Pre-treatment ADC image-based random forest classifier for identifying resistant rectal adenocarcinoma to neoadjuvant chemoradiotherapy

ConclusionThe random forest classifier based on radiomics features derived from pre-treatment ADC images have the potential to predict tumor resistance to NCRT in patients with LARC, and the use of predicting model may facilitate individualized management of rectal cancer.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research

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CASE SUMMARY: A 65-year-old man underwent colonoscopy to evaluate rectal bleeding and was found to have a low rectal mass. Biopsy revealed moderately differentiated microsatellite stable adenocarcinoma. The tumor was palpable at the fingertip in the anterior rectum with the inferior border 5 cm from the anal verge by rigid proctoscopy. CEA was 0.8 ng/mL. CT imaging of the chest, abdomen, and pelvis showed no evidence of distant metastases. MRI confirmed a 5-cm mass with one 8-mm mesorectal lymph node metastasis and no extramural venous invasion. The tumor penetrated the mesorectal fat to a depth of 4&thinsp...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Resident’s Corner Source Type: research
AbstractPurposePatients with locally advanced rectal cancer who achieve pathologic complete response (pCR) following neoadjuvant therapy have better long-term outcomes and could be spared from the perioperative and long-term morbidity of rectal resection. The aim of this study was to identify factors that predict the ability to achieve pCR at completion of conventional neoadjuvant therapy, therefore determining their suitability for non-surgical management.MethodsA retrospective analysis was performed on data obtained from a prospectively maintained colorectal neoplasia database. Patients treated for biopsy-proven primary ...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
AbstractDiversion colostomy plays a crucial role in the management of carcinoma rectum in low- and middle-income countries as significant number of patients present with partial intestinal obstruction. The aim of this study was to compare laparoscopic and open approaches for fecal diversion done in patients with adenocarcinoma of the rectum as a pretreatment procedure. The primary end point of our study was time to initiation of neoadjuvant chemo radiation. It was a retrospective study that included all patients diagnosed to have carcinoma rectum and underwent a pretreatment fecal diversion between 2012 and 2014. A total o...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSION: Multi-visceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality. PMID: 32674548 [PubMed - as supplied by publisher]
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
We report 3 cases of mismatch repair-deficient (dMMR) locally advanced adenocarcinoma of the rectum that showed significant response with neoadjuvant immunotherapy-based systemic treatment. The first patient was not eligible for standard therapy because of a history of radiotherapy to the prostate with concurrent comorbidities and therefore received single-agent pembrolizumab. The second patient did not respond to total neoadjuvant chemoradiation and subsequently received combined nivolumab and ipilimumab. The third patient had a known family history of Lynch syndrome and presented with locally advanced rectal cancer and a...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Conclusion: We suggest a new feasible treatment strategy for the management of synchronous colorectal and prostate cancers.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: This case report helps in understanding the course of progression from rectal cancer to periorbital metastasis.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSION: At 17% of its planned accrual, E5204 did not meet its primary endpoint. The addition of bevacizumab to FOLFOX6 in the adjuvant setting did not significantly improve OS in patients with stage II/III rectal cancer. IMPLICATIONS FOR PRACTICE: At 17% of its planned accrual, E5204 was terminated early owing to poor accrual. At a median follow-up of 72 months, there was no significant difference in 5-year overall survival (88.3% vs. 83.7%) or in 5-year disease-free survival (71.2% vs. 76.5%) between the two arms. Despite significant advances in the treatment of rectal cancer, especially in improving local contro...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist 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
In conclusion, irradiation or chemicals induce the formation of PGCCs and PGCCs produce daughter cells with strong migration and invasion abilities after a long incubation period. Appropriate rest interval (incubation period) is very important for patients with LARC who will receive nCRT. PMID: 31558902 [PubMed]
Source: Journal of Oncology - Category: Cancer & Oncology Tags: J Oncol Source Type: research
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