Rectal cancer: The influence of tumor proliferation on response to preoperative irradiation

Willett, Christopher G.; Warland, Gretchen; Coen, John J.; Shellito, Paul C.; Compton, Carolyn C.

doi:10.1016/0360-3016(94)00457-v

Cited by 63 publications

(12 citation statements)

References 20 publications

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“…A growing number of studies since then have re-confirmed that tumor length is an indicator of more aggressive behavior independent of T stage [22,23]. Our findings suggest that tumor length might also predict the response to CRT, an observation that could potentially be explained by current radiobiological models, the number of cells killed, as described previously in a study on rectal cancer [24]. …”

Section: Discussionsupporting

confidence: 79%

Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma

et al. 2014

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BackgroundsIn this study, we evaluated the factors associated with a pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma (ESCC).MethodsPre-nCRT parameters in ESCC patients treated between 1999 and 2006 were analyzed to identify predictors of pCR. All patients received 5-fluorouracil/cisplatin-based chemotherapy and external beam radiation followed by scheduled esophagectomy. Variables were analyzed using univariate and multivariate analyses with pCR as the dependent variable. Estimated pCR rate was calculated with a regression model.ResultsFifty-nine (20.9%) of 282 patients achieved pCR. Univariate analysis identified four patient factors (age, smoking status, drinking history and hypertension), one pre-nCRT parameter (tumor length) as significant predictors of pCR (all P <0.05). On multivariate analysis, tumor length ≤3 cm (favorable, odds ratio (OR): 4.85, P = 0.001), patient age >55 years (favorable, OR: 1.95, P = 0.035), and being a non-smoker (favorable, OR: 3.6, P = 0.003) were independent predictors of pCR. The estimated pCR rates based on a logistic regression including those three predictors were 71%, 35 to approximately 58%, 19 to approximately 38%, and 12% for patients with 3, 2, 1 and 0 predictors, respectively.ConclusionAge, smoking habit and tumor length were important pCR predictors. These factors may be used to predict outcomes for ESCC patients receiving nCRT, to develop risk-adapted treatment strategies, and to select patients who could participate in trials on new therapies.

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Section: Discussionsupporting

confidence: 79%

Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma

et al. 2014

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“…In our study, the albumin level was not a significant factor. In addition, other clinical parameters such as small tumor diameter and normal CEA level have been shown to predict pathologic complete response after preoperative CRT in rectal cancer [20, 21], and these were also significant predictors in our study.…”

Section: Discussionsupporting

confidence: 66%

Neutrophil-lymphocyte ratio predicts pathologic tumor response and survival after preoperative chemoradiation for rectal cancer

2014

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BackgroundNeutrophil-lymphocyte ratio (NLR) reflects the balance between pro- and anti-tumor immune activities. We evaluated whether NLR is associated with pathologic tumor response and prognosis in rectal cancer patients that underwent preoperative chemoradiaton therapy (CRT) with surgery.MethodsOne hundred two patients with rectal cancer that were treated by preoperative CRT followed by surgery were enrolled. A total of 50.4 GY of radiation and 5-FU-based chemotherapy were delivered. An NLR ≥ 3 was considered to be elevated. Pathologic tumor response based on ypTNM stage was categorized into two groups, good response (n = 35, pathologic complete response and ypTNM I) and poor response groups (n = 67, ypTNM II, III, and IV).ResultsTwenty-five patients (24.5%) had elevated NLR. Multivariate analysis showed that an elevated CEA level (p = 0.001), larger tumor (p = 0.03), and elevated NLR (p = 0.04) were significant predictors for a poor response. Poor pathological tumor response and elevated NLR were risk factors for cancer-specific and recurrence-free survivals.ConclusionAn elevated NLR before CRT can be used as predictors for poor tumor response and unfavorable prognostic factors. Dominant pro-tumor activities of neutrophils or reduced anti-tumor immune response by lymphocytes, as determined by NLR, may have a impact on poor tumor response and unfavorable prognosis.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2482-14-94) contains supplementary material, which is available to authorized users.

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“…And advanced clinical T status are always associated with a larger tumor size which was identified as a significant factor for pCR following preoperative CRT in rectal cancer. 17,18 Thus, the radiobiological paradigm that is dependent on tumor size to eradicate tumor cells might in part explain the observed association between clinical T category and TRG. Except the pretreatment factors, we found that some postoperative factors were associated with TRG, which is similar to the report by Claus Rödel et al 10 Additionally, perineural invasion was also related to TRG in the present study.…”

Section: Discussionmentioning

confidence: 99%

Pathological Assessment of the AJCC Tumor Regression Grading System After Preoperative Chemoradiotherapy for Chinese Locally Advanced Rectal Cancer

Zhang¹,

Xiao

Xi³

et al. 2016

Medicine

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Rectal cancer: The influence of tumor proliferation on response to preoperative irradiation

Cited by 63 publications

References 20 publications

Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma

Predictors of pathological complete response to neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma

Neutrophil-lymphocyte ratio predicts pathologic tumor response and survival after preoperative chemoradiation for rectal cancer

Pathological Assessment of the AJCC Tumor Regression Grading System After Preoperative Chemoradiotherapy for Chinese Locally Advanced Rectal Cancer

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