Incidence and Clinical Impact of Sterilized Disease and Minimal Residual Disease After Preoperative Radiochemotherapy for Rectal Cancer

Gavioli, M.; Luppi, Gabriele; Losi, Lorena; Bertolini, Federica; Santantonio, M.; Falchi, A.; D'Amico, Roberto; Conte, Pierfranco; Natalini, Gianni

doi:10.1007/s10350-005-0133-6

Cited by 73 publications

(48 citation statements)

References 34 publications

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“…On the other hand, tumor regression was associated with local recurrence (389 patients; refs. 4,8,27,28), overall survival (247 patients; refs. 8,29), or disease-free survival (270 patients; refs.…”

Section: Discussionmentioning

confidence: 99%

Circumferential Margin Involvement Is the Crucial Prognostic Factor after Multimodality Treatment in Patients with Locally Advanced Rectal Carcinoma

Gosens

Klaassen

Tan-Go

et al. 2007

Clinical Cancer Research

143

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Purpose: After preoperative (radio)chemotherapy, histologic determinants for prognostification have changed. It is unclear which variables, including assessment of tumor regression, are the best indicators for local recurrence and survival. Experimental Design: A series of 201 patients with locally advanced rectal cancer (cT3/T4, M0) presenting with an involved or at least threatened circumferential margin (CRM) on preoperative imaging (<2 mm) were evaluated using standard histopathologic variables and four different histologic regression systems. All patients received neoadjuvant radiochemotherapy or radiotherapy. The prognostic value of all factors was tested with univariate survival analysis of time to local recurrence and overall survival. Results: Local recurrence occurred in only 8% of the patients with a free CRM compared with 43% in case of CRM involvement (P < 0.0001). None of the four regression systems were associated with prognosis, not even when corrected for CRM status. However, we did observe a higher degree of tumor regression after radiochemotherapy compared with radiotherapy (P < 0.001). Absence of tumor regression was associated with increasing invasion depth and a positive CRM (P = 0.02 and 0.03, respectively). Conclusions: Assessment of CRM involvement is the most important pathologic variable after radiochemotherapy. Although tumor regression increases the chance on a free CRM, in cases with positive resection margins prognosis is poor irrespective of the degree of therapyinduced regression.

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Section: Discussionmentioning

confidence: 99%

Circumferential Margin Involvement Is the Crucial Prognostic Factor after Multimodality Treatment in Patients with Locally Advanced Rectal Carcinoma

Gosens

Klaassen

Tan-Go

et al. 2007

Clinical Cancer Research

143

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show abstract

“…TRG has been shown to provide valuable prognostic information in patients with carcinomas of the breast, stomach, oesophagus and colorectum who have been treated with neoadjuvant chemotherapy and serves as a morphological marker to guide further treatment after surgery. [101][102][103][104][105] The applicability of several well-known and widely used systems for TRG has been considered for pelvic gynaecological carcinomas. Some of the systems that are used for breast carcinoma are unduly complex and include the separate assessment of both the primary tumour and involved lymph nodes.…”

Section: Carcinosarcoma Subtypesmentioning

confidence: 99%

Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

et al. 2015

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“…Recent studies have revealed that pathological CR and greater than 95% pathological response groups achieve a significantly improved overall survival and recurrence-free survival when compared with less than 95% pathological response groups (Ruo et al, 2002;Guillem et al, 2005). Therefore, we divided the cases into two groups: Dworak grades 1 and 2, and grades 3 and 4 (Gavioli et al, 2005). The latter were considered as responders to CRT.…”

Section: Pathological Response To Crtmentioning

confidence: 99%

High Ki67, Bax, and thymidylate synthase expression well correlates with response to chemoradiation therapy in locally advanced rectal cancers: proposal of a logistic model for prediction

et al. 2009

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BACKGROUND: Recently, preoperative chemoradiation therapy (CRT) for rectal cancer has been increasingly used as a neoadjuvant treatment. In the present study, the relation between histological response to CRT and immunohistochemical markers in biopsy specimens was investigated. METHODS: Biopsy specimens from a total of 60 patients were collected before preoperative CRT with S-1 and irinotecan, and liniac 45 Gy. Immunohistochemical staining for Ki67, Mcm3, Bax, Bcl-2, ssDNA, Grp78, thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), CD34, vascular endothelial growth factor, nestin, and L-type amino-acid transporter 1 was performed to allow comparison of the Ki67 labelling index (LI), Bax score, TS score, DPD score, microvessel density by CD34, and Grp78 score with cancer regression. RESULTS: When the cases were divided into responders (Dworak grades 3 and 4) and non-responders (grades 1 and 2) groups, good correlations were evident with Ki67 LI, Bax, Grp78, and TS expression. On multiple logistic regression analysis, Ki67 LI, Bax, and TS scores were found to be independent factors. With their use in a logistic model, P-values could predict responder cases with a sensitivity of 82.8% and a specificity of 83.9%. CONCLUSION: Using this system, treatment strategy for locally advanced rectal cancers can be determined before chemoradiation.

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Incidence and Clinical Impact of Sterilized Disease and Minimal Residual Disease After Preoperative Radiochemotherapy for Rectal Cancer

Cited by 73 publications

References 34 publications

Circumferential Margin Involvement Is the Crucial Prognostic Factor after Multimodality Treatment in Patients with Locally Advanced Rectal Carcinoma

Circumferential Margin Involvement Is the Crucial Prognostic Factor after Multimodality Treatment in Patients with Locally Advanced Rectal Carcinoma

Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR)

High Ki67, Bax, and thymidylate synthase expression well correlates with response to chemoradiation therapy in locally advanced rectal cancers: proposal of a logistic model for prediction

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