Recurrence hazard of rectal cancer compared with colon cancer by adjuvant chemotherapy status: a nationwide study in Japan

Ahiko, Yuka; Shida, Dai; Kudose, Yozo; Nakamura, Yuya; Moritani, Konosuke; Yamauchi, Shinichi; Sugihara, Kenichi; Kanemitsu, Yukihide

doi:10.1007/s00535-021-01771-6

Cited by 10 publications

(11 citation statements)

References 27 publications

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“…Surgery combined with chemotherapy and radiotherapy remains the standard component of curative multimodal treatment approaches for LACRC. OS and disease-free survival (DFS) benefits from postoperative adjuvant chemotherapy were observed for LACRC patients in previous clinical trials (3)(4)(5)(6)(7)(8). However, approximately 30% of CRC patients delayed or even refused adjuvant chemotherapy after curative resection because of postoperative complications and poor physical condition, and less than half of the eligible patients received a full course of chemotherapy, which reduced the therapeutic efficacy (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Neoadjuvant immunotherapy for colorectal cancer: Right regimens, right patients, right directions?

Zhu

Lian

et al. 2023

Front. Immunol.

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Neoadjuvant chemoradiotherapy (NACRT) or chemotherapy (NACT) followed by radical resection and then adjuvant therapy is considered the optimal treatment model for locally advanced colorectal cancer (LACRC). A recent total neoadjuvant therapy (TNT) strategy further improved the tumour regression rate preoperatively and reduced local-regional recurrence in locally advanced rectal cancer (LARC). However, distant metastasis was still high, and little overall survival benefit was obtained from these preoperative treatment models. According to mismatch repair protein expression, MSI-H/dMMR and non-MSI-H/pMMR statuses were defined in colorectal cancer (CRC) patients. Due to the special features of biologics in MSI-H/dMMR CRC patients, this subgroup of patients achieved little treatment efficacy from chemoradiotherapy but benefited from immune checkpoint inhibitors (ICIs). The KEYNOTE-177 trial observed favourable survival outcomes in metastatic CRC patients treated with one-line pembrolizumab with tolerable toxicity. Given the better systemic immune function, increased antigenic exposure, and improved long-term memory induction before surgery, neoadjuvant ICI (NAICI) treatment was proposed. The NICHE trial pioneered the use of NAICI treatment in LACRC, and recent reports from several phase II studies demonstrated satisfactory tumour downsizing in CRC. Preclinical rationales and preliminary early-phase human trials reveal the feasibility of NAICI therapy and the therapeutic efficacy provided by this treatment model. Better tumour regression before surgery also increases the possibility of organ preservation for low LARC. However, the optimal treatment strategy and effective biomarker identification for beneficiary selection remain unknown, and potential pitfalls exist, including tumour progression during neoadjuvant treatment due to drug resistance and surgery delay. Given these foundations and questions, further phase II or III trials with large samples need to be conducted to explore the right regimens for the right patients.

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Section: Introductionmentioning

confidence: 99%

Neoadjuvant immunotherapy for colorectal cancer: Right regimens, right patients, right directions?

Zhu

Lian

et al. 2023

Front. Immunol.

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“…1 The risk of rectal cancer recurrence (17.3%-39%), either metastatic or local, varies greatly depending on the stage and location of the tumour and the possible preoperative chemoradiotherapy. 2,3 Moreover, the local recurrence risk is smaller (7.1%-20%), yet still represents a rather significant cause of morbidity in patients. 4 Pretreatment magnetic resonance imaging (MRI) serves as an important tool for preoperative multidisciplinary team (MDT) meetings when weighing treatment options for a patient with nonmetastatic rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Rectal cancer impacts the lives of approximately 732 000 people in the world annually 1 . The risk of rectal cancer recurrence (17.3%–39%), either metastatic or local, varies greatly depending on the stage and location of the tumour and the possible preoperative chemoradiotherapy 2,3 . Moreover, the local recurrence risk is smaller (7.1%–20%), yet still represents a rather significant cause of morbidity in patients 4 …”

Section: Introductionmentioning

confidence: 99%

The ability of magnetic resonance imaging to predict lymph node metastases and the risk of recurrence in rectal cancer

Lehtonen

Ilvesmäki

Koskenvuo

et al. 2023

Journal of Surgical Oncology

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Aim This study aimed to examine the diagnostic accuracy and prognostic value of magnetic resonance imaging (MRI) detected lymph nodes in rectal cancer. Method We evaluated 806 rectal cancer patients consecutively operated on between 2015 and 2018 at Helsinki University Hospital. In total, 485 patients met the inclusion criteria of presenting with stage I–III disease and were intended for curative treatment at the time of diagnosis. The effect of MRI‐detected clinical lymph node status (cN) on cumulative overall survival (OS), disease‐specific survival (DSS) and disease‐free survival (DFS) was calculated using the Kaplan–Meier analysis. Results Negative predictive value (NPV) of MRI‐lymphnode negativity was 74.8%. Positive predictive value of lymph node metastasis was only 48.6%. In the Kaplan–Meier survival analysis, OS (p = 0.989), DSS (p = 0.911), and DFS (p = 0.109) did not significantly differ according to MRI nodal status. However, cumulative disease‐free survival significantly (p < 0.001) differed according to the histopathological lymph node metastasis status (pN). Conclusions MRI detected lymph node positivity appears insufficiently precise and cannot predict disease recurrence or survival. Therefore, it should not serve as an independent risk factor when considering neoadjuvant treatment options for rectal cancer patients.

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“…[ 1–4 ] After curative‐intent surgery or adjuvant chemotherapy, the recurrence rate is still 27% for stage III CC. [ 5 ] Recurrence occurs in 80% of cases during the first 3 years after resection, and patients after radical resection have a poor prognosis even when radical resection is performed again. [ 6,7 ] The overall treatment is relatively unacceptable because of the relatively high incidence and prevalence of CC.…”

Section: Introductionmentioning

confidence: 99%

Identification of Candidate Antigens and Immune Subtypes in Colon Cancer for mRNA Vaccine Development

Feng

Zhu

Zheng

et al. 2022

Advanced Therapeutics

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The use of mRNA vaccines to treat colon cancer (CC) remains largely unexplored. The aim of this study is to identify CC antigens that may potentially be used for the development of anti‐CC mRNA vaccines and to select suitable patients for vaccination. Immune subtypes are identified by consensus clustering analysis, and the visualization of the CC immune landscape is performed by graph‐learning‐based dimensionality reduction. Plot cell trajectory and the WGCNA are applied to resolve the heterogeneity of the population suitable for vaccination. Four tumor antigens, COQ2, BGN, CASP6, and FAP, which are related to prognosis and infiltration of antigen‐presenting cells, are identified in CC. CC patients are divided into four immune subtypes characterized by differential molecular, cellular, pathological, and clinical features. Group B has the characteristics of immunologically “cold” tumors, and the immunosuppressive phenotype has worse survival than other groups. Moreover, different immune subtype tumors differed in the expression of immune checkpoints and immunogenic cell death modulators. Last, immune cell components in individual patients are revealed by the immune landscape. COQ2, BGN, CASP6, and FAP are potential antigens for use in a CC‐mRNA vaccine and suitable for patients in Group B.

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Recurrence hazard of rectal cancer compared with colon cancer by adjuvant chemotherapy status: a nationwide study in Japan

Cited by 10 publications

References 27 publications

Neoadjuvant immunotherapy for colorectal cancer: Right regimens, right patients, right directions?

Neoadjuvant immunotherapy for colorectal cancer: Right regimens, right patients, right directions?

The ability of magnetic resonance imaging to predict lymph node metastases and the risk of recurrence in rectal cancer

Identification of Candidate Antigens and Immune Subtypes in Colon Cancer for mRNA Vaccine Development

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