Oncologic outcome and morbidity for elderly rectal cancer patients compared to younger patients after preoperative chemoradiotherapy and curative surgery: A multi-institutional and case-matched control study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 736-736
Author(s):  
Soo Yoon Sung ◽  
Jong Hoon Lee ◽  
Sung Hwan Kim
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Late Complication ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Hematologic Toxicity ◽  
Recurrence Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Younger Patients

736 Background: To elucidate the toxicity and survival outcome of neoadjuvant chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME) in elderly rectal cancer patients compared to younger patients. Methods: A total of 1232 rectal cancer patients who received neoadjuvant CRT and curative surgery were collected from 7 tertiary institutions. After propensity-score matching, 310 patients of < 70 years for younger arm and 310 patients of ≥ 70 years for elderly arm were identified, respectively and matched with 1:1 manner. Treatment response and toxicity, surgical outcome, recurrence, and survival were assessed and compared between two arms. Results: The two younger (< 70 years) and elderly (≥ 70 years) arms were well-matched and had similar baseline characteristics. Median ages were 58 years for younger arm and 74 years for elderly arm, respectively. Pathologic complete response rates were not significantly different between younger arm and elderly arm (17.1% vs. 14.8%, P = 0.443). The 5-year recurrence-free survival (70.0% vs. 69.8%, P = 0.773) and overall survival (79.5% vs. 82.9%, P = 0.270) rates were not significantly different between two arms. Adjuvant chemotherapy after surgery was less frequently delivered to elderly arm than younger arm (69.0% vs. 83.9%, P = 0.773). Grade 3 or higher acute hematologic toxicity was observed more frequently in elderly arm than in younger arm (9.0% vs. 16.1%, P = 0.008 ), but late complication was not significantly increased in elderly arm (2.6% vs. 4.5%, P = 0.193). Conclusions: Despite an increased acute toxicity, elderly rectal cancer patients with good performance status would have equivalent tumor response and recurrence-free survival compared to younger patients.

Impact of diabetes on site-specific oncologic outcome in stage I-III colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14114-e14114
Author(s):  
Justin Y Jeon ◽  
Deok Hyun Jeong ◽  
Min Keun Park ◽  
Jennifer A. Ligibel ◽  
Jeffrey A. Meyerhardt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Proximal Colon ◽  
Survival Outcome ◽  
Recurrence Free Survival ◽  
Site Specific ◽  
Free Survival ◽  
All Cause Mortality

e14114 Background: Background: Conflicting results have been reported whether pre diagnosis diabetes mellitus (DM) influence survival of colorectal cancer patients or not. Therefore, we determine the influence of DM on long-term outcomes of stage 1-3 patients with resected colon and rectal cancer. Methods: This prospective study include a total of 4,131 participants who were treated for cancer between 1995 and 2005 in South Korea in a single hospital (Non DM: 3,614 patients, DM: 517 patients) with average follow up period of 12 years. We analyzed differences in all cause mortality, disease free survival (DFS), recurrence free survival (RFS) and colorectal cancer-specific mortality between colorectal patients with DM and those without DM. Results: After adjustment for potential confounders, pre-diagnosis DM significantly associated with increased all cause mortality (HR: 1.46, 95% CI: 1.11-1.92), and recurrence free survival reduced DFS (HR: 1.45, 95%CI: 1.15-1.84) and RFS (HR: 1.32, 95% CI: 0.98-1.76) in colon cancer patients but not in rectal cancer patients. In colon cancer patients, DM negatively affects the survival outcome of proximal colon cancer (HR: 2.08, 95%CI: 1.38-3.13), but not of distal cancer (HR:1.34, 95% CI: 0.92-1.96). Conclusions: To our knowledge, the current study first reported the effects of pre-diagnosis DM on survival outcome of colorectal cancer are site specific (proximal colon, distal colon and rectum). The current study was supported by the National Research Foundation of Korea (KRF) (No. 2011-0004892) and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1120230). [Table: see text]

scholarly journals Pathological Response Has Survival Benefits for Rectal Cancer following Neoadjuvant Therapy

2019 ◽  
Author(s):  
Wei-Chih Chen ◽  
Li-Jen Kuo ◽  
Chia-Che Chen ◽  
Po-Li Wei ◽  
Yu-Min Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Associated Factors ◽  
Disease Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
N Stage

Abstract Background Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. The purpose of this study was to identify the prognostic factors of tumor response and outcome in rectal cancer patients.Methods The study was a retrospective analysis. Patients with locally advanced rectal cancer underwent nCRT followed by surgery from 2010 to 2014 with 5 years of follow-up. The primary outcomes were associated factors of pathological completed response and downstaging. The risk factors of survival outcome and disease recurrence were also observed.Results A total of 169 rectal cancer patients were included. The PCR rate was 17.8%, and the downstaging rate was 60.9%. Patients with a histology type of adenocarcinoma associated with PCR, and patients positive for clinical N stage were associated with downstaging. Kaplan-Meier analysis showed the PCR group performed better to a statistically significant level both in overall survival and disease recurrence free survival than the no PCR group (p= 0.033 & 0.025, respectively). Patients with a downstaging response also showed better overall survival benefits and disease recurrence free survival benefits than their counter-parts (both p<0.001). After controlling confounding variables, the risk factors of overall survival were downstaging [Hazard Ratio (HR): 0.40, 95% CI: 0.21-0.74], male, abnormal post-nCRT CEA level and abnormal Hb level. In addition, the protective factors of recurrence were downstaging and having adjuvant chemotherapy.Conclusions Among rectal cancer patients who received the neoadjuvant therapy, histology type and clinical N stage were associated with PCR and downstaging, respectively. Downstaging was an important protective factor for better overall survival and recurrence free survival.

scholarly journals CDK9 Expression Shows Role as a Potential Prognostic Biomarker in Breast Cancer Patients Who Fail to Achieve Pathologic Complete Response after Neoadjuvant Chemotherapy

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ashley J. Schlafstein ◽  
Allison E. Withers ◽  
Soumon Rudra ◽  
Diana Danelia ◽  
Jeffrey M. Switchenko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Prognostic Biomarker ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Recurrence Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Risk Of Death

Failure to achieve pathologic complete response is associated with poor prognosis in breast cancer patients following neoadjuvant chemotherapy (NACT). However, prognostic biomarkers for clinical outcome are unclear in this patient population. Cyclin-dependent kinase 9 (CDK9) is often dysregulated in breast cancer, and its deficiency results in genomic instability. We reviewed the records of 84 breast cancer patients from Emory University’s Winship Cancer Institute who had undergone surgical resection after NACT and had tissue available for tissue microarray analysis (TMA). Data recorded included disease presentation, treatment, pathologic response, overall survival (OS), locoregional recurrence free survival (LRRFS), distant-failure free survival (DFFS), recurrence-free survival (RFS), and event-free survival (EFS). Immunohistochemistry was performed on patient samples to determine CDK9 expression levels after NACT. Protein expression was linked with clinical data to determine significance. In a Cox proportional hazards model, using a time-dependent covariate to evaluate the risk of death between groups beyond 3 years, high CDK9 expression was significantly associated with an increase in OS (HR: 0.26, 95% CI: 0.07-0.98, p=0.046). However, Kaplan-Meier curves for OS, LRRFS, DFFS, RFS, and EFS did not reach statistical significance. The results of this study indicate that CDK9 may have a potential role as a prognostic biomarker in patients with breast cancer following NACT. However, further validation studies with increased sample sizes are needed to help elucidate the prognostic role for CDK9 in the management of these patients.

Is Adjuvant Chemotherapy Really Needed After Curative Surgery for Rectal Cancer Patients Who are Node-Negative After Neoadjuvant Chemoradiotherapy?

2011 ◽  
Vol 19 (4) ◽  
pp. 1206-1212 ◽  
Author(s):  
Ravi P. Kiran ◽  
Hasan T. Kirat ◽  
Adele N. Burgess ◽  
Pasha J. Nisar ◽  
Matthew F. Kalady ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Neoadjuvant Chemoradiotherapy ◽  
Curative Surgery ◽  
Node Negative

The effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer

2021 ◽  
Author(s):  
Jeong-Heum Baek ◽  
Youngbae Jeon ◽  
Kyoung-Won Han ◽  
Kyung-Ok Kim
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Tumor Response ◽  
Anal Verge ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Oncologic Outcomes ◽  
Tumor Regression Grade ◽  
Mistletoe Extract

Abstract Background Mistletoe extract, which is usually used as a complementary agent for cancer patients, provides an anticancer effect on various malignancies. The present study aimed to evaluate the effect of mistletoe extract (Abnoba Viscum Q®) on tumor responses in neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Methods The rectal cancer patients who underwent neoadjuvant chemoradiotherapy were analyzed from Jan 2018 to Jul 2020. In the mistletoe group (MG), the patients were administered Abnoba Viscum Q® subcutaneously during chemoradiotherapy, and it was maintained just before surgery. Patients' demographics, clinical outcomes, and histopathological outcomes were compared between chemoradiation with the MG and nonmistletoe group (NMG). Results A total of 52 patients were included. There were MG of 15 patients and NMG of 37 patients. Baseline demographics were statistically similar between the two groups except the CA19-9 and tumor location levels from anal verge. There was no difference in the clinical stage for both groups. We also observed better tumor response in MG in terms of TRG, T stage, and overall TNM stage. Tumor response was significantly better in MG comparing NMG in terms of pathologic complete response rate (53.3% vs 21.6%, p = 0.044), good responder of tumor regression grade (66.7% vs 32.4%, p = 0.024), T downstaging (86.7% vs 43.2%, p = 0.004), and overall downstaging (86.7% vs 56.8%, p = 0.040). The toxicities during NCRT in both groups were minimal. Conclusion MG treated with chemoradiation combined with mistletoe extract showed better outcomes than NMG in terms of tumor responses. This diversity in treatment may elevate the method to hope for better oncologic outcomes. Prospective and randomized studies with long-term follow-up are warranted to confirm and extend this study.

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
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