دورية أكاديمية
أعرض في EDS

Poor response at restaging MRI and high incomplete resection rates of locally advanced mucinous rectal cancer after chemoradiation therapy.

التفاصيل البيبلوغرافية
العنوان: Poor response at restaging MRI and high incomplete resection rates of locally advanced mucinous rectal cancer after chemoradiation therapy.
المؤلفون: Koëter T; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., Stijns RCH; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., van Koeverden S; Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., Hugen N; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., van der Heijden JAG; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., Nederend J; Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands., van Zwam PH; Department of Pathology, PAMM Laboratory for Pathology and Medical Microbiology, Eindhoven, The Netherlands., Nagtegaal ID; Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands., Verheij M; Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands., Rutten HJT; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., de Wilt JHW; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
المصدر: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2021 Sep; Vol. 23 (9), pp. 2341-2347. Date of Electronic Publication: 2021 Jun 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 100883611 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1463-1318 (Electronic) Linking ISSN: 14628910 NLM ISO Abbreviation: Colorectal Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford, UK : Blackwell Science Ltd.,
مواضيع طبية MeSH: Neoplasm Recurrence, Local*/diagnostic imaging , Neoplasm Recurrence, Local*/therapy , Rectal Neoplasms*/diagnostic imaging , Rectal Neoplasms*/pathology , Rectal Neoplasms*/therapy, Chemoradiotherapy ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Neoplasm Staging ; Retrospective Studies ; Treatment Outcome
مستخلص: Aim: Mucinous carcinoma is a histological subtype of rectal cancer and has been associated with a poor response to neoadjuvant chemoradiotherapy (CRT). The primary aim of this study was to analyse the response on MRI of mucinous locally advanced rectal cancer (LARC) after CRT compared to regular adenocarcinoma.
Method: Patients with LARC (defined as cT4 and/or cN2), who underwent CRT followed by restaging MRI and surgery in two tertiary referral hospitals were retrospectively included in the study. Pre- and post-treatment MRI was reviewed by an experienced abdominal radiologist.
Results: A total of 102 patients, of whom 29 were diagnosed with mucinous carcinoma, were included for analysis. At restaging MRI, adenocarcinoma patients demonstrated significantly less clinical involvement of the mesorectal fascia (37% vs. 62%, P = 0.003) while this was not demonstrated in mucinous carcinoma patients (86% vs. 97%, P = 0.16). Significant downstaging after CRT in adenocarcinoma patients (P = 0.01) was seen while, in mucinous carcinoma patients, no downstaging after CRT (P = 0.89) was seen. Pathology revealed significantly higher rates of an involved circumferential resection margin in mucinous carcinoma versus adenocarcinoma patients (27.6% vs. 1.4%; P < 0.001). After multivariate regression analysis, mucinous carcinoma remained an independent prognostic factor for local recurrence (hazard ratio 3.6; 95% CI 1.1-12.4), although no differences in overall or disease-free survival were observed.
Conclusion: Mucinous rectal carcinoma is associated with a poor clinical response at restaging MRI after CRT, leading to relatively higher rates of involved circumferential resection margins at pathology. In this cohort, mucinous carcinoma seems to be a prognostic factor for increased risk of local recurrence, without an effect on overall survival.
(© 2021 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
التعليقات: Comment in: Colorectal Dis. 2021 Sep;23(9):2473-2474. (PMID: 34157211)
Comment in: Colorectal Dis. 2021 Oct;23(10):2774-2775. (PMID: 34273221)
Comment in: Colorectal Dis. 2021 Oct;23(10):2775-2776. (PMID: 34273235)
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فهرسة مساهمة: Keywords: MRI; chemoradiotherapy; locally advanced; mucinous rectal cancer; neoadjuvant treatment; rectal cancer; response evaluation
تواريخ الأحداث: Date Created: 20210529 Date Completed: 20211004 Latest Revision: 20211027
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC8519080
DOI: 10.1111/codi.15760
PMID: 34051043
قاعدة البيانات: MEDLINE
الوصف
تدمد:1463-1318
DOI:10.1111/codi.15760