Total Neoadjuvant Therapy Followed by 'Watch and Wait' Approach or Organ Preservation for Low-risk Rectal Cancer
Condition: Rectum Cancer Intervention: Procedure: 'Watch and Wait' Approach or Organ Preservation Sponsor: Beijing Cancer Hospital Not yet recruiting
National Comprehensive Cancer Network guidelines recommend either long-course chemoradiation (LC) or short-course radiation (SC, 5 × 5 Gy) for rectal cancer before total mesorectal excision. However, they do not recommend SC for low-lying tumors. As early toxicity of SC is lower than that of LC, and postoperative complications as well as late toxicity are similar, the probable reason is a notion that for low-lying tumors LC ma y be more effective than SC in assuring local control.
Conclusion: In patients aged 75 years or older with LARC, neoadjuvant chemoradiotherapy followed by surgery was well tolerated with promising survival outcomes, which should be strongly suggested if medically suitable.
Conditions: Cancer of Rectum; Lymph Node Disease Intervention: Behavioral: Survival Sponsors: University of Sao Paulo; SERGIO CARLOS NAHAS; CAIO SERGIO NAHAS; Ivan Cecconello; Ulysses Ribeiro Junior Recruiting
AbstractBackgroundNumerous studies have reported the preventive and protective effects of aspirin in patients with rectal cancer. However, it is not clear whether aspirin can be used as an assistance drug in preoperative neoadjuvant chemoradiotherapy. Therefore, this study will explore the efficacy of aspirin as an adjuvant agent in rectal cancer neoadjuvant chemoradiotherapy.MethodsA literature search was performed using the electronic platforms to obtain relevant research studies published up to Jan 2020. The search was limited to papers published in English or Chinese language. Confidence intervals of research endpoints...
ConclusionModerate evidence suggests that delayed resection of colorectal cancer worsens survival; the impact of time to surgery on gastric and pancreatic cancer outcomes is uncertain. Early resection of gastrointestinal malignancies provides the best chance for curative therapy. During the COVID-19 pandemic, prioritization of procedures should account for available evidence on time to surgery and oncologic outcomes.
Background/Aim: The present study compared the prognostic value of the yield pathologic (yp) stage, tumor regression grade (TRG), and neoadjuvant rectal (NAR) score in patients with locally advanced rectal cancer (LARC) who received neoadjuvant chemoradiotherapy (nCRT). Patients and Methods: For the assessment of tumor regression, the Dworak grading system was used. The NAR score was calculated using the following equation: (5ypN–3[cT–ypT]+12)2÷9.61. Results: In univariate analysis, the NAR score and ypTNM stage were significantly associated with DFS [hazard ratio (HR)=2.514, p
Conclusion: There is correlation between inflammatory markers and MSI during CRT and it influences prognosis. Therefore, inflammatory markers might have a role in assessing the microenvironment related to MSI and the immunologic response in rectal cancer.
CONCLUSION: Neoadjuvant FOLFIRINOX followed by CRT for middle and lower rectal cancer is feasible, tolerable with satisfactory sphincter preservation rate. . PMID: 32592369 [PubMed - as supplied by publisher]
ConclusionBenefits of LLND are not clear and further randomized controlled trials should be performed to determine which strategy would allow improving survival in rectal cancer patients.Trial registrationThe study protocol was registered in PROSPERO prior to study screening (CRD42019123181) and published in September 2019.
Colorectal cancers (CRCs) remain the most prevalent malignancies worldwide  with incidences increasing approximately by 22% over the past 10 years among patients