Outcome and prognostic factors in 593 non-metastatic rectal cancer patients: a mono-institutional survey

Abstract

This retrospective study was undertaken to provide more modern data of real-life management of non-metastatic rectal cancer, to compare therapeutic strategies, and to identify prognostic factors of overall survival (OS) in a large cohort of patients. Data on efficacy and on acute/late toxicity were retrospectively collected. Patients were diagnosed a non-metastatic rectal cancer between 2004 and 2015, and were treated at least with radiotherapy. OS was correlated with patient, tumor and treatment characteristics with univariate and multivariate analyses. Data of 593 consecutive non-metastatic rectal cancer patients were analyzed. Median follow-up was 41 months. Median OS was 9 years. Radiotherapy was delivered in pre-operative (n = 477, 80.5%), post-operative (n = 75, 12.6%) or exclusive (n = 41, 6.9%) setting. In the whole set of patients, age, nutritional condition, tumor stage, tumor differentiation, and surgery independently influenced OS. For patients experiencing surgery, OS was influenced by age, tumor differentiation and nodal status. Surgical resection is the cornerstone treatment for locally-advanced rectal cancer. Poor tumor differentiation and node involvement were identified as major predictive factor of poor OS. The research in treatment intensification and in identification of radioresistance biomarkers should therefore probably be focused on this particular subset of patients.

Prediction of cancer-specific survival and overall survival in middle-aged and older patients with rectal adenocarcinoma using a nomogram model

“…The pathological grade was “poorly differentiated,” and the prognosis of patients with undifferentiated grade was poorer than those with “moderately differentiated” and “well-differentiated” grades, which was also confirmed by Julien et al. [15] . Among the clinicopathological features, although no significant differences were found in the scores of stage II and III patients, the scores of stage I and IV patients were significantly different.…”

Hubungan antara status tumor budding dengan berbagai parameter klinikopatologi pada adenokarsinoma kolorektal di RSUP Sanglah, Bali, Indonesia

“…Parameter histopatologi yang rutin dinilai pada evaluasi sediaan histopatologi pada kanker kolorektal adalah tipe histopatologi tumor, grade histopatologi tumor, status invasi limfo-vaskuler (LVI), derajat inflamasi, status margin, status nodal, serta stadium TNM tumor. 1 Klasifikasi TNM masih merupakan gold standard untuk menentukan prognosis pasien kanker kolorektal, namun terdapatnya heterogenitas survival pada tumor dengan stadium yang sama menunjukkan bahwa diperlukan biomarker prognostik tambahan yang diperlukan untuk menentukan prognosis pasien. 2 Dewasa ini mulai diteliti tentang gambaran morfologi spesifik yaitu adanya tumor budding yang dikaitkan dengan agresivitas tumor.…”

“…Status nodal dikategorikan menjadi negatif dan positif berdasarkan adalah ada-tidaknya metastasis sel kanker pada kelenjar getah bening regional. Tumor budding grade adalah kelompok kecil (1)(2)(3)(4)…”

Pre-Treatment Computed Tomography Radiomics for Predicting the Response to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Retrospective Study

“…The prognostic factors for non-metastatic rectal cancer patients have been noted to include age, nutritional condition, tumor stage, tumor differentiation, and surgery, which may independently affect overall survival ( 49 ). Our best performing model for predicting response to nCRT incorporated both radiomics and clinical variables, such as radiomic features, distance to anal verge, lymphocyte-to-monocyte ratio (LMR), and carcinoembryonic antigen (CEA).…”