Usefulness of endorectal ultrasound after preoperative radiotherapy in rectal cancer

Gavioli, M.; Bagni, Alberto; Piccagli, I; Fundarò, Salvatore Piero; Natalini, Gianni

doi:10.1007/bf02236553

Cited by 106 publications

(67 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A szakirodalomban a re-staging pontossága a T-stádi-um tekintetében széles határok között mozog (27-75%) [1,[7][8][9][10][11][12][13][14][15][16][17]. Marone és mtsai 6 éves periódusban hasonlí-tották össze az előrehaladott rectumtumorok stagingjé-nek és a neoadjuváns kezelést követő re-stagingjének RUH pontosságát 85 beteg bevonásával.…”

Section: áBraunclassified

A neoadjuváns kezelés mint a rectalis ultrahangvizsgálat korlátozó tényezője

et al. 2016

View full text Add to dashboard Cite

Bevezetés: A rectalis ultrahang a rectumtumorok stagingjének egyik alapmódszere. Előrehaladott tumorok esetén a műtét előtti neoadjuváns kezelés hatására létrejövő szöveti változások hatással vannak a módszer pontosságára. Cél-kitűzés: A rectalis ultrahang pontosságának felmérése preoperatív kemo-radioterápiát követően, összehasonlítva az iniciális staging során tapasztalt pontossággal. Módszer: Retrospektív módon vetették össze a Szegedi Tudomány-egyetem I. Belgyógyászati Klinikán 2006 és 2014 között végzett rectalis ultrahangvizsgálatok során meghatározott T-, illetve N-stádiumot a műtéti reszekátum feldolgozásakor megadott patológiai T-és N-stádiummal neoadjuváns kezelést követően és az iniciális staging során (kontrollcsoport). Eredmények: A T-stádium esetén az iniciális staging 70%-ban, a re-staging 61%-ban volt pontos, utóbbinál 31%-ban túlértékelés történt. Az ypT0 stádiumot egy esetben sem sikerült azonosítani. Az N-stádium meghatározásának pontossága 64% volt a kontrollcsoportban és 61% volt restaging alkalmával. Következtetések: Neoadjuváns kezelést követően a rectalis ultrahang pontossága romlik. Az onkológiai kezelés hatásosságának megítélésében és a műtéti tervezésben a rectalis ultrahanggal történő re-staging szerepe megkérdőjelezhető. Orv. Hetil., 2016, 157(30), 1193-1197. Kulcsszavak: rectumcarcinoma, rectalis ultrahang, staging, neoadjuváns kezelés Neoadjuvant treatment as a limiting factor to rectal ultrasonographyIntroduction: Rectal ultrasonography is a basic method for staging rectal cancer. Tissue changes after neoadjuvant treatment alter the accuracy of the method. Aim: The aim of the authors was to assess the accuracy of rectal ultrasonography after preoperative chemo-radiotherapy compared to the initial staging accuracy. Method: Rectal ultrasounds performed between 2006 and 2014 were assessed retrospectively. Ultrasonographic and pathological T and N stages were compared both in case of initial staging (control group) and re-staging. Results: T staging was accurate in 70% in the control group and in 61% in re-staging. Rate of overstaging was 31% after neoadjuvant treatment. None of the ypT0 cases were identified. N staging accuracy was 64% in the control group and 61% in re-staging. Conclusions: Neoadjuvant treatment impairs the accuracy of rectal ultrasound. The role of re-staging with rectal ultrasonography is debatable in the assessment of the efficacy of oncological treatment and surgical planning.

show abstract

Section: áBraunclassified

A neoadjuváns kezelés mint a rectalis ultrahangvizsgálat korlátozó tényezője

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The residual tumor tissue in the resected specimen was classified according to the TNM staging system of the UICC [7]. The residual tumor mass and any RCT-induced fibrotic changes were semiquantitatively evaluated using an established five-point rectal cancer regression grading system [27,28]. Briefly, tumor samples without any fibrosis/regression were considered to be TRG 0, whereas complete regression (TRG 4) was defined as the absence of viable tumor cells in the primary tumor and in the lymph nodes (ypT0N0).…”

Section: Surgery and Histopathological Examinationmentioning

confidence: 99%

Gender-Specific Acute Organ Toxicity during Intensified Preoperative Radiochemotherapy for Rectal Cancer

et al. 2011

View full text Add to dashboard Cite

Learning Objectives After completing this course, the reader will be able to: Describe present strategies of treatment of locally advanced rectal cancer and ongoing clinical trials, including neoadjuvant radiochemotherapy with 50.4 Gy and concomitant 5-FU +/− oxaliplatin.Define the basic clinical parameters, with special emphasis on gender and BMI, correlating with radiochemotherapy-associated side effects in rectal cancer patients and differences in severity of toxicity. CME This article is available for continuing medical education credit at CME.TheOncologist.com Patients with locally advanced rectal cancer (cUICC stages II/III) are typically treated with preoperative 5-fluorouracil–based (5-FU–based) radiochemotherapy (RCT). However, trials are currently being conducted to improve the complete remission rates and the systemic control by combining 5-FU with oxaliplatin. The primary objective was to identify the subgroups of rectal cancer patients who were at risk for high-grade toxicity. All 196 patients who were included in the present study were treated with 50.4 Gy and chemotherapy that included either 5-FU (n = 115) or 5-FU+oxaliplatin (n = 81). The preoperative RCT was followed by a total mesorectal excision and adjuvant chemotherapy. Acute toxicity was monitored weekly and a toxicity grade ≥3 (Common Toxicity Criteria) for a skin reaction, cystitis, proctitis, or enteritis was defined as high-grade acute organ toxicity. After RCT with 5-FU+oxaliplatin, complete tumor remission was achieved in 13.6% of the patients and in 11.3% after RCT with 5-FU alone. Complete irradiation dosages of 50.4 Gy were given to 99% (5-FU) and 95% (5-FU+oxaliplatin) of the patients. Concomitant chemotherapy was fully administered in 95% of the patients treated with 5-FU compared with the 84% of patients treated with 5-FU+oxaliplatin. A significantly higher proportion of acute organ toxicity was found in the patients who were treated with 5-FU+oxaliplatin compared with those who were treated with 5-FU. Additionally, women with a low body mass index were at the highest risk for acute organ toxicity. These results suggest that there are basic clinical parameters, such as gender and body mass index, that may be potential markers for generating individual risk profiles of RCT-induced toxicity.

show abstract

“…Nos 05 casos que o exame histopatológico evidenciou ausência de lesão neoplásica, o US 3-D foi concordante em todos os casos (E=100%). Gavioli e cols (21) demonstraram 67% de concordância com histopatológico em identificar regressão total. No entanto, Kahn e cols (18) demonstraram apenas 17% de concordância na identificação de resposta completa na sua casuística.…”

Section: Vol 29 Nºunclassified

“…O re-estadiamento quanto a invasão parietal e a identificação de linfonodos residuais utilizando exames de imagem demonstram redução na sua eficácia (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) . Alguns autores mencionam que as alterações produzidas na parede do reto pela ação da irradiação dificultam ou até impossibilitam a identificação das camadas da parede retal, limitando, portanto, a possibilidade de re-estadiamento das lesões (18,19,21) . Tem sido relatada eficácia entre 47.0 a 62.0% no re-estadiamento dos tumores quanto à invasão parietal pós-radioterapia utilizando ultrassom anorretal (16)(17)(18)(19) .…”

Section: Introductionunclassified

“…Gavioli e cols. (21) utilizando transdutor linear (setorial) demonstraram que a fibrose é a base da imagem gerada no ultrassom após a radioterapia, sendo realizado, portanto o estadiamento da fibrose que pode ou não conter tumor residual. Dessa forma, relataram que o papel do US é indireto, avaliando a extensão da fibrose e por conseguinte da lesão em seu interior.…”

Section: Introductionunclassified

See 1 more Smart Citation