scholarly journals Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yiyi Zhang ◽  
Liangliang Yan ◽  
Yong Wu ◽  
Meifang Xu ◽  
Xing Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Treatment Response ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Young Patients ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

scholarly journals Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

2020 ◽  
Author(s):  
Yiyi Zhang ◽  
Liangliang Yan ◽  
Yong Wu ◽  
Meifang Xu ◽  
Xing Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Young Patients ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Curve Analysis ◽  
Age Group ◽  
Decision Curve Analysis ◽  
Cd133 Expression

Abstract Background: To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC).Method: LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (<40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients.Result: A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age <40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients.Conclusion: Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

scholarly journals Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

2020 ◽  
Author(s):  
Yiyi Zhang ◽  
Liangliang Yan ◽  
Yong Wu ◽  
Meifang Xu ◽  
Xing Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Young Patients ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Curve Analysis ◽  
Age Group ◽  
Decision Curve Analysis ◽  
Cd133 Expression

Abstract Background: To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC).Method: LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (<40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients.Result: A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age <40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients.Conclusion: Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

scholarly journals The predictive value of baseline volumetric PET/CT parameters on treatment response and prognosis in locally-advanced rectal cancer treated with neoadjuvant chemoradiotherapy

2021 ◽  
Author(s):  
Abdullah SAKİN ◽  
Suleyman Sahin ◽  
Sevda Saglampınar Karyagar ◽  
Savas Karyagar ◽  
Muhammed Mustafa atci ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Cells ◽  
Treatment Response ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Group I ◽  
Pet Ct ◽  
Group Ii

Abstract Purpose:To investigate the prognostic effects of baseline volumetric PET/CT parameters including the maximum standard uptake value(SUVmax), metabolic tumor volume(MTV), and tumor lesion glycolysis(TLG) on treatment response and prognosis in locally-advanced rectal cancer(LARC) treated with neoadjuvant chemoradiotherapy(NACRT).Methods:Between 2015 and 2018, 51 patients with LARC treated with NACRT followed by surgery were included in this retrospective study. Patients were divided into 2 groups by tumor regression grade(TRG) as follows;Group I=TRG 1(No detectable cancer cells)+TRG 2(single cells and/or small groups of cancer cells) and Group II=TRG3(residual tumor outgrown by fibrosis)+TRG 4(remarkable fibrosis outgrown by tumor cells)+TRG 5(No fibrosis with extensive residual cancer).Results:Of the 51 patients, 34(66.7%) were male. The median age was 55(range,37-78) years. According to TRG status, 14(27.4%) patients were in group I and 37(72.6%) patients were in group II. The area under the curve(95% CI) was 0.749(0.593-0.905) in the ROC curve plotted for MTV. The cut of value for MTV was 12, with 70% sensitivity and 65% specificity. MTV was≥12 in 32(62.8%) patients. MTV and TLG values were significantly different between Group I and II, whereas there was no significant difference between the groups in terms of SUVmax values (p=0.006, p=0.033, and p=0.673, respectively). The disease-free survival was not reached in patients with MTV<12 vs. 20 months in those with MTV≥12 (p=0.323). In multivariate analysis, MTV(OR, 95% Cl, 5.00[1.17-21.383]) was found to be the factor that affected pathological complete response.Conclusion:In LARC treated with NACRT, MTV prior to treatment can help predict the response to treatment.

scholarly journals Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

2020 ◽  
Author(s):  
Yiyi Zhang ◽  
Meifang Xu ◽  
Yong Wu ◽  
Shoufeng Li ◽  
Xing Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Young Patients ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Curve Analysis ◽  
Age Group ◽  
Decision Curve Analysis ◽  
Cd133 Expression

Abstract Background: To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC).Method: LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (<40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients.Result: A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age <40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients.Conclusion: Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

scholarly journals A Pipeline for Predicting the Treatment Response of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer Using Single MRI Modality: Combining Deep Segmentation Network and Radiomics Analysis Based on “Suspicious Region”

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaolin Pang ◽  
Fang Wang ◽  
Qianru Zhang ◽  
Yan Li ◽  
Ruiyan Huang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Treatment Response ◽  
External Validation ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Analysis Model ◽  
Suspicious Region

Patients with locally advanced rectal cancer (LARC) who achieve a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) typically have a good prognosis. An early and accurate prediction of the treatment response, i.e., whether a patient achieves pCR, could significantly help doctors make tailored plans for LARC patients. This study proposes a pipeline of pCR prediction using a combination of deep learning and radiomics analysis. Taking into consideration missing pre-nCRT magnetic resonance imaging (MRI), as well as aiming to improve the efficiency for clinical application, the pipeline only included a post-nCRT T2-weighted (T2-w) MRI. Unlike other studies that attempted to carefully find the region of interest (ROI) using a pre-nCRT MRI as a reference, we placed the ROI on a “suspicious region”, which is a continuous area that has a high possibility to contain a tumor or fibrosis as assessed by radiologists. A deep segmentation network, termed the two-stage rectum-aware U-Net (tsraU-Net), is designed to segment the ROI to substitute for a time-consuming manual delineation. This is followed by a radiomics analysis model based on the ROI to extract the hidden information and predict the pCR status. The data from a total of 275 patients were collected from two hospitals and partitioned into four datasets: Seg-T (N = 88) for training the tsraUNet, Rad-T (N = 107) for building the radiomics model, In-V (N = 46) for internal validation, and Ex-V (N = 34) for external validation. The proposed method achieved an area under the curve (AUC) of 0.829 (95% confidence interval [CI]: 0.821, 0.837) on In-V and 0.815 (95% CI, 0.801, 0.830) on Ex-V. The performance of the method was considerable and stable in two validation sets, indicating that the well-designed pipeline has the potential to be used in real clinical procedures.

scholarly journals Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

2020 ◽  
Author(s):  
Yiyi Zhang ◽  
Meifang Xu ◽  
Yong Wu ◽  
Shoufeng Li ◽  
Xing Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Young Patients ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Curve Analysis ◽  
Age Group ◽  
Decision Curve Analysis ◽  
Cd133 Expression

Abstract Background To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC) and explore the underlying mechanism.Method LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (<40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients.Result A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age <40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients.Conclusion Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

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