Tumor Regression Grading After Preoperative Chemoradiotherapy for Locally Advanced Rectal Carcinoma Revisited: Updated Results of the CAO/ARO/AIO-94 Trial

Fokas, Emmanouil; Liersch, Torsten; Fietkau, Rainer; Hohenberger, Werner; Beißbarth, Tim; Hess, Clemens F.; Becker, Heinz; Ghadimi, Michael; Mrak, Karl; Merkel, Susanne; Raab, Hans-Rudolf; Sauer, Rolf; Wittekind, Christian; Rödel, Claus

doi:10.1200/jco.2013.54.3769

Cited by 375 publications

(353 citation statements)

References 54 publications

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“…При II и III ста-диях рака прямой кишки (cT3/сТ4 или cN+) в боль-шинстве случаев стандартным подходом является со-четание хирургического лечения и неоадъювантной ХТ. Это позволяет значимо снизить частоту рецидивов, а по данным некоторых исследований, приводит к улучшению выживаемости [14,15]. По результатам лечебного патоморфоза определяется необходимость коррекции послеоперационной терапии [16].…”

Section: Discussionunclassified

Tumor regression after neoadjuvant chemotherapy in locally advanced colon cancer

Расулов¹,

Кулушев²,

Ананьев³

et al. 2015

Onkol. koloproktol.

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Section: Discussionunclassified

Tumor regression after neoadjuvant chemotherapy in locally advanced colon cancer

Расулов¹,

Кулушев²,

Ананьев³

et al. 2015

Onkol. koloproktol.

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“…6,25,26 Another strategy, as suggested by Schrag,9 is to intensify the systemic treatment or to administer the systemic treatment earlier in the treatment course to prevent dissemination of micrometastases. The recent updated results from the German CAO/ARO/AIO-94 trial 27 showed a significant association between local treatment efficacy (TRG) and disease-free survival. Thus, it is likely that MRI volumetry of the primary tumour can predict systemic treatment response and therefore can be used to customize subsequent treatment regimens.…”

Section: Discussionmentioning

confidence: 99%

MRI volumetry for prediction of tumour response to neoadjuvant chemotherapy followed by chemoradiotherapy in locally advanced rectal cancer

Seierstad

Hole

Grøholt

et al. 2015

BJR

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“…Pathological tumor response (PTR), including tumor regression grade (TRG) and downstaging, has been indicated to be an important prognostic factor for LARC following CRT (6)(7)(8). PTR may be useful to stratify patients with different prognoses and to tailor surgical treatment strategies, particularly for sphincter-sparing candidates (9). Therefore, the early and accurate prediction of PTR is important.…”

Section: Introductionmentioning

confidence: 99%

Tumor volume reduction rate is superior to RECIST for predicting the pathological response of rectal cancer treated with neoadjuvant chemoradiation: Results from a prospective study

Xiao

Tan

et al. 2015

Oncology Letters

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Abstract. The aim of the present study was to compare the tumor volume reduction rate (TVRR), as determined by three-dimensional region-of-interest magnetic resonance volumetry, and Response Evaluation Criteria in Solid Tumors (RECIST) data for predicting the pathological tumor response (PTR) of locally advanced rectal cancer (LARC) following treatment with neoadjuvant chemoradiation (CRT). The current cohort consisted of 105 patients with LARC [clinical tumor stage (cT)3-4 or clinical lymph node stage (cN)+] from a prospective randomized trial who had undergone pre-operative CRT and radical proctectomy. Tumor volumes were measured prior to and following CRT to determine TVRR. Furthermore, receiver operating characteristic (ROC) curves of TVRR and RECIST were constructed to predict the PTR in terms of tumor regression grade (TRG) and downstaging. Values for the area under the ROC curve (AUC) were compared and TVRR cut-off levels were determined. RECIST was used to identify 5 (4.8%) cases of complete response, 44 (41.9%) of partial response, 55 (52.4%) of stable disease and 1 (0.9%) of progressive disease. The mean TVRR was 58.6±24.4%, and a good TRG (0-1) and downstaging occurred in 54 (51.4%) and 59 (56.2%) patients, respectively. In addition, TVRR and RECIST were significantly correlated with TRG and downstaging (P<0.01). The TVRR AUC was significantly larger than that of RECIST for TRG (P=0.020). For downstaging, TVRR also exhibited a larger AUC than RECIST, however, the difference was not significant (P=0.180). The sensitivity and specificity of TVRR in predicting a good TRG were 70.4 and 80.4%, respectively, therefore, the optimal TVRR cut-off value was determined to be 65%. TVRR appeared to be more accurate than RECIST in predicting PTR, particularly for TRG associated with survival. Thus, TVRR may be considered as a novel parameter for evaluating the efficacy of CRT for patients with LARC. IntroductionColorectal cancer is the third most commonly diagnosed type of cancer worldwide (1). In China, ~50% of cases of colorectal cancer arise in the rectum, accounting for >100,000 new diagnoses of rectal cancer in 2012 (2). Despite the advent of total mesorectal excision (TME) (3) facilitating major improvements in the management of locally advanced rectal cancer (LARC), which is defined as clinical tumor stage (cT)3-4 or clinical lymph node stage (cN)+, management remains a challenge following Miles' procedure due to the high recurrence rate and poor quality of life (4).Neoadjuvant chemoradiation (CRT) has been established as the standard treatment strategy for LARC, as it appears to be associated with improved local control and a higher rate of sphincter-sparing procedures (5). Pathological tumor response (PTR), including tumor regression grade (TRG) and downstaging, has been indicated to be an important prognostic factor for LARC following CRT (6-8). PTR may be useful to stratify patients with different prognoses and to tailor surgical treatment strategies, particularly for sphincter-sparing candidates (9). Th...

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Tumor Regression Grading After Preoperative Chemoradiotherapy for Locally Advanced Rectal Carcinoma Revisited: Updated Results of the CAO/ARO/AIO-94 Trial

Cited by 375 publications

References 54 publications

Tumor regression after neoadjuvant chemotherapy in locally advanced colon cancer

Tumor regression after neoadjuvant chemotherapy in locally advanced colon cancer

MRI volumetry for prediction of tumour response to neoadjuvant chemotherapy followed by chemoradiotherapy in locally advanced rectal cancer

Tumor volume reduction rate is superior to RECIST for predicting the pathological response of rectal cancer treated with neoadjuvant chemoradiation: Results from a prospective study

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