Determining Timing of Hepatectomy for Colorectal Cancer with Distant Metastasis According to Imaging-Based Tumor Shrinkage Ratio

Sasaki, Yoshiyuki; Osada, Shinji; Mori, Ryuutarou; Imai, Hisashi; Tanaka, Yoshihiro; Matsuhashi, Nobuhiro; Okumura, Naoki; Nonaka, Kenichi; Takahashi, Tsuyoshi; Yoshida, Kazuhiro

doi:10.7150/ijms.6244

Cited by 7 publications

(9 citation statements)

References 36 publications

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“…On this basis, cytoreduction of the disease may prolong OS and PFS times. We recently reported that the overall rate of tumor shrinkage was highest during the first 50 days after the start of therapy and gradually decreased over the next 210 days subsequent to plateauing at 105 days ( 33 , 34 ). The present results indicated that the effect of anti-EGFR monoclonal antibodies plus FOLFOX on tumor size is achieved at around 3 months (6–8 courses).…”

Section: Discussionmentioning

confidence: 99%

A novel therapeutic strategy of personalized medicine based on anti-epidermal growth factor receptor monoclonal antibodies in patients with metastatic colorectal cancer

et al. 2018

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Achieving tumor shrinkage may be a clinically relevant improvement in the treatment of metastatic colorectal cancer (mCRC). The present study attempted to evaluate early tumor shrinkage (ETS) and deepness of response over 6–8 courses of therapy, which were assessed previously in first-line trials of anti-epidermal growth factor receptor (EGFR) monoclonal antibodies. A total of 37 patients with mCRC that was considered unresectable or borderline resectable were enrolled in the study. Patients exhibited the wild-type RAS gene, and anti-EGFR monoclonal antibodies were used as the first-line treatment in the Department of Surgical Oncology at Gifu University School of Medicine (Gifu, Japan) between January 2010 and March 2017. Tumor shrinkage and other characteristics were evaluated according to the Response Evaluation Criteria In Solid Tumors (RECIST) classifications (version 1.1). The 3-year overall survival (OS) rate was >60.0% for all cases (n=37). The mean tumor shrinkage rate in the right side of the colon according to the RECIST classifications was −11.1%, whereas that for CRC on the left side showed a statistically significant difference at −54.0% (P=0.042). In addition, the rates of OS for stable disease + progressive disease compared with partial response + complete response, and those of OS for conversion therapy compared with non-conversion therapy were significantly different (both P<0.001). Carcinoembryonic antigen (CEA) was suggested to be a possible predictive factor for convalescence due to the 50% drop in its value after the 6–8 courses of therapy. Overall, the predictive performance of ETS with respect to PFS and OS is at least as good as the standard RECIST response, with the advantage of an earlier assessment, and this may improve convalescence, with CEA as a marker in support of ETS over a clinical treatment course. In RAS wild-type patients, it is important to evaluate the rate of tumor shrinkage from the beginning of the first-line treatment until 6–8 courses of anti-EGFR monoclonal antibodies have been administered.

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Section: Discussionmentioning

confidence: 99%

A novel therapeutic strategy of personalized medicine based on anti-epidermal growth factor receptor monoclonal antibodies in patients with metastatic colorectal cancer

et al. 2018

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“…In contrast to its tumor suppressive functions, RNF8 may also play positive roles in tumor progression. The mRNA level of RNF8 was found to be higher in colorectal cancer than in normal tissues [77], which suggests RNF8 may promote the survival of certain cancers. The silencing of RNF8 by specific siRNA in nasopharyngeal cancer (NPC) cells enhanced the sensitivity of NPC cells to irradiation.…”

Section: Tumorigenesis and Cancer Progressionmentioning

confidence: 94%

The Functions of DNA Damage Factor RNF8 in the Pathogenesis and Progression of Cancer

Zhou¹,

Yi²,

Wang³

et al. 2019

Int. J. Biol. Sci.

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The really interesting new gene (RING) finger protein 8 (RNF8) is a central factor in DNA double strand break (DSB) signal transduction. DSB damage is the most toxic type of DNA damage to cells and is related to genomic instability. Multiple roles for RNF8 have been identified in DNA damage response as well as in other functions, such as telomere protection, cell cycle control and transcriptional regulation. These functions are closely correlated to tumorigenesis and cancer progression. Indeed, deficiency of RNF8 caused spontaneous tumorigenesis in a mouse model. Deciphering these mechanisms of RNF8 may shed light on strategies for cancer treatment. In this review, we summarize the current understanding of both classical and nonclassical functions of RNF8, and discuss its roles in the pathogenesis and progression of tumor.

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“…We reported previously that the tumor shrinkage effect reaches a plateau in about 100 days based on the radiological response of tumor shrinkage and drug-resistance mechanisms [16] [17]. Based on this evidence, including the ndings of the past trials [18] [19] [20], following the approval of a multidisciplinary team, six cycles of oxaliplatin-based PC with molecular targeted drug therapy were administered to patients with borderline or unresectable CRLM that was in extensive contact with the root of the major hepatic veins or Glisson's capsules or who had insu cient residual liver volume.…”

Section: Treatment Strategies For Crlmmentioning

confidence: 99%

The prognostic significance of a histological response to preoperative chemotherapy in patients with synchronous colorectal liver metastases

Tanaka

Matsuhashi

Imai

et al. 2021

Preprint

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Background Preoperative chemotherapy (PC) for colorectal liver metastasis (CRLM) is widely used to improve prognosis, but its clinical benefit has not been fully established. This study aimed to assess the effectiveness of PC for synchronous CRLMs, and to analyze the correlation between histological response to PC and survival. Methods We retrospectively analyzed the clinicopathological factors and outcomes of 69 patients who underwent initial hepatectomy for synchronous CRLM between 2004 and 2018 after receiving PC (PC group: n = 43) or who underwent upfront hepatectomy without PC (Non-PC group: n = 26). In the PC group, the patients were divided into two groups, Grade 1 (n = 27) and Grade 2/3 (n = 16) groups according to their histological responses to PC. Results The median survival and 5-year overall survival (OS) rates were 80.9 months and 61.5%, respectively, in the PC group and 71.7 months and 61.5%, respectively, in the Non-PC group (P = 0.867). Regarding recurrence-free survival (RFS) and remnant liver-RFS, there were no significant differences between the two groups (P = 0.087 and 0.291). However, in a subgroup analysis according to the histological response to PC, the median 5-year OS, RFS, and remnant liver-RFS in the Grade 2/3 group were significantly longer than in the Grade 1 group (OS: 66 vs. 53 months; P = 0.008, RFS: 15 vs. 6.7 months; P = 0.002, remnant liver-RFS: 62 vs. 8.3 months; P < 0.001). Surgical margin positive status (< 1 mm) was associated with a high remnant liver recurrence rate (hazard ratio 2.597, P = 0.008). Conclusion PC should not be routinely administered to all patients with synchronous CRLMs. However, some patients benefit from PC, and the histological response to PC had prognostic significance for patients with synchronous CRLM.

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Determining Timing of Hepatectomy for Colorectal Cancer with Distant Metastasis According to Imaging-Based Tumor Shrinkage Ratio

Cited by 7 publications

References 36 publications

A novel therapeutic strategy of personalized medicine based on anti-epidermal growth factor receptor monoclonal antibodies in patients with metastatic colorectal cancer

A novel therapeutic strategy of personalized medicine based on anti-epidermal growth factor receptor monoclonal antibodies in patients with metastatic colorectal cancer

The Functions of DNA Damage Factor RNF8 in the Pathogenesis and Progression of Cancer

The prognostic significance of a histological response to preoperative chemotherapy in patients with synchronous colorectal liver metastases

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