The potential predictive value of MRI and PET-CT in mucinous and nonmucinous rectal cancer to identify patients at high risk of metastatic disease

Barbaro, Brunella; Leccisotti, Lucia; Vecchio, Fabio Maria; Matteo, Marialuisa Di; Serra, Teresa; Salsano, Marco; Poscia, Andrea; Coco, Claudio; Persiani, Roberto; Alfieri, Sergio; Gambacorta, Maria Antonietta; Valentini, Vincenzo; Giordano, Alessandro; Bonomo, Lorenzo

doi:10.1259/bjr.20150836

Cited by 30 publications

(27 citation statements)

References 48 publications

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“…Young LARC patients often present with aggressive pathological features and advanced stage compared with older patients [4][5][6]. Additionally, aggressive pathological features could result in a poorer response to NCRT [22][23][24][25][26][27][28]. Ou results are consistent with those reported by Li et.al [29] in which analysis of the Surveillance, Epidemiology, and End Results (SEER) population-based database revealed that young patients had a better prognosis than old patients.…”

Section: Discussionsupporting

confidence: 80%

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

Zhang

et al. 2020

Preprint

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Background To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC) and explore the underlying mechanism.Method LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (<40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients.Result A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age <40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients.Conclusion Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

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Section: Discussionsupporting

confidence: 80%

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

Zhang

et al. 2020

Preprint

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“…What’s more, the positive detection rate of combination of m SEPT9 with CECT was higher than signal CECT and was higher than the combination of tumor marker with CECT. Thus, a validated blood-based biomarker like m SEPT9 for CRC may help to identify patients with radiologically undetectable recurrence or metastases [32].…”

Section: Discussionmentioning

confidence: 99%

The role of mSEPT9 in screening, diagnosis, and recurrence monitoring of colorectal cancer

et al. 2019

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Background The application of circulating, cell-free, methylated Septin9 ( m SEPT9) DNA in screening and recurrence monitoring is highly promising. CpG island methylator phenotype (CIMP) is associated with microsatellite instability (MSI). The present study was performed to determine the diagnostic accuracy of m SEPT9 for colorectal cancer (CRC) and to evaluate its utility in CRC screening and recurrence monitoring. Methods For screening and diagnosis of CRC, peripheral m SEPT9 detection and fecal occult blood test (FOBT) were performed in 650 subjects, then the level of CEA, CA19–9 and CA724 was quantified in 173 subjects. Clinicopathological parameters and mismatch repair protein were detected among subjects with CRC. For recurrence monitoring of CRC, the sensitivity of m SEPT9 of 70 subjects was compared with tumor markers and contrast enhanced computed tomography (CECT). Results Seventy-three percent of CRC patients were m SEPT9-positive at 94.5% specificity, and 17.1% of patients with intestinal polyps and adenoma were m SEPT9-positive at 94.5% specificity, which were higher than FOBT for the screening of CRC. The sensitivity and specificity of m SEPT9 for diagnosis and recurrence monitoring were higher than that of CEA, CA19–9 and CA724. The combined detection of m SEPT9 and CECT enhanced the sensitivity for recurrence monitoring. Pre-therapeutic levels of m SEPT9 were strongly associated with TNM stage, Dukes stages and mismatch repair deficiency (dMMR). Conclusions m SEPT9 analysis might be popularized as a routine biomarker for CRC screening. The combined detection of m SEPT9 and CECT can play an important role for recurrence monitoring. CIMP was highly associated with the pathological stage of CRC and dMMR. Electronic supplementary material The online version of this article (10.1186/s12885-019-5663-8) contains supplementary material, which is available to authorized users.

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“…Young LARC patients often present with aggressive pathological features and advanced stage compared with older patients [ 4 – 6 ]. Additionally, aggressive pathological features could result in a poorer response to NCRT [ 22 – 28 ]. Our results are consistent with those reported by Li et.al [ 29 ], in which analysis of the Surveillance, Epidemiology, and End Results (SEER) population-based database revealed that young patients had a better prognosis than old patients.…”

Section: Discussionmentioning

confidence: 99%

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

Zhang

Liu

et al. 2020

BMC Cancer

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Background: To evaluate the impact of age on the efficacy of neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC). Method: LARC patients undergoing NCRT and radical surgery from 2011 to 2018 were divided into young (< 40 years) and old (≥40 years) groups. Multivariate analyses were performed to identify predictive factors for pathological complete response (pCR). Predictive nomograms and decision curve analysis were used to compare the models including/excluding age groups. Immunohistochemical analysis was performed to detect CD133 expression in LARC patients. Result: A total of 901 LARC patients were analyzed. The young group was associated with poorly differentiated tumors, more metastatic lymph nodes, higher perineural invasion, and a lower tumor regression grade (P = 0.008; P < 0.001; P < 0.001; P = 0.003). Logistic regression analysis demonstrated that age < 40 years (HR = 2.190, P = 0.044), tumor size (HR = 0.538, P < 0.001), pre-NCRT cN stage (HR = 0.570, P = 0.036), and post-NCRT CEA level (HR = 0.877, P = 0.001) were significantly associated with pCR. Predictive nomograms and decision curve analysis demonstrated that the predictive ability of models including the age group was superior to that of models excluding the age group. Higher CD133 expression was more common in young LARC patients. Conclusion: Young patients with LARC were associated with lower pCR rates following NCRT. The ability of the predictive model was greater when based on the age group. Young LARC patients were associated with a higher CD133+ tumor stem cell burden, which contributed to the lower pCR rates.

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The potential predictive value of MRI and PET-CT in mucinous and nonmucinous rectal cancer to identify patients at high risk of metastatic disease

Abstract: mEMVI could identify patients with NMC, who are at high risk of synchronous metastases. The MC group is at a high risk of developing metachronous metastases. Advances in knowledge: Patients at high risk of metastases are more likely to benefit from more aggressive neoadjuvant therapy.

Cited by 30 publications

References 48 publications

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

The role of mSEPT9 in screening, diagnosis, and recurrence monitoring of colorectal cancer

Worse treatment response to neoadjuvant chemoradiotherapy in young patients with locally advanced rectal cancer

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