Neoadjuvant radiochemotherapy and surgery for advanced rectal cancer

Eich, Hans Theodor; Stępień, Anna; Zimmermann, Christian; Hellmich, Martin; Metzger, Ralf; Hölscher, Arnulf H.; Müller, Rolf-Peter

doi:10.1007/s00066-011-2113-1

Cited by 28 publications

(19 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The treatment of locally advanced extra-peritoneal rectal adenocarcinoma used for the last two decades, has been the association of preoperative chemoradiotherapy followed by resection surgery with total mesorectal excision (6) . The neoadjuvant therapy leads to a decrease of the lesion, facilitating the surgical resection and increasing the rates of sphincter preservation and maintenance of urinary and sexual functions (11) .…”

Section: Introductionmentioning

confidence: 99%

NEOADJUVANT THERAPY AND SURGERY FOR RECTAL CANCER. Comparative study between partial and complete pathological response

Andrade

Coy

Leal

et al. 2016

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Background -The approach of locally advanced extra-peritoneal rectal adenocarcinoma implies a treatment with neoadjuvant chemoradiotherapy associated with total mesorectal excision surgery. However, the tumors respond variably to this neoadjuvant therapy, and the mechanisms for response are not completely understood. Objective -Evaluate the variables related to the complete tumor response and the outcomes of patients who underwent surgery, comparing those with partial tumor regression and those with total remission of rectal lesion, at the pathological examination. Methods -Retrospective analysis of medical records of 212 patients operated between 2000 and 2010, in which 182 (85.9%) obtained partial remission at neoadjuvant therapy (Group 1) and 30 (14.1%), total remission (Group 2). Results -No difference was found between the groups in relation to gender, ethnicity, age, tumor distance from the anal verge, occurrence of metastases and synchronous lesions on preoperative staging, dose of radiotherapy and performed surgery. In Group 2, was verified high rate of complete remission when the time to surgery after neoadjuvant therapy was equal or less than 8 weeks (P=0.027), and a tendency of lower levels of pretreatment carcinoembryonic antigen (P=0.067). In pathological analysis, the Group 1 presented in relation to Group 2, more affected lymph nodes (average 1.9 and 0.5 respectively; P=0.003), more angiolymphatic (19.2% and 3.3%; P=0.032) and perineural involvement (15.4% and 0%; P=0.017) and greater number of lymph nodes examined (16.3 and 13.6; P=0.023). In the late follow-up, Group 1 also had lower overall survival than Group 2 (94.1 months and 136.4 months respectively; P=0.02) and disease-free survival (85.5 months and 134.6 months; P=0.004). There was no statistical difference between Group 2 and Group 1 in local recurrence (15% and 3.4%, respectively) and distant metastasis (28% and 13.8%, respectively). Conclusion -In this study, the only factor associated with complete remission of rectal adenocarcinoma was the time between neoadjuvant therapy and surgery. This group of patients had less affected lymph nodes, less angiolymphatic and perineural involvement, a longer overall and disease-free survival, but no significant statistical difference was observed in local recurrence and distant metastasis. Although the complete pathologic remission was associated with better prognosis, this not implied in the cure of the disease for all patients. HEADINGS -Neoadjuvant therapy. Colorectal surgery. Rectal neoplasms.

show abstract

Section: Introductionmentioning

confidence: 99%

NEOADJUVANT THERAPY AND SURGERY FOR RECTAL CANCER. Comparative study between partial and complete pathological response

Andrade

Coy

Leal

et al. 2016

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…This treatment approach offers the best locoregional control and a chance for sphincter preservation in tumours located less that 6 cm from the anal verge [5,6,7,15,38]. Numerous chemotherapeutic schemes have been tested over the last decade for simultaneous administration with external beam radiotherapy (EBRT), aiming to improve the rates of locoregional control, sphincter-sparing surgery and diminish distant failure [30,33,37].…”

Section: Simultaneous Neoadjuvant Radiochemotherapy With Capecitabinementioning

confidence: 99%

Simultaneous neoadjuvant radiochemotherapy with capecitabine and oxaliplatin for locally advanced rectal cancer

Winkler

Zipp

Knoblich³

et al. 2012

Strahlenther Onkol

View full text Add to dashboard Cite

show abstract

“…Most of the clinical trials designed for rectal cancers have included patients below the age of 75 or 80 years [6,8,27]. This is notably the case for the recent large randomized trials [1,4,9,10,25] testing the role of neo-adjuvant chemoradiotherapy (NACRT).…”

Section: Clinical Outcome Of Rectal Cancer In Patients ≥ 80 Years Trementioning

confidence: 99%

Clinical outcome of rectal cancer in patients ≥ 80 years treated in southern France (PACA region) between 2002 and 2005

et al. 2012

View full text Add to dashboard Cite

show abstract

Neoadjuvant radiochemotherapy and surgery for advanced rectal cancer

Cited by 28 publications

References 28 publications

NEOADJUVANT THERAPY AND SURGERY FOR RECTAL CANCER. Comparative study between partial and complete pathological response

NEOADJUVANT THERAPY AND SURGERY FOR RECTAL CANCER. Comparative study between partial and complete pathological response

Simultaneous neoadjuvant radiochemotherapy with capecitabine and oxaliplatin for locally advanced rectal cancer

Clinical outcome of rectal cancer in patients ≥ 80 years treated in southern France (PACA region) between 2002 and 2005

Contact Info

Product

Resources

About