Predictive factors of disease-free survival after complete pathological response to neoadjuvant radiotherapy for rectal adenocarcinoma: retrospective case series

Souadka, Amine; Majbar, Mohammed Anass; Benkabbou, Amine; Serji, Badr; Souiki, Tarik; Bouchentouf, Sidi Mohammed; Abid, Mourad; Khannousi, Basma El; Harroudi, Tijani El; Malki, Hadj Omar El; Raiss, M.; Ifrine, L.; Mazaz, Khalid; Zentar, Aziz; Mohsine, Raouf; Souadka, A.; Belkouchi, A.; Ahallat, M.; Hrora, A.

doi:10.1186/s12885-019-6239-3

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…A recent study by our group showed that RC patients with NMAC had better survival after short-course radiotherapy compared to long-course radiotherapy, while there was no such difference in the MAC group, indicating that patients with MAC or NMAC may also respond differently to type of preoperative radiotherapy [ 17 ]. A study by Souadka et al from 2019 including 84 patients with complete pathologic response after neoadjuvant treatment followed by TME, showed that MAC and poorly differentiated tumors were independent factors for worse disease-free survival (DFS) [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of adjuvant chemotherapy on survival in mucinous and non-mucinous rectal adenocarcinoma patients after TME surgery

et al. 2023

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Introduction The value of adjuvant chemotherapy for rectal cancer patients is debated and varies in different subgroups. One such subgroup is mucinous adenocarcinoma (MAC), which is more treatment resistant compared to non-mucinous adenocarcinoma (NMAC). To date, mucinous histology is not taken into account when deciding on adjuvant treatment strategy. This is the first study to exclusively include patients with rectal cancer, then separate MAC and NMAC and compare the survival in patients that had or did not have adjuvant chemotherapy. Material and methods The study included retrospective register data from 365 Swedish patients with stage II-IV rectal adenocarcinoma, 56 patients with MAC and 309 patients with NMAC. All patients were considered curative, had surgery with total mesorectal excision in 2004–2013, and were followed up until death or 2021. Results Patients with MAC that had adjuvant chemotherapy had better overall survival (OS, HR 0.42; CI 95%: 0.19–0.93; p = 0.032) and a trend towards better cancer-specific survival (CSS, HR 0.41 CI 95%: 0.17–1.03; p = 0.057) compared to patients without chemotherapy (HR 0.42; CI 95%: 0.19–0.93; p = 0.032). The difference in OS was still significant even after adjusting for sex, age, stage, differentiation, neoadjuvant chemotherapy and preoperative radiotherapy (HR 0.40; CI 95%: 0.17–0.92; p = 0.031). There was no such difference in the NMAC patients except in the stage-by-stage subgroup analyses where patients in stage IV had better survival after adjuvant chemotherapy. Conclusions There may be a difference in treatment response to adjuvant chemotherapy between MAC and NMAC patients. Patients with MAC could possibly benefit from adjuvant chemotherapy in stages II-IV. Further studies are however needed to confirm these results.

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Section: Introductionmentioning

confidence: 99%

The impact of adjuvant chemotherapy on survival in mucinous and non-mucinous rectal adenocarcinoma patients after TME surgery

et al. 2023

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“…A number of prognostic factors have been addressed in rectal cancer patients who underwent preoperative CRT and surgery [ 33 – 35 ]. Our study did not focus on identification of established prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Rectal Cancer: Long-Term Results after Protocol-Based Treatment

Lee

Ahn

et al. 2022

Journal of Oncology

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Background. Volumetric modulated arc therapy (VMAT) with simultaneous integrated boost (SIB) is an advanced form of radiotherapy (RT) technology. The purpose of this study was to report long-term treatment outcomes in patients with locally advanced rectal cancer undergoing VMAT-SIB based concurrent chemoradiotherapy (CRT). Methods. Between January 2016 and January 2018, a total of 22 patients with operable stage II-III rectal adenocarcinoma were recruited for the pre-designed VMAT-SIB RT protocol. All patients underwent standard diagnostic and staging work-up. The RT target volumes included the following areas: PTV1 = mesorectum that contained gross tumors and enlarged lymph node regions and PTV2 = mesorectum and regional lymphatics from L4-5/S1 to 3-4 cm below the tumor or levator ani muscle, excluding PTV1. The VMAT-SIB dose prescription was as follows: PTV1 = 52.5 Gy/daily 2.1 Gy/25 fractions, PTV2 = 45 Gy/daily 1.8 Gy/25 fractions. Results. The mean age of the study population was 64 (range, 18-84) years, and 15 (68.2%) patients were male. Radical operation (total mesorectal excision) was performed by either low anterior resection, ultralow anterior resection, or abdominal perineal resection. All five (22.7%) of the patients with confirmed increasing serum carcinoembryonic antigen (CEA) level at diagnosis showed normalization of serum CEA level after the planned treatment. Among 20 patients who underwent preoperative CRT and surgery, tumor down staging in T- and N-stages was achieved in 10 patients (50%) and 13 patients (65%), respectively, with 20% of ypT0/Tis. With a median follow-up of 54.2 (range, 22.6-61.1) months, the 5-year disease-free survival, overall survival, and local control rates were 64.6%, 81.8%, and 84.4%, respectively. Five patients developed distant metastasis and one developed local recurrence as a first event. Two cases with anastomosis site leakage, three with adhesive ileus, and two with abscess formation were observed during postoperative periods. Conclusions. The current VMAT-SIB-based CRT protocol provided acceptable treatment and toxicity outcomes.

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“…First, to our knowledge, this is the first multi-centre national study auditing laparoscopic surgery for colon cancer in Africa. In addition, there are 5 university hospitals in Morocco, and the study included surgical departments from 2 university hospitals that are the most advanced in colorectal cancer surgery in the country [ 15 , 38 , 39 ] [ 40 ]. Therefore, we can reasonably consider the results of this study representative of surgical practice within public university hospitals in the country.…”

Section: Discussionmentioning

confidence: 99%

Audit of laparoscopic surgery for colon cancer in Morocco: A report of the results of a prospective multicentre cohort study

Aya¹,

Salma²,

Benkabbou

et al. 2022

Annals of Medicine &Amp; Surgery

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Predictive factors of disease-free survival after complete pathological response to neoadjuvant radiotherapy for rectal adenocarcinoma: retrospective case series

Cited by 5 publications

References 29 publications

The impact of adjuvant chemotherapy on survival in mucinous and non-mucinous rectal adenocarcinoma patients after TME surgery

The impact of adjuvant chemotherapy on survival in mucinous and non-mucinous rectal adenocarcinoma patients after TME surgery

Simultaneous Integrated Boost Volumetric Modulated Arc Therapy for Rectal Cancer: Long-Term Results after Protocol-Based Treatment

Audit of laparoscopic surgery for colon cancer in Morocco: A report of the results of a prospective multicentre cohort study

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