Rectal Cancer

Benson, Al B.; Bekaii‐Saab, Tanios; Chan, Emily; Chen, Yi Jen; Choti, Michael A.; Cooper, Harry S.; Engstrom, Paul F.; Enzinger, Peter C.; Fakih, Marwan; Fuchs, Charles S.; Grem, Jean L.; Hunt, Steven C.; Leong, Lucille; Lee, Edward; Martin, Michael; May, Kilian Salerno; Mulcahy, Mary F.; Murphy, Kathleen R.; Rohren, Eric M.; Ryan, David P.; Saltz, Leonard B.; Sharma, Sunil; Shibata, David; Skibber, John M.; Small, William; Sofocleous, Constantinos T.; Venook, Alan P.; Willett, Christopher G.; Freedman-Cass, Deborah A.; Gregory, Kristina M.

doi:10.6004/jnccn.2012.0158

Cited by 141 publications

(85 citation statements)

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“…Further more, so far there is no high quality evidence concerning 5-year recurrence and survival rate comparing laparoscopic rectum surgery and open rectum surgery. As a result, the latest NCCN (National Comprehensive Cancer Network) Clinical Practice Guidelines for Colon Cancer stated that laparoscopic colectomy has become an option in the surgical management of colon cancer (Benson et al, 2011), but for rectal cancer which said that laparoscopic surgery is preferred in the setting of a clinical trial (Benson et al, 2012). Based on these reasons, we intended to undertake this systematic review to comparing laparoscopic rectum surgery (LRS) and open rectum surgery (ORS) in patients with rectal cancer and to provide high level of evidence for clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhang

Zhou²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Introductionmentioning

confidence: 99%

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhang

Zhou²,

Wang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…According to ESMO clinical practice guidelines for rectal cancer (21), generally the treatment method for T3a and T3b or good group (DME < 5 mm) is the same (surgery alone, and radical dissection using TME method), and for T3c and T3d or intermediate/bad group (DME > 5 mm), the treatment method is similar (preoperative chemoradiotherapy followed by TME). Management consideration (adjuvant chemotherapy after neoadjuvant chemoradiotherapy/surgery regardless of the surgical pathology results) for T3 tumors as a whole without nodal involvement and even T2 rectal cancers are found to be the same (22). However, the clinician makes the final decision for the treatment considering the degree of tumor extension and metastasis.…”

Section: Management For T3 Rectal Cancermentioning

confidence: 99%

“…U n c o r r e c t e d P r o o f operative staging of rectal cancer tumor has been correlated with the patient's disease-free survival and prognosis (17,22). The advantage of pre-operative MRI is that the patients with potentially involved margins can receive neoadjuvant therapy that results in tumor down-staging so that tumor regression can help the follow-up treatment.…”

Section: Management For T3 Rectal Cancermentioning

confidence: 99%

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

et al. 2018

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Background: MRI predicted distance of mesorectal extension (mrDME) in rectal cancer is one of the independent risk factors for recurrence and poor overall survival. In T3 rectal cancer, if no lymph node or distant metastasis is seen, the selection of optimum treatment is based on the distance of mesorectal extension. Therefore, it is very crucial to investigate the reproducibility of DME in T3 rectal cancer. Objectives: To investigate the reproducibility of the distance of mesorectal extension by tumor invasion in T3 stage rectal cancer by evaluating sub-stages T3a, T3b T3c and T3d individually versus T3a, T3b (T3ab) and T3c, T3d (T3cd) combined together using MRI. Methods: From July 2014 to December 2015, 188 patients with surgically and histologically confirmed T3 rectal cancer who underwent preoperative MRI were enrolled into this study. Two blinded radiologists evaluated the maximum distance of mesorectal extension (mrDME) in T2 weighted image in MRI. The study population was sub classified into T3a (< 1 mm), T3b (1 -5 mm), T3c (5 -15 mm) and T3d (> 15 mm) according to the distance of mesorectal extension by tumor invasion. The inter-observer and intra-observer data were then assessed using Kappa analysis (k); intraclass correlation coefficients (ICC) were also analyzed subsequently. Results: Difference in the value of inter/intra observer kappa (k), and inter/intra-observer intraclass coefficients (ICC) between the two groups was very distinct. In the individual group (T3a, T3b, T3c and T3d), the inter-observer and intra-observer (k) for the mrDME was 0.700 and 0.718 respectively; the inter-observer and intra-observer ICC was 0.772 and 0.786 respectively. In the combined group (T3ab and T3cd), the inter-observer and intra-observer kappa (k) for the mrDME was 0.819 and 0.883 respectively; the inter-observer and intra-observer ICC was 0.829 and 0.796 respectively. Conclusions: There was a distinct increase in the kappa (K) and intraclass coefficient (ICC) value in the combined group compared with the individual group. This high reproducibility result suggested that it is more reliable to measure T3ab and T3cd combined together than individually. This finding can play a crucial role in the management of rectal cancer and clinical decision making for non-expert radiologists in non-academic setting.

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“…Therefore, Western investigations have focused on the multidisciplinary management of patients with RC beyond TME planes (18). The National Comprehensive Cancer Network guidelines currently recommend that clinically suspicious nodes beyond the fields of resection should be biopsied or removed if possible (19).…”

Section: Univariate Analysismentioning

confidence: 99%

Clinical significance of enlarged lateral pelvic lymph nodes before and after preoperative chemoradiotherapy for rectal cancer

Inoue

Saigusa

Hiro

et al. 2016

Molecular and Clinical Oncology

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Abstract. Preoperative chemoradiotherapy (CRT) with total mesorectal excision (TME) is the widely accepted treatment for rectal cancer (RC) in Western countries. However, there remains controversy as to whether preoperative CRT is useful in tumors that extend beyond the mesorectum, including metastasis to the lateral pelvic lymph nodes (LPLN). The aim of this study was to assess the prognostic significance of LPLN enlargement in patients with RC who receive preoperative CRT followed by TME without LPLN dissection. We evaluated the prognostic effect of radiographic LPLN enlargement before and after CRT, as well as the patients' clinicopathological and genetic profiles. Of the 104 patients investigated, pretreatment imaging identified 19 (18%) as LPLN-positive (>7 mm in diameter). Of these 19 patients, 7 (37%) exhibited LPLN downsizing to <7 mm following CRT. The median follow-up period was 52 months. The 5-year cancer-specific survival (CSS) or relapse-free survival (RFS) did not differ significantly between patients who did and those who did not have positive LPLN on pretreatment imaging. However, LPLN that remained positive after CRT were significantly associated with poorer 5-year CSS (73 vs. 84%, respectively; P=0.0052) and RFS (32 vs. 78%, respectively; P=0.0264). None of the patients whose LPLN were downsized to <7 mm following CRT developed recurrence; however, those with positive LPLN after CRT had a 55% higher recurrence rate, characterized by delayed local recurrence, a pattern that may be affected by certain chemokines. In conclusion, changes in initially positive LPLN (>7 mm) may predict the prognosis of patients with RC who receive preoperative CRT-TME. LPLN positivity after CRT was associated with shorter CSS and RFS. Strategies to improve patient survival may include selective LPLN dissection or more aggressive multimodality therapy.

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Rectal Cancer

Cited by 141 publications

References 0 publications

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Clinical Feasibility Assessment of T3 Sub-Stage in Rectal Cancer Using MRI

Clinical significance of enlarged lateral pelvic lymph nodes before and after preoperative chemoradiotherapy for rectal cancer

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