Mucinous Rectal Adenocarcinoma Is Associated with a Poor Response to Neoadjuvant Chemoradiotherapy: A Systematic Review and Meta-analysis

McCawley, Niamh; Clancy, Cillian; O’Neill, Brian; Deasy, Joseph; McNamara, Deborah A.; Burke, John P.

doi:10.1097/dcr.0000000000000635

Cited by 134 publications

(112 citation statements)

References 30 publications

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“…This difference in cutoff value may explain the higher incidence of MA in the western countries compared to those in Asia [16,19]. Many studies showed that patients with MA of the rectum had worse prognosis in terms of RFS and OS compared to non-mucinous adenocarcinoma (NMA) [9,19,20]. On the other hand, the prognostic significance of MA of the colon is yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with short recurrence-free survival in completely resected colon cancer

Alnimer

Ghamrawi

Aburahma

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Several factors could affect disease recurrence in surgically resected colon cancer. While the role of certain factors such as cancer stage and grade is well established, the role of other factors (e.g., histological subtypes) is yet to be determined. Objective:Therefore, we conducted a study to evaluate the impact of several factors in recurrence-free survival (RFS) in patients who were disease free following surgical resection of the colon cancer. Design/Methods: Data were collected for patients with Stage I–III colon cancer who underwent complete surgical resection of the tumor between January 2010 and December 2015 in our institution. A total of 90 subjects met the inclusion criteria and were included in the study. The following factors were collected at the time of surgical resection of the colonic tumor: patient’s age, gender, colon cancer stage, grade and histological subtype, body mass index, hemoglobin A1c, and smoking history. Results: A total of 28 patients (31%) developed recurrence and had a mean follow-up time of 19.8 months (range: 2–54.4 months). Median RFS was 54.4 months with a 5-year RFS of 49%. Advanced colonic cancer stage and mucinous histological subtype were associated with shorter RFS with an HR of 2.37, 95% CI = 1.38–4.06, and 95% CI = 1.02–5.90, respectively. Current smokers or those who quit less than 15 years earlier tended to have worse RFS with an HR of 2.47, 95% CI = 0.98–6.27. Conclusion: Advanced colon cancer stage and mucinous histological subtype are independent risk factors for cancer recurrence and shorter RFS in completely resected colonic tumor.

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Section: Discussionmentioning

confidence: 99%

Factors associated with short recurrence-free survival in completely resected colon cancer

Alnimer

Ghamrawi

Aburahma

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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“…In addition, some pathological features have been shown to predict the response to nCRT. Tumor differentiation, circumferential tumor, mucinous histology and the presence of macroscopic ulceration are associated with poor response to nCRT [20,21,22,23,24]. Imaging modalities including positron emission tomography-computed tomography, magnetic resonance imaging (MRI) and endoscopic ultrasound are currently used for pretreatment staging, assessment of response to nCRT, and restaging after nCRT [25,26,27,28,29,30,31,32].…”

Section: Introductionmentioning

confidence: 99%

Predictive and Prognostic Molecular Biomarkers for Response to Neoadjuvant Chemoradiation in Rectal Cancer

Dayde

Tanaka

Jain

et al. 2017

IJMS

145

152

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Abstract:The standard of care in locally advanced rectal cancer is neoadjuvant chemoradiation (nCRT) followed by radical surgery. Response to nCRT varies among patients and pathological complete response is associated with better outcome. However, there is a lack of effective methods to select rectal cancer patients who would or would not have a benefit from nCRT. The utility of clinicopathological and radiological features are limited due to lack of adequate sensitivity and specificity. Molecular biomarkers have the potential to predict response to nCRT at an early time point, but none have currently reached the clinic. Integration of diverse types of biomarkers including clinicopathological and imaging features, identification of mechanistic link to tumor biology, and rigorous validation using samples which represent disease heterogeneity, will allow to develop a sensitive and cost-effective molecular biomarker panel for precision medicine in rectal cancer. Here, we aim to review the recent advance in tissue-and blood-based molecular biomarker research and illustrate their potential in predicting nCRT response in rectal cancer.

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“…Clinicopathological factors associated with the CRT response to rectal cancer include the levels of serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9, and fibrinogen; the histological grade and mucinous histology; tumor size, volume, circumference, and movability; the hemoglobin level and blood lymphocyte counts; the clinical T or N stage; and the distance from the tumor to the anal verge [21,[45][46][47][48][49][50][51][52][53][54][55][56][57]. Of these factors, the serum CEA level has been the most relevant [48][49][50].…”

Section: Predictive Markers Clinicopathological Factorsmentioning

confidence: 99%

Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review

Yoo

Yeo

2017

EPMA Journal

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Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organsparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations. However, a model predictive of the CRT response, applied before any treatment commenced, would be valuable to facilitate such a personalized approach. This would increase organ preservation, particularly in patients for whom upfront CRT is not generally prescribed. Molecular biomarkers hold the greatest promise for development of a pretreatment predictive model of CRT response. A combination of clinicopathological, radiological, and molecular markers will be necessary to render the model robust. Molecular research will also contribute to the development of drugs that can overcome the radioresistance of rectal tumors. Current treatments for rectal cancer are based on the expected prognosis given the presenting disease extent. In the future, treatment schemes may be modified by including the predicted CRT response evaluated at presentation.

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Mucinous Rectal Adenocarcinoma Is Associated with a Poor Response to Neoadjuvant Chemoradiotherapy: A Systematic Review and Meta-analysis

Abstract: Mucinous rectal adenocarcinoma represents a biomarker for poor response to preoperative chemoradiotherapy and is an adverse prognostic indicator.

Cited by 134 publications

References 30 publications

Factors associated with short recurrence-free survival in completely resected colon cancer

Factors associated with short recurrence-free survival in completely resected colon cancer

Predictive and Prognostic Molecular Biomarkers for Response to Neoadjuvant Chemoradiation in Rectal Cancer

Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review

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