Elizabeth Alwers1, Lina Jansen2, Jakob Kather3, Efrat Amitay2, Hendrik Bläker4, Matthias Kloor5, Katrin E Tagscherer6,7, Wilfried Roth6,7, Esther Herpel6,8, Jenny Chang-Claude9,10, Hermann Brenner2,11,12, Michael Hoffmeister2. 1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany. Elizabeth.alwers@dkfz.de. 2. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany. 3. Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany. 4. Institute of Pathology, University Hospital Leipzig, Leipzig, Germany. 5. Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany. 6. Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany. 7. Institute of Pathology, University Medical Center Mainz, Mainz, Germany. 8. NCT Tissue Bank, National Center for Tumor Diseases (NCT), Heidelberg, Germany. 9. Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. 10. Genetic Tumor Epidemiology Group, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 11. Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), Heidelberg, Germany. 12. German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND: In rectal cancer, prediction of tumor response and pathological complete response (pCR) to neoadjuvant treatment could contribute to refine selection of patients who might benefit from a delayed- or no-surgery approach. The aim of this study was to explore the association of clinical and molecular characteristics of rectal cancer with response to neoadjuvant treatment and to compare patient survival according to level of response. METHODS: Resected rectal cancer patients were selected from a population-based cohort study. Molecular tumor markers were determined from the surgical specimen. Tumor response and pCR were defined as downstaging in T or N stage and absence of tumor cells upon pathological examination, respectively. The associations of patient and tumor characteristics with tumor response and pCR were explored, and patient survival was determined by degree of response to neoadjuvant treatment. RESULTS: Among 1536 patients with rectal cancer, 602 (39%) received neoadjuvant treatment. Fifty-five (9%) patients presented pCR, and 239 (49%) and 250 (53%) patients showed downstaging of the T and N stages, respectively. No statistically significant associations were observed between patient or tumor characteristics and tumor response or pCR. Patients who presented any type of response to neoadjuvant treatment had significantly better cancer-specific and overall survival compared with non-responders. CONCLUSION: In this study, patient characteristics were not associated with response to neoadjuvant treatment, and molecular characteristics determined after surgical resection of the tumor were not predictive of pCR or tumor downstaging. Future studies should include molecular biomarkers from biopsy samples before neoadjuvant treatment.
BACKGROUND: In rectal cancer, prediction of tumor response and pathological complete response (pCR) to neoadjuvant treatment could contribute to refine selection of patients who might benefit from a delayed- or no-surgery approach. The aim of this study was to explore the association of clinical and molecular characteristics of rectal cancer with response to neoadjuvant treatment and to compare patient survival according to level of response. METHODS: Resected rectal cancerpatients were selected from a population-based cohort study. Molecular tumor markers were determined from the surgical specimen. Tumor response and pCR were defined as downstaging in T or N stage and absence of tumor cells upon pathological examination, respectively. The associations of patient and tumor characteristics with tumor response and pCR were explored, and patient survival was determined by degree of response to neoadjuvant treatment. RESULTS: Among 1536 patients with rectal cancer, 602 (39%) received neoadjuvant treatment. Fifty-five (9%) patients presented pCR, and 239 (49%) and 250 (53%) patients showed downstaging of the T and N stages, respectively. No statistically significant associations were observed between patient or tumor characteristics and tumor response or pCR. Patients who presented any type of response to neoadjuvant treatment had significantly better cancer-specific and overall survival compared with non-responders. CONCLUSION: In this study, patient characteristics were not associated with response to neoadjuvant treatment, and molecular characteristics determined after surgical resection of the tumor were not predictive of pCR or tumor downstaging. Future studies should include molecular biomarkers from biopsy samples before neoadjuvant treatment.
Authors: Sven Lichthardt; Lisa Zenorini; Johanna Wagner; Johannes Baur; Alexander Kerscher; Niels Matthes; Caroline Kastner; Jörg Pelz; Volker Kunzmann; Christoph-Thomas Germer; Armin Wiegering Journal: J Cancer Res Clin Oncol Date: 2017-07-29 Impact factor: 4.553
Authors: N A Janjan; C Crane; B W Feig; K Cleary; R Dubrow; S Curley; J N Vauthey; P Lynch; L M Ellis; R Wolff; R Lenzi; J Abbruzzese; R Pazdur; P M Hoff; P Allen; T Brown; J Skibber Journal: Am J Clin Oncol Date: 2001-04 Impact factor: 2.339
Authors: Andrea L Russo; David P Ryan; Darrell R Borger; Jennifer Y Wo; Jackie Szymonifka; Wen-Yih Liang; Eunice L Kwak; Lawrence S Blaszkowsky; Jeffrey W Clark; Jill N Allen; Andrew X Zhu; David L Berger; James C Cusack; Harvey J Mamon; Kevin M Haigis; Theodore S Hong Journal: J Gastrointest Cancer Date: 2014-03
Authors: Maxime J M van der Valk; Denise E Hilling; Esther Bastiaannet; Elma Meershoek-Klein Kranenbarg; Geerard L Beets; Nuno L Figueiredo; Angelita Habr-Gama; Rodrigo O Perez; Andrew G Renehan; Cornelis J H van de Velde Journal: Lancet Date: 2018-06-23 Impact factor: 79.321
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983