541PUpfront radical surgery with total mesorectal excision (TME) versus preoperative chemoradiotherapy followed by TME in clinical stage II/III patients with rectal cancer: A propensity score analysis

ConclusionsPCRT may not be required for all stage II/III rectal cancer patients, especially for the MRI-based intermediate-risk group (cT1-2/N1, cT3N0) without CRM involvement and lateral lymph node metastasis. Further prospective studies are warranted.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research

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ConclusionCRT should be considered for cT3N0 patients, but its timing (neoadjuvant vs. adjuvant) seems not to affect the disease-free survival in the present cohort of patients.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
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.
Source: Abdominal Imaging - Category: Radiology Source Type: research
AbstractPurposeTo evaluate the role of diffusion kurtosis and diffusivity as potential imaging biomarkers to predict response to neoadjuvant chemoradiation therapy (CRT) from baseline staging magnetic resonance imaging (MRI) in locally advanced rectal cancer (LARC).Materials and methodsThis retrospective study included 45 consecutive patients (31 male/14 female) who underwent baseline MRI with highb-value sequences (up to 1500  mm/s2) for LARC followed by neoadjuvant chemoradiation and surgical resection. The mean age was 57.4  years (range 34.2–72.9). An abdominal radiologist using open source software man...
Source: Abdominal Imaging - Category: Radiology Source Type: research
We examined the association between pathological lateral pelvic lymph node (LPLN) metastasis and the LPLN diameter in patients with locally advanced rectal cancer (LARC) who received a neoadjuvant chemotherapy (NAC) regimen based on oxaliplatin as induction chemotherapy. We aimed to determine whether or not the LPLN size predicts LPLN metastasis in NAC cases.MethodsWe retrospectively examined data from 3 institutes for 60 patients with LARC who received mesorectal excision and LPLN dissection after NAC. We evaluated the LPLN size on magnetic resonance imaging (MRI) scans acquired before and after NAC. We performed multivar...
Source: Surgery Today - Category: Surgery Source Type: research
To analyse changes in post-neoadjuvant follow-up magnetic resonance imaging (MRI) staging accuracy for malignant adenopathies in rectal cancer, by comparing size criteria with morphological criteria using high-resolution T2-weighted sequences, as well as variations when adding diffusion-weighted imaging.
Source: Clinical Radiology - Category: Radiology Authors: Source Type: research
CONCLUSION: Our study demonstrated that combining the interpretation of endoscopy with biopsy and MRI could provide a good prediction rate for CR in patients with rectal cancer after CRT. PMID: 31487768 [PubMed]
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
Abstract Thirty per cent of all colorectal tumours develop in the rectum. The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions. Most patients with early rectal cancer can be adequately managed by surgery alone. However, a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery. Neoadjuvant therapy involves a variety of options including radiotherapy, chemotherapy used alone o...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
AbstractPurposeThe aim of this study was to build an appropriate diagnostic model for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC), by combining magnetic resonance imaging (MRI) parameters with clinical factors.MethodsEighty-four patients with LARC who underwent MR examination before and after nCRT were enrolled in this study. MRI parameters including cylindrical approximated tumor volume (CATV) and relative signal intensity of tumor (rT2wSI) were measured; corresponding reduction rates (RR) were calculated; and MR tumor re...
Source: Abdominal Imaging - Category: Radiology Source Type: research
CONCLUSION: New methods of assessing the response to neo-adjuvant therapy in locally-advanced rectal cancer have emerged, showing promising results. Further studies need to assess the best combination between imaging and these biomarkers in order to increase the accuracy and standardize the criteria for non-operative management. KEY WORDS: Biomarkers, Complete pathologic response, Non-Operative management, Rectal cancer, Staging. PMID: 31355776 [PubMed - as supplied by publisher]
Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
Authors: Seo N, Kim H, Cho MS, Lim JS Abstract Baseline magnetic resonance imaging (MRI) has become the primary staging modality for surgical plans and stratification of patient populations for more efficient neoadjuvant treatment. Patients who exhibit a complete response to chemoradiotherapy (CRT) may achieve excellent local tumor control and better quality of life with organ-preserving treatments such as local excision or even watch-and-wait management. Therefore, the evaluation of tumor response is a key factor for determining the appropriate treatment following CRT. Although post-CRT MRI is generally accepted a...
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
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