyland ◽  
P R O'Connell ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Prognostic Significance ◽  
Tumour Budding

scholarly journals Prognostic significance of tumor budding in rectal cancer biopsies before neoadjuvant therapy

2013 ◽  
Vol 27 (1) ◽  
pp. 156-162 ◽  
Author(s):  
Ailín C Rogers ◽  
David Gibbons ◽  
Ann M Hanly ◽  
John MP Hyland ◽  
P Ronan O'Connell ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Prognostic Significance ◽  
Tumor Budding

scholarly journals Tumor budding outperforms ypT and ypN classification in predicting outcome of rectal cancer after neoadjuvant chemoradiotherapy

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Iryna Trotsyuk ◽  
Halina Sparschuh ◽  
Alice Josephine Müller ◽  
Konrad Neumann ◽  
Martin Kruschewski ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Tumor Regression ◽  
Prognostic Significance ◽  
Neoadjuvant Chemoradiotherapy ◽  
Preoperative Chemoradiotherapy ◽  
Tumor Budding ◽  
Poor Differentiation ◽  
Low Degrees

Abstract Background Budding is a complementary prognostic factor for colorectal cancer. In this study, we aimed to clarify the role of tumor budding in rectal cancer patients after preoperative chemoradiotherapy. Methods A total of 124 patients with rectal cancer treated with neoadjuvant chemoradiotherapy and consecutive surgery were included. Surgical specimens were evaluated for budding and routine clinicopathological features. Budding was evaluated on hematoxylin and eosin (H&E)-stained slides and by cytokeratin immunohistochemical (IHC) staining. Results A budding rate of 36.9% (n = 38) by H&E and 55.6% (n = 55) by IHC was observed. Budding was significantly associated with a high ypT and ypN status, poor differentiation, and low degrees of tumor regression. Moreover, budding was strongly predictive of a worse patient outcome, as measured by tumor recurrence or death. In multivariate analyses, budding remained the only significant parameter for overall survival and was even superior to the ypT and ypN status (budding in H&E: hazard ratio (HR) 2.72, 95% confidence interval (95% CI) 1.15–6.44, p = 0.023; budding in IHC: HR 5.19, 95% CI 1.62–16.61, p = 0.006). Conclusion Budding is a strong prognostic predictor of survival in rectal cancer patients after neoadjuvant therapy. A standardized evaluation of tumor budding after neoadjuvant therapy may thus aid in risk stratification and guide the clinical management of patients with rectal cancer. Immunostaining can help to enhance the diagnostic accuracy and prognostic significance.

The expression and prognostic significance of bcl-2-associated transcription factor 1 in rectal cancer following neoadjuvant therapy

2015 ◽  
Vol 68 (4) ◽  
pp. 556-566 ◽  
Author(s):  
Gordon T Brown ◽  
Beatriz Cash ◽  
Ayham Alnabulsi ◽  
Leslie M Samuel ◽  
Graeme I Murray
Keyword(s):  
Rectal Cancer ◽  
Transcription Factor ◽  
Neoadjuvant Therapy ◽  
Prognostic Significance ◽  
Transcription Factor 1

Submit Manuscript | http://medc rav eonline.co m Introduction Colorectal adenocarcinoma is the third most common malignant neoplasia and the third leading cause of death from cancer in men and women in the United States. Current data show that the incidence of colorectal adenocarcinoma is decreasing in developed countries but increasing in developing countries. 1 The 2018 estimates of the Bra - zilian National Cancer Institute (Instituto Nacional do Câncer–INCA) were 17,380 new cases in men and 18,980 in women, making col - orectal adenocarcinoma the third most common neoplasia in men and the second most common in women in Brazil. 2 In the past 15 years, rectal cancer management has evolved in several aspects. Specifical - ly, a better understanding of the natural history of the disease, more precise radiological staging, multimodal therapeutic intervention, refined surgical techniques, and more detailed histopathological re - ports may have positively influenced patient survival. In this context, multidisciplinary management of colorectal cancer plays an important role and requires the coordinated teamwork of colorectal surgeons, oncologists, radiologists, and radiotherapists. 3 Total mesorectal exci - sion is still the basis of treatment in rectal cancer. However, neoadju - vant therapy and more conservative practices have been adopted in cases of clinical/pathological responses to radiochemotherapy. 4 Ra - diological evaluation of the response is of paramount importance for the selection of patients eligible for alternative treatment strategies, including ‘watch-and-wait’. Diffusion-weighted imaging is already being used routinely in the evaluation of the pathological response of rectal tumour patients submitted to neoadjuvant therapy. Some re - searchers have tried to estimate the tumour regression grade (TRG) using magnetic resonance imaging, as has been described for post-ra - diochemotherapy pathological evaluation, thus rendering it a valuable instrument. Considering the good results obtained with multimodal therapy in extraperitoneal rectal cancer, the evaluation of the pathological re - sponse post-neoadjuvant therapy must be considered as a factor for safe indication, both for the conservative option, in which the organ is preserved, and for radical surgical resection, influencing the choice between sphincter-preserving surgery and abdominoperineal excision. A precise evaluation, by comparing the results of post-neoadjuvant therapy magnetic resonance imaging with those obtained from his - Int J Radiol Radiat Ther. 2018;5(4):254 ‒ 258. 254 © 2018 Oliveira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially. Magnetic resonance imaging is effective in assessing tumour regression after neoadjuvancy in rectal adenocarcinoma

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Fábio Henrique de Oliveira ◽  
Antônio Lacerda-Filho ◽  
Fábio Lopes de Queiroz ◽  
Tatiana Martins Gomide Leite ◽  
Paulo Guilherme Oliveira Sales ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rectal Cancer ◽  
Magnetic Resonance ◽  
Neoadjuvant Therapy ◽  
Colorectal Adenocarcinoma ◽  
The United States ◽  
Tumour Regression ◽  
Resonance Imaging ◽  
Cancer Management ◽  
The Third

scholarly journals Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

2021 ◽  
Author(s):  
Gabriele Anania ◽  
Richard Justin Davies ◽  
Alberto Arezzo ◽  
Francesco Bagolini ◽  
Vito D’Andrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Neoadjuvant Therapy ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Mesorectal Excision ◽  
Timeline Analysis

Abstract The role of lateral lymph node dissection (LLND) during total mesorectal excision (TME) for rectal cancer is still controversial. Many reviews were published on prophylactic LLND in rectal cancer surgery, some biased by heterogeneity of overall associated treatments. The aim of this systematic review and meta-analysis is to perform a timeline analysis of different treatments associated to prophylactic LLND vs no-LLND during TME for rectal cancer. Methods A literature search was performed in PubMed, SCOPUS and WOS for publications up to 1 September 2020. We considered RCTs and CCTs comparing oncologic and functional outcomes of TME with or without LLND in patients with rectal cancer. Results Thirty-four included articles and 29 studies enrolled 11,606 patients. No difference in 5-year local recurrence (in every subgroup analysis including preoperative neoadjuvant chemoradiotherapy), 5-year distant and overall recurrence, 5-year overall survival and 5-year disease-free survival was found between LLND group and non LLND group. The analysis of post-operative functional outcomes reported hindered quality of life (urinary, evacuatory and sexual dysfunction) in LLND patients when compared to non LLND. Conclusion Our publication does not demonstrate that TME with LLND has any oncological advantage when compared to TME alone, showing that with the advent of neoadjuvant therapy, the advantage of LLND is lost. In this review, the most important bias is the heterogeneous characteristics of patients, cancer staging, different neoadjuvant therapy, different radiotherapy techniques and fractionation used in different studies. Higher rate of functional post-operative complications does not support routinely use of LLND.

scholarly journals Influence of incorrect staging of colorectal carcinoma on oncological outcome: are we playing safely?

2021 ◽  
Author(s):  
Claudia Reali ◽  
Gabriele Bocca ◽  
Ian Lindsey ◽  
Oliver Jones ◽  
Chris Cunningham ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Preoperative Staging ◽  
Neoadjuvant Treatment ◽  
Preoperative Imaging ◽  
Resection Margins ◽  
Colorectal Cancers ◽  
Radiological Staging ◽  
N Stage

AbstractAccurate preoperative staging of colorectal cancers is critical in selecting patients for neoadjuvant therapy prior to resection. Inaccurate staging, particularly understaging, may lead to involved resection margins and poor oncological outcomes. Our aim is to determine preoperative imaging accuracy of colorectal cancers compared to histopathology and define the effect of inaccurate staging on patient selection for neoadjuvant treatment(NT). Staging and treatment were determined for patients undergoing colorectal resections for adenocarcinomas in a single tertiary centre(2016–2020). Data were obtained for 948 patients. The staging was correct for both T and N stage in 19.68% of colon cancer patients. T stage was under-staged in 18.58%. At resection, 23 patients (3.36%) had involved pathological margins; only 7 of which had been predicted by pre-operative staging. However, the staging was correct for both T and N stage in 53.85% of rectal cancer patients. T stage was understaged in 26.89%. Thirteen patients had involved(R1)margins; T4 had been accurately predicted in all of these cases. There was a general trend in understaging both the tumor and lymphonodal involvement (T p < 0.00001 N p < 0.00001) causing a failure in administrating NT in 0.1% of patients with colon tumor, but not with rectal cancer. Preoperative radiological staging tended to understage both colonic and rectal cancers. In colonic tumours this may lead to a misled opportunity to treat with neoadjuvant therapy, resulting in involved margins at resection.

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