scholarly journals Can NLR/PLR/CEA be a marker for predicting a complete pathological response in locally advanced rectal cancer?

2021 ◽  
Vol 12 (1) ◽  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
Complete Pathological Response

Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before surgery in patients with locally advanced rectal cancer (A phase II study)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mai Ezzat Elhawi ◽  
Aly Mohammed Azmy ◽  
Ramy Refaat Youssef Ghali ◽  
Ass. Prof. Dr. Nagy Samy Gobran ◽  
Ass. Prof. Dr. Marwa Mosaad Shakweer ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
Induction Chemotherapy ◽  
Locally Advanced ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
Toxicity Profile ◽  
Complete Pathological Response

Abstract Background Locally advanced rectal cancer (LARC) has a high incidence of local and distant relapse even after adequate treatment. The emerging role of neoadjuvant induction chemotherapy may allow initial down staging of the primary tumor, less toxicity profile and early treatment of micrometastatic disease followed by chemoradiation, and optimum local control may be attained, with the hope of increased complete response rates Objectives to identify the effect of induction chemotherapy with oxaliplatin and capecitabine (CapeOx) before concurrent chemoradiation in locally advanced rectal cancer in terms of response and toxicity. Primary end point is assessment of complete pathological response rate. Patient and Methods patients with MRI based criteria of high-risk LARC (T4 tumors, tumors within 2 mm of mesorectal fascia, T3 tumors at or below levators and T2-4N+ve tumors) were included. Patients received 12 weeks of induction capecitabine/oxaliplatin followed by concomitant capecitabine and conventional three dimensional conformal radiotherapy. Surgery was done at least 6 weeks after CCRTH. Results Thirty five patients with LARC were recruited during the period from December 2017 till January 2019. Five patients (20.8%) had a pathological complete response (TRG 0) (ypT0N0). Another three patients (12.5%) had near complete pathological response (TRG 1). While unfortunately 29.2% and 37.5% had partial response and poor response respectively. Conclusion Induction chemotherapy could be a promising option for better response rates either clinical or pathological for high risk LARC patients with acceptable toxicity profile.

Total mesorectal excision compared to local excision in locally advanced rectal cancer achieving complete pathological response with neoadjuvant therapy: A National Cancer Database Analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4107-4107
Author(s):  
Ahmed Abdalla ◽  
Sindhu Janarthanam Malapati ◽  
Sunny R K Singh ◽  
Susan Szpunar ◽  
Tarik H. Hadid ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Neoadjuvant Therapy ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
National Cancer Database ◽  
Mesorectal Excision ◽  
Complete Pathological Response

4107 Background: Total mesorectal excision (TME) is the standard surgical intervention for patients with locally advanced rectal cancer (LARC) regardless of response to neoadjuvant therapy. In this study, we perform a comprehensive review of the National Cancer Database (NCDP) to compare the clinical and surgical outcomes of TME to local excision (LE) in patients with LARC. Methods: NCDP was systematically researched to abstract all patients with stage II and III rectal adenocarcinoma between the years 2004 and 2015. We subsequently excluded all the patients who did not achieve complete pathological response (pT0) after neoadjuvant therapy. The patients were then divided into two groups; those who underwent TME and those who underwent LE. Data were analyzed using SPSS v. 26.0, SAS v. 9.4. Results: A total of 4,705 were included in the study; 4,589 in the TME group and 116 in the LE group. Baseline characteristics were similar between the groups except for age. A total of 81(1.8%) of patients in the TME group and 8(6.9%) of patients in the LE group did not receive radiation (p=0.006) and 19(0.4%) of patients the TME group and 4(3.4%) of patients in the LE group did not receive chemotherapy. There was no difference in median overall survival between TME and LE groups. The median length of hospital stay was remarkably shorter in the LE group compared to the TME group (1 day vs 6 days, p<0.0001). The rate of 30-day and 90-day postoperative mortality were similar between the two groups (p-value=0.334 and 0.06, respectively). In the LE group, 4 (3.4%) of patients were readmitted within 30 days of the resection compared to 374 (8.5%) in the TME group but was not a statistically significant difference (p=0.059). Conclusions: In this study, TME and LE had similar overall survival and time to 25% mortality in patients with LARC who achieved complete pathological response after neoadjuvant therapy. Also, LE had a shorter hospital stay compared to the TME group. This study is limited by its retrospective nature, however these interesting observations warrant further investigation in randomized clinical trials. [Table: see text]

Total Neoadjuvant Treatment for Rectal Cancer: Preliminary Experience

2020 ◽  
pp. 000313482095149
Author(s):  
Hayim Gilshtein ◽  
Amandeep Ghuman ◽  
Mirelle Dawoud ◽  
Shlomo Yellinek ◽  
Ilan Kent ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathologic Response ◽  
Pathological Response ◽  
Complete Pathologic Response ◽  
Regression Analyses ◽  
Complete Pathological Response

Introduction: Administration of chemotherapeutic regimens such as FOLFOX or CAPEOX with chemoradiation in the neoadjuvant setting, termed total neoadjuvant treatment (TNT), was introduced in recent years. By increasing the complete pathologic and clinical responses, patients with locally advanced rectal cancer may have better oncologic outcomes and potentially abstain from undergoing a proctectomy. Methods: All patients who underwent TNT at a single National Accreditation Program for Rectal Cancer accredited referral center were included. A retrospective analysis was performed using a computerized Institutional Review Board-approved database. Patient demographics, diagnostic workup, treatment regimens, and surgical and pathological reports were reviewed. Complete pathological response was the primary outcome. Univariable and multivariable logistic regression analyses were performed to identify potential factors predisposing to complete pathological response. Results: Thirty patients met the inclusion criteria, 14(46.6%) of whom had complete pathologic response. There was no difference in baseline demographic characteristics between patients who achieved complete pathological response and those who did not. Pathology revealed a 92% intact mesorectum rate in the complete pathologic response group and a mean of 24 harvested lymph nodes in the entire study cohort. Both univariable and multivariable logistic regression analyses failed to demonstrate statistically significant factors predicting complete pathologic response, magnetic resonance imaging (MRI) tumor size, and posttreatment MRI lymph node positivity. Conclusion: TNT is safe and efficient for patients with locally advanced rectal cancer. It increases complete pathological and clinical response rates and may more widely evolve to be the treatment of choice in this group of patients in the near future.

scholarly journals Neoadjuvant Strategies: Locally Advanced Rectal Cancer

2017 ◽  
Vol 30 (05) ◽  
pp. 383-386 ◽  
Author(s):  
Shahab Ahmed ◽  
Cathy Eng
Keyword(s):  
Rectal Cancer ◽  
Multidisciplinary Approach ◽  
Causes Of Death ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
Successful Management ◽  
Complete Pathological Response

AbstractColorectal cancer is one of the major leading causes of death in both men and women. The successful management of colon or rectal cancer demands a multidisciplinary approach. In the last few years, significant improvement has been noticed in the management of localized rectal cancer to reduce local recurrence and obtain complete pathological response following appropriate surgical steps, if necessary. Implementation of neoadjuvant therapy not only enhances disease control, it may also ensure sphincter preserving procedures or organ-preserving options. This article principally concentrates on the current neoadjuvant treatment for locally advanced rectal cancer and the prognostic outcomes of such therapy, including a discussion on the historical perspective.

scholarly journals Complete Pathological Response Following Radiochemotherapy for Locally Advanced Rectal Cancer: Short and Long-term Outcome

2019 ◽  
Vol 39 (9) ◽  
pp. 5105-5113 ◽  
Author(s):  
OTHMAN ISKANDER ◽  
LISE COURTOT ◽  
NICOLAS TABCHOURI ◽  
ALICE ARTUS ◽  
NICOLAS MICHOT ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
Complete Pathological Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term

scholarly journals Complete pathological response after preoperative chemotherapy for locally advanced rectal cancer: a case report

2019 ◽  
Vol 30 ◽  
pp. vi129
Author(s):  
Ryoichi Miyamoto ◽  
Kazunori Kikuchi ◽  
Atsushi Uchida ◽  
Masayoshi Ozawa ◽  
Michihiro Maeda ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Preoperative Chemotherapy ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Pathological Response ◽  
Complete Pathological Response
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