Watch and Wait in Rectal Cancer: Worse Survival for Some Watch and Wait in Rectal Cancer: Worse Survival for Some

A watch-and-wait strategy was associated with improved rectal preservation but poorer survival in patients who achieved a complete response following neoadjuvant therapy.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hematology-Oncology News Source Type: news

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Condition:   Rectal Cancer Intervention:   Drug: Chemotherapy Sponsors:   King Abdullah Medical City;   King Faisal Specialist Hospital & Research Center;   King Saud Medical City;   Al Hada Military Hospital Recruiting
Source: - Category: Research Source Type: clinical trials
AbstractPurposeDespite a high incidence of fecal incontinence following sphincter-preservation surgery (SPS), there are no definitive factors measured before ileostomy reversal that predict fecal incontinence. We investigated whether vector volume anorectal manometry before ileostomy reversal predicts major fecal incontinence following SPS in patients with mid or low rectal cancer.MethodsThis longitudinal prospective cohort study comprised 173 patients who underwent vector volume anorectal manometry before ileostomy reversal. The Fecal Incontinence Severity Index was measured 1  year after the primary SPS and classifi...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
CONCLUSIONS: Patients with rectal cancer with node-positive cancer at baseline who develop a complete clinical response after neoadjuvant chemoradiation are not at increased risk for local tumor regrowth or development of more advanced disease at the time of recurrence. These patients seem to be safe candidates for organ-preserving strategies after achieving complete clinical response. See Video Abstract at
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
Objective: To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. Background: Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in rectal cancer. AJCC regression scores have been shown to correlate with prognosis. Methods: Patient demographics, tumor characteristics, and AJCC scores (0 = complete response; 1 = isolated tumor cells remaining; 2 = residual cancer outgrown by fibrosis; 3 = extensive residual cancer) were...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
ConclusionSuspicious isolated recurrences of rectal cancer in unusual locations may require surgical excision to confirm definitive diagnosis.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
AbstractObjectiveThe aim of this study was to investigate whether pretherapeutic, multiparametric magnetic resonance imaging (MRI) radiomic features can be used for predicting non-response to neoadjuvant therapy in patients with locally advanced rectal cancer (LARC).MethodsWe retrospectively enrolled 425 patients with LARC [allocated in a 3:1 ratio to a primary (n = 318) or validation (n = 107) cohort] who received neoadjuvant therapy before surgery. All patients underwent T1-weighted, T2-weighted, diffusion-weighted, and contrast-enhanced T1-weighted MRI scans before receiving neoadjuvant thera...
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSION: Total neoadjuvant therapy should be considered in patients with high-risk locally advanced rectal cancer owing to improved chemotherapy compliance and disease control. Further prospective studies are required to determine whether this approach translates into improved disease-related survival or increases the proportion of patients suitable for non-operative management. PMID: 31074508 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
AbstractRectal cancer accounts for one-third of newly diagnosed colorectal cancer cases. Given its anatomical location and risk for local recurrence, a multidisciplinary treatment program including surgery, radiation therapy, and chemotherapy has demonstrated improved outcomes in localized disease. Genetic analysis has become part of the standard approach for management of advanced disease and new trials are considering tailored therapies for locally advanced disease. This review describes molecular subsets of colorectal cancer; implications for clinical management, including patterns of metastatic spread and response to t...
Source: Abdominal Imaging - Category: Radiology Source Type: research
AbstractOur study was done in order to identify novel molecular markers to predict which locally advanced rectal cancers (LARCs) might be resistant to neoadjuvant chemoradiotherapy (nCRT). Seventy-four patients with LARCs treated with nCRT were collected. Pathological evaluation after nCRT was performed according to the tumor regression grading (TRG) system. Next-generation sequencing kit including 279 exons of 59 genes was performed on Illumina Miseq Platform. Sanger sequencing was performed to confirm some mutations. Four of the tumors (4/74, 5.4%) hadBRAF mutation, which presented in one TRG 2 tumor and three TRG 3 tumo...
Source: Virchows Archiv - Category: Pathology Source Type: research
Abstract Rectal cancer response to neoadjuvant chemoradiotherapy (pCRT) is highly variable. In fact, it has been estimated that only about 21 % of patients show pathologic complete response (pCR) after therapy, while in the most of the patients a partial or incomplete tumour regression are observed. Consequently, patients with a priori chemoradioresistant tumour should not receive the treatment, which is associated with substantial adverse effects and does not guarantee any clinical benefit. Despite for locally advanced rectal cancer patients (LARC) a standardized neoadjuvant treatment protocol is applied, the ide...
Source: Current Medicinal Chemistry - Category: Chemistry Authors: Tags: Curr Med Chem Source Type: research
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