Rectal Cancer, Version 2.2015

Benson, Al B.; Venook, Alan P.; Bekaii‐Saab, Tanios; Chan, Emily; Chen, Yi Jen; Cooper, Harry S.; Engstrom, Paul F.; Enzinger, Peter C.; Fenton, Moon J.; Fuchs, Charles S.; Grem, Jean L.; Grothey, Axel; Hochster, Howard S.; Hunt, Steven R.; Kamel, Ayman H.; Kirilcuk, Natalie; Leong, Lucille; Lin, Edward H.; Messersmith, Wells A.; Mulcahy, Mary F.; Murphy, James D.; Nurkin, Steven; Rohren, Eric M.; Ryan, David P.; Saltz, Leonard; Sharma, Sunil; Shibata, David; Skibber, John M.; Sofocleous, Constantinos T.; Stoffel, Elena M.; Stotsky-Himelfarb, Eden; Willett, Christopher G.; Gregory, Kristina M.; Freedman-Cass, Deborah A.

doi:10.6004/jnccn.2015.0087

Cited by 203 publications

(133 citation statements)

References 41 publications

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“…The indications of such treatment are: sub serosa invasion (T3,T4) and/or lymph node metastasis (N + ) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Benefits of Neoadjuvant Hypofractionated Radiotherapy in the Treatment of Locally Advanced Adenocarcinomas

Abid¹,

Mansouri²,

Bataiche³

et al. 2017

J Gen Pract

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Background: The current treatment of locally advanced lower and middle rectum's adenocarcinoma is well codified. It is based on neoadjuvant radiotherapy (NRT) followed by surgical excision. However, two broad radiotherapy approaches are being debated: short course of hypo-fractionated radiation therapy "SRT" (5 GY × 5 days) and long course concomitant radio-chemotherapy "CRT" using higher radiation dose (45-50 GY over 5 weeks) combined with chemotherapy. The first approach allows taking care of about 4 times more patients compared to the second in a same period. SRT was introduced at a large scale at the Pierre ET Marie Curie center (Algiers) in May 2010 by a new multidisciplinary board (Rectum board), aiming to reduce long-lasting schedules.

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“…The indications of such treatment are: sub serosa invasion (T3,T4) and/or lymph node metastasis (N + ) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Benefits of Neoadjuvant Hypofractionated Radiotherapy in the Treatment of Locally Advanced Adenocarcinomas

Abid¹,

Mansouri²,

Bataiche³

et al. 2017

J Gen Pract

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“…The clinical guidelines for neoadjuvant and adjuvant therapy vary from country to country. Patients with less than 5 mm between the tumor border and the mesorectal fascia are given a long-course of preoperative chemo-radiation therapy in some places but also underwent surgery alone in some places (27,28). Current guidelines recommend preoperative chemoradiation therapy and post-operative chemotherapy for clinically staged T3, T4 (27).…”

Section: Re-categorization Of T3 Sub-stagingmentioning

confidence: 99%

“…Patients with less than 5 mm between the tumor border and the mesorectal fascia are given a long-course of preoperative chemo-radiation therapy in some places but also underwent surgery alone in some places (27,28). Current guidelines recommend preoperative chemoradiation therapy and post-operative chemotherapy for clinically staged T3, T4 (27). Local recurrence and overall survival in rectal cancer have shown significant improvement, but the risk of side effects such as bowel and sexual dysfunction by unnecessary chemotherapy and radiotherapy that is caused by over-staging and risk of local recurrence due to under-staging is also frequently seen (28-30).…”

Section: Re-categorization Of T3 Sub-stagingmentioning

confidence: 99%

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

et al. 2018

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Background: MRI predicted distance of mesorectal extension (mrDME) in rectal cancer is one of the independent risk factors for recurrence and poor overall survival. In T3 rectal cancer, if no lymph node or distant metastasis is seen, the selection of optimum treatment is based on the distance of mesorectal extension. Therefore, it is very crucial to investigate the reproducibility of DME in T3 rectal cancer. Objectives: To investigate the reproducibility of the distance of mesorectal extension by tumor invasion in T3 stage rectal cancer by evaluating sub-stages T3a, T3b T3c and T3d individually versus T3a, T3b (T3ab) and T3c, T3d (T3cd) combined together using MRI. Methods: From July 2014 to December 2015, 188 patients with surgically and histologically confirmed T3 rectal cancer who underwent preoperative MRI were enrolled into this study. Two blinded radiologists evaluated the maximum distance of mesorectal extension (mrDME) in T2 weighted image in MRI. The study population was sub classified into T3a (< 1 mm), T3b (1 -5 mm), T3c (5 -15 mm) and T3d (> 15 mm) according to the distance of mesorectal extension by tumor invasion. The inter-observer and intra-observer data were then assessed using Kappa analysis (k); intraclass correlation coefficients (ICC) were also analyzed subsequently. Results: Difference in the value of inter/intra observer kappa (k), and inter/intra-observer intraclass coefficients (ICC) between the two groups was very distinct. In the individual group (T3a, T3b, T3c and T3d), the inter-observer and intra-observer (k) for the mrDME was 0.700 and 0.718 respectively; the inter-observer and intra-observer ICC was 0.772 and 0.786 respectively. In the combined group (T3ab and T3cd), the inter-observer and intra-observer kappa (k) for the mrDME was 0.819 and 0.883 respectively; the inter-observer and intra-observer ICC was 0.829 and 0.796 respectively. Conclusions: There was a distinct increase in the kappa (K) and intraclass coefficient (ICC) value in the combined group compared with the individual group. This high reproducibility result suggested that it is more reliable to measure T3ab and T3cd combined together than individually. This finding can play a crucial role in the management of rectal cancer and clinical decision making for non-expert radiologists in non-academic setting.

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“…In addition, a high rate of sphincter preservation is a benefit from preoperative chemoradiotherapy [43] . Therefore, preoperative chemoradiotherapy was standardized for tumors classified as T3-4/N any lower rectal adenocarcinoma in Europe and the USA [44,45] . On the contrary, few physicians have performed preoperative chemoradiotherapy for neuroendocrine tumors, and its efficacy remains uncertain [46,47] .…”

Section: Neoadjuvant Chemoradiotherapy For Rectal Manecmentioning

confidence: 99%

Diagnosis, Assessment, and Therapeutic Strategy for Colorectal Mixed Adenoneuroendocrine Carcinoma

Tanaka¹,

Kaneko²,

Nozawa³

et al. 2017

Neuroendocrinology

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Colorectal mixed adenoneuroendocrine carcinoma (MANEC), which acts like an aggressive tumor, is a rare clinical manifestation on which only a limited amount of literature exists. Surgical resection by regional lymphadenectomy is considered as the only curative treatment for colorectal MANEC, and adjuvant chemotherapy or radiotherapy is recommended because of its high recurrence rate. Colorectal MANEC is frequently diagnosed at an advanced stage, when it is unresectable, and chemotherapy plays a central role in its treatment. Pathological confirmation of the target lesion component is critical for regimen selection. If the lesion comprises an adenocarcinomatous component, a regimen for colorectal adenocarcinoma should be administered. For lesions comprising mainly a neuroendocrine carcinomatous component, cisplatin combined with etoposide or irinotecan has proven to be clinically appropriate. Everolimus, a mechanistic target of rapamycin pathway inhibitor, also improves survival. Sunitinib malate, another molecular targeting agent, is effective for treating neuroendocrine carcinoma; however, the evidence on its effectiveness for treating gastrointestinal neuroendocrine carcinoma is insufficient.

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Rectal Cancer, Version 2.2015

Cited by 203 publications

References 41 publications

Benefits of Neoadjuvant Hypofractionated Radiotherapy in the Treatment of Locally Advanced Adenocarcinomas

Benefits of Neoadjuvant Hypofractionated Radiotherapy in the Treatment of Locally Advanced Adenocarcinomas

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

Diagnosis, Assessment, and Therapeutic Strategy for Colorectal Mixed Adenoneuroendocrine Carcinoma

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