Upfront radical surgery with total mesorectal excision followed by adjuvant FOLFOX chemotherapy for locally advanced rectal cancer (TME-FOLFOX): an open-label, multicenter, phase II randomized controlled trial

Lee, Jii Bum; Kim, Han Sang; Jung, Inkyung; Shin, Sang Joon; Beom, Seung‐Hoon; Chang, Jee Suk; Koom, Woong Sub; Kim, Tae Il; Hur, Hyuk; Min, Byung Soh; Kim, Nam Kyu; Park, So Hee; Jeong, Seung Yong; Baek, Jeong‐Heum; Kim, Seon Hahn; Lim, Joon Seok; Lee, Kang Young; Ahn, Joong Bae

doi:10.1186/s13063-020-04266-6

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…The results demonstrated that SSIM and FOM of INLM were both obviously higher than those of FBP algorithm and NLM algorithm, while the average running time of INLM algorithm was less than that of FBP and NLM algorithm. The differences between the indexes of three algorithms had statistical significance ( P < 0.05), which was similar to the results of the analysis of image reconstruction algorithm conducted by Lee et al [ 23 ]. The similarity of these results demonstrated that the proposed INLM algorithm could improve the accuracy of image reconstruction by traditional algorithm, shorten running time, and enhance overall diagnostic efficiency.…”

Section: Discussionsupporting

confidence: 87%

“…e differences between the indexes of three algorithms had statistical significance (P < 0.05), which was similar to the results of the analysis of image reconstruction algorithm conducted by Lee et al [23]. e similarity of these results demonstrated that the proposed INLM algorithm could improve the accuracy of image reconstruction by traditional algorithm, shorten running time, and enhance overall diagnostic efficiency.…”

Section: Discussionsupporting

confidence: 84%

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Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

Duan

et al. 2022

Computational Intelligence and Neuroscience

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This research aimed to discuss the application of traditional nonlocal mean (NLM) algorithm-based computerized tomography (CT) images in intervention evaluation of the nursing for patients performing laparoscopy-guided radical surgery of colon cancer. A total of 100 patients who were diagnosed with colon cancer after enteroscopy and performed laparoscopic radical surgery were chosen as the research objects. They were divided into an observation group (comprehensive nursing in operation room) and a control group (routine nursing), each of which included 50 cases. All cases received CT examination. Meanwhile, the improved traditional NLM (INLM) algorithm was proposed, and the effects of image reconstruction were analyzed to improve the quality of CT images. The result showed that structural similarity index measure (SSIM) and figure of merit (FOM) of INLM were obviously higher than those of filtered back projection (FBP) algorithm and NLM algorithm, and the average running time was significantly less than that of FBP algorithm and NLM algorithm (P < 0.05). The operation time and the amount of intraoperative blood loss of patients in the observation group were both less than those of patients in the control group, and differences had statistical significance (P < 0.05). Besides, the time of getting out of bed, ventilation recovery time, postoperative meal time, stomach tube encumbrance time, and catheter encumbrance time of patients in the observation group were all less than those of patients in the control group, and the differences had statistical significance (P < 0.05). In the observation group, there were 3 cases with postoperative complications, and 2 out of them got incision infection while 1 suffered from constipation. In contrast, there were 9 cases with postoperative complications in the control group, 3 of which were patients with incision infection, and 2 suffered from urinary retention while the other 4 suffered from constipation. According to the above results, the INLM algorithm proposed in this research could improve the image reconstruction accuracy of traditional algorithm, shorten the running time, and enhance the overall diagnostic efficiency. The comprehensive nursing in operation room with laparoscopic radical surgery of colon cancer could improve the cure rate and prognosis of patients, so it was worthy of clinical promotion and application.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 84%

Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

Duan

et al. 2022

Computational Intelligence and Neuroscience

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“…The phase II TME-FOLFOX study aims to evaluate the efficacy of upfront radical surgery with TME followed by adjuvant chemotherapy with folinic acid (or leucovorin), 5-FU, and oxaliplatin (FOLFOX) versus the current standard treatment in patients with surgically resectable LARC. The study investigates whether patients with cT 1-2 N 1 or cT 3 N 0 without circumferential resection margin (CRM) involvement and lateral lymph node metastasis as evaluated on preoperative high-resolution magnetic resonance imaging (MRI) may not require preoperative CRT [ 47 ]. If in resectable mid/low LARC, omission of CRT is non-inferior to the standard treatment; radiation-related toxicity could be avoided.…”

Section: Introductionmentioning

confidence: 99%

The “Immunoscore” in rectal cancer: could we search quality beyond quantity of life?

et al. 2022

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Because of the function and anatomical environment of the rectum, therapeutic strategies for local advanced rectal cancer (LARC) must deal with two challenging stressors that are a high-risk of local and distal recurrences and a high-risk of poor quality of life (QoL). Over the last three decades, advances in screening tests, therapies, and combined-modality treatment options and strategies have improved the prognosis of patients with LARC. However, owing to the heterogeneous nature of LARC and genetic status, the patient may not respond to a specific therapy and may be at increased risk of side-effects without the life-prolonging benefit. Indeed, each therapy can cause its own side-effects, which may worsen by a combination of treatments resulting in long-term poor QoL. In LARC, QoL has become even more essential with the increasing www.oncotarget.com incidence of rectal cancer in young individuals. Herein, we analyzed the value of the Immunoscore-Biopsy (performed on tumor biopsy at diagnosis) in predicting outcomes, alone or in association with clinical and imaging data, for each therapy used in LARC.

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“…In conclusion, omitting PRCT and treatment with upfront surgery alone in CRM negative rectal cancer stage II/III patients may be considered as future treatment options. To further validate our retrospective results, a phase 2, randomized controlled trial of upfront surgery versus PRCT followed by surgery is currently ongoing (ClinicalTrials.gov, NCT02167321) ( 35 ).…”

Section: Discussionmentioning

confidence: 96%

Role of Preoperative Chemoradiotherapy in Clinical Stage II/III Rectal Cancer Patients Undergoing Total Mesorectal Excision: A Retrospective Propensity Score Analysis

et al. 2021

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BackgroundAlthough the current standard preoperative chemoradiotherapy (PCRT) for stage II/III rectal cancer decreases the risk of local recurrence, it does not improve survival and increases the likelihood of preoperative overtreatment, especially in patients without circumferential resection margin (CRM) involvement.MethodsStage II/III rectal cancer without CRM involvement and lateral lymph node metastasis was radiologically defined by preoperative magnetic resonance imaging (MRI). Patients who received PCRT followed by total mesorectal excision (TME) (PCRT group) and upfront surgery (US) with TME (US group) between 2010 and 2016 were analyzed. We derived cohorts of PCRT group versus US group using propensity-score matching for stage, age, and distance from the anal verge. Three-year relapse-free survival rate, disease-free survival (DFS), and overall survival (OS) were compared between the two groups.ResultsA total of 202 patients were analyzed after propensity score matching. There were no differences in baseline characteristics. The median follow-up duration was 62 months (interquartile range, 46–87). There was no difference in the 3-year disease-free survival rate between the PCRT and US groups (83 vs. 88%, respectively; p=0.326). Likewise, there was no significant difference in the 3-year OS (89 vs. 91%, respectively; p=0.466). The 3-year locoregional recurrence rates (3 vs. 2% with US, p=0.667) and distant metastasis rates (16 vs. 11%, p=0.428) were not significantly different between the two groups. Time to completion of curative treatment was significantly shorter in the US group (132 days) than in the PCRT group (225 days) (p<0.001).ConclusionUsing MRI-guided selection for better risk stratification, US without neoadjuvant therapy can be considered in early stage patients with good prognosis. PCRT may not be required for all stage II/III rectal cancer patients, especially for the MRI-proven intermediate-risk group (cT1-2/N1, cT3N0) without CRM involvement and lateral lymph node metastasis. Further prospective studies are warranted.

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Upfront radical surgery with total mesorectal excision followed by adjuvant FOLFOX chemotherapy for locally advanced rectal cancer (TME-FOLFOX): an open-label, multicenter, phase II randomized controlled trial

Cited by 7 publications

References 30 publications

Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

Adoption of Artificial Intelligence (AI)-Based Computerized Tomography (CT) Evaluation of Comprehensive Nursing in the Operation Room in Laparoscopy-Guided Radical Surgery of Colon Cancer

The “Immunoscore” in rectal cancer: could we search quality beyond quantity of life?

Role of Preoperative Chemoradiotherapy in Clinical Stage II/III Rectal Cancer Patients Undergoing Total Mesorectal Excision: A Retrospective Propensity Score Analysis

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