Microsatellite Instability (MSI) as an Independent Predictor of Pathologic Complete Response (PCR) in Locally Advanced Rectal Cancer: A National Cancer Database (NCDB) Analysis

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 regression analysis was conducted to identify demographic, therapeutic, and clinical characteristics predictive of pCR. Cox proportional-hazard ratios were used for survival. Results: All patients were treated with definitive chemoradiation (median dose 50.4 Gy) followed by resection within 4 months. MSI(+) patients were associated with earlier year of diagnosis and higher-grade tumors (P
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

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ConclusionRadiomics of pretreatment MRIs can predict pCR, TRG, and NAR score in patients with LARC undergoing neoadjuvant treatment and TME with moderate accuracy despite extremely heterogenous image data. Both the tumor and MC contain important prognostic information.Key Points• Machine learning of rectal cancer on images from the pretreatment MRI can predict important patient outcomes with moderate accuracy.• The tumor and the tissue around it both contain important prognostic information.
Source: European Radiology - Category: Radiology Source Type: research
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Locally Advanced Rectal Cancer Interventions:   Drug: PD-1 antibody;   Drug: Capecitabine;   Drug: Irinotecan;   Radiation: Neoadjuvant Radiotherapy Sponsor:   Fudan University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This article will make a further study on this point. Methods: We collected perioperative clinical data from 382 patients with rectal cancer who underwent surgery from September 2015 to May 2017. After 1 month of follow-up, relevant risk factor data were collected and analyzed. Results: Data analysis showed that the incidence of AL was 14.65%. In single factor analysis, patients with high score of NRS-2002, high score of PG-SGA, diabetes, perioperative blood transfusion, postoperative diarrhea, later tumor stage, high score of ASA, low postoperative albumin, and rectal cancer patients with tumor close to the anus...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
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