| Autor: |
Mendoza-Moreno, Fernando, Díez-Alonso, Manuel, Matías-García, Belén, Ovejero-Merino, Enrique, Vera-Mansilla, Cristina, Quiroga-Valcárcel, Ana, Blázquez-Martín, Alma, Jiménez-Martín, Rubén, Lasa-Unzúe, Inmaculada, Ortega, Miguel A., Alvarez-Mon, Melchor, Gutiérrez-Calvo, Alberto |
| Předmět: |
|
| Zdroj: |
Cancers; May2024, Vol. 16 Issue 10, p1797, 12p |
| Abstrakt: |
Simple Summary: The neoadjuvant treatment consisting of chemoradiotherapy has shown significant improvement in survival and recurrence rate in patients undergoing rectal cancer surgery. In recent years, different neoadjuvant regimens have been proposed as initial therapy in patients with locally advanced rectal cancer. However, the response to neoadjuvant treatment (understood as the degree of tumor regression) is not the same in all patients. The aim of our study has been to analyze the different factors (both preoperative and postoperative) that influence a better degree of tumor regression, and therefore a greater survival and disease-free interval. Introduction: Colorectal cancer is the fourth leading cause of cancer-related death in both men and women in our population. In this regard, rectal cancer accounts for more than half of colorectal cancer deaths, and its incidence is expected to increase in the coming years. There have been significant changes in neoadjuvant therapy regimens, with promising results, as demonstrated by the recent RAPIDO and PRODIGE23 studies. Around 40% of patients diagnosed with locally advanced rectal cancer show some degree of response to neoadjuvant treatment, with complete tumor regression observed in up to one in five patients. Materials and Methods: Retrospective observational study. A total of 181 patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by surgery were analyzed. Clinical and pathological data were collected from the patients, including assessment of tumor regression through histopathological studies after surgery. The Mandard tumor regression grading system was used to categorize tumor response into different grades. Results: The results showed a significant association between the degree of tumor regression and several important clinical outcomes. Specifically, patients with higher tumor regression had significantly better disease-free survival than those with less regression (p = 0.004). In addition, tumor regression was also correlated with the incidence of local recurrence (p = 0.018) and distant metastasis (p = 0.032). These associations suggest that tumor responsiveness to neoadjuvant therapy may influence the long-term progression of the disease. Regarding tumor deposits and the presence of lymphadenopathy, these factors were also found to be significantly associated with clinical outcomes. Patients with tumor deposits had a higher incidence of local recurrence (p = 0.025) and distant metastases (p = 0.041), while the presence of lymphadenopathy increased the risk of local recurrence (p = 0.013). These findings highlight the importance of evaluating not only tumor regression but also other pathological markers to predict prognosis and guide clinical management. Conclusions: The degree of tumor regression was not an independent predictor of survival compared to other variables such as nodal stage and presence of tumor deposits. This indicates that while tumor regression is an important factor, other elements also play a crucial role in determining the prognosis of patients with locally advanced rectal cancer. This study provides additional evidence for the importance of tumor regression, tumor deposits, and lymphadenopathy as predictors of clinical outcomes in patients with rectal cancer treated with neoadjuvant chemoradiotherapy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
|
Nepřihlášeným uživatelům se plný text nezobrazuje |
K zobrazení výsledku je třeba se přihlásit.
|
