scholarly journals The Relationship between MR Demonstration of Extramural Venous Invasion and Nodal Disease in Rectal Cancer

2008 ◽  
Vol 2 ◽  
pp. CMO.S370 ◽  
Author(s):  
Dow-Mu Koh ◽  
Neil J. Smith ◽  
R. Ian Swift ◽  
Gina Brown
Keyword(s):  
Rectal Cancer ◽  
Mr Imaging ◽  
Sensitivity And Specificity ◽  
Neoadjuvant Treatment ◽  
Rectal Surgery ◽  
Venous Invasion ◽  
Nodal Disease ◽  
Expert Radiologist ◽  
N2 Disease ◽  
The Relationship

Purpose To investigate the relationship between extramural venous invasion (EMVI) detected at T2-weighted MRI and nodal disease rectal cancer compared with histopathology. Materials and Methods The MR imaging of 79 consecutive patients with rectal cancer who underwent primary rectal surgery without neoadjuvant treatment were reviewed. MR images were scored by an expert radiologist for the presence and degree of EMVI using a five point scale blinded to pathological findings. Receiver operating characteristic curve analyses were performed to determine the sensitivity and specificity of MRI scoring in predicting EMVI and nodal disease at histopathology. Results Compared with histology, an MR score of >2 was found to have 100% sensitivity (95% CI: 77%-100%) and 89% specificity (95% CI: 79%–96%) in identifying EMVI involving veins >3 mm in diameter. An EMVI score of >2 was had a sensitivity of 56% (95% CI: 30%–80%) and specificity of 81% (95% CI: 69%–90%) for identifying patients with stage N2 disease. Conclusions EMVI score of >2 on T2-weighted MR imaging has a high sensitivity and specificity for histopathologically proven extramural venous invasion involving venules ≥3 mm in diameter. However, EMVI scores have only moderate sensitivity in the predicting nodal involvement.

Impact of biomarker dynamic profile and pathological response induced by neoadjuvant chemoradiotherapy in rectal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3614-3614
Author(s):  
A. L. Gentile ◽  
C. Pinto ◽  
C. Ceccarelli ◽  
F. Di Fabio ◽  
C. Funaioli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Neoadjuvant Treatment ◽  
Rectal Adenocarcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Rectal Surgery ◽  
Pathological Response ◽  
Resection Margins ◽  
Tumor Regression Grade ◽  
Operative Specimen

3614 Background: The aim of this study was to evaluate the correlation among biomarkers, pathological response and clinical outcomes in patients (pts) with rectal cancer submitted to neoadjuvant chemoradiotherapy. Methods: Pts entering the study had rectal adenocarcinoma, uT3/4N-/+ or uT2N-/+ with inferior location. Chemotherapy consisted of oxaliplatin 60 mg/m2 weekly infusion IV for 6 times and 5-fluorouracil 225 mg/m2/die continuous infusion IV d 1–38. Radiotherapy was delivered up to a dose of 50.4 Gy in daily fractions of 1.8 Gy d 1–38. Rectal surgery with TME was performed 6–8 weeks after neoadjuvant treatment. Immunohistochemical determination of Ki67, p53, bcl2, TS, EGFR, MLH1 and MSH2 was performed in pretreatment biopsy and operative specimen. Results: Between March 2002 and May 2005, 32 pts had completed neoadjuvant therapy and surgery. Pt characteristics: 24 (75%) men and 8 (25%) women; median age 64 (33–80) years; stage uT2N-M0 3 (9.4%) pts, uT3N-M0 14 (43.8%), uT3N+M0 10 (31.2%), uT3NXM0 2 (6.2%), uT4N+M0 3 (9.4%). Surgery consisted of abdominal-perineal amputation in 12 (37.5%) and low-anterior resection in 17 (53.1%) pts, with negative circumferential resection margins in 86.2%. Laparoscopic local excision was performed in 3 (9.4%) pts. Pathological down-staging occurred in 18 (56.2%) pts, including 7 (21.9%) pT0N0, with sphincter preservation in 40%. Tumor Regression Grade (TRG) (according to Mandard) evaluation of operative specimen was: 7 TRG1, 11 TRG2, 11 TRG3 and 3 TRG4. Expression mean value in pretreatment biopsy and operative specimen was: Ki67 88.8% and 31.7%; p53 49.7% and 40.7%; TS 12.6% and 10.0%; MLH1 89.7% and 76.4%; MSH2 84.3% and 72.2%. The evaluation of biomarker profile in operative specimen of TRG2 pts vs TRG3–4 showed: Ki67 16.6% vs 46.2% (p=0.03); TS 4.5% vs 12.9% (ns); MSH2 82.3% vs 65.6% (ns); p53 52.3% vs 34.8% (ns). Median DFS was 19 (3–35) months. At a median follow-up of 22 (5–41) months, 100.0% of TRG1 pts, 90.9% of TRG2, 73.3% of TRG3–4 had no-evidence of disease relapse. Conclusions: These preliminary results suggest a correlation between Ki67 and pathological response in rectal cancer pts treated with neoadjuvant therapy. Moreover, DFS appears to be related to TRG. No significant financial relationships to disclose.

Role of Recent Advances of Diffusion Weighted MRI in Assessment of Therapeutic Response of Rectal Cancer

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Yasser Ali Mohamed ◽  
Ahmed Abdel Aziz Abo Zeid ◽  
Enas Ahmed Azab ◽  
Rasha Salah ElDin Hussein ◽  
Mona Ahmed Abo EL-ELa Hassan
Keyword(s):  
Rectal Cancer ◽  
Mr Imaging ◽  
Morphological Changes ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Response Monitoring ◽  
Base Line ◽  
Before And After ◽  
Adc Values

Abstract Aim of the work The purpose of this study is to determine the role of DWI-MRI in the pretreatment prediction and early response monitoring to neoadjuvant treatment in rectal cancer. Materials and Methods The study included 24 patients with pathologically proven cancer rectum and who were subjected to neoadjuvant chemo-radiotherapy. Each patient was imaged twice on an MRI machine; a base line pre neoadjuvant treatment and 8 weeks after finishing the neoadjuvant treatment. We focused on the feasibility of DWI as well as the morphological changes according to size (maximum craniocaudal dimension).Conventional sequences were viewed first to identify the lesion and measure its size (maximum craniocaudal dimension) then DWI images were viewed. The ADC parameter was calculated. Results were compared before and after neoadjuvant therapy. Results The ADC values before and after NACT were significantly higher in the responder group, suggesting that ADC values might be useful in assessing the good response before surgery. Conclusion In conclusion, the present study demonstrates that adding DW MR imaging to conventional MR imaging yields better diagnostic accuracy than use of conventional MR imaging alone in the evaluation of treatment response to neoadjuvant CRT in patients with locally advanced rectal cancer.

Impact of duration of neoadjuvant radiation on rectal cancer survival.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 682-682
Author(s):  
Aalok Kumar ◽  
Renata D'Alpino Peixoto ◽  
Hagen F. Kennecke ◽  
Caroline Speers ◽  
Winson Y. Cheung
Keyword(s):  
Rectal Cancer ◽  
Univariate Analysis ◽  
Stage Ii ◽  
Recurrence Free Survival ◽  
Tumor Characteristics ◽  
Free Survival ◽  
N2 Disease ◽  
Significant Difference ◽  
To Receive ◽  
The Relationship

682 Background: The utility of neoadjuvant radiation (XRT) for the treatment of stages II-III rectal cancer has been demonstrated previously. However, the optimal amount and duration XRT in this setting remains unknown. Using a population-based cohort of stage II and II rectal cancer (RC) patients treated with curative intent including XRT, our aims were to 1) examine the patterns in XRT use and 2) explore the relationship between XRT course and survival. Methods: We analyzed patients diagnosed with clinical stage II-III RC from 2006 to 2010 and treated with long course 45-50.4 Gray (LC) or short course 25 Gray (SC) XRT at any 1 of 5 regional cancer centers in British Columbia. Logistic regression models were constructed to determine the factors associated with the course of XRT given, LC vs. SC. Kaplan-Meier methods and Cox regression that accounted for known prognostic factors were used to evaluate the relationship between XRT course and disease-free (DFS), overall survival (OS), local recurrence free survival (LRFS) and distant recurrence free survival (DRFS). Results: 427 patients were identified: median age 65 years (range 31 to 94), 67% men, 87% T3/4 tumors, and 74% with N1 or N2 disease. Among them, 240 (56%) received SC and 187 (44%) received LC. Adjusting for confounders, patients with N1 or N2 disease were more likely to receive LC (OR for LC 5.08, 95% CI, 2.51-11.22, p<0.0001 and 8.35, 95% CI, 3.35-22.39, p<0.0001, respectively), while older age patients were less likely to receive LC (OR 0.95, 95% CI, 0.94-0.98, p<0.0001). On univariate analysis, there was no significant difference seen in DFS, OS, LRFS, and DRFS between LC and SC. Similarly, in multivariate analyses comparing LC vs. SC, the course of XRT was not associated with differences in DFS (HR 1.06, 95% CI, 0.68-1.64, p=0.80), OS (HR 0.91, 95% CI, 0.61-1.37, p=0.66), LRFS (HR 0.79, 95% CI, 0.39-1.57, p=0.50) and DRFS (HR 0.99, 95% CI, 0.60-1.61, p=0.95). Additional baseline clinical and tumor characteristics did not influence outcomes (all p>0.05). Conclusions: Appropriate pre-operative selection of SC vs. LC neoadjuvant XRT for early stage RC based on patient and tumor characteristics was not associated with differences in survival outcomes.

Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

2021 ◽  
pp. 1-12
Author(s):  
Aparna Roy ◽  
T. V. Sekher
Keyword(s):  
Nutritional Status ◽  
Sensitivity And Specificity ◽  
Measurement Data ◽  
Anthropometric Measurement ◽  
Alternative Measure ◽  
Upper Arm ◽  
Male Adolescents ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference ◽  
The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

scholarly journals Evaluation of potential tumor markers that may predict neoadjuvant treatment efficiency in rectal cancer

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatma Demet Arslan ◽  
Ayse Kocak ◽  
Cengiz Aydın ◽  
Emel Ebru Pala ◽  
Dilek Oncel ◽  
...  
Keyword(s):  
Gene Expression ◽  
Rectal Cancer ◽  
Tumor Markers ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Beclin 1 ◽  
Tumor Regression Grade ◽  
Protein Levels ◽  
Study Gene Expression ◽  
Regression Grade

AbstractObjectivesThe recurrence of rectal cancer or its resistance to neoadjuvant treatment develops due to the adaptation to hypoxia, apoptosis or autophagy. Survivin, one of the inhibitors of apoptosis; Beclin 1, which is a positive regulator in the autophagy pathway; and hypoxia-inducible factor-1α (HIF-1α) and carbonic anhydrase-9 (CA9), which are associated with tumor tissue hypoxia, may be related to resistance to treatment. Our aim was to evaluate the potential tumor markers that may help to monitor the response to neoadjuvant treatment in locally advanced rectal cancer (RC).MethodsTwenty-five patients with locally advanced RC were included in the study. Gene expression and protein levels of Beclin 1, Survivin, HIF-1α, and CA9 were analyzed in fresh tissue specimens and blood samples. The relationships of these markers to tumor staging and regression grade were evaluated.ResultsHigher blood CA9 gene expression levels and lower blood HIF-1α protein levels were found in the response group according to tumor regression grade. After neoadjuvant treatment, tissue Beclin 1 and blood Survivin gene expressions and tissue CA9, blood Beclin 1 and blood HIF-1α protein levels decreased significantly.ConclusionBeclin 1, Survivin, HIF-1α ve CA9 may help to predict the effects of the applied treatment approach.

Sign in / Sign up

Export Citation Format

Share Document