LinkedIn

 آمار

تعداد نشریات20
تعداد شماره‌ها1,149
تعداد مقالات10,518
تعداد مشاهده مقاله45,415,575
تعداد دریافت فایل اصل مقاله11,291,394
Lyra Junior, Humberto, Minatti, Luiz Henrique, de Oliveira, João Carlos, Gerber, Marlus, de Novaes Gerber, Flavia, Vieira, Daniella, dos Santos, José Mauro. (1399). Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years. سامانه مدیریت نشریات علمی, 8(3), 141-147. doi: 10.30476/acrr.2020.87993.1063
Humberto Fenner Lyra Junior; Luiz Henrique Minatti; João Carlos Costa de Oliveira; Marlus Tavares Gerber; Flavia Cristina de Novaes Gerber; Daniella Serafin Couto Vieira; José Mauro dos Santos. "Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years". سامانه مدیریت نشریات علمی, 8, 3, 1399, 141-147. doi: 10.30476/acrr.2020.87993.1063
Lyra Junior, Humberto, Minatti, Luiz Henrique, de Oliveira, João Carlos, Gerber, Marlus, de Novaes Gerber, Flavia, Vieira, Daniella, dos Santos, José Mauro. (1399). 'Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years', سامانه مدیریت نشریات علمی, 8(3), pp. 141-147. doi: 10.30476/acrr.2020.87993.1063
Lyra Junior, Humberto, Minatti, Luiz Henrique, de Oliveira, João Carlos, Gerber, Marlus, de Novaes Gerber, Flavia, Vieira, Daniella, dos Santos, José Mauro. Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years. سامانه مدیریت نشریات علمی, 1399; 8(3): 141-147. doi: 10.30476/acrr.2020.87993.1063

Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years

Iranian Journal of Colorectal Research
دوره 8، شماره 3، آذر 2020، صفحه 141-147    اصل مقاله (619.03 K)
نوع مقاله: Research/Original Article
شناسه دیجیتال (DOI): 10.30476/acrr.2020.87993.1063
نویسندگان
Humberto Fenner Lyra Junior* 1؛ Luiz Henrique Minatti2؛ João Carlos Costa de Oliveira1؛ Marlus Tavares Gerber3؛ Flavia Cristina de Novaes Gerber4؛ Daniella Serafin Couto Vieira5؛ José Mauro dos Santos1
1Department of Surgery, Colon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, Brazil
2Graduate student, Medicine Course, Federal University of Santa Catarina, Florianopolis-SC, Brazil
3Colon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, Brazil
4Pathologist of Universitary Hospital of Federal University of Santa Catarina
5Department of Pathology of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, Brazil
چکیده
Background: With the advances of neoadjuvant chemoradiotherapy, the identification of complete tumor responses, and the reduction of local recurrence even with the adoption of expectant approaches aimed at sphincter preservation, several authors have published results analyzing these aspects with conflicting results, which require further investigation.
Objectives: This study aims to evaluate the anatomopathological changes in surgical specimens of rectal resection due to adenocarcinoma in patients undergoing neoadjuvant therapy, including the complete response rate, in addition to estimating the sensitivity and specificity indexes of the imaging methods used in the preoperative period.
Methods: This was an observational, retrospective, cross-sectional study in which 44 medical records of patients with cancer of the middle and lower rectum who underwent neoadjuvant chemoradiotherapy and subsequently underwent oncological surgical resections over 10 years were studied. Demographic data, CT scans, colonoscopies, anatomopathological reports and surgical reports were analyzed.
Results: Abdominoperineal resection of the rectum (APR) was performed in 16 cases (36.4%), and abdominal rectosigmoidectomy (AR) was performed in 28 cases (63.6%). Preoperative computerized tomography (CT) showed a sensitivity of 75% and specificity of 77.8% for the detection of lymph node metastases. The complete pathological response to neoadjuvant chemoradiotherapy was found in 11.36% of cases. The local recurrence was detected in 23.9% cases and distant metastasis in 15.2% of the patients on the follow-up period, additionally, there was a 77.7% 5-years disease-free survival and the overall survival was 73.9%.
Conclusions: The rate of complete pathological response to neoadjuvant therapy was 11.36%. Locally advanced disease and angiolymphatic embolization were associated with a higher frequency of lymph node involvement. CT obtained high rates of sensitivity and specificity for comparison with anatomopathological results.
کلیدواژه‌ها
Colorectal neoplasms؛ neoadjuvant therapy؛ rectal neoplasms؛ organ preservation
مراجع

1.            Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86.

2.            Brenner H, Altenhofen L, Hoffmeister M. Sex, age, and birth cohort effects in colorectal neoplasms: a cohort analysis. Ann Intern Med. 2010;152(11):697-703.

3.            Balch GC, De Meo A, Guillem JG. Modern management of rectal cancer: a 2006 update. World J Gastroenterol. 2006;12(20):3186-95.

4.            Toiyama Y, Kusunoki M. Changes in surgical therapies for rectal cancer over the past 100 years: A review. Ann Gastroenterol Surg. 2020;4(4):331-42.

5.            Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery--the clue to pelvic recurrence? Br J Surg. 1982;69(10):613-6.

6.            Swanson RS, Compton CC, Stewart AK, Bland KI. The prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined. Ann Surg Oncol. 2003;10(1):65-71.

7.            Kelder W, Inberg B, Schaapveld M, Karrenbeld A, Grond J, Wiggers T, et al. Impact of the number of histologically examined lymph nodes on prognosis in colon cancer: a population-based study in the Netherlands. Dis Colon Rectum. 2009;52(2):260-7.

8.            Scott N, Jackson P, al-Jaberi T, Dixon MF, Quirke P, Finan PJ. Total mesorectal excision and local recurrence: a study of tumour spread in the mesorectum distal to rectal cancer. Br J Surg. 1995;82(8):1031-3.

9.            Knol JJ, D'Hondt M, Souverijns G, Heald B, Vangertruyden G. Transanal endoscopic total mesorectal excision: technical aspects of approaching the mesorectal plane from below--a preliminary report. Tech Coloproctol. 2015;19(4):221-9.

10.          Calmels M, Collard MK, Cazelles A, Frontali A, Maggiori L, Panis Y. Local excision after neoadjuvant chemoradiotherapy versus total mesorectal excision: A case-matched study in 110 selected high-risk patients with rectal cancer. Colorectal Dis. 2020.

11.          Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351(17):1731-40.

12.          Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;30(16):1926-33.

13.          Roh MS, Colangelo LH, O'Connell MJ, Yothers G, Deutsch M, Allegra CJ, et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol. 2009;27(31):5124-30.

14.          van Gijn W, Marijnen CA, Nagtegaal ID, Kranenbarg EM, Putter H, Wiggers T, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12(6):575-82.

15.          Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, et al. Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Histopathology. 2005;47(2):141-6.

16.          Wiltshire KL, Ward IG, Swallow C, Oza AM, Cummings B, Pond GR, et al. Preoperative radiation with concurrent chemotherapy for resectable rectal cancer: effect of dose escalation on pathologic complete response, local recurrence-free survival, disease-free survival, and overall survival. Int J Radiat Oncol Biol Phys. 2006;64(3):709-16.

17.          Appelt AL, Ploen J, Vogelius IR, Bentzen SM, Jakobsen A. Radiation dose-response model for locally advanced rectal cancer after preoperative chemoradiation therapy. Int J Radiat Oncol Biol Phys. 2013;85(1):74-80.

18.          Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U, Jr., Silva e Sousa AH, Jr., et al. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg. 2004;240(4):711-7; discussion 7-8.

19.          Maas M, Beets-Tan RG, Lambregts DM, Lammering G, Nelemans PJ, Engelen SM, et al. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol. 2011;29(35):4633-40.

20.          Dalton RS, Velineni R, Osborne ME, Thomas R, Harries S, Gee AS, et al. A single-centre experience of chemoradiotherapy for rectal cancer: is there potential for nonoperative management? Colorectal Dis. 2012;14(5):567-71.

21.          Habr-Gama A, Perez RO, Sabbaga J, Nadalin W, Sao Juliao GP, Gama-Rodrigues J. Increasing the rates of complete response to neoadjuvant chemoradiotherapy for distal rectal cancer: results of a prospective study using additional chemotherapy during the resting period. Dis Colon Rectum. 2009;52(12):1927-34.

22.          Habr-Gama A, Sao Juliao GP, Fernandez LM, Vailati BB, Andrade A, Araujo SEA, et al. Achieving a Complete Clinical Response After Neoadjuvant Chemoradiation That Does Not Require Surgical Resection: It May Take Longer Than You Think! Dis Colon Rectum. 2019;62(7):802-8.

23.          Maas M, Nelemans PJ, Valentini V, Das P, Rodel C, Kuo LJ, et al. Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. Lancet Oncol. 2010;11(9):835-44.

24.          Mukkai Krishnamurty D, Wise PE. Importance of surgical margins in rectal cancer. J Surg Oncol. 2016;113(3):323-32.

25.          van der Paardt MP, Zagers MB, Beets-Tan RG, Stoker J, Bipat S. Patients who undergo preoperative chemoradiotherapy for locally advanced rectal cancer restaged by using diagnostic MR imaging: a systematic review and meta-analysis. Radiology. 2013;269(1):101-12.

26.          Mancini R, Pattaro G, Diodoro MG, Sperduti I, Garufi C, Stigliano V, et al. Tumor Regression Grade After Neoadjuvant Chemoradiation and Surgery for Low Rectal Cancer Evaluated by Multiple Correspondence Analysis: Ten Years as Minimum Follow-up. Clin Colorectal Cancer. 2018;17(1):e13-e9.

27.          Park IJ, You YN, Skibber JM, Rodriguez-Bigas MA, Feig B, Nguyen S, et al. Comparative analysis of lymph node metastases in patients with ypT0-2 rectal cancers after neoadjuvant chemoradiotherapy. Dis Colon Rectum. 2013;56(2):135-41.

آمار
تعداد مشاهده مقاله: 377
تعداد دریافت فایل اصل مقاله: 228


سامانه مدیریت نشریات علمی. قدرت گرفته از سیناوب