Functional outcomes after TEM in patients with complete clinical response after neoadjuvant chemoradiotherapy

Ghiselli, Roberto; Ortenzi, Monica; Cardinali, Luca; Skrami, Edlira; Gesuita, Rosaria; Guerrieri, Mario

doi:10.1007/s00464-016-5321-z

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…However, radical surgery is difficult to perform, especially for initially unresectable advanced colon cancer and mid‐low rectal cancer . Preoperative radiotherapy is widely used to downstage tumors to lower treatment failure, but the local recurrence and outcome remain variable, which indicates significant differences in tumor response to radiation . Therefore, it is essential to explore the molecular mechanisms of CRC cell survival following irradiation treatment, and, furthermore, there is an urgent need to identify useful molecular targets to improve the response of CRC to local irradiation.…”

Section: Introductionmentioning

confidence: 99%

RBBP6 increases radioresistance and serves as a therapeutic target for preoperative radiotherapy in colorectal cancer

et al. 2018

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Radiotherapy (RT) can be used as preoperative treatment to downstage initially unresectable locally rectal carcinoma, but radioresistance and recurrence remain significant problems. Retinoblastoma binding protein 6 (RBBP6) has been implicated in the regulation of cell cycle, apoptosis and chemoresistance both in vitro and in vivo. The present study investigated whether the inhibition of RBBP6 expression would improve radiosensitivity in human colorectal cancer cells. After SW620 and HT29 cells were exposed to radiation, the levels of RBBP6 mRNA and protein increased over time in both cells. Moreover, a significant reduction in clonogenic survival and a decrease in cell viability in parallel with an obvious increase in cell apoptosis were demonstrated in irradiated RBBP6‐knockdown cells. Transfection with RBBP6 shRNA improved the levels of G2‐M phase arrest, which blocked the cells in a more radiosensitive period of the cell cycle. These observations indicated that cell cycle and apoptosis mechanisms may be connected with tumor cell survival following radiotherapy. In vivo, the tumor growth rate of nude mice in the RBBP6‐knockdown group was significantly slower than that in other groups. These results indicated that RBBP6 overexpression could resist colorectal cancer cells against radiation by regulating cell cycle and apoptosis pathways, and inhibition of RBBP6 could enhance radiosensitivity of human colorectal cancer.

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Section: Introductionmentioning

confidence: 99%

RBBP6 increases radioresistance and serves as a therapeutic target for preoperative radiotherapy in colorectal cancer

et al. 2018

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“…This same cohort also reported worse QOL related to fecal incontinence (58). One study found an association between incidence of radiation proctitis and worsening anorectal function (59). On the other hand, a study Coco et al suggested that even though there might be a trend toward increased short-term morbidity in patients receiving preoperative LC-CRT, there was no difference in sphincter function; this study however, did not include data regarding patient impact, potentially biasing towards a null result (54).…”

Section: Quality Of Life After Preoperative Chemoradiation and Organ-sparing Surgery (Local Excision)mentioning

confidence: 72%

Quality of Life After Radiotherapy for Rectal and Anal Cancer

Neibart

Manne

Jabbour

2020

Curr Colorectal Cancer Rep

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Purpose of Review-With advances in radiation therapy (RT) techniques for rectal and anal cancers allowing for the modulation of critical normal tissues, there has been an increased emphasis on improving the quality of life (QOL) of cancer survivors. Herein, we review the literature to examine the impact of RT on QOL and patient reported outcomes (PROs) to better inform providers about the challenges of survivorship.Recent Findings-Large systematic reviews, recent studies and long-term follow-up of pivotal clinical trials have shown that RT impacts QOL, particularly fecal continence and sexual function. Modern preoperative RT techniques allow for decreased dose to organs-at-risk will likely improve QOL.Summary-RT, though critical in the treatment of rectal and anal cancer, has a profound impact on QOL for some patients. Recent studies have included PROs and validated QOL metrics to better inform providers and patients.

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“…However, it does not seem to affect the continence status after one year from surgery [ 158 – 161 ]. Age and gender could be additional factors to influence anorectal function [ 134 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

et al. 2021

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Background and aims Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts’ consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods The discussion among the steering group of clinical experts and methodologists from the societies’ expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020–January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.

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Functional outcomes after TEM in patients with complete clinical response after neoadjuvant chemoradiotherapy

Cited by 9 publications

References 25 publications

RBBP6 increases radioresistance and serves as a therapeutic target for preoperative radiotherapy in colorectal cancer

RBBP6 increases radioresistance and serves as a therapeutic target for preoperative radiotherapy in colorectal cancer

Quality of Life After Radiotherapy for Rectal and Anal Cancer

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