Pathological prognostic factors in locally advanced rectal carcinoma after neoadjuvant radiochemotherapy: analysis of 113 cases

2014 ◽  
Vol 65 (5) ◽  
pp. 623-630 ◽  
Author(s):  
Aurélie Sannier ◽  
Jérémie H Lefèvre ◽  
Yves Panis ◽  
Dominique Cazals-Hatem ◽  
Pierre Bedossa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Rectal Carcinoma ◽  
Locally Advanced ◽  
Neoadjuvant Radiochemotherapy

Nuclear factor-kB (NF-kB), p53, survivin, Ki-67, and Bcl-2 as prognostic factors in locally advanced rectal cancer patients receiving radiochemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22062-e22062
Author(s):  
R. Berardi ◽  
A. Mandolesi ◽  
A. Onofri ◽  
E. Maccaroni ◽  
G. Mantello ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Neoadjuvant Radiochemotherapy ◽  
Ki 67 ◽  
Female Ratio

e22062 Background: NF-kB, p53, Survivin, Ki-67 and Bcl-2 expressions have been demonstrated to be prognostic factors in solid tumors. The aim of our analysis was to investigate the importance of their expression, as prognostic factors in patients with locally advanced rectal cancer patients receiving receiving neoadjuvant radiochemotherapy Methods: We analyzed the expression of NF-kB, p53, Survivin, Ki-67 and Bcl-2 in patients with locally advanced rectal cancer who underwent neoadjuvant treatment (radiotherapy ± chemotherapy) at our Department Results: Seventy-four patients were eligible for our analysis. Median age at diagnosis was 66 years (range 36–85). Male/female ratio was 47/37; 37 patients (90%) were diagnosed with adenocarcinoma, whilst 4/41 (10%) with mucinous adenocarcinoma. All the patients received radiotherapy ± 5-fuorouracil/capecitabile-based chemotherapy. Median follow up was 28 months (range 6,7–56,6 months). At univariate and multivariate analysis of the above mentioned parameters, NF-kB, Ki67 and bcl-2 showed an impact on outcome.In particular, in NF-kB-strongly positive patients time to progression (TTP) and overall survival were significantly shorter (p=0,011 and p=0,018 respectively). Moreover a high expression of Ki-67 and a low expression of bcl-2 were associated with a better TTP Conclusions: Our results suggest that NF-kB, bcl-2 and Ki-67 could represent important parameters able to predict the outcome in patients receiving neoadjuvant treatment for rectal cancer. Further prospective studies are warranted in order to confirm the prognostic role of the above mentioned factors in this setting. This could be useful in order to select patients to receive adjuvant chemotherapy after neoadjuvant treatment and surgery for locally advanced rectal cancer, intensifying the adjuvant therapy in some groups of patients and obviating the use of the some drugs (i.e. those involving NF-kB in their mechanism of action) in selected patients No significant financial relationships to disclose.

Prognostic factors for severe diarrhea in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiation with capecitabine: A single-center cohort study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15176-e15176
Author(s):  
Wesley Hartman ◽  
Esther Oomen De Hoop ◽  
Cornelis Verhoef ◽  
Joost Nuyttens ◽  
Esther van Meerten
Keyword(s):  
Multivariate Analysis ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Rectal Carcinoma ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Female Gender ◽  
Neoadjuvant Chemoradiation ◽  
Tertiary Center ◽  
Grade 3

e15176 Background: Chemoradiation with concomitant capecitabine (CRT) followed by total mesorectal excision is the standard of care for locally advanced rectal carcinoma (LARC). Grade ≥ 3 diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiotherapy. The aim of this study is to describe the risk factors of grade ≥ 3 diarrhea in patients with LARC during CRT. Methods: A single centre retrospective cohort study was conducted in our tertiary center. All patients with LARC treated with CRT from 2009 to 2015 were included. Patients with local recurrence who received CRT for the first time were also included. Univariate logistic regression analyses were used, followed by a multivariate analysis of the significant factors with backward selection at p < 0.05. Results: A total of 738 patients were included: 67% male, median age 64 years (range 17-88), 95% primary presentation. DPYD-testing was not performed upfront. In this cohort 69 patients (9%) developed ≥3 grade diarrhea. In the univariate analysis, factors significantly associated with ≥3 grade diarrhea were; female gender, age ≥65 years, body weight and decreased renal function (defined as MDRD GFR < 60 ml/min/1,73 m2). The following factors remained significantly associated with ≥3 grade diarrhea in the multivariate analysis; female gender (odds ratio (OR) 2.77, 95% confidence interval (CI) 1.54-4.99, p 0.001), age ≥65 years (OR 2.85, 95% CI 1.63-4.98, p < 0.001) and a lower bodyweight (OR 0.98, 95% CI 0.96-1.00, p 0.015). Conclusions: Female gender and age ≥65 years significantly increase the risk of grade ≥ 3 diarrhea caused by neoadjuvant CRT for LARC. So, older female patient must be closely watched during this treatment to intervene on time. The difference in toxicity between females and males might be explained by the pelvic anatomical differences between men and women. The found prognostic factors will be validated in a second cohort of patients with LARC treated with CRT. Besides, sarcopenia will be tested as a prognostic factor as well.

Neoadjuvant Chemotherapy and Radiotherapy in Locally Advanced Rectal Carcinoma

2019 ◽  
Vol 23 (1) ◽  
pp. 221-228
Author(s):  
Mohmed Gaber ◽  
Mohamed Alhashemee ◽  
Al Sayed Hassan ◽  
Sahar Hammam
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Rectal Carcinoma ◽  
Locally Advanced

Tailored Strategy for Locally-Advanced Rectal Carcinoma (GRECCAR 4)

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Philippe Rouanet ◽  
Eric Rullier ◽  
Bernard Lelong ◽  
Philippe Maingon ◽  
Jean-Jacques Tuech ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Locally Advanced
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