Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer.

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Abstract Text:

Prajnan Das,John M Skibber,Miguel A Rodriguez-Bigas,Barry W Feig,George J Chang,Robert A Wolff,Cathy Eng,Sunil Krishnan,Nora A Janjan,Christopher H Crane,

BACKGROUND: The objective of this study was to identify predictive factors for pathologic complete response and tumor downstaging after preoperative chemoradiation for rectal cancer. METHODS: Between 1989 and 2004, 562 patients with nonmetastatic rectal adenocarcinoma received preoperative chemoradiation and underwent mesorectal excision. The median radiation dose was 45 Gray (Gy) (range, 19.8-58.6 Gy), 77% of patients received concurrent infusional 5-fluorouracil, 20% of patients received concurrent capecitabine, and 3% of patients received other regimens. RESULTS: Nineteen percent of patients achieved a pathologic complete response (CR), whereas 20% of patients had only microscopic residual disease at surgery, and 61% of patients had macroscopic residual disease at surgery. Downstaging of the tumor stage occurred in 57% of patients. The results from a univariate analysis indicated that tumor circumferential extent>60% (P=.033) and pretreatment carcinoembryonic antigen (CEA) level>2.5 ng/mL (P=.015) were associated significantly with lower pathologic CR rates. The univariate analysis also indicated that tumor circumferential extent>60% (P=.001), pretreatment CEA level>2.5 ng/mL (P=.006), and distance from the anal verge>5 cm (P=.035) were associated significantly with lower downstaging rates. The results from a multivariate logistic regression analysis indicated that greater circumferential extent of tumor (odds ratio [OR], 0.43; P=.033) independently predicted a lower pathologic CR rate. The multivariate logistic regression analysis also indicated that greater circumferential extent of tumor (OR, 0.49; P=.020) and greater distance from the anal verge (OR, 0.46; P=.010) independently predicted a lower downstaging rate. CONCLUSIONS: Circumferential extent of tumor, CEA level, and distance from the anal verge predicted for the pathologic response to preoperative chemoradiation for patients with rectal cancer. Therefore, these factors may be used to predict outcomes for patients, to develop risk-adapted treatment strategies, and to target patients who participate in trials of newer therapies.

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Publishing Authors By Initials

P Das,JM Skibber,MA Rodriguez-Bigas,BW Feig,GJ Chang,RA Wolff,C Eng,S Krishnan,NA Janjan,CH Crane,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

PUBMED ID PMID:

MEDLINE DATE:

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Cancer

VOLUME: 109

Page Numbers: 1750-5

Journal Abbreviation: Cancer

ISSN: 0008-543X

DAY: 1

MONTH: May

YEAR: 2007

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 374236

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: therapy

Chemical & Substance for Abstract: Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Information

Substance Name: Carcinoembryonic Antigen

Registry Number: 0

Grant and Affiliation Information for Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer.

AFFILIATION: Department of Radiation Oncology, the University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. prajdas@mdanderson.org

Country: United States

AGENCY: United States NCI

GRANT: CA06294

ACRONYM: CA

MEDLINETA: Cancer

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer Related Publications

• A fuzzy discrete event system approach to determining optimal HIV/AIDS treatment regimens.
• A region analysis approach for segmenting neural-cell images.
• A self-learning fuzzy discrete event system for HIV/AIDS treatment regimen selection.
• Analyzing the cost effectiveness of Santiago, Chile's policy of using urban forests to improve air quality.
• Conformational switching in the fungal light sensor Vivid.
• EFFECTIVE PUBLIC SPEAKING.
• Electron transfer between cytochrome c and cytochome c peroxidase in single crystals.
• Hemangioma, capillary and cavernous, with thrombopenic purpura; report of a case with observations at autopsy.
• LOVE MAKES THE WORLD GO 'ROUND.
• Medical school faculty discontent: prevalence and predictors of intent to leave academic careers.
• Melanocytic nevi and sun exposure in a cohort of colorado children: anatomic distribution and site-specific sunburn.
• Non-target barge-in detection.
• Patterns of self-reported symptoms in pancreatic cancer patients receiving chemoradiation.
• Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer.
• Remember 1967? We do...
• Response to the comments by Bernaschi et al. on 'Optimisation and parallelisation strategies for Monte Carlo simulation of HIV infection'.
• Responses of neurons in primary visual cortex to transient changes in local contrast and luminance.
• Rigid Body Refinement of Protein Complexes with Long-Range Distance Restraints from Pulsed Dipolar ESR.
• SANITATION IN VENEZUELA AND COLOMBIA.
• SEARCHING FOR A DENTAL ASSISTANT.
• Segmentation of cultured neurons using logical analysis of grey and distance difference.
• Segmentation of neuronal-cell images from stained fields and monomodal histograms.
• TO BE SUCCESSFUL LOOK SUCCESSFUL.
• The management of your patients with eye problems.
• The payoff: preventing errors. Medication management.
• Trees.
• Upper body clothing is a source of fungal beta-(1,3)-glucan exposure.
• WILL OUR PATIENTS BENEFIT?
• Water vapor absorption at isotopic CO2 laser wavelengths.
• [Chronic obstructive pulmonary disease (COPD) burden in Japan--confronting COPD Japan survey]