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1. Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart A: Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol; 2010 Jan 10;28(2):256-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes.
  • PURPOSE: The sixth edition of the American Joint Committee on Cancer (AJCC) rectal cancer staging subdivided stage II into IIA (T3N0) and IIB (T4N0) and stage III into IIIA (T1-2N1M0), IIIB (T3-4N1M0), and IIIC (anyTN2M0).
  • Subsequent analyses supported revised substaging of stage III as a result of improved survival with T1-2N2 versus T3-4N2 and survival of T4N1 more similar to T3-4N2 than T3N1.
  • The AJCC Hindgut Taskforce sought population-based validation that depth of invasion interacts with nodal status to affect survival.
  • METHODS: Surveillance, Epidemiology, and End Results (SEER) population-based data from January 1992 to December 2004 for 35,829 patients with rectal cancer were compared with rectal pooled analysis data (3,791 patients).
  • RESULTS: SEER rectal cancer analyses confirm that T1-2N2 cancers have better prognosis than T3-4N2, T4bN1 have similar prognosis to T4N2, T1-2N1 have similar prognosis to T2N0/T3N0, and T1-2N2a have similar prognosis to T2N0/T3N0 (T1N2a) or T4aN0 (T2N2a).
  • CONCLUSION: This SEER population-based rectal cancer analysis validates the rectal pooled analyses and supports the shift of T1-2N2 lesions from IIIC to IIIA or IIIB and T4bN1 from IIIB to IIIC.
  • SEER outcomes support subdividing T4, N1, and N2 and revised substaging of stages II and III.
  • [MeSH-major] Neoplasm Staging / methods. Rectal Neoplasms / pathology. Survival Rate

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  • [CommentIn] J Clin Oncol. 2010 Aug 10;28(23):e397-8; author reply e399-400 [20547986.001]
  • (PMID = 19949015.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Validation Studies
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2815714
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2. Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK: Revised TN categorization for colon cancer based on national survival outcomes data. J Clin Oncol; 2010 Jan 10;28(2):264-71
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  • [Title] Revised TN categorization for colon cancer based on national survival outcomes data.
  • PURPOSE: The sixth edition of American Joint Committee on Cancer (AJCC) Cancer Staging Manual for colon cancer subdivided stage II into IIA (T3N0) and IIB (T4N0) and stage III into IIIA (T1-2N1M0), IIIB (T3-4N1M0), and IIIC (anyTN2M0).
  • Subsequent analyses supported revised substaging of stage III because of improved survival for T1-2N2 versus T3-4N2 and T4N1 survival was more similar to T3-4N2 than to T3N1.
  • The AJCC Hindgut Taskforce sought population-based validation that depth of invasion and nodal status interact to affect survival.
  • PATIENTS AND METHODS: Surveillance, Epidemiology, and End Results (SEER) population-based data from January 1992 to December 2004 for 109,953 colon cancer patients were compared with National Cancer Data Base (NCDB) data on 134,206 patients.
  • RESULTS: SEER rectal cancer analyses confirm that T1-2N2 cancers have better prognosis than T3-4N2,T4bN1 have similar prognosis to T4N2, T1-2N1 have similar prognosis to T2N0/T3N0, and T1-2N2ahave similar prognosis to T2N0/T3N0 (T1N2a) or T4aN0 (T2N2a).
  • CONCLUSION: This SEER population-based colon cancer analysis is highly consistent with rectal cancer pooled analysis and SEER rectal cancer analyses, supporting the shift of T1-2N2 lesions from IIIC to IIIA/IIIB, shifting T4bN1 from IIIB to IIIC, subdividing T4/N1/N2, and revising substaging of stages II/III.
  • Survival outcomes by TN category for colon and rectal cancer are strikingly similar.
  • [MeSH-major] Colonic Neoplasms / pathology. Neoplasm Staging / methods

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  • [Cites] Histopathology. 1985 Dec;9(12):1319-27 [3830856.001]
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  • [Cites] Int J Radiat Oncol Biol Phys. 1987 Jan;13(1):5-10 [3804816.001]
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  • [CommentIn] J Clin Oncol. 2010 Aug 10;28(23):e397-8; author reply e399-400 [20547986.001]
  • [CommentIn] J Clin Oncol. 2010 Sep 20;28(27):e469; author reply e470 [20585093.001]
  • (PMID = 19949014.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2815715
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3. Prosnitz RG, Patwardhan MB, Samsa GP, Mantyh CR, Fisher DA, McCrory DC, Cline KE, Gray RN, Morse MA: Quality measures for the use of adjuvant chemotherapy and radiation therapy in patients with colorectal cancer: a systematic review. Cancer; 2006 Nov 15;107(10):2352-60
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  • [Title] Quality measures for the use of adjuvant chemotherapy and radiation therapy in patients with colorectal cancer: a systematic review.
  • BACKGROUND: Chemotherapy (CT) and radiation therapy (RT) are essential components of adjuvant (preoperative or postoperative) therapy for many patients with colorectal cancer (CRC); however, quality measures (QMs) of these critical aspects of CRC treatment have not been characterized well.
  • The most useful QMs identified were 1) the percentage of patients with AJCC Stage III colon cancer who received postoperative CT and 2) the percentage of patients with Stage II or III rectal cancer who received chemoradiotherapy.

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  • (PMID = 17039499.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] United States
  • [Number-of-references] 39
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4. O'Neill B, Brown G, Wotherspoon A, Burton S, Norman A, Tait D: Successful downstaging of high rectal and recto-sigmoid cancer by neo-adjuvant chemo-radiotherapy. Clin Med Oncol; 2008;2:135-44
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  • [Title] Successful downstaging of high rectal and recto-sigmoid cancer by neo-adjuvant chemo-radiotherapy.
  • The purpose of this study is to demonstrate the feasibility and downstaging of treating locally advanced tumours from high rectum to distal sigmoid with preoperative chemoradiotherapy (CRT).
  • METHODS AND MATERIALS: Seventeen patients with high rectal, rectosigmoid or distal sigmoid tumours above the peritoneal reflection received neoadjuvant CRT, selected on MRI findings indicating T4 disease or threatened circumferential resection margin.
  • Nine patients (52.9%) lowered pathologic disease AJCC stage, i.e. 'downstaged'.
  • One patient suffered a grade III acute toxicity, but no grade IV (RTOG).
  • There were 3 grade III and 3 grade IV late toxicities (LENT-SOMA).
  • CONCLUSIONS: Locally advanced high rectal and recto-sigmoid tumours may be treated with pre-operative CRT with acceptable toxicity, impressive down-staging, and clear surgical margins.

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  • (PMID = 21892276.001).
  • [ISSN] 1177-9314
  • [Journal-full-title] Clinical medicine. Oncology
  • [ISO-abbreviation] Clin Med Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
  • [Other-IDs] NLM/ PMC3161699
  • [Keywords] NOTNLM ; chemoradiotherapy / chemotherapy / downstaging / radiotherapy / total mesorectal excision
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5. Rottoli M, Bona S, Rosati R, Elmore U, Bianchi PP, Spinelli A, Bartolucci C, Montorsi M: Laparoscopic rectal resection for cancer: effects of conversion on short-term outcome and survival. Ann Surg Oncol; 2009 May;16(5):1279-86
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  • [Title] Laparoscopic rectal resection for cancer: effects of conversion on short-term outcome and survival.
  • BACKGROUND: Laparoscopic rectal resection (LRR) is an oncologically safe procedure.
  • No differences in age, gender, American Society of Anesthesiologists (ASA) score, and T and N stages were observed between CR and NCR patients.
  • Conversion was associated with higher body mass index (BMI) (27.3 versus 24.9 kg/m(2), P < 0.001) and American Joint Committee on Cancer (AJCC) stage IV (26.9% versus 4.8%, P < 0.001), and resulted in longer operative time (342 versus 285 min, P = 0.006) and increased intraoperative complication rate (31% versus 5%, P < 0.001).
  • After exclusion of stage IV patients from the analysis, 5-year disease-free survival was 71.1% in CR group and 85.3% in NCR group (P = 0.17), while the overall recurrence rate was 26.3% in CR patients and 11.4% in NCR patients (P = 0.07).
  • [MeSH-major] Colectomy / mortality. Rectal Neoplasms / surgery

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  • (PMID = 19252948.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Georgescu SO, Neacşu CN, Vintilă D, Popa P, Forţu L, Nistor A, Ferariu D, Târcoveanu E: [Long-term results after surgery for colorectal adenocarcinoma, stage I-III. Problems of prognosis]. Rev Med Chir Soc Med Nat Iasi; 2007 Oct-Dec;111(4):932-9
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  • [Title] [Long-term results after surgery for colorectal adenocarcinoma, stage I-III. Problems of prognosis].
  • [Transliterated title] Rezultate la distanţă după tratamentul chirurgical al adenocarcinomului colo-rectal stadiile I-III. Probleme de prognostic.
  • Colorectal cancer is one of the leading causes of cancer-related death worldwide.
  • STUDY DESIGN: Prospective study on 142 consecutively cases with stage I to III colorectal adenocarcinomas (TNM AJCC/UICC) in which patients underwent potentially curative surgery in one single public health service (1st Surgical Clinic Iaşi, Romania) between 2004 and 2005.
  • The surgical procedures performed were the following: right colectomy (n = 54; 30%); transverse colectomy (n = 2; 1.4%); left colectomy (n = 19; 13.4%); segmental colon resection with anastomosis (n = 5 ; 3.5%); Hartmann procedure (n = 18; 12.7%); anterior rectal resection (n = 11; 7.7%) and abdominoperineal resection (n = 33; 23.2%).
  • RESULTS: The factors with a significant negative influence in overall survival and 42-months survival rates were: the age over 70 years, the emergency surgery related to cancer's complications, the advanced AJCC/ UICC stage, vascular invasion, perineural invasion, the recurrence of disease, the moderate and lower differentiated adenocarcinoma and incomplete or not performed chemotherapy.
  • CONCLUSION: Even with a radical surgical approach the advanced stage of colorectal adenocarcinoma has a low prognostic, but some other factors have also a high significance in postoperative outcome.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Anastomosis, Surgical. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Postoperative Complications / mortality. Prognosis. Prospective Studies. Romania. Survival Analysis. Treatment Outcome

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  • (PMID = 18389783.001).
  • [ISSN] 0048-7848
  • [Journal-full-title] Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
  • [ISO-abbreviation] Rev Med Chir Soc Med Nat Iasi
  • [Language] rum
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Romania
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7. Kurt M, Ozkan L, Yilmazlar T, Ercan I, Zorluoglu A, Memik F, Engin K: Postoperative concomitant chemoradiotherapy in locally advanced rectal cancer. Hepatogastroenterology; 2005 Sep-Oct;52(65):1411-5
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  • [Title] Postoperative concomitant chemoradiotherapy in locally advanced rectal cancer.
  • METHODOLOGY: Thirty-eight patients with locally advanced rectal cancer were enrolled in the study.
  • Administration of chemotherapy concomitant with radiotherapy (p=0.089), AJCC stage III (p=0.079), Duke's stage C (p=0.079), presence of lymph node involvement (p=0.079) and presence of local recurrence (p=0.066) appeared to be effecting distant metastasis although differences did not reach statistically significance.
  • CONCLUSIONS: Our results have provided further evidence of the ability of postoperative chemoradiotherapy to delay and prevent local recurrence and metastasis of rectal cancer.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Fluorouracil / administration & dosage. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Life Tables. Male. Middle Aged. Neoplasm Staging. Postoperative Period. Radiotherapy Dosage

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  • (PMID = 16201085.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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8. Rades D, Kuhn H, Schultze J, Homann N, Brandenburg B, Schulte R, Krull A, Schild SE, Dunst J: Prognostic factors affecting locally recurrent rectal cancer and clinical significance of hemoglobin. Int J Radiat Oncol Biol Phys; 2008 Mar 15;70(4):1087-93
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  • [Title] Prognostic factors affecting locally recurrent rectal cancer and clinical significance of hemoglobin.
  • PURPOSE: To investigate potential prognostic factors, including hemoglobin levels before and during radiotherapy, for associations with survival and local control in patients with unirradiated locally recurrent rectal cancer.
  • PATIENTS AND METHODS: Ten potential prognostic factors were investigated in 94 patients receiving radiotherapy for recurrent rectal cancer: age (<or=68 vs. >or=69 years), gender, Eastern Cooperative Oncology Group performance status (0-1 vs. 2-3), American Joint Committee on Cancer (AJCC) stage (<or=II vs. III vs. IV), grading (G1-2 vs. G3), surgery, administration of chemotherapy, radiation dose (equivalent dose in 2-Gy fractions: <or=50 vs. >50 Gy), and hemoglobin levels before (<12 vs. >or=12 g/dL) and during (majority of levels: <12 vs. >or=12 g/dL) radiotherapy.
  • RESULTS: Improved survival was associated with better performance status (p<0.001), lower AJCC stage (p=0.023), surgery (p=0.011), chemotherapy (p=0.003), and hemoglobin levels>or=12 g/dL both before (p=0.031) and during (p<0.001) radiotherapy.
  • On multivariate analyses, performance status, AJCC stage, and hemoglobin levels during radiotherapy maintained significance.
  • Improved local control was associated with better performance status (p=0.040), lower AJCC stage (p=0.010), lower grading (p=0.012), surgery (p<0.001), chemotherapy (p<0.001), and hemoglobin levels>or=12 g/dL before (p<0.001) and during (p<0.001) radiotherapy.
  • CONCLUSION: Predictors for outcome in patients who received radiotherapy for locally recurrent rectal cancer were performance status, AJCC stage, chemotherapy, surgery, extent of resection, histologic grading, and hemoglobin levels both before and during radiotherapy.
  • [MeSH-major] Hemoglobins / analysis. Neoplasm Recurrence, Local. Rectal Neoplasms
  • [MeSH-minor] Aged. Female. Follow-Up Studies. Humans. Male. Multivariate Analysis. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Severity of Illness Index. Sex Factors

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  • (PMID = 17892921.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hemoglobins
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9. Chen CC, Yang SH, Lin JK, Lin TC, Chen WS, Jiang JK, Wang HS, Chang SC: Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer? J Surg Res; 2005 Apr;124(2):169-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is it reasonable to add preoperative serum level of CEA and CA19-9 to staging for colorectal cancer?
  • BACKGROUND: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most common tumor markers for colorectal cancer.
  • The aim of this study was to evaluate the possibility of adding them into the current staging system by analyzing their prognostic significance.
  • MATERIALS AND METHODS: The study population was patients (n = 574, 67.1 +/- 11.3 years old, 397 males) who received potentially curative resection of colorectal adenocarcinoma (stage I-III) between January 1994 and August 2002, including preoperative measurements of CEA and CA19-9.
  • Survival was analyzed for AJCC staging, CEA (+) versus (-), CA19-9 (+) versus (-), and four groups.
  • However, the combined use of the two markers revealed a significant survival benefit (P = 0.035) of group 1 ("-" for both markers) over 4 ("+" for both) in stage II.
  • CONCLUSIONS: Patients with an elevated level of both CEA and CA19-9 in stage II of colorectal cancer have a significantly poorer prognosis than those with normal levels of these markers.
  • We recommend adding both CEA and CA19-9 to the current staging system.
  • [MeSH-minor] Aged. Biomarkers, Tumor / blood. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging / methods. Preoperative Care. Prognosis

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  • (PMID = 15820244.001).
  • [ISSN] 0022-4804
  • [Journal-full-title] The Journal of surgical research
  • [ISO-abbreviation] J. Surg. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen
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10. Unsal D, Akyurek N, Uner A, Erpolat OP, Han U, Akmansu M, Mentes BB, Dursun A: Gelatinase B expression as a prognostic factor in patients with stage II/III rectal carcinoma treated by postoperative adjuvant therapy. Am J Clin Oncol; 2008 Feb;31(1):55-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gelatinase B expression as a prognostic factor in patients with stage II/III rectal carcinoma treated by postoperative adjuvant therapy.
  • OBJECTIVE: The matrix-metalloproteinases (MMPs) are thought to be critically involved in tumor invasion and metastasis.
  • This retrospective study was aimed both to examine the gelatinase expression status in patients with rectal cancer and to investigate their prognostic value on survival.
  • METHODS: Sixty patients who underwent postoperative adjuvant chemoradiotherapy for Stage II and III rectal carcinoma were included.
  • Expressions of MMP-2, MMP-9, and tissue inhibitors of MMP (TIMP-1 and TIMP-2) were analyzed by immunohistochemistry in paraffin-embedded primary rectal cancers and graded for the intensity and the percentage of cells stained.
  • The ratio of tumors with positive MMP-9 expression was increased according to N stage (P = 0.005), AJCC stage (P = 0.005), and tumor differentiation (P = 0.017).
  • CONCLUSION: MMP-9 expression was observed in the tumors of patients with Stage II and III rectal carcinoma in comparable values and was characterized by poor overall survival and disease-free survival.
  • [MeSH-major] Adenocarcinoma / enzymology. Adenocarcinoma / therapy. Matrix Metalloproteinase 9 / metabolism. Rectal Neoplasms / enzymology. Rectal Neoplasms / therapy
  • [MeSH-minor] Cell Differentiation. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Immunoenzyme Techniques. Lymphatic Metastasis. Male. Matrix Metalloproteinase 2 / metabolism. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Tissue Inhibitor of Metalloproteinase-1 / metabolism. Tissue Inhibitor of Metalloproteinase-2 / metabolism

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  • (PMID = 18376229.001).
  • [ISSN] 1537-453X
  • [Journal-full-title] American journal of clinical oncology
  • [ISO-abbreviation] Am. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Tissue Inhibitor of Metalloproteinase-1; 127497-59-0 / Tissue Inhibitor of Metalloproteinase-2; EC 3.4.24.24 / Matrix Metalloproteinase 2; EC 3.4.24.35 / Matrix Metalloproteinase 9
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11. Di Fabio F, Shrier I, Bégin LR, Gordon PH: Absence of prognostic value of nuclear shape factor analysis in colorectal carcinoma: relevance of interobserver and intraobserver variability. Dis Colon Rectum; 2008 Dec;51(12):1781-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Absence of prognostic value of nuclear shape factor analysis in colorectal carcinoma: relevance of interobserver and intraobserver variability.
  • METHODS: Ninety-eight patients who underwent colorectal carcinoma resection were prospectively enrolled.
  • RESULTS: The nuclear shape factor mean values by American Joint Committee on Cancer stage were: 0.73 (0.07) in Stage I, 0.74 (0.06) in Stage II, and 0.75 (0.05) in Stage III carcinomas (P = 0.78, ANOVA).
  • We failed to confirm a prognostic value for nuclear shape factor in colorectal carcinoma.
  • [MeSH-major] Carcinoma / diagnosis. Cell Nucleus Shape. Colonic Neoplasms / diagnosis. Rectal Neoplasms / diagnosis
  • [MeSH-minor] Humans. Image Processing, Computer-Assisted. Neoplasm Staging. Observer Variation. Predictive Value of Tests. Prognosis. Reproducibility of Results. Survival Rate

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  • [CommentIn] Dis Colon Rectum. 2009 Aug;52(8):1523; author reply 1524 [19617771.001]
  • (PMID = 18581174.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Choi HJ, Park KJ, Shin JS, Roh MS, Kwon HC, Lee HS: Tumor budding as a prognostic marker in stage-III rectal carcinoma. Int J Colorectal Dis; 2007 Aug;22(8):863-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Tumor budding as a prognostic marker in stage-III rectal carcinoma.
  • BACKGROUND AND AIM: Tumor budding along the invasive margin is known to be associated with biological behavior in colorectal carcinoma.
  • The aims of this study were to explore if the semiquantitative assessment of tumor budding in rectal cancers correlates with oncological behavior and to appraise if the tumor budding is valid as a pathological parameter in distinguishing tumors with higher malignancy potential from those with lower one for prognostic stratification.
  • MATERIALS AND METHODS: Surgical specimens from 244 patients with well- or moderately differentiated rectal carcinoma were retrieved to assess the intensity of tumor budding at the invasive margin.
  • RESULTS: The cutoff of the intensity considered to be the best indicator for dividing patients into subgroups with different DFS was between quartiles 3 and 4, but this survival difference in subgroups in either side of the cutoff was significant only in stage-III disease [5-year DFS, 62.1 vs 35.1%; p = 0.0023; 95% confidence interval (CI), 0.1824-0.6919].
  • When scores were given to grade of budding (lower, 0; higher, 1) and N stage (N1, 0; N2, 1) in stage III, a better prognostic stratification in terms of the 5-year DFS was obtained than the American Joint Committee on Cancer nodal staging only (0 vs 1 vs 2, 66.5 vs 42.6 vs 29.2%; p = 0.0101).
  • CONCLUSIONS: Quantitative assessment of tumor budding is a reliable biological prognostic variable to identify higher malignancy potential.
  • Scoring system using tumor budding and N stage showed better prognostic stratification in stage-III rectal carcinoma.
  • A prospective evaluation would confirm the clinical significance of tumor budding for prognostic stratification.
  • [MeSH-major] Rectal Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cell Differentiation. Disease-Free Survival. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Predictive Value of Tests. Prognosis. Reproducibility of Results. Retrospective Studies. Time Factors

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  • (PMID = 17216219.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
  • [Publication-country] Germany
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13. Chan AK, Wong A, Jenken D, Heine J, Buie D, Johnson D: Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys; 2005 Mar 1;61(3):665-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy.
  • PURPOSE: To evaluate the prognostic value of the posttreatment TNM stage as a predictor of outcome in locally advanced rectal cancers treated with preoperative chemotherapy and radiotherapy.
  • METHODS AND MATERIALS: Between 1993 and 2000, 128 patients with tethered (103) or fixed (25) rectal cancers were treated with 50 Gy preoperative pelvic radiotherapy and two cycles of concurrent 5-fluorouracil infusion (20 mg/kg/d) and leucovorin (200 mg/m(2)/d) chemotherapy on Days 1-4 and 22-25 and a single bolus mitomycin C injection (8 mg/m(2)) on Day 1.
  • Of the 128 patients, 111 had Stage T3 and 17 Stage T4 according to the rectal ultrasound or CT findings and clinical evaluation.
  • Postoperatively, the disease stage was determined according to the surgical and pathologic findings using the American Joint Committee on Cancer TNM staging system.
  • RESULTS: Of the 128 patients, 32 had postchemoradiotherapy (pCR) Stage 0 (T0N0M0), 37 pCR Stage I, 26 pCR Stage II, 28 pCR Stage III, and 5 pCR Stage IV disease.
  • Of the 128 patients, 79 had pCR Stage T0-T2, 35 pCR Stage T3, and 14 pCR Stage T4.
  • The rate of T stage downstaging was 66% (84 of 128).
  • The 5-year disease-specific survival rate was 97% for pCR Stage 0, 88% for pCR Stage I, 74% for pCR Stage II, 44% for pCR Stage III, and 0% for pCR Stage IV (p = 0.0000059).
  • The 5-year relapse-free survival rate was 97% for pCR Stage 0, 80% for pCR Stage I, 72% for pCR Stage II, 42% for pCR Stage III, and 0% for pCR Stage IV (p < 0.000001).
  • In univariate analysis, the pretreatment tumor status (fixed vs. tethered tumors), the pCR TNM stage, T stage downstaging, pathologic T4 tumors, node-positive disease after chemoradiotherapy, and lymphovascular or perineural invasion were statistically significant prognosticators of disease-specific survival and relapse-free survival. pCR Stage T4 disease was a strong predictor of local recurrence.
  • In multivariate analysis, the pCR TNM stage was the most statistically significant independent predictor of survival (p = 0.003) and relapse-free survival (p < 0.001).
  • CONCLUSION: For patients who underwent preoperative chemoradiotherapy for locally advanced rectal cancer, the pCR TNM stage was a strong prognosticator of recurrence and survival.
  • [MeSH-major] Neoplasm Staging / methods. Rectal Neoplasms / pathology

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  • (PMID = 15708244.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 50SG953SK6 / Mitomycin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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14. Vance W, Tucker SL, de Crevoisier R, Kuban DA, Cheung MR: The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome. Int J Radiat Oncol Biol Phys; 2007 Mar 1;67(3):828-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome.
  • PURPOSE: To determine the value of a 2-year post-radiotherapy (RT) prostate biopsy for predicting eventual biochemical failure in patients who were treated for localized prostate cancer.
  • The independent prognostic value of the biopsy results for forecasting eventual biochemical outcome and overall survival was tested with other factors (the Gleason score, 1992 American Joint Committee on Cancer tumor stage, pretreatment prostate-specific antigen level, risk group, and RT dose) in a multivariate analysis.
  • Patients with rising prostate-specific antigen (PSA) or suspicious digital rectal examination before the biopsy were excluded.
  • RESULTS: The biopsy results were normal in 78 patients, scant atypical and malignant cells in 30, carcinoma with treatment effect in 43, and carcinoma without treatment effect in 13.

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  • (PMID = 17161554.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] EC 3.4.21.77 / Prostate-Specific Antigen
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