Associations between clinical characteristics and tumor response to neoadjuvant chemoradiotherapy in rectal cancer

Pang, Xiaolin; Gao, Yuanhong; Yi, Hanchen; Liu, Hailing; Liu, Shuai; Zheng, Jian

doi:10.1002/cam4.4051

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…Here, PLS-DA was used for radiomic features selection; the radiomics signature showed considerable predictive power (AUC: 0.832 [training], 0.763 [testing]). As for clinical features, based on multivariate regression and previous studies and clinical background, we chose pre-treatment CEA (multivariate regression p = 0.003, [54] , [55] ), clinical tumour stage (multivariate regression p = 0.005, [56] , [57] ) and tumour location [58] , [59] . We established a combined prediction nomogram based on MRI-radiomics and clinical features with AUC 0.842 for the training cohort and 0.809 for the testing cohort, respectively.…”

Section: Discussionmentioning

confidence: 99%

MRI-based radiomics to predict neoadjuvant chemoradiotherapy outcomes in locally advanced rectal cancer: A multicenter study

Xiang

Li²,

Wang³

et al. 2023

Clinical and Translational Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

MRI-based radiomics to predict neoadjuvant chemoradiotherapy outcomes in locally advanced rectal cancer: A multicenter study

Xiang

Li²,

Wang³

et al. 2023

Clinical and Translational Radiation Oncology

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“…Based on very few previous studies of this population, most focused on predictions for pCR patients [3,6,7], Zhang et al considered good response as a predictive endpoint and developed a nomogram model C-index of 0.760 (95%CI: 0.681-0.844), but the study had a smaller sample size, fewer included factors in the model, and no external validation, with lower predictive accuracy than the present study [8]. This study was based on a retrospective cohort analysis of patients from two large colorectal consultation centers to compensate for the predictive model for this population, and the model was applied in an external institution for validation, with some external applicability to help clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…The classification criteria were as follows: Specimens of all cases were reviewed by 2 pathologists in their units for pathological findings. Based on postoperative pathological examinations as criteria, treatment response was defined as follows: good response, stage ypT0∼2N0M0 and as the primary study endpoint in this study; and poor response, stage ypT3∼4N0M0 or N positive [3,8]. pCR was defined as complete tumor regression, no found tumor cells, and those patients with only fibroblasts remaining would not receive postoperative adjuvant chemotherapy after surgery, whereas the remaining patients continued the total preoperative and postoperative courses of chemotherapy for a cumulative period of 6 months.…”

Section: Definitionsmentioning

confidence: 99%

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A nomogram for predicting good response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer: a retrospective, double-center, cohort study

Wang

Zheng

Chen

et al. 2022

Int J Colorectal Dis

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Aim The purpose of this study was to explore the clinical factors associated with achieving good response after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and to develop and validate a nomogram. Methods A total of 1724 consecutive LARC patients treated at Fujian Medical University Union Hospital from January 2010 to December 2021 were retrospectively evaluated as the training cohort; 267 consecutive LARC patients treated at Zhangzhou Affiliated Hospital of Fujian Medical University during the same period were evaluated as the external 2 cohorts. Based on the pathological results after radical surgery, treatment response was defined as follows: good response, stage ypT0∼2N0M0 and poor response, ypT3∼4N0M0 and/or N positive. Independent influencing factors were analyzed by logistic regression, a nomogram was developed and validated, and the model was evaluated using internal and external data cohorts for validation. Results In the training cohort, 46.6% of patients achieved good response after nCRT combined with radical surgery. The rate of the retained anus was higher in the good response group (93.5% vs. 90.7%, P < 0.001). Cox regression analysis showed that the risk of overall survival and disease-free survival was significantly lower among good response patients than poor response patients, HR = 0.204 (95%CI: 0.146–0.287). Multivariate logistic regression analysis showed an independent association with 9 clinical factors, including histopathology, and a nomogram with an excellent predictive response was developed accordingly. The C-index of the predictive accuracy of the nomogram was 0.764 (95%CI: 0.742–0.786), the internal validation of the 200 bootstrap replication mean C-index was 0.764, and the external validation cohort showed an accuracy C-index of 0.789 (95%CI: 0.734–0.844), with good accuracy of the model. Conclusion We identified factors associated with achieving good response in LARC after treatment with nCRT and developed a nomogram to contribute to clinical decision-making.

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“…However, the survival of ypII and III rectal cancer patients are variable. They maybe experience recurrence at a rate of 20–30% ( 7 – 11 ). Thus, only depending on yp stage is not enough to identify the high-risk population.…”

Section: Introductionmentioning

confidence: 99%

Stratified Prognostic Value of Pathological Response to Preoperative Treatment in yp II/III Rectal Cancer

Yang

Chen

et al. 2021

Front. Oncol.

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AimAccumulated studies have verified that tumor regression is associated with the prognosis of rectal cancer. However, stratified analysis within a certain stage is still unknown. The purpose of our study was to assess the impact of pathologic response on the survival of stageII and III rectal cancer patients after neoadjuvant chemoradiotherapy (nCRT).MethodsClinicopathologic characteristics and tumor regression scores (TRS) were assessed in 236 rectal cancer patients who treated with nCRT followed by surgery. Survival analysis was performed using Cox proportional hazards models.ResultsAmong these patients, the stage of 88 patients was ypII, and 91 patients were with the stage of ypIII. The median follow-up time was 59.8 months. TRS was not an independent prognostic factor in ypII patients while it was significantly associated with the prognosis of ypIII patients (5-year survival rate 67.2% vs. 42.5%, P < 0.001). Furthermore, ypIII patients with the response to nCRT had similar survival to that of ypII patients (5-year survival rate 67.2% vs. 70.5%, P = 0.56). For ypIII patients, multivariable analysis showed that well differentiation, negative surgical margin, and the administration of adjuvant chemotherapy were associated with better survival. The surgical margin and differentiation were prognostic factors for ypII patients.ConclusionsypIII rectal cancer patients with poor response to preoperative treatment are at high risk of worse oncological outcomes.

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Associations between clinical characteristics and tumor response to neoadjuvant chemoradiotherapy in rectal cancer

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 34 publications

MRI-based radiomics to predict neoadjuvant chemoradiotherapy outcomes in locally advanced rectal cancer: A multicenter study

MRI-based radiomics to predict neoadjuvant chemoradiotherapy outcomes in locally advanced rectal cancer: A multicenter study

A nomogram for predicting good response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer: a retrospective, double-center, cohort study

Stratified Prognostic Value of Pathological Response to Preoperative Treatment in yp II/III Rectal Cancer

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