Factors associated with rectal tumor and their influence on tumor regression grade after neoadjuvant chemoradiotherapy
- Authors: Aliyarov Y.R1
-
Affiliations:
- National Center of Oncology
- Issue: Vol 99, No 4 (2018)
- Pages: 611-616
- Section: Theoretical and clinical medicine
- URL: https://journal-vniispk.ru/kazanmedj/article/view/9201
- DOI: https://doi.org/10.17816/KMJ2018-611
- ID: 9201
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Abstract
Aim. To determine relation between localization, grade of invasion and differentiation in rectal tumor and tumor regression grade after neoadjuvant chemoradiation therapy.
Methods. 88 patients with local advanced rectal cancer (Т2-4N0-2М0) were analyzed: 46 females and 42 males. The average age was 52.4±1.4 years. All patients underwent neoadjuvant chemoradiotherapy. In all groups regardless of tumor localization patients with stage T3 and moderate differentiation grade predominated.
Results. Complete pathological tumor response of grade 4 (TRG4) was revealed in 13 (14.7%) patients, grade 3 (TRG3) in 34 (38.6%) patients, low treatment effect (tumor response grade 2, TRG2) was registered in 26 (29.5%) patients, and lack of treatment effect (grade 1, TRG1) in 15 (17.2%) patients. Analysis of the data from patients with complete or nearly complete tumor regression (grade 3 and 4) demonstrated that such effect of neoadjuvant treatment was most often observed in patients with tumor localized in rectal lower ampulla (58.6%). Among patients with moderately differentiated adenocarcinomas, patients with tumor response of grade 3 and 4 predominated: 28 (56%) patients. According to invasion grade, in all groups patients with therapeutic response grade 3 and 4 prevailed, but most prominently - in groups of patients with stage T4a and T4b - 58.9%.
Conclusion. The closer to anus tumor is located, the more significant effect neoadjuvant therapy has; moderate tumor differentiation grade can be considered as a relative predictive factor of tumor regression on preoperative chemoradiation therapy.
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##article.viewOnOriginalSite##About the authors
Yu R Aliyarov
National Center of Oncology
Author for correspondence.
Email: yusifaliyarov@yahoo.com
Baku, Azerbaijan
References
- Gerard J.P., Conroy T., Bonnetain F. et al. Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J. Clin. Oncol. 2006, 24: 4620-4625. doi: 10.1200/JCO.2006.06.7629.
- Wolff H., Gaedeke J., Jung K. et al. High grade acute organ toxicity during preoperative radiochemotherapy as positive predictor for complete histopathological tumor regression in multimodal treatment of locally advanced rectal cancer. Strahlentherapie Oncol. 2010; 186: 30-35. doi: 10.1007/s00066-009-2037-1.
- Sanghera P., Wong D., McConkey C. et al. Chemoradiotherapy for rectal cancer: an updated analysis of factors affecting pathological response. Clin. Oncol. 2008; 20: 176-183. doi: 10.1016/j.clon.2007.11.013.
- Sauer R., Beckeretal H. Preoperative versus postoperative chemoradiation for rectal cancer. N. Engl. J. Med. 2004; 351: 1731-1740. doi: 10.1056/NEJMoa040694.
- Van Gijn W., Marijnen C.A., Nagtegaal I.D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicenter, randomized controlled TME trial. Lancet Oncol. 2011; 12: 575-582. doi: 10.1016/S1470-2045(11)70097-3.
- Frasson M., Garcia-Granero E., Roda D. et al. Preoperative chemoradiation may not always be needed for patients with T3 and T2N+ rectal cancer. Cancer. 2011; 117: 3118-3125. doi: 10.1002/cncr.25866.
- Das P., Skibber J.M., Rodrigues-Biges M.A. Predictors of tumor response and downstaging in patients who receive preoperative chemoradiotherapy for rectal cancer. Cancer. 2007; 109; 1750-1755. doi: 10.1002/cncr 22625.
- Wallin U., Rothenberger D., Loury A. et al. CEA - a predictor for pathologic complete response after neoadjuvant therapy for rectal cancer. Dis. Colon Rectum. 2013; 56 (7): 859-868. doi: 10.1097/DCR.06013e 31828e5a7277.
- Rodel C., Martus P., Papadoupolos T. et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J. Clin. Oncol. 2005; 23: 8688-8696. doi: 10.1200/JCO.2005.02.1329.
- Habr Gama A., Perez R., Sabbaga J et al. Increasing the rates of complete response to neoadjuvant chemoradiotherapy for distal rectal cancer. Results of a prospective study using additional chemoradiotherapy during the resting period. Dis. Colon Rectum. 2009, 52: 1927-1934. doi: 10.1007/DCR.0b013e3181ba14ed.
- Lee S.D., Park J.W., Park K.S. et al. Influence of anaemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer. Int. J. Colorect. Dis. 2009; 24: 1451-1458. doi: 10.1007/s00384-009-0762-7.
- Dworak O., Keilholz L., Hoffmann A. Pathologic features of rectal cancer after preoperative radiochemotherapy. Int. J. Colorect. Dis. 1997; 12: 19-23. doi: 10.1007/s003840050072.
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