542PNeoadjuvant chemoradiotherapy with/without lateral lymph node dissection for low rectal cancer: Which patients can benefit?

AbstractBackgroundGuidelines for rectal cancer treatment differ in Japan, Europe, and the United States. Neoadjuvant chemoradiotherapy (CRT) has been used to control lateral lymph nodes (LLNs) in the West. The usefulness of LLN dissection (LLND) has been discussed in Japan, and a randomized study stated the possible advantage of local control. However, it is still unclear whether adding LLND to CRT is beneficial.MethodsTo investigate the effectiveness of LLND on rectal cancer patients who underwent neoadjuvant CRT, we retrospectively collected magnetic resonance images (MRIs) in a cohort of 1500 patients with cStage II/III lower rectal cancer below the peritoneal reflection and centrally reviewed MRIs. We measured short-axis LLN sizes on pre- and post-CRT images and evaluated patients ’ prognosis according to LLN size and whether LLND was performed.ResultsMRIs were collected from 752 patients, of whom 189 underwent neoadjuvant CRT. Both pre- and post-CRT MRIs were available in 155 patients, of whom 66 underwent LLND (LLND group) and 89 did not (non-LLND group). The LLND and non-LLND group showed the following differences: positive circumferential resection margin by MRI after CRT: 53.0% vs. 32.6%; positive extramural venous invasion: 36.4% vs. 24.7%; laparoscopic surgery: 39.4% vs. 88.8%; and mean pre-CRT LLN size: 5.2  mm vs. 3.6 mm. Five-year relapse-free survival (5y-RFS) was 73.8% and 66.1% in the LLND and non-LLND groups, respectively (p =&thin...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research

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ConclusionR-TME for rectal cancer can achieve better oncological outcomes compared with L-TME, especially in stage III rectal cancers. However, a longer follow-up period is needed to confirm these findings.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionOur findings suggest that tumor progression accompanied by a high stage, long operative time, and insufficient bowel preparation and early postoperative diarrhea due to a large tumor circumference may be risk factors of AL after LALAR for rectal cancer.
Source: Journal of Gastrointestinal Cancer - Category: Cancer & Oncology Source Type: research
Rectal cancers account for 39% of colorectal tumours, and represent the 8th most common malignancy and the 9th leading cause of cancer-related deaths [1]. In 2018, 704,376 new diagnoses and 310,394 deaths for this disease were registered worldwide [1]. The global distribution of rectal cancer is characterised by some geographic variation with incidence rates being higher in Eastern Europe, Australia/New Zealand and Eastern Asia while lower in most African regions and Southern Asia [1]. Rectal cancers are the most common colorectal tumour among people
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Systematic or Meta-analysis Studies Source Type: research
This study aims to assess long-term outcomes of emergency versus elective CRC surgery.MethodsSingle-center retrospective cohort study. Patients undergoing emergency or elective CRC surgery from July 2002 to January 2013 were included. Primary outcome was 5-year survival, secondary outcomes were in-hospital mortality and local tumor recurrence.ResultsOverall, 475 patients were included. Median age was 69.0 (IQR 59.0 –77.0) years. A total of 141 patients (30%) were operated for rectal cancer and 334 patients (70%) for colon cancer. Median follow-up was 445 (IQR 67–1409) days. Emergency resection was performed in ...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
MicroRNA‑195 suppresses rectal cancer growth and metastasis via regulation of the PI3K/AKT signaling pathway. Mol Med Rep. 2019 Oct 01;: Authors: Wang Y, Mu L, Huang M Abstract MicroRNAs (miRNAs) play a vital role in the progression of cancer, however, only limited data on miRNAs in rectal cancer are available. The aim of the present study was to investigate whether miR‑195 could inhibit the progression of rectal cancer. The miR‑195 mimic was transfected into 2 types of human rectal cancer cells (SW837 and SW1463). Cell viability and apoptosis were analyzed by Cell Counting Kit‑8 (CCK‑8) assa...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
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]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
We examined the relation of cardiorespiratory fitness to colorectal cancer in 59,191 UK Biobank participants aged 39 –70 years without prevalent cancer at baseline, followed from 2009 to 2014. Submaximal bicycle ergometry was conducted at study entry, and cardiorespiratory fitness was defined as physical work capacity at 75% of the maximum heart rate, standardised to body mass (PWC75%). Multivariable Cox proportional hazards regression was performed to obtain hazard ratios (HR) and corresponding 95% confidence intervals (CI). During a mean follow-up of 4.6  years, 232 participants developed colorectal cance...
Source: European Journal of Epidemiology - Category: Epidemiology Source Type: research
Authors: Wang L, Yang L, Yang J, Shan S Abstract Background: Permissive hypercapnia has been recommended during the treatment of chronic diseases; however, there are insufficient clinical data to investigate the feasibility of permissive hypercapnia in relatively long-term surgeries such as laparoscopic surgery for rectal carcinoma. This prospective study is aimed at investigating the efficacy and safety of permissive hypercapnia under different CO2 pneumoperitoneum pressures during the laparoscopic surgery for rectal carcinoma. Methods: A total of 90 patients undergoing laparoscopic surgery for rectal carcinom...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
CONCLUSIONS: Our study showed that four candidate proteins, including PIDA3, Galectin3, Dhe3, and Vimentin, might be the potential biomarkers in the identification of radiation response in rectal cancer. PMID: 31696471 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
In the interest of discussing some topics that are things besides the job market and optimism/pessimism, based on a (IMO) good suggestion from an SDN user, I'm going to start a series of threads on general diagnoses and encourage people to discuss how these are managed clinically in your practice/residency/dreams, whatever. Judicious (not 80 links, but like 1-5) use of studies when relevant to the point at hand are encouraged but not mandatory. If you have other ideas in this vein I'm open... Clinical Case Management - Locally Advanced Rectal Cancer
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Radiation Oncology Source Type: forums
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