548PLocal immune status in cancer cell nests can be a predictor of survival for rectal cancer with neoadjuvant radiotherapy
AbstractBackgroundAlthough neoadjuvant chemoradiotherapy is the standard treatment for locally advanced rectal cancer (LARC), it remains difficult to predict the prognosis of LARC patients. We aimed to explore the impacts of local immune status on survival of LARC after noeadjuvant radiotherapy (nRT).MethodsA total of 76 consecutive LARC patients were enrolled in our institute from February 2012 to September 2015. CD3+ T-cell and CD8+ T-cell count were determined from surgical specimens. Factors associated with disease-free survival (DFS) and overall survival (OS) were identified by univariate and multivariate Cox regression. SPSS 22.0 was used for statistical analyse.ResultsThe median follow-up time was 29.0 months (range 2.0-59). The Cutoff Finder software identified an optimal CD3+ T-cell cutoff value of 12.5% and CD8+ T-cell value of 9% for our patients. According to the Kaplan-Meier analysis, CD3+ T-cell ≥12.5% was significantly related to favorable DFS (P = 0.020), while there was no significant difference between CD3+ T-cell and OS (P = 0.238). Meanwhile, CD8+ T-cell ≥9% was found to have a positive effect on DFS and OS (P = 0.012 and P = 0.035, respectively). In the multivaria te Cox regression model, CD8+ T-cell
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CONCLUSION: Although MRIyT=2N0/TRG1-2 cannot predict all cases of a complete pathologic response, it can effectively predict a low rate of lymph node involvement and a better prognosis in patients who undergo total mesorectal excision. PMID: 31687781 [PubMed - as supplied by publisher]
Abstract OBJECTIVE: In selected rectal cancer patients with residual local disease following neoadjuvant chemoradiation (CRT) and the preference of an organ preservation pathway, additional treatment with dose escalation by endoluminal radiotherapy (RT) may ultimately result in a clinical complete response. To date, the widespread introduction of selective endoluminal radiation techniques is hampered by a lack of evidence-based guidelines that describe the radiation treatment volume in relation to the residual tumor mass. In order to convert an incomplete response into a complete one with additional treatment such...
ConclusionThis study has demonstrated delaying a patient to adjuvant ChT will lower their DFS and increase their HR compared with those whose treatment is not delayed. We have long been too focused on local control; hence, priority needs to be shifted to efforts in managing potential distant disease in a timely manner.
ConclusionAside from one reader demonstrating increased sensitivity, no significant difference in accuracy parameters or inter-observer agreement was found between MR using b800 and b1500 for the detection of residual tumor after neoadjuvant CRT for LARC. However, there was a suggestion of a trend towards increased sensitivity with b1500, and further studies using larger cohorts may be needed to further investigate this topic.
ConclusionR2-resections do not result in a survival benefit compared to non-surgical treatment in this non-randomized series. Patients with a high chance on a R2-resection could be offered non-surgical treatment, without local resection.
Conclusion: To the best of our knowledge, this systematic review and NMA will first use both direct and indirect evidence to compare the differences of all available interval to surgery after CRT in rectal cancer. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.
This study aimed to compare the oncologic outcomes of patients undergoing rectal preservation as intended by the surgeon, and the outcomes of patients refusing rectal resection against medical advice.MethodsThe study population consisted of patients in whom the rectum was preserved after neoadjuvant chemoradiotherapy for clinical stage I –III mid or low rectal cancer between May 2003 and August 2017 (n = 2883); these patients were divided into those in whom rectal preservation was intended by their surgeon (intended rectal preservation, group A,n = 41) and those in whom the rectum was ...
ConclusionsIn a large number of patients with LPLNSM on initial imaging, metastatic LPLN are present after nCRT and surgical treatment. Even in LPLN that are considered responsive on restaging, significant rates of pathologically confirmed metastases are reported.
ConclusionsAdding DWI to HRT2w significantly improved specificity for the detection of perirectal infiltration at primary staging by experienced radiologists and also by inexperienced ones, although to a lesser extent. In the post-neoadjuvant treatment subgroup, only minimal changes were observed.