Stage II/III rectal cancer with intermediate response to preoperative radiochemotherapy: Do we have indications for individual risk stratification?

Sprenger, Thilo; Rothe, H.; Jung, Klaus; Christiansen, Hans; Conradi, LC; Ghadimi, B. Michael; Becker, Heinz; Liersch, Torsten

doi:10.1186/1477-7819-8-27

Cited by 21 publications

(13 citation statements)

References 36 publications

(44 reference statements)

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“…Furthermore, in patients younger than 69 years we did not find better survival rates, which is opposite to the results of other studies 27,28. Finally, we found increased TIMP-1 levels (≥170mg/mL) to be an independent risk factor for worse OS (p = 0.047).…”

Section: Discussioncontrasting

confidence: 99%

The correlation between the levels of tissue inhibitor of metalloproteinases 1 in plasma and tumour response and survival after preoperative radiochemotherapy in patients with rectal cancer

Oblak¹,

Velenik²,

Anderluh³

et al. 2013

Radiology and Oncology

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BackgroundThe aim of this study was to analyse whether the level of tissue inhibitor of metalloproteinases (TIMP) 1 is associated with the tumour response and survival to preoperative radiochemotherapy in rectal cancer patients.Patients and methods.Ninety-two patients with histologically confirmed non-metastatic rectal cancer of clinical stage I– III were treated with preoperative radiochemotherapy, surgery and postoperative chemotherapy. Plasma TIMP-1 concentrations were measured prior to the start of the treatment with an enzyme-linked immunosorbent assay (ELISA).ResultsMedian follow-up time was 68 months (range: 3–93 months) while in survivors it was 80 months (range: 68–93 months). The 5-year locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) rates for all patients were 80.2%, 56.4%, 63.7% and 52.2%, respectively. The median TIMP-1 level was 185 ng/mL (range: 22–523 ng/mL) and the mean level (±standard deviation) was 192 (±87) ng/mL. Serum TIMP-1 levels were found to be significantly increased in patients with preoperative CRP>12 mg/L and in those who died from rectal cancer or had cT4 tumours. No correlation was established for age, gender, carcinoembriogenic antigene (CEA) level, platelets count, histopathological grade, response to preoperative therapy, resectability and disease reappearance. On univariate analysis, various parameters favourably influenced one or more survival endpoints: TIMP-1 <170 ng/mL, CRP <12 mg/L, platelets count <290 10E9/L, CEA <3.4mg/L, age <69 years, male gender, early stage disease (cN0 and/or cT2–3), radical surgery (R0) and response to preoperative radiochemotherapy. In multivariate model, LRC was favourably influenced by N-downstage, DFS by lower CRP and N-downstage, DSS by lower CRP and N-downstage and OS by lower TIMP-1 level, lower CRP and N-downstage.ConclusionsAlthough we did not find any association between pretreatment serum TIMP-1 levels and primary tumour response to preoperative radiochemotherapy in our cohort of patients with rectal cancer, TIMP-1 levels were recognized as an independent prognostic factor for OS in these patients.

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Section: Discussioncontrasting

confidence: 99%

The correlation between the levels of tissue inhibitor of metalloproteinases 1 in plasma and tumour response and survival after preoperative radiochemotherapy in patients with rectal cancer

Oblak¹,

Velenik²,

Anderluh³

et al. 2013

Radiology and Oncology

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“…Er scheint sich für eine weitere individuelle Risikostratifizierung zu eignen [112]. Unter der Voraussetzung einer umfassenden, standardisierten histopathologischen Aufarbeitung des Rektumresektates (nach TME Die integrierte anatomisch-metabolische Bildgebung mit Fluordesoxyglukose (FDG)-PET/CT gilt heute als ein etabliertes Verfahren [124].…”

Section: × Gy Versus Rct Beim Rektumkarzinomauswirkung Auf Die Lebensunclassified

Gastrointestinale Tumore – interdisziplinäre Diskussion neuer Daten

et al. 2011

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“…[6][7][8] In recent years, however, several studies have reported that preoperative CRT generally decreases the number of lymph nodes (LNs) in rectal cancer specimens or may even lead to a complete deletion of mesorectal LN. [9][10][11] In a previous study, we could demonstrate that nodal staging with a consistent LN yield of >30 nodes per specimen is feasible.…”

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confidence: 99%