Neoadjuvant treatment response and outcomes in locally advanced rectal cancer: Establishing oncologic benchmarks.

Chang, George J.; Park, I. J.; You, Y. N.; Hu, Chiyu; Hamilton, Stanley R.; Eng, Cathy; Feig, Barry W.; Das, Priti; Krishnan, Sunil; Crane, Christopher H.; Nguyen, Susan; Rodrı́guez-Bigas, Miguel A.; Skibber, John M.

doi:10.1200/jco.2011.29.15_suppl.3545

Cited by 2 publications

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“…Regardless of the exact mechanisms of the lower rates of neoadjuvant treatment response among obese patients, we observed a clear relationship between treatment response as an early response indicator and long-term recurrence free survival in both the obese and non-obese patients 10 . There was no apparent interaction between obesity and treatment response as a predictor of recurrence risk.…”

Section: Discussionmentioning

confidence: 60%

Oncologic and Functional Hazards of Obesity Among Patients With Locally Advanced Rectal Cancer Following Neoadjuvant Chemoradiation Therapy

Park

You

Skibber

et al. 2017

American Journal of Clinical Oncology

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Objective Obesity is a major health concern and risk factor for colorectal cancer that may also impact cancer treatment and outcomes. Rectal cancer response to chemoradiotherapy (CXRT) is associated with long-term survival and sphincter preservation. The purpose of this study was to evaluate the impact of obesity on treatment outcomes after neoadjuvant CXRT for rectal cancer. Methods A retrospective cohort study of patients diagnosed (1993–2010) with cT3-4 or cN+ (by EUS, CT, or MRI) rectal carcinoma and treated with CXRT and TME was performed. Patients were classified as obese (BMI≥30 kg/m2) or non-obese (BMI<30 kg/m2),and by response to CXRT: complete (ypCR) or incomplete (ypIR). Associations between obesity, tumor response, and sphincter preservation were evaluated using multivariate logistic regression analysis and survival outcomes by Cox regression. Results 753 patients met criteria and 28.7% (n=216) patients were obese. Obese and non-obese groups did not differ in age, gender, tumor location, grade, or number of examined lymph nodes. However, obesity was associated with a lower rate of ypCR (ORmulti=0.60; 95% CI:0.38–0.94, p=.04) and among mid-to-low rectal cancer patients, a lower rate of sphincter preservation (ORmulti=.67; 95% CI:.45 to.99). Both among obese and non-obese patients, CR was associated with more favorable recurrence-free survival than iCR. Conclusions Considering the increasing obesity prevalence and its association with CXRT response, oncologic outcomes, and sphincter preservation, further study is needed regarding the impact of obesity on neoadjuvant treatment response. Moreover, obesity should be targeted as a modifiable risk factor for adverse outcomes following multimodality treatment for rectal cancer.

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Section: Discussionmentioning

confidence: 60%

Oncologic and Functional Hazards of Obesity Among Patients With Locally Advanced Rectal Cancer Following Neoadjuvant Chemoradiation Therapy

Park

You

Skibber

et al. 2017

American Journal of Clinical Oncology

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“…Furthermore, whether pCR is the optimal endpoint remains controversial versus the more traditional outcome of DFS or OS. Retrospective analyses have suggested that pCR is a potential surrogate for DFS or OS [ 71 , 72 ]. These findings must be validated prospectively in a phase III trial.…”

Section: Discussionmentioning

confidence: 99%

The Current State of Targeted Agents in Rectal Cancer

Kim

Eng

2012

International Journal of Surgical Oncology

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Targeted biologic agents have an established role in treating metastatic colorectal cancer (CRC), and the integration of targeted therapies into the treatment of CRC has resulted in significant improvements in outcomes. Rapidly growing insight into the molecular biology of CRC, as well as recent developments in gene sequencing and molecular diagnostics, has led to high expectations for the identification of molecular markers to be used in personalized treatment regimens. The mechanisms of action and toxicities of targeted therapies differ from those of traditional cytotoxic chemotherapy. Targeted therapy has raised new insight about the possibility of tailoring treatment to an individual's disease, the assessment of drug effectiveness and toxicity, and the economics of cancer care. This paper covers the last decade of clinical trials that have explored the toxicity and efficacy of targeted agents in locally advanced and metastatic CRC and how their role may benefit patients with rectal cancer. Future efforts should include prospective studies of these agents in biomarker-defined subpopulations, as well as studies of novel agents that target angiogenesis, tumor-stromal interaction, and the cell signaling pathways implicated in rectal cancer.

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Neoadjuvant treatment response and outcomes in locally advanced rectal cancer: Establishing oncologic benchmarks.

Cited by 2 publications

References 0 publications

Oncologic and Functional Hazards of Obesity Among Patients With Locally Advanced Rectal Cancer Following Neoadjuvant Chemoradiation Therapy

Oncologic and Functional Hazards of Obesity Among Patients With Locally Advanced Rectal Cancer Following Neoadjuvant Chemoradiation Therapy

The Current State of Targeted Agents in Rectal Cancer

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