Diffusion weighted imaging improves diagnostic ability of MRI for determining complete response to neoadjuvant therapy in locally advanced rectal cancer

Publication date: 2020Source: European Journal of Radiology Open, Volume 7Author(s): Anuradha Chandramohan, Umar M. Siddiqi, Rohin Mittal, Anu Eapen, Mark R. Jesudason, Thomas S. Ram, Ashish Singh, Dipti Masih
Source: European Journal of Radiology Open - Category: Radiology Source Type: research

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AbstractPurpose of ReviewTo summarize the current available treatments for stage I rectal cancer and the evidence that supports them.Recent FindingsRadical surgery, or total mesorectal excision (TME) without neoadjuvant therapy, reports excellent oncologic outcomes, with 5-year disease-free survival of approximately 95%. Alternative therapies include local excision, which has acceptable long-term outcomes in some low-risk T1 tumors; but overall local excision, with or without additional chemotherapy or radiation, generally reports 5-year disease-free survival less than TME alone. New research is showing complete clinical r...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research
AbstractBackgroundWe currently do not know the optimal time interval between the end of chemoradiotherapy and surgery. Longer intervals have been associated with a higher pathological response rate, worse pathological outcomes and more morbidity. The aim of this study was to evaluate the effect and safety of the current trend of increasing time interval between the end of chemoradiotherapy and surgery (
Source: Updates in Surgery - Category: Surgery Source Type: research
Source: Cancer Management and Research - Category: Cancer & Oncology Tags: Cancer Management and Research Source Type: research
This study aimed to explore the prognostic impact of lymph node regression grade (LRG) in patients with locally advanced rectal cancer (LARC) following NCRT and radical surgery and develop a predictive nomogram for disease-free survival (DFS).MethodsLARC patients undergoing NCRT and radical surgery between 2013 and 2014 were enrolled and divided into LRG low ( ≤ 2), middle (3–9), and high (≥ 10) groups. Clinicopathological characteristics and survival outcomes were compared. Predictors for DFS were identified by Cox regression analysis, and a nomogram was constructed.ResultsA total of 257 LAR...
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
Objective: The relationship between microsatellite instability (MSI) and response to neoadjuvant chemoradiation in rectal cancer is not well understood. Background: We utilized the National Cancer Database (NCDB) to investigate the association between MSI and pathologic complete response (pCR) in this patient population. Methods: We analyzed 5086 patients between 2010 and 2015 with locally advanced rectal cancer who were tested for MSI and treated definitively with chemoradiation followed by surgery. Primary comparison groups were between 4450 MSI-negative(−) and 636 MSI-positive(+) patients. Multivariable re...
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
ConclusionThe intraoperative assessment of the TME specimen by an expert pathologist together with the surgeon is a valuable tool to avoid unnecessary APR or R1 resections. We therefore suggest routine intraoperative pathological assessment in all operations for borderline low rectal cancers.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
SummaryIn locally advanced rectal cancer, neoadjuvant chemoradiotherapy provides a  significant benefit to local cancer control in addition to total mesorectal excision. However, in 10–40% of all patients, a complete clinical remission can be detected after completion of chemoradiotherapy. Recent studies have shown that those patients omitting radical surgery after successful neoadjuvant pretreatment can be safely managed within a close follow-up network without compromising short-term overall and disease-free survival. However, available data suggest that 20–30% of all patients assigned to a&nbs...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsmrTRG 1 showed high specificity for pCR and ≤ypT1, but suboptimal sensitivity. mrTRG 1 or 2 showed higher sensitivity for pCR and ≤ypT1, but lower specificity. Because of the suboptimal sensitivity of mrTRG 1, it might be limited as a criterion for less aggressive treatment after neoadjuvant chemoradiotherapy.Key Points• Magnetic resonance tumor regression grade 1 shows high specificity for pCR and ≤ypT1, but suboptimal sensitivity.• Magnetic resonance tumor regression grade 1 or 2 shows higher sensitivity for pCR and ≤ypT1, but lower specificity than magnetic resonance tumor regression grade 1 alone.
Source: European Radiology - Category: Radiology Source Type: research
Abstract BACKGROUND: The incidence of rectal cancer among adults aged less than 50 years is rising. Survival data are limited and conflicting, and the oncological benefit of standard neoadjuvant and adjuvant therapies is unclear. METHODS: Disease-specific outcomes of patients diagnosed with rectal cancer undergoing surgical resection with curative intent between 2006 and 2016 were analysed. RESULTS: A total of 797 patients with rectal cancer were identified, of whom 685 had surgery with curative intent. Seventy patients were younger than 50 years and 615 were aged 50 years or more. C...
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
Publication date: Available online 6 March 2020Source: European Journal of Surgical OncologyAuthor(s): S. Hoendervangers, C.L. Sparreboom, M.P.W. Intven, J.F. Lange, H.M. Verkooijen, P.G. Doornebosch, W.M.U. van Grevenstein, the Dutch ColoRectal Audit
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
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