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Subject: search.filters.subject.Rectal cancer

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    Prognostic role of sensitive-to-apoptosis gene expression in rectal cancer
    (BAISHIDENG PUBL GRP CO LTD, 2011-01-01) Ozden, Sevgi A.; Ozyurt, Hazan; Ozgen, Zerrin; Kilinc, Olca; Oncel, Mustafa; Gul, Aylin E.; Karadayi, Nimet; Serakinci, Nedime; Kan, Beki; Orun, Oya
    AIM: To investigate the association between prognosis of rectal cancer treated with chemoradiotherapy (CRT) and expression of sensitive-to-apoptosis (SAG), B-cell lymphoma-extra large (Bcl-XL) and Bcl-2 homologous antagonist/killer (Bak). METHODS: Real-time quantitative polymerase chain reaction was used to determine the expression of proteins of interest, namely SAG, Bcl-XL, Bak and beta-actin, in rectal carcinoma patients who had a follow-up period of 3 years after CRT. Biopsy specimens were excised from the rectal tumor preceding CRT. RESULTS: SAG, Bcl-XL and Bak proteins showed significant correlations with each other. In multivariate analysis, patients with high vs low SAG expression showed a statistically significant difference in 2-year survival rates: 56\% vs 73\%, respectively (P = 0.056). On the other hand, there were no significant correlations between the expression levels of all three genes and metastatic rates or tumor responses to CRT. Mean overall survival in the patients with elevated SAG expression was 27.1 mo +/- 3.9 mo {[}95\% confidence interval (CI): 19.3-34.9], and in patients with reduced expression, it was 32.1 mo +/- 2.5 mo (95\% CI: 27.3-36.9). The corresponding values for Bcl-XL were 28.0 mo +/- 4.1 mo (95\% CI: 19.9-36.1) and 31.7 mo +/- 2.9 mo (95\% CI: 26.0-37.5), and those for Bak were 29.8 mo +/- 3.7 mo (95\% CI: 22.5-37.2) and 30.6 mo +/- 2.4 mo (95\% CI: 25.5-35.0), respectively. CONCLUSION: Two-year survival rates significantly correlated with low SAG expression, and SAG may be a candidate gene for good prognosis, independent of therapeutic response of different individuals. (C) 2011 Baishideng. All rights reserved.
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    Neoadjuvant hyperfractionated accelerated radiotherapy plus concomitant 5-fluorouracil infusion in locally advanced rectal cancer: A phase. study
    (BAISHIDENG PUBLISHING GROUP INC, 2018-01-01) Gural, Zeynep; Saglam, Sezer; Yucel, Serap; Kaytan-Saglam, Esra; Asoglu, Oktar; Ordu, Cetin; Acun, Hediye; Sharifov, Rasul; Onder, Semen; Kizir, Ahmet; Oral, Ethem N.
    AIM To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy (HART) and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil (325 mg/m(2)). All patients were operated 4-8 wk after neoadjuvant concomitant therapy. RESULTS In the early phase of treatment, 6 patients had grade III- IV gastrointestinal toxicity, 2 patients had grade III-IV hematologic toxicity, and 1 patient had grade V toxicity due to postoperative sepsis during chemotherapy. Only 1 patient had radiotherapy-related late side effects, i.e., grade IV tenesmus. Complete pathological response was achieved in 6 patients (21\%), while near-complete pathological response was obtained in 9 (31\%). After a median follow-up period of 60 mo, the local tumor control rate was 96.6\%. In 13 patients, distant metastasis occurred. Disease-free survival rates at 2 and 5 years were 63.3\% and 53\%, and corresponding overall survival rates were 70\% and 53.1\%, respectively. CONCLUSION Although it has excellent local control and complete pathological response rates, neoadjuvant HART concurrent chemotherapy appears to not be a feasible treatment regimen in locally advanced rectal cancer, having high perioperative complication and intolerable side effects. Effects of reduced 5-fluorouracil dose or omission of chemotherapy with the aim of reducing toxicity may be examined in further studies.
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    Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series
    (BMC, 2022-01-01) Asoglu, Oktar; Bulut, Alisina; Aliyev, Vusal; Piozzi, Guglielmo Niccolo; Guven, Koray; Bakir, Baris; Goksel, Suha
    Aim To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method Retrospective analysis of prospectively maintained database was performed. Oncological outcomes of mid-low LARC patients (n=60) were analyzed after a follow-up of 63 (50-83) months. Patients with clinical complete response (cCR) were treated with the watch-and-wait (WW) protocol. Patients who could not achieve cCR were treated with total mesorectal excision (TME) or local excision (LE). Results Thirty-nine (65\%) patients who achieved cCR were treated with the WW protocol. TME was performed in 15 (25\%) patients and LE was performed in 6 (10\%) patients. During the follow-up period, 10 (25.6\%) patients in the WW group had regrowth (RG) and 3 (7.7\%) had distant metastasis (DM). Five-year overall survival (OS) and disease-free survival (DFS) were 90.1\% and 71.6\%, respectively, in the WW group. Five-year OS and DFS were 94.9\% (95\% CI: 88-100\%) and 80\% (95\% CI: 55.2-100\%), respectively, in the RG group. For all patients (n=60), 5-year TME-free DFS was 57.3\% (95\% CI: 44.3-70.2\%) and organ preservation-adapted DFS was 77.5\% (95\% CI: 66.4-88.4\%). For the WW group (n=39), 5-year TME-free DFS was 77.5\% (95\% CI: 63.2-91.8\%) and organ preservation-adapted DFS was 85.0\% (95\% CI: 72.3-97.8\%). Conclusion CRT-CNCT provides cCR as high as 2/3 of LARC patients. Regrowths, developed during follow-up, can be successfully salvaged without causing oncological disadvantage if strict surveillance is performed.
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    Persistent extramural vascular invasion positivity on magnetic resonance imaging after neoadjuvant chemoradiotherapy predicts poor outcome in rectal cancer
    (ELSEVIER SINGAPORE PTE LTD, 2021-01-01) Guner, Osman Serhat; Tumay, Latif Volkan
    Background: In rectal cancer, extramural vascular invasion (EMVI) is the presence of tumour cells in blood vessels outside the muscular layer, which is associated with poor prognosis. Regression of EMVI on MRI following neoadjuvant chemoradiotherapy or its persistence may have prognostic implications. Methods: This retrospective study included 52 patients with rectal cancer who underwent total mesorectal excision following long-course neoadjuvant chemoradiotherapy (CRT). EMVI assessments were done on previous pelvic MRIs obtained before neoadjuvant CRT and eight weeks after the completion of neoadjuvant chemoradiotherapy in initially EMVI positive cases. Results: Persistently EMVI positive patients had worse overall survival and disease-free survival compared to initially EMVI negative patients and patients who returned to negative (p < 0.001 for both). Multivariate analysis identified persistent EMVI positivity after neoadjuvant treatment (HR, 102.9