Clinical Criteria Underestimate Complete Pathological Response in Rectal Cancer Treated With Neoadjuvant Chemoradiotherapy

Smith, F. H.; Wiland, Homer O.; Mace, Adam G.; Pai, Rish K.; Kalady, Matthew F.

doi:10.1097/dcr.0b013e3182a84eba

Cited by 142 publications

(115 citation statements)

References 14 publications

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“…If an ulceration, palpable node or stenosis are found during examination, it means incomplete clinical response. 12 Two different terms …”

Section: Discussionmentioning

confidence: 99%

“…But on the other hand, without surgery we can not reliably assess pCR as accuracy of other methods for assesment of tumour response to preoperative treatment is low. 12 Is there any possibility to assess preoperatively, whether patients responded to treatment completely and all tumor cells were destroyed? Clinical complete response (cCR) represents a list of clinical and endoscopic characteristics: whitening of rectal wall mucosa, telangiectasias within mucosa, scars in rectal wall, seen as light stiffness of the wall during the insuflation.…”

Section: Discussionmentioning

confidence: 99%

“…Other group of patients experiences downstaging and 15-25% has surgical specimens without any viable tumor cells, a condition referred to as pathologic complete response (ypCR). 10,11,12 The aim of this study was to find out if tumor regression affected long-term survival in patients with localy advanced rectal cancer, treated with neoadjuvant radiochemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…Only a fourth of cCR patients achieved also pCR, what points out, how important is careful selection of patients, suitable for nonoperative treatment. 12,22 Our research allowed us to demonstrate that patients with good response to preoperative radiochemotherapy have better prognosis and less recurrences or distant metastases. For them, benefits of neoadjuvant therapy are indisputable.…”

mentioning

confidence: 99%

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Prognostic Significance of Tumor Regression in Locally Advanced Rectal Cancer after Preoperative Radiochemotherapy

Potisek¹

2015

Clin Med Rev Case Rep

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Disclosure: No potential conflicts of interest were disclosed.Background. The majority of rectal cancers are discovered in locally advanced forms (UICC stage II, III). Treatment consists of preoperative radiochemotherapy, followed by surgery 6-8 weeks later and finally by postoperative chemotherapy. The aim of this study was to find out if tumor regression affected long-term survival in patients with localy Results. Two hundred and two patients met inclusion criteria. Median follow-up was 53.2 months. Stage ypT0N0 (pathologic complete response, pCR) was observed in 14.8% of patients. Pathohistologic stage had statistically significant impact on survival (p = 0.001). 5-year survival in patients with pCR was>90%. Postoperative T and N status were also found to be statistically significant (p = 0.011 for ypT and p < 0.001 for ypN). According to multivariate analysis, tumor response to neoadjuvant therapy was the only independent prognostic factor (p = 0.003).Conclusions. Pathologic response of tumor to preoperative radiochemotherapy is an important prognostic factor for prediction of long-term survival of patients with locally advanced rectal cancer.

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“…If an ulceration, palpable node or stenosis are found during examination, it means incomplete clinical response. 12 Two different terms …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Significance of Tumor Regression in Locally Advanced Rectal Cancer after Preoperative Radiochemotherapy

Potisek¹

2015

Clin Med Rev Case Rep

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“…A more recent retrospective study demonstrated that most patients who demonstrate a pCR on microscopic evaluation do not display mucosal features indicative of a complete response on macroscopic examination. Clinical examination alone had a sensitivity of 26% specificity of 96% in predicting pCR [20].…”

Section: Complete Clinical Responsementioning

confidence: 99%

Complete Clinical Response in Rectal Adenocarcinoma: Review of Treatment Options

Scully¹,

C²,

Lee-Kong³

2017

J Clin Gastroenterol Hepatol

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The standard treatment for locally advanced rectal cancer is neoadjuvant chemoradiation followed by radical proctectomy with total mesorectal excision. A significant percentage of patients exhibit a pathological complete response with associated survival benefit. The management of patients who exhibit a complete clinical response after neoadjuvant chemoradiation, and could potentially avoid major resection, is a topic of great interest in colorectal surgery today. This paper reviews treatment options for this population.

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Looking Forward, Not Backward, on Watch and Wait for Rectal Cancer

2019

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ect introduced the use of TNM classification in small cell lung cancer. Our results demonstrate superior outcomes in patients with stage I or II disease compared with stage III disease and highlight the prognostic importance of TNM staging in this disease. 2 A lively debate on the role of surgery vs chemoradiotherapy in early (TNM stage I-II) limited-stage small cell lung cancer has been ongoing for years. 3 It is unlikely that a comparative study will ever be completed owing to small patient numbers and strong views on the topic in the thoracic surgery and oncology communities. In this context and acknowledging our study's limitations, benchmarking the outcomes (both survival and toxic effects) of stage I and II small cell lung cancer treated with modern chemoradiotherapy is of clinical relevance. 2 These results will undoubtedly provide important information that clinicians can relay to their patients to aid clinical decision making.The use of positron emission tomography/computed tomography (PET/CT) in the staging of small cell lung cancer is also debated.

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Clinical Criteria Underestimate Complete Pathological Response in Rectal Cancer Treated With Neoadjuvant Chemoradiotherapy

Cited by 142 publications

References 14 publications

Prognostic Significance of Tumor Regression in Locally Advanced Rectal Cancer after Preoperative Radiochemotherapy

Prognostic Significance of Tumor Regression in Locally Advanced Rectal Cancer after Preoperative Radiochemotherapy

Complete Clinical Response in Rectal Adenocarcinoma: Review of Treatment Options

Looking Forward, Not Backward, on Watch and Wait for Rectal Cancer

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