Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

A Phase II Study of Preoperative Chemoradiotherapy with Capecitabine Plus Simvastatin in Patients with Locally Advanced Rectal Cancer: Hyunji Jo, Seung Tae Kim, Jeeyun Lee, Se Hoon Park, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Jeong Il Yu, Hee Chul Park, Doo Ho Choi, Yoonah Park, Yong Beom Cho, Jung Wook Huh, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Won Ki Kang; Cancer Res Treat. 2023;55(1):189-195. Published online June 8, 2022; DOI: https://doi.org/10.4143/crt.2021.1527

Purpose
The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC).
Materials and Methods
Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity.
Results
Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin.
Conclusion
The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

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Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy for locally advanced rectal cancer: an updated meta-analysis
Yue Guo, Zhifeng Guo, Jiaojiao Zhang, Guowu Qian, Wangquan Ji, Linlin Song, Zhe Guo, Zhuo Han
BMC Gastroenterology.2025;[Epub] CrossRef
A randomized phase II/III trial of rosuvastatin with neoadjuvant chemo-radiation in patients with locally advanced rectal cancer
Prachi S. Patil, Avanish Saklani, Naveena A. N. Kumar, Ashwin De’Souza, Rahul Krishnatry, Snehal Khanvilkar, Mufaddal Kazi, Reena Engineer, Vikas Ostwal, Anant Ramaswamy, Munita Bal, Priya Ranganathan, Ekta Gupta, Sanjeev Galande
Frontiers in Oncology.2025;[Epub] CrossRef
Effects of Hyperlipidemia on Osseointegration of Dental Implants and Its Strategies
Haiyang Sun, Shuhuai Meng, Junyu Chen, Qianbing Wan
Journal of Functional Biomaterials.2023; 14(4): 194. CrossRef

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Lung and Thoracic cancer

Predictive Value of Interstitial Lung Abnormalities for Postoperative Pulmonary Complications in Elderly Patients with Early-stage Lung Cancer: Won Gi Jeong, Yun-Hyeon Kim, Jong Eun Lee, In-Jae Oh, Sang Yun Song, Kum Ju Chae, Hye Mi Park; Cancer Res Treat. 2022;54(3):744-752. Published online September 28, 2021; DOI: https://doi.org/10.4143/crt.2021.772

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Purpose
Identifying pretreatment interstitial lung abnormalities (ILAs) is important because of their predictive value for complications after lung cancer treatment. This study aimed to assess the predictive value of ILAs for postoperative pulmonary complications (PPCs) in elderly patients undergoing curative resection for early-stage non-small cell lung cancer (NSCLC).
Materials and Methods
Elderly patients (age ≥ 70 years) who underwent curative resection for pathologic stage I or II NSCLC with normal preoperative spirometry results (pre-bronchodilator forced expiratory volume in 1 s to forced vital capacity [FVC] ratio > 0.70 and FVC ≥ 80% of the predicted value) between January 2012 and December 2019 were retrospectively identified. Univariable and multivariable regression analyses were performed to assess risk factors for PPCs. The Kaplan–Meier method and log-rank test were used to analyze the relationship between ILAs and postoperative mortality. One-way analysis of variance was performed to assess the correlation between ILAs and hospital stay duration.
Results
A total of 262 patients (median age, 73 [interquartile range, 71–76] years; 132 male) were evaluated. A multivariable logistic regression model revealed that, among several relevant risk factors, fibrotic ILAs independently predicted both overall PPCs (adjusted odds ratio [OR], 4.84; 95% confidence interval [CI], 1.35–17.38; p=0.016) and major PPCs (adjusted OR, 8.72; 95% CI, 1.71–44.38; p=0.009). Fibrotic ILAs were significantly associated with higher postoperative mortality and longer hospital stay (F=5.21, p=0.006).
Conclusion
Pretreatment fibrotic ILAs are associated with PPCs, higher postoperative mortality, and longer hospital stay.

Citations

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Prevalence and prognostic significance of interstitial lung abnormalities in lung cancer: A meta-analysis
Ruiyuan Yang, Haoyu Wang, Dan Liu, Weimin Li
Lung Cancer.2025; : 108458. CrossRef
Pretreatment Interstitial Lung Abnormalities Detected on Abdominal Computed Tomography Scans in Prostate Cancer Patients
Hyun Jin Kim, Won Gi Jeong, Jeong Yeop Lee, Hyo-Jae Lee, Byung Chan Lee, Hyo Soon Lim, Yun-Hyeon Kim
Journal of Computer Assisted Tomography.2024; 48(3): 406. CrossRef
Interstitial Lung Abnormalities
Noriaki Wada, Gary M. Hunninghake, Hiroto Hatabu
Clinics in Chest Medicine.2024; 45(2): 433. CrossRef
Incidence and risk factors of pulmonary complications after lung cancer surgery: A systematic review and meta-analysis
Ting Deng, Jiamei Song, Jinmei Tuo, Yu Wang, Jin Li, Lorna Kwai Ping Suen, Yan Liang, Junliang Ma, Shaolin Chen
Heliyon.2024; 10(12): e32821. CrossRef
Survival impact of fibrotic interstitial lung abnormalities in resected stage IA non-small cell lung cancer
Won Gi Jeong, Yun-Hyeon Kim
The British Journal of Radiology.2023;[Epub] CrossRef
Radiologic Progression of Interstitial Lung Abnormalities following Surgical Resection in Patients with Lung Cancer
Yoon Joo Shin, Jeong Geun Yi, Mi Young Kim, Donghee Son, Su Yeon Ahn
Journal of Clinical Medicine.2023; 12(21): 6858. CrossRef
Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
Pengfei Wang, Li Zhang, Qian Guo, Lifen Zhao, Yanyan Hao
Open Medicine.2023;[Epub] CrossRef
Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer
Seong Woo Cho, Won Gi Jeong, Jong Eun Lee, In‐Jae Oh, Sang Yun Song, Hye Mi Park, Hyo‐Jae Lee, Yun‐Hyeon Kim
Thoracic Cancer.2022; 13(7): 977. CrossRef

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Gastrointestinal Cancer

Effect of Preoperative Tumor Under-Staging on the Long-term Survival of Patients Undergoing Radical Gastrectomy for Gastric Cancer: Mi Lin, Qi-Yue Chen, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Chang-Ming Huang; Cancer Res Treat. 2021;53(4):1123-1133. Published online March 5, 2021; DOI: https://doi.org/10.4143/crt.2020.651

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to evaluate the effect of preoperative tumor staging deviation (PTSD) on the long-term survival of patients undergoing radical gastrectomy for gastric cancer (RGGC).
Materials and Methods
Clinicopathological data of 2,346 patients who underwent RGGC were retrospectively analyzed. The preoperative tumor-lymph node-metastasis (TNM) under-staging group (uTNM) comprised patients who had earlier preoperative TNM than postoperative TNM, and the no preoperative under-staging group (nTNM) comprised the remaining patients.
Results
There were 1,031 uTNM (44.0%) and 1,315 nTNM cases (56.0%). Cox prognostic analysis revealed that PTSD independently affected the overall survival (OS) after surgery. The 5-year OS was lower in the uTNM group (41.8%) than in the nTNM group (71.6%). The patients less than 65 years old, with lower American Society of Anaesthesiologists score, 2-5 cm tumor located at the lower stomach, and cT1 or cN0 preoperative staging would more likely undergo D1+ lymph node dissection (LND) in uTNM (p < 0.05). Logistic analyses revealed that tumor size > 2 cm and body mass index ≤ 22.72 kg/m2 were independent risk factors of preoperative TNM tumor under-staging in patients with cT1N0M0 staging (p < 0.05).
Conclusion
Underestimated tumor staging is not rare, which possibly results in inadequate LND and affects the long-term survival for patients undergoing RGGC. D2 LND should be carefully performed in patients who are predisposed to this underestimation.

Citations

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Preoperative prediction of gastric cancer T-staging based on ordinal regression models
O. V. Krasko, M. Yu. Reutovich, A. L. Patseika
Informatics.2024; 21(2): 36. CrossRef
rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy
Yong Wang, Chen Fang, Renfang Chen, Shangkun Yuan, Lin Chen, Xiaotong Qiu, Xiaoying Qian, Xinwei Zhang, Zhehao Xiao, Qian Wang, Biqi Fu, Xiaoling Song, Yong Li
BMC Cancer.2022;[Epub] CrossRef
Factors of Organizing Surgical Treatment of Upper Gastrointestinal Cancers and Patient Survival: Real-World Data
D. A. Andreev, A. A. Zavyalov
Russian Journal of Gastroenterology, Hepatology, Coloproctology.2022; 32(6): 20. CrossRef

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Patterns of Rectal Cancer Radiotherapy Adopting Evidence-Based Medicine: An Analysis of the National Database from 2005 to 2016: Hae Jin Park, Sanghyun Cho, Yoon Kim; Cancer Res Treat. 2018;50(3):975-983. Published online October 27, 2017; DOI: https://doi.org/10.4143/crt.2017.459

Abstract PDF PubReader ePub

Purpose
Not many studies have evaluated the adoption and dissemination of evidence-based medicine in rectal cancer radiotherapy (RT). We aimed to analyze the differences by institutional characteristics and geography in adopting evidence-based care for rectal cancer RT and factors affecting the adoption in Korea.
Materials and Methods
Korean National Health Insurance Service claims database was used. All rectal cancer patients treated with radical surgery and adjuvant RT at the same institution in 2005-2016 were included in this study. RT within 3 months before and after surgery was regarded as preoperative and postoperative RT, respectively.
Results
A total of 16,827 patients treated in 83 institutions were included in the analysis. The use of preoperative RT has substantially increased over time, from 40.6% in 2005 to 84.2% in 2016 all over the nation. The proportion of preoperative RT (54.8%) exceeded that of postoperative RT (45.2%) in 2006. However, a wide range of institutional and regional variation was observed. Compared to high-volume institutions, low-volume institutions showed late adoption and variable dissemination patterns of preoperative RT. Busan–Ulsan–Gyeongsangnam-do and Gangwon-do showed slower adoption and less use of preoperative RT than other region.
Conclusion
We demonstrated gradual and steady increase in adoption of preoperative RT in rectal cancer treatment nationally from 2005 to 2016. Institutional variations between high- and low-volume institutions were observed.

Citations

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Postoperative hypofractionated–accelerated radiotherapy (HypoAR) for locally advanced rectal cancer
Michael I Koukourakis, Christos Kavazis, Axiotis Giagtzidis, Panagiotis Mamalis, Alexandra Tsaroucha, Sotirios Botaitis, Alexandra Giatromanolaki, Michael Pitiakoudis
Japanese Journal of Clinical Oncology.2022; 52(5): 493. CrossRef
Association of neutrophil-to-lymphocyte ratio, radiotherapy fractionation/technique, and risk of development of distant metastasis among patients with locally advanced rectal cancer
Gowoon Yang, Jee Suk Chang, Jeong Eun Choi, Eun Sil Baek, Seung-Seob Kim, Hwa Kyung Byun, Yeona Cho, Woong Sub Koom, Seung Yoon Yang, Byung Soh Min, Sang Joon Shin
Radiation Oncology.2022;[Epub] CrossRef
Lymph node regression grading of locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy
Lei He, Juan Xiao, Ping Zheng, Lei Zhong, Qian Peng
World Journal of Gastrointestinal Oncology.2022; 14(8): 1429. CrossRef
The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer
Giovanni Li Destri, Andrea Maugeri, Alice Ramistella, Gaetano La Greca, Pietro Conti, Giovanni Trombatore, Giada Maria Vecchio, Gaetano Giuseppe Magro, Martina Barchitta, Antonella Agodi
Updates in Surgery.2020; 72(3): 793. CrossRef
CCR6 Is a Predicting Biomarker of Radiosensitivity and Potential Target of Radiosensitization in Rectal Cancer
Hui Chang, Jia-wang Wei, Ya-lan Tao, Pei-rong Ding, Yun-fei Xia, Yuan-hong Gao, Wei-wei Xiao
Cancer Research and Treatment.2018; 50(4): 1203. CrossRef

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Clinical Outcomes of Local Excision Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer: Nam Kwon Lee, Dae Yong Kim, Sun Young Kim, Jae Hwan Oh, Won Park, Doo Ho Choi, Taek-Keun Nam, Kyung-Ja Lee; Cancer Res Treat. 2014;46(2):158-164. Published online April 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.2.158

Abstract PDF PubReader ePub

Purpose

To evaluate the treatment outcomes of local excision following preoperative chemoradiotherapy in patients with locally advanced rectal cancer who have not undergone radical surgery for any reason.

Materials and Methods

The data of 27 patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondary endpoint was the pattern of recurrence.

Results

The median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and 85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patient had local recurrence only, three (11%) patients had distant recurrence only, and two (7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients with ypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6% (p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively.

Conclusion

Local excision following preoperative chemoradiotherapy may be an alternative treatment for highly selected patients with locally advanced rectal cancer who have achieved ypT0-1 after preoperative chemoradiotherapy.

Citations

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Organ‐saving surgery for rectal cancer after neoadjuvant chemoradiation: Analysis of failures and long‐term results
Maurizio Cosimelli, Pietro Ursi, Raffaello Mancini, Giada Pattaro, Pasquale Perri, Chiara Parrino, Valerio De Peppo, Maria Grazia Diodoro, Andrea Balla, Gian Luca Grazi
Journal of Surgical Oncology.2020; 121(2): 375. CrossRef
Local excision for ypT2 rectal cancer following preoperative chemoradiation therapy: it should not be justified
Kwan Mo Yang, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim
International Journal of Colorectal Disease.2018; 33(4): 487. CrossRef
Are We Predicting Disease Progress of the Rectal Cancer Patients without Surgery after Neoadjuvant Chemoradiotherapy?
Bo Young Oh, Jung Wook Huh, Woo Yong Lee, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun
Cancer Research and Treatment.2018; 50(3): 634. CrossRef
Total Mesorectal Excision Versus Local Excision After Favorable Response to Preoperative Chemoradiotherapy in “Early” Clinical T3 Rectal Cancer: A Propensity Score Analysis
Young Seob Shin, Chang Sik Yu, Jin-hong Park, Jin Cheon Kim, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Kyu-pyo Kim, Sang Min Yoon, Ji Hyeon Joo, Jong Hoon Kim
International Journal of Radiation Oncology*Biology*Physics.2017; 99(1): 136. CrossRef
Controversial issues in radiotherapy for rectal cancer: a systematic review
Jong Hoon Kim
Radiation Oncology Journal.2017; 35(4): 295. CrossRef
Local excision of low rectal cancer treated by chemoradiotherapy: is it safe for all patients with suspicion of complete tumor response?
Clotilde Debove, Nathalie Guedj, Ecoline Tribillon, Léon Maggiori, Magaly Zappa, Yves Panis
International Journal of Colorectal Disease.2016; 31(4): 853. CrossRef
Seven low-mass ions in pretreatment serum as potential predictive markers of the chemoradiotherapy response of rectal cancer
Kangsan Roh, Seung-Gu Yeo, Byong Chul Yoo, Kyung-Hee Kim, Sun Young Kim, Min-Jeong Kim
Anti-Cancer Drugs.2016; 27(8): 787. CrossRef
A Systematic Review of Local Excision After Neoadjuvant Therapy for Rectal Cancer: Are ypT0 Tumors the Limit?
Sally Hallam, David E. Messenger, Michael G. Thomas
Diseases of the Colon & Rectum.2016; 59(10): 984. CrossRef
Definitive high-dose radiotherapy with concurrent chemotherapy for locally advanced rectal cancer
Min-Jeong Kim, Eun Seok Kim, Seung-Gu Yeo
Medicine.2016; 95(40): e5059. CrossRef
Association of pretreatment serum carcinoembryonic antigen levels with chemoradiation-induced downstaging and downsizing of rectal cancer
SEUNG-GU YEO
Molecular and Clinical Oncology.2016; 4(4): 631. CrossRef
The Role of Fibrinogen as a Predictor in Preoperative Chemoradiation for Rectal Cancer
Jong Hoon Lee, Jong Hee Hyun, Dae Yong Kim, Byong Chul Yoo, Ji Won Park, Sun Young Kim, Hee Jin Chang, Byung Chang Kim, Tae Hyun Kim, Jae Hwan Oh, Dae Kyung Sohn
Annals of Surgical Oncology.2015; 22(1): 209. CrossRef
Oncologic Outcomes according to the Treatment Strategy in Radiologic Complete Responders after Neoadjuvant Chemoradiation for Rectal Cancer
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
Oncology.2015; 89(6): 311. CrossRef

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Preoperative Concurrent Chemoradiotherapy for Locally Advanced Rectal Cancer: Treatment Outcomes and Analysis of Prognostic Factors: Moonkyoo Kong, Seong Eon Hong, Woo Suk Choi, Si-Young Kim, Jinhyun Choi; Cancer Res Treat. 2012;44(2):104-112. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.104

Abstract PDF PubReader ePub

PURPOSE
This study was designed to investigate the long-term oncologic outcomes for locally advanced rectal cancer patients after treatment with preoperative concurrent chemoradiotherapy followed by total mesorectal excision, and to identify prognostic factors that affect survival and pathologic response.
MATERIALS AND METHODS
From June 1996 to June 2009, 135 patients with locally advanced rectal cancer were treated with preoperative concurrent chemoradiotherapy followed by total mesorectal excision at Kyung Hee University Hospital. Patient data was retrospectively collected and analyzed in order to determine the treatment outcomes and identify prognostic factors for survival.
RESULTS
The median follow-up time was 50 months (range, 4.5 to 157.8 months). After preoperative chemoradiotherapy, sphincter preservation surgery was accomplished in 67.4% of whole patients. A complete pathologic response was achieved in 16% of patients. The estimated 5- and 8-year overall survival, loco-regional recurrence-free survival, and distant metastasis-free survival rate for all patients was 82.7% and 75.7%, 76.8% and 71.9%, 67.9% and 63.3%, respectively. The estimated 5- and 8-year overall survival, loco-regional recurrence-free survival, and distant metastasis-free survival rate for pathologic complete responders was 100% and 100%, 100% and 88.9%, 95.5% and 95.5%, respectively. In the multivariate analysis, pathologic complete response was significantly associated with overall survival. The predictive factor for pathologic complete response was pretreatment clinical stage.
CONCLUSION
Preoperative chemoradiotherapy for locally advanced rectal cancer resulted in a high rate of overall survival, sphincter preservation, down-staging, and pathologic complete response. The patients achieving pathologic complete response had very favorable outcomes. Pathologic complete response was a significant prognostic factor for overall survival and the significant predictive factor for a pathologic complete response was pretreatment clinical stage.

Citations

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Analysis of clinical and pathological prognostic factors of survival in rectal adenocarcinoma treated with preoperative radiochemotherapy
Sarhan Sydney Saad, Nora Forones, Gaspar Lopes Filho, Jaques Waisberg, Elesiario Caetano Júnior, Ricardo Artigiani-Neto, Delcio Matos
Acta Cirúrgica Brasileira.2025;[Epub] CrossRef
The optimal time interval between neoadjuvant chemoradiotherapy and surgery for patients with an unfavorable pathological response in locally advanced rectal cancer: a retrospective cohort study
Litao Wang, Jianyong Fan, Yaqi Guo, Shipeng Shang, Han Gao, Jianfei Xu, Peng Gao, Enrui Liu
Frontiers in Oncology.2025;[Epub] CrossRef
Characteristics of Patients Presented With Metastases During or After Completion of Chemoradiation Therapy for Locally Advanced Rectal Cancer: A Case Series
Radwan Torky, Mohammed Alessa, Ho Seung Kim, Ahmed Sakr, Eman Zakarneh, Fozan Sauri, Heejin Bae, Nam Kyu Kim
Annals of Coloproctology.2021; 37(3): 186. CrossRef
A prospective analysis of the diagnostic accuracy of 3 T MRI, CT and endoscopic ultrasound for preoperative T staging of potentially resectable esophageal cancer
Jia Guo, Zhaoqi Wang, Jianjun Qin, Hongkai Zhang, Wentao Liu, Yan Zhao, Yanan Lu, Xu Yan, Zhongxian Zhang, Ting Zhang, Shouning Zhang, Nickel Marcel Dominik, Ihab R. Kamel, Hailiang Li, Jinrong Qu
Cancer Imaging.2020;[Epub] CrossRef
Sustaining Blood Lymphocyte Count during Preoperative Chemoradiotherapy as a Predictive Marker for Pathologic Complete Response in Locally Advanced Rectal Cancer
Jaesung Heo, Mison Chun, O Kyu Noh, Young-Taek Oh, Kwang Wook Suh, Jun Eun Park, Oyeon Cho
Cancer Research and Treatment.2016; 48(1): 232. CrossRef
Differential effects of patient-related factors on the outcome of radiation therapy for rectal cancer
Ikuko Kato, Gregory Dyson, Michael Snyder, Hyeong-Reh Kim, Richard K. Severson
Journal of Radiation Oncology.2016; 5(3): 279. CrossRef
JOURNAL CLUB: Preoperative MRI Evaluation of Primary Rectal Cancer: Intrasubject Comparison With and Without Rectal Distention
Feng Ye, Hongmei Zhang, Xiao Liang, Han Ouyang, Xinming Zhao, Chunwu Zhou
American Journal of Roentgenology.2016; 207(1): 32. CrossRef
Utility of high resolution MRI for pre-operative staging of rectal carcinoma, involvement of the mesorectal fascia and circumferential resection margin
Tamir A. Hassan, Hossam M. Abdel-Rahman, Hala Yehia Ali
The Egyptian Journal of Radiology and Nuclear Medicine.2016; 47(4): 1243. CrossRef
Severe weight loss during preoperative chemoradiotherapy compromises survival outcome for patients with locally advanced rectal cancer
Junzhong Lin, Jianhong Peng, Aiham Qdaisat, Liren Li, Gong Chen, Zhenhai Lu, Xiaojun Wu, Yuanhong Gao, Zhifan Zeng, Peirong Ding, Zhizhong Pan
Journal of Cancer Research and Clinical Oncology.2016; 142(12): 2551. CrossRef
Complete radiotherapy response in rectal cancer: A review of the evidence
Daniel G Couch
World Journal of Gastroenterology.2016; 22(2): 467. CrossRef
The Value of High-Resolution MRI Technique in Patients with Rectal Carcinoma: Pre-Operative Assessment of Mesorectal Fascia Involvement, Circumferential Resection Margin and Local Staging
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Polish Journal of Radiology.2015; 80: 115. CrossRef
Is complete mesocolic excision with central vascular ligation safe and effective in the surgical treatment of right-sided colon cancers? A prospective study
Gennaro Galizia, Eva Lieto, Ferdinando De Vita, Francesca Ferraraccio, Anna Zamboli, Andrea Mabilia, Annamaria Auricchio, Paolo Castellano, Vincenzo Napolitano, Michele Orditura
International Journal of Colorectal Disease.2014; 29(1): 89. CrossRef
Accuracy of High-Resolution MRI with Lumen Distention in Rectal Cancer Staging and Circumferential Margin Involvement Prediction
Elsa Iannicelli, Sara Di Renzo, Mario Ferri, Emanuela Pilozzi, Marco Di Girolamo, Alessandra Sapori, Vincenzo Ziparo, Vincenzo David
Korean Journal of Radiology.2014; 15(1): 37. CrossRef
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European Journal of Cancer.2014; 50(1): 1.e1. CrossRef
Eine intensivierte Chemotherapie erhöht die Effektivität nicht, oder doch?
Gunther Klautke
Info Onkologie.2014; 17(6): 17. CrossRef
Sphincter preservation in distal CT2N0 rectal cancer after preoperative chemoradiotherapy
Nir Wasserberg, Yulia Kundel, Ofer Purim, Andrei Keidar, Hanoch Kashtan, Eran Sadot, Eyal Fenig, Baruch Brenner
Radiation Oncology.2014;[Epub] CrossRef
Metformin use and improved response to therapy in rectal cancer
Heath D. Skinner, Christopher H. Crane, Christopher R. Garrett, Cathy Eng, George J. Chang, John M. Skibber, Miguel A. Rodriguez‐Bigas, Patrick Kelly, Vlad C. Sandulache, Marc E. Delclos, Sunil Krishnan, Prajnan Das
Cancer Medicine.2013; 2(1): 99. CrossRef

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Prognostic Significance of Serum and Tissue Carcinoembryonic Antigen in Patients with Gastric Adenocarcinomas: Seong-Hoon Park, Ki-Beom Ku, Ho-Young Chung, Wansik Yu; Cancer Res Treat. 2008;40(1):16-21. Published online March 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.1.16

Abstract PDF PubReader ePub

Purpose

Carcinoembryonic antigen (CEA) is known to be elevated in nearly all solid malignancies. The prognostic role of CEA in gastric cancers however, is still controversial. We evaluated preoperative serum CEA levels and CEA expression from the resected tumor tissues to determine whether they have prognostic significance in gastric cancer patients.

Materials and Methods

Medical records of 810 patients who underwent surgery for gastric adenocarcinoma from June, 1998 to February, 2002 in Kyungpook National University Hospital were reviewed. Serum CEA level was evaluated by radioimmunoassay preoperatively, and the cut-off level for positivity was 7.0 ng/ml. Labeled streptavidin-biotin peroxidase method was used to determine CEA expression from the gastric cancer tissues.

Results

Serum and tissue CEA were positive in 9.3% and 91.1% of the patients, respectively. They had no correlation with each other. The positivity rate of serum CEA had positive correlation with invasion depth (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.006), and final stage (p<0.001). Well differentiated tumors showed higher serum CEA positivity (p=0.002). Patients with positive serum CEA had higher recurrence rate (p<0.001). Multivariate analysis showed significantly lower survival rate in patients with preoperative CEA levels over 7 ng/ml than those with lower levels (48.0% vs. 80.7%; p<0.001). The positivity rates of tissue CEA were higher in advanced cancers (p=0.033) and in more advanced stages (p=0.029). Tissue CEA positivity showed no correlation with recurrence or survival.

Conclusions

Preoperative serum CEA level had correlation with disease progression and survival in gastric cancer patients, and proved to be an independent prognostic factor. Tissue CEA expression in gastric cancers had no prognostic information.

Citations

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In Pursuit of Novel Markers: Unraveling the Potential of miR-106, CEA and CA 19-9 in Gastric Adenocarcinoma Diagnosis and Staging
Adrian Boicean, Ioana Boeras, Sabrina Birsan, Cristian Ichim, Samuel Bogdan Todor, Danusia Maria Onisor, Olga Brusnic, Ciprian Bacila, Horatiu Dura, Corina Roman-Filip, Maria Livia Ognean, Ciprian Tanasescu, Adrian Hasegan, Dan Bratu, Corina Porr, Iulian
International Journal of Molecular Sciences.2024; 25(14): 7898. CrossRef
Carcinoembryonic Antigen Expression in Human Tumors: A Tissue Microarray Study on 13,725 Tumors
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Cancers.2024; 16(23): 4052. CrossRef
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Ruopeng Zhang, Xiaojiang Chen, Guoming Chen, Zhoukai Zhao, Yicheng Wei, Feiyang Zhang, Jun Lin, Runcong Nie, Yingbo Chen
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Prospective Phase II Study of Preoperative Chemoradiation with Capecitabine in Locally Advanced Rectal Cancer: Jin-hong Park, Jong Hoon Kim, Seung Do Ahn, Sang-wook Lee, Seong Soo Shin, Jin Cheon Kim, Chang Sik Yu, Hee Cheol Kim, Yoon-Koo Kang, Tae Won Kim, Heung Moon Chang, Min Hee Ryu, Eun Kyung Choi; Cancer Res Treat. 2004;36(6):354-359. Published online December 31, 2004; DOI: https://doi.org/10.4143/crt.2004.36.6.354

Abstract PDF PubReader ePub

Purpose

Capecitabine is an attractive oral chemotherapeutic agent that has a radiosensitizing effect and tumor-selectivity. This study was performed to evaluate the efficacy and toxicity of preoperative chemoradiation therapy, when used with oral capecitabine, for locally advanced rectal cancer.

Materials and Methods

A prospective phase II trial of preoperative chemoradiation for locally advanced adenocarcinomas of the lower two-thirds of the rectum was conducted. A radiation dose of 50 Gy over five weeks and a daily dose of 1650 mg/m² capecitabine in two potions was administered during the entire course of radiation therapy. Surgery was performed with standardized total mesorectal excision four to six weeks after completion of the chemoradiation.

Results

Between January 2002 and September 2003, 61 patients were enrolled onto this prospective phase II trial. The pretreatment clinical stages were T3 in 64% (n=39), T4 in 36% (n=22) and N1-2 in 82% (n=50) of these patients. Fifty-six (92%) patients completed the chemoradiation as initially planned and a complete resection performed in 58 (95%). Down-staging was observed in 45 patients (74%) and a pathologic complete response in 6 (10%). Among the 37 patients with tumors located within 5 cm from the anal verge on colonoscopy, 27 (73%) underwent a sphincter-preserving procedure. No grade 3 and 4 proctitis or hematological toxicities were observed.

Conclusion

Preoperative chemoradiation therapy with capecitabine achieved encouraging rates of tumor downstaging and sphincter preservation, with a low toxicity profile. This combined modality can be regarded as a safe and effective treatment for locally advanced rectal cancer.

Citations

Citations to this article as recorded by

MRI for Rectal Cancer: Staging, mrCRM, EMVI, Lymph Node Staging and Post-Treatment Response
David D.B. Bates, Maria El Homsi, Kevin J. Chang, Neeraj Lalwani, Natally Horvat, Shannon P. Sheedy
Clinical Colorectal Cancer.2022; 21(1): 10. CrossRef
MRI of Rectal Cancer: An Overview and Update on Recent Advances
Kartik S. Jhaveri, Hooman Hosseini-Nik
American Journal of Roentgenology.2015; 205(1): W42. CrossRef
Current Controversies in Neoadjuvant Chemoradiation of Rectal Cancer
P. Terry Phang, Xiaodong Wang
Surgical Oncology Clinics of North America.2014; 23(1): 79. CrossRef
Tailored rectal cancer treatment – a time for implementing contemporary prognostic factors?
A. Wibe, W. L. Law, V. Fazio, C. P. Delaney
Colorectal Disease.2013; 15(11): 1333. CrossRef
Oncologic Outcome After Preoperative Chemoradiotherapy in Patients With Pathologic T0 (ypT0) Rectal Cancer
Tae Young Jang, Chang Sik Yu, Yong Sik Yoon, Seok-Byung Lim, Seung-Mo Hong, Tae Won Kim, Jong Hoon Kim, Jin Cheon Kim
Diseases of the Colon & Rectum.2012; 55(10): 1024. CrossRef
Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck
J G Kim, S K Sohn, D H Kim, J H Baek, S B Jeon, Y S Chae, K B Lee, J S Park, J H Sohn, J C Kim, I K Park
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Preoperative Concurrent Chemoradiotherapy with Oral Fluoropyrimidine in Locally Advanced Rectal Cancer: How Good Is Good Enough?
Hyun Cheol Chung
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The Treatment Results of Preoperative Concurrent Chemoradiation in Locally Advanced Rectal Cancer: Jun Sang Kim, Jae Sung Kim, Ji Young Jang, Wan Hee Yoon, Kyu Sang Song, Hae Kyeung In, Moon June Cho; J Korean Cancer Assoc. 2000;32(5):933-942.

Abstract PDF: PURPOSE
To assess the tumor response, sphincter preservation, acute toxicity and survival with preoperative concurrent chemoradiation in locally advanced rectal cancer.
MATERIALS AND METHODS
Fifty-four patients were treated with preoperative chemoradiaton for tumor downstaging and sphincter preservation. Radiation was delivered to whole pelvis to 45 Gy followed by a boost 5.4 Gy to primary tumor site. Chemotherapy consists of concurrent 2 cycles of 5-fluorouracil (500 mg/m2/day) and leucovorin (20 mg/m2/day). Surgery was performed approximately 6 weeks after treatment.
RESULTS
Median follow-up period and rate were 48 months and 98%, respectively. The downstaging including primary tumor and lymph node occurred in 64%. Three of 53 patients (6%) had pathologic complete response. The resectability of tumor was 98%. A sphincter preservation was possible in 61%. Three patients developed grade 4 hematologic toxicity. Grade 3 skin erythema and diarrhea were 24% and 18%, respectively. The 5-year survival and local disease-free survival were 62% and 89%, respectively. Local failure and distant metastasis rate were 9% and 35%, respectively.
CONCLUSION
Preoperative chemoradiation affords considerable downstaging with acceptable acute toxicity and postoperative morbidity. Also sphincter preservation is feasible by improved downstaging of tumor. This treatment could be improved local control of tumor, and may have a potential for long-term survival.

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The Effect of the Degree of Tumor Necrosis on Survival in Patients with Hepatocellular carcinoma Treated with Curative Resection Following Preoperative Transcatheter Arterial Therapy: Chang Mok Lee, Dong Sup Yoon, Sung Won Kwon, Hoon Sang Chi, Byong Ro Kim; J Korean Cancer Assoc. 1998;30(6):1168-1174.

Abstract PDF: PURPOSE
To investigate the effect of patient and tumor factors on the degree of tumor necrosis and the effect of the degree of the tumor necrosis on the survival in patients treated with curative resection following transcatheter arterial therapy.
MATERIALS AND METHODS
90 patients diagnosed as having hepatocellular carcinoma and treated with curative resection following transcatheter arterial therapy at Yonsei Medical Center between January 1986 and December 1995. The subjects were classified into four groups: 100% necrosis group (Group I, n=29), over 95% necrosis group (Group II, n=28), 50-95% necrosis group (Group III, n=13) and below 50% necrosis group (Group IV, n=20). The factors which affect on the necrosis of the tumor were compared. The overall and disease-free survival rates according to the degree of tumor necrosis were illustrated.
RESULTS
There was no statistical difference in the degree of the tumor necrosis according to age, sex, HBsAg, g-FP, liver cirrhosis, tumor size and morphological classification. In the comparison between the preoperative transcatheter arterial therapies, however, transcatheter arterial chemo-oily embolization (TACOE), which used the injection of the mixture of 3 10 cc Lipiodol and 30-50 mg Adriamycin followed by Gelfoam em- bolization, showed the higher number of 100% necrosis and over 95% necrosis cases. The 1, 3 year overall survival rates were greater for Group I, although not statistically significant. The 1, 5 year disease-free survival rates were greater for Group I, although not statistically significant.
CONCLUSION
In the preoperative transcatheter arterial embolization, TACOE was most effective to get total necrosis of tumor. However overall survival and disease free survival were not affected by the amount of tumor necrosis.

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Preoperative Chemotherapy in Wilms Tumor: Chuhl Joo Lyu, Byung Soo Kim, Woo Hee Jungn, Chang Ok Suh, Seung Kang Choi, Eui Ho Hwang; J Korean Cancer Assoc. 1994;26(4):631-637.

Abstract PDF: From l988, the use of preoperative chemotherapy for selected Wilms tumor was adopted at Yonsei Cancer Center. Between 1988 and 1992, 10 children has given preoperative chemotherapy. During that period, 21 children with Wilms tumor underwent primary nephrectomy(postop- erative treatment group). The criteria for preoperative chemotherapy were (a) initial surgical removal is excessively hazardous to patient (b) inoperable because of large size or extent of disease (c) patient with vena cava or atrial extension (d) radiologic evidence of extensive local invasion of adjacent or- gans or distant metastasis. After preaperative treatment, the tumor size was markedly(>50%) reduced in five patients. In all patients, nephrectomy was performed safely without rupture of tumor. Except stage IV patients, the dawnstaging may reduced the use of radiotherapy during ad)uvant treatment. The 3-year survival rate for patients with preoperative chemotherapy was 80%. The survival of the preoperative chemotherapy group was similar to that in the postoperative treatment group(2-year survival rate; 80% vs 84%). But there was a higher rate of local recurrence in preoperative chemotherapy group. We conclude that preoperative chemotherapy is the effective method of treatment in the selected cases of Wilms tumor.

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Effects of Concurrent Chemoradiotherapy Followed by Surgery in Locoreginal Cancer - preliminary report -: Yun Hae Chang, Sung Bae Kim, Sang Hee Kim, Jong SU Choi, Dae Young Chang, Je Whan Lee, Sang We Kim, Cheolwon Suh, Kyon Hung Lee, Jung Shin Lee, Woo Gyun Kim, Ho Young Song, Hye Sook Chang, Hong Hoon K; J Korean Cancer Assoc. 1996;28(4):690-698.

Abstract PDF: Prognosis of locoregional esophageal cancer treated with conventional surgery or radiotherapy alone has been very poor. In order to improve outcome and determine the efficacy of a combined modality therapy, this prospective study was performed. Between May 1993 and April l995, 44 patients with locoregional esophageal cancer were entered this study. They were treated with 2 courses of 5-FU(DI-5, D30-33) and cisplatin (Dl, D29) plus 48Gy radiation therapy over 4 weeks. 44 patients completed the preoperative reatment. A transhiatal esophagectomy was planned 3~4 weeks after chemoradiotherapy. Clinical response were reevaluable in 43 patients after treatment: 34 patients showed improvement, 5 patients showed stable, 4 patients showed progression. One patient was died of sepsis 1 week after completion of chemotherapy. l8 patients underwent operation after chemoradiation and 9 patients showed complete pathologic response. Grade 3,4 leukopenia and thrombocytopenia were observed in 21% and 7%, respectively. Esophagitis and vomiting were moderate to severe in 43% patients. Median follow-up duration was 7.5months(2-21M), the median survival was not reached. In conclusion, this intensive combined therapy is promising modality with regards to relatively high pathologic complete response rate. Further randomized Jarge scaled study was warrented

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Effect of Preoperative Transcatheter Arterial Chemoembolization on Recurrence Rate and Survival After Curative Resection in Patients with Hepatocellular Carcinoma: Dong Sup Yoon, Seung Ho Choi, Ki Whang Kim, Hoon Sang Chi, Byong Ro Kim; J Korean Cancer Assoc. 1996;28(4):726-733.

Abstract PDF: In order to evaluate the effect of preoperative transcatheter arterial chemoembolization on recurrence rate and survival after curative resection in patients with hepatocellular carcinoma, a retrospective clinical study of 57 patients underwent curative resection was performed. Fifty seven patients with hepatocellular carcinoma, underwent curative liver resection at Yongdong Severance Hospital from June 1985 to June 1995, were divided into two different treatment groups. Of the 57 patients, 25 patients(Group I) had received preoperative transcatheter arterial chemoembolization and 32(Group II) had not received. In any of the variables considered, age, sex, HBsAg, Child class, tumor number, tumor size, a- FP, operative method, no significant difference of patient characteristics between the two groups was found(p>0.05). Using the Kaplan-Meier Product-limit method and log-rank test, the differences of 1, 3, 5-year overall survival and disease-free survival rates, between these comparable groups were analyzed. The l, 3, 5-year overall survival rates in Group I and Group II were, respectively, 95.2%, 59.5%, 39.7% and 76.6%, 58.7%, 44.0%. Furthermore, the disease-free survival rates were, respectively, 81.5%, 50.3%, 50.3% and 69.4%, 43.9%, 30.8 %. This result indicates that there was no statistical significant difference between two groups in overall and disease-free survival. But, we gained a better results in Group I patients especially with total necrosis of tumor. So, further study, when & how we obtained total necrosis of hepatocellular carcinoma preoperatively, will be needed.

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Effect of Combined Modality Treatment and Clinical Significance of P-Glycoprotein Overexpression in Patients with Osteosarcoma: Yong Seok Yun, Jae Kyung Roh, Hyun Cheol Chung, Jae Yong Cho, Kyoo Ho Shin, Soo Bong Han, Beom Seok Kim, Joon Oh Park, Soo Jung Gong, Sun Young Rha, Nae Choon Yoo, Joo Hang Kim, Jin Sik Min, Byung So; J Korean Cancer Assoc. 1996;28(6):1104-1117.

Abstract PDF: Osteosarcoma is a highly malignant bone tumor and usually encountered in the first three decades of life. The Prognosis of osteasarcoma treated with surgery alone had been poor, with 20% of the patients surviving 5 years. The addition of adjuvant chemotherapy after surgery has siginificantly improved the outcome of osteosarcoma. The new concept of pre-operative chemotherapy has permitted histological assessment of treatment effect and limb salvage procedures. As the role of chemotherapy has been raised, the resistance of tumors to multiple drugs, such as p-glycoprotein overexpression, has become a major problem in the treatment of osteosarcoma. We retrospectively reviewed the clinical records of 53 patients with stage IIB osteosarcoma who were treated at Yonsei Medical Center and Yonsei Cancer Center between March 1, 1986 and June 30, 1996. The purpose of this study was to assess the efficacy and toxicity of cisplatin(IA)-adriamycin(IV) combination pre-operative chemotherapy and the clinical significance of p-glycoprotein status and histologic response as prognostic factors. Among 53 patients, 33 were male and 20 were female with a median age of 21 years(range: 5~61). The tumor locations were as follows: distal femur 24(45.3%), proximal tibia 17(32.1%), humerus 7(13.2%), proximal femur 3(5.4%), fibular 1(1.9%), radius 1(1.9%). Histologic subclassifications were as follows: osteoblastic type 42(78.2%), telangiectatic type 4(7.5%), chondrablastic type 3(5.7%), fibroblastic type 2(3.8%) and undetermined 2(2.8%). The three year overall survival and disease-free survival rates were 66.1% and 61.9% respectively in all patients. Thirty-two patients were treated by pre-operative cisplatin(IA)-adriamycin(IV) combination chemotherapy and 21 patients were taken only post-operative adjuvant chemotherapy. No significant difference was found between the two groups in probability of survival and recurrence rates. The histological response ta pre-operative chemotherapy was scored by degree of tumor necrosis. Twenty-two patients had a good response [grade IV, 13(40.6%);grade III, 8(25.0%)] and 11 patients had a poor response [grade II, 6(18.8%);grade I, 5(15.6%)]. The histological response was not significantly related to the probability of the survival rate. However, the recurrence rate was higher in the poor-response group(p=0.04). Overexpression of p-glycoprotein was found in tumors from 11 of l8 patients(61.1%) who were given only post-operative adjuvant chemotherapy. No relation was found between the p-glycoprotein expression and survival rate. The degree of tumor necrosis after pre-operative chemotherapy and initial serum alkaline-phosphatase level were considered as prognositic factors. Other clinicopathologic features including age, gender, anatomical site, histological subclassification,operation types,tumor size.p-glycoprotein expression were not associate with patient outcome. Treatment-related side effects were relatively tolerable and reversible by conservative treatment. Pre-operative cisplatin(IA)-adriamycin(IV) combination chemotherapy in our study did not show improved survival than conventional post-operative chemotherapy with limited follow-up duration. The degree of histologic response after chemotherapy and the initial alkaline phosphatase level were found to be the major predictor for tumor recurrences, while p-glycoprotein overexpression did not alter the clinical outcome. Further studies are warranted to improve the efficacy of adjuvant chemotherapy and to evaluate the significance of multiple resistance gene overexpression in osteosarcoma.

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