scholarly journals A critical reappraisal for the value of tumor size as a prognostic variable in rectal adenocarcinoma

2017 ◽  
Vol 8 (10) ◽  
pp. 1927-1934 ◽  
Author(s):  
Chien-Hsin Chen ◽  
Mao-Chih Hsieh ◽  
Ping-Kun Hsiao ◽  
En-Kwang Lin ◽  
Yen-Jung Lu ◽  
...  
Keyword(s):  
Tumor Size ◽  
Rectal Adenocarcinoma ◽  
Prognostic Variable

Value of Tumor Size as a Prognostic Variable in Colorectal Cancer

2011 ◽  
Vol 34 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Peter Kornprat ◽  
Marion J. Pollheimer ◽  
Richard A. Lindtner ◽  
Andrea Schlemmer ◽  
Peter Rehak ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Size ◽  
Prognostic Variable

Mutational analysis of locally advanced rectal cancer and response to neoadjuvant chemoradiation.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 449-449
Author(s):  
Andrea Lyn Russo ◽  
David P. Ryan ◽  
Darrell R. Borger ◽  
Jennifer Yon-Li Wo ◽  
Jackie Szymonifka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Size ◽  
Mutational Analysis ◽  
Anal Verge ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Rectal Adenocarcinoma ◽  
Tumor Regression Grade ◽  
Common Mutation ◽  
Kras Mutations

449 Background: Preoperative chemoradiation (CRT) is the standard of care for locally advanced rectal adenocarcinoma and leads to pathologic complete response (pCR) rates of 8-20%. pCR has been correlated with improved long term outcomes. Known mutations may contribute to lack of pCR. We retrospectively evaluated our single institution experience to determine rates and potential mutational and clinical predictors of pCR. Methods: With IRB approval, we reviewed 79 consecutive patients with stage II/III rectal adenocarcinoma, diagnosed from 7/2005–6/2010. Patients received preoperative CRT to 50.4 Gy and concurrent 5-FU based chemotherapy prior to total mesorectal excision. Primary endpoint was pCR rate by Dworak tumor regression grade. Mutations were analyzed on pre- and/or post-treatment tissue available for 47 patients with a multiplexed clinical assay on nucleic acid (SNaPshot), which tests for 130 mutations across 15 cancer genes. 32 patients did not have enough tissue for analysis. Other variables including T/N stage, grade, circumferentiality, distance to anal verge, tumor size (continuous, per cm), pre and post-CRT CEA levels, and treatment duration were evaluated using logistic regression analysis. Results: Median age was 58 years and 85% had stage III disease. Among 54% of patients with mutations assessed, the following were present: 37% KRAS, 3% APC, 3% BRAF, 5% NRAS, 4% PIK3CA, 8% TP53. TP53 testing was limited to common mutation sites. In the entire cohort, 20% had a pCR. No patients with BRAF, NRAS or KRAS mutations had a pCR. Patients with a pCR were more likely to have a post-RT CEA ≤ 2.5 (93% vs 62%, p=0.002) and no mutations identified (100% vs 38%, p=0.019). pCR patients had a trend to lower rates of KRAS mutations (0% vs 41%, p=0.1). On UVA, predictors of pCR included: post-RT CEA ≤ 2.5 (OR 8.6, 95% CI 1.03 – 71.9, p=0.047), insufficient tissue to analyze (OR 5.1, CI 1.45-18, p=0.011), and smaller tumor size (OR 0.69, CI 0.48 – 1.0, p=0.05). With a median follow-up of 30 months, there were 3 local and 6 distant recurrences. None with a pCR developed recurrence. Conclusions: Patients with the composite characteristics of being BRAF, KRAS, and NRAS wild type rectal cancer are more likely to have a pCR with preoperative CRT.

Comparison of survival outcomes of rectal squamous cell carcinoma with rectal adenocarcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 745-745
Author(s):  
Chi Lin ◽  
Abhijeet Bhirud ◽  
Jinluan Li ◽  
Mary E. Charlton
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Early Stage ◽  
Rectal Adenocarcinoma ◽  
Cox Proportional Hazards ◽  
Entire Group

745 Background: Rectal squamous cell carcinoma (RSCC) is a rare disease. It is unclear whether the prognosis or treatment outcomes differ from that of rectal adenocarcinoma (RAC). The objective of this study is to compare the overall survival (OS), cancer specific survival (CSS) and prognostic factors of RSCC to those of rectal adenocarcinoma (RAC) using the Surveillance, Epidemiology, and End Results (SEER) registry. Methods: A total of 42,317 patients diagnosed with RSCC (999) and RAC (41,318) without distant metastasis between 1998 and 2011 were identified from the SEER database. Factors analyzed included histology (RSCC/RAC), age (≤56/>56), gender, race (white/nonwhite), tumor size (<5 cm/≥5 cm), grade (well-moderate/poor-undifferentiated), stage (local/regional), year of diagnosis (1998-2003/2004-2011), with or without surgery, and with or without radiotherapy (RT). OS and CSS were evaluated using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to examine the prognostic factors for survival. Results: The median follow up is 77 months (M). The entire group had 5 year OS and CSS of 62% and 77% with a median OS of 95 M but did not reach a median CSS. Compared to patients with RAC, patients with RSCC tend to be younger, female, diagnosed more recently, with less advanced stage but higher grade and larger tumor size. For patients with RSCC, 40% underwent surgery and 75% received RT. In contrast, for patients with RAC, 89% underwent surgery and 59% received RT. Patients with RSCC had a higher median OS than those with RAC (105 vs 94 M, Log-rank p <0.05). Cox proportional hazards analysis showed that patients with RAC had worse OS (hazard ratio [HR] 1.4) and CSS (HR 1.6) than patients with RSCC (p<0.05), after adjusting for all prognostic factors. Factors associated with improved OS and CSS in both RSCC and RAC included age ≤56, nonwhite, early stage, well-moderate differentiated, undergoing surgery and receiving RT. Gender is a prognostic factor for OS but not for CSS. Conclusions: Patients with rectal squamous cell carcinoma had a significantly superior OS and CSS than patient with rectal adenocarcinoma. Future studies should seek to explore the optimal management for these two distinct diseases.

Prognostic factors in osteosarcoma: a critical review.

1994 ◽  
Vol 12 (2) ◽  
pp. 423-431 ◽  
Author(s):  
A M Davis ◽  
R S Bell ◽  
P J Goodwin
Keyword(s):  
Prognostic Factors ◽  
Preoperative Chemotherapy ◽  
Tumor Size ◽  
Tumor Necrosis ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Prognostic Variables ◽  
Prognostic Variable ◽  
Review Reports ◽  
High Grade Osteosarcoma

PURPOSE The purpose of this critical appraisal was to determine the prognostic factors that influence survival in patients with nonmetastatic, high-grade osteosarcoma of the extremities. DESIGN A computerized literature search of reports published from January 1973 to March 1992 was conducted to determine those eligible for inclusion in the review. Reports were reviewed blindly by two of the authors; inclusion and scoring were determined according to preestablished criteria. RESULTS Eight reports were included in the appraisal. The prognostic variables evaluated were age, sex, anatomic tumor location, tumor size, and tumor necrosis. Tumor size and necrosis following preoperative chemotherapy were significant prognostic variables in relation to survival in univariate analysis. However, only tumor necrosis maintained its significance in multivariate modeling. CONCLUSION The most important prognostic variable for patients with osteosarcoma of the extremity was tumor necrosis evident following preoperative chemotherapy. There is no consensus as to any prognostic variable that might be used to stratify patients before the onset of therapy.

980: Analysis of 3-CM Tumor Size Threshold for Intervention in Patients with Birt-Hogg-Dubé and Hereditary Papillary Renal Cancer

2005 ◽  
Vol 173 (4S) ◽  
pp. 265-265 ◽  
Author(s):  
Robert L. Grubb ◽  
Nicol S. Corbin ◽  
Peter Choyke ◽  
Gladys M. Glenn ◽  
Kathleen Hurley ◽  
...  
Keyword(s):  
Renal Cancer ◽  
Tumor Size ◽  
Size Threshold
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