Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer
Background The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer. Method The resected primary tumor specimens follo...
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| Veröffentlicht in: | International journal of colorectal disease 2015-10, Vol.30 (10), p.1339-1347 |
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| container_title | International journal of colorectal disease |
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| creator | Beppu, Naohito Kobayashi, Masayoshi Matsubara, Nagahide Noda, Masashi Yamano, Tomoki Doi, Hiroshi Kamikonya, Norihiko Kakuno, Ayako Kimura, Fumihiko Yamanaka, Naoki Yanagi, Hidenori Tomita, Naohiro |
| description | Background
The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer.
Method
The resected primary tumor specimens following the two different approaches were assessed utilizing the tumor regression grade (TRG 0–4), and each positive lymph node was assessed according to the lymph node regression grade (LRG 1–3), with TRG 4 and LRG 3 indicating total regression. The lymph node sizes were measured to elucidate any correlation with LRG scores.
Results
Seventy-four patients with ypN-positive rectal cancer had 220 positive lymph nodes following the SCRT-delay, and 48 patients had 141 positive lymph nodes following the LC-CRT. The distribution of LRG 1/2/3 in the two groups was 123/72/25 and 60/31/50 (
p
|
| doi_str_mv | 10.1007/s00384-015-2321-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1713942290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714490359</galeid><sourcerecordid>A714490359</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-f55ce5a70e422336038c0b489ff7fd7fda7ac92b6a5aca60cd64c5c620bbd0643</originalsourceid><addsrcrecordid>eNp1Us2O1SAUJkbjXEcfwI0hceOmI1Ba2uXkRkeTSdzomlA4vWXSQgXq5D7gvJd0ese_OIGEwPeTcw4fQq8puaCEiPeRkLLhBaFVwUpGi-YJ2lFesoKymj1FO0JFW9C2as7QixhvSL7Xgj9HZxkmdcmbHbrb-2lWwUbvsO9xGgDPKg1-9Aer1YgDxNm7CA_gBNEH0ClDs4822R-AnTcQcQfpFsDhOPiQCu2XkFV6gMkHZazP4qDmI761acAGRnUEg-MSDhCOWDmDR-8Oj8usW-uy4FLcLE5FaOU0hJfoWa_GCK9O5zn69vHD1_2n4vrL1ef95XWhedmmoq8qDZUSBDhjZVnn6WnS8abte9GbvJVQumVdrSqlVU20qbmudB5W1xlS8_Icvdt85-C_LxCTnGzUMI7KgV-ipIKWbfZuSaa-_Yd6k3tzubp7lmCiadvfrIMaQVrX-xSUXk3lpaCcZ6NqZV38h5WXgclq76C3-f0vAd0EOvgYA_RyDnZS4SgpkWt05BYdmaMj1-jIJmvenApeugnML8VDVjKBbYSYIZf_7Y-OHnX9CVBX020</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1713727899</pqid></control><display><type>article</type><title>Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer</title><source>MEDLINE</source><source>Springer Online Journals</source><creator>Beppu, Naohito ; Kobayashi, Masayoshi ; Matsubara, Nagahide ; Noda, Masashi ; Yamano, Tomoki ; Doi, Hiroshi ; Kamikonya, Norihiko ; Kakuno, Ayako ; Kimura, Fumihiko ; Yamanaka, Naoki ; Yanagi, Hidenori ; Tomita, Naohiro</creator><creatorcontrib>Beppu, Naohito ; Kobayashi, Masayoshi ; Matsubara, Nagahide ; Noda, Masashi ; Yamano, Tomoki ; Doi, Hiroshi ; Kamikonya, Norihiko ; Kakuno, Ayako ; Kimura, Fumihiko ; Yamanaka, Naoki ; Yanagi, Hidenori ; Tomita, Naohiro</creatorcontrib><description>Background
The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer.
Method
The resected primary tumor specimens following the two different approaches were assessed utilizing the tumor regression grade (TRG 0–4), and each positive lymph node was assessed according to the lymph node regression grade (LRG 1–3), with TRG 4 and LRG 3 indicating total regression. The lymph node sizes were measured to elucidate any correlation with LRG scores.
Results
Seventy-four patients with ypN-positive rectal cancer had 220 positive lymph nodes following the SCRT-delay, and 48 patients had 141 positive lymph nodes following the LC-CRT. The distribution of LRG 1/2/3 in the two groups was 123/72/25 and 60/31/50 (
p
< 0.001), respectively, and the distribution of TRG 0/1/2/3/4 in the two groups was 36/19/19/0 and 12/15/20/1 (
p
= 0.005), respectively. The requirements of total regression of positive lymph nodes were a primary tumor degenerated to TRG 3 with a size less than 6 mm in SCRT-delay (sensitivity, 60.9 %) or a primary tumor degenerated to TRG 2–4 with a size less than 5 mm at TRG 2 (sensitivity, 57.6 %) or 6 mm at TRG 3 and 4 (sensitivity, 84.2 %) in LC-CRT as indicated by the receiver operating characteristic curve analysis.
Conclusion
The tumor regression effect of LC-CRT on the primary tumor and positive nodes was more favorable than SCRT-delay, and LC-CRT is able to predict the LRG 3 response with a high sensitivity.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-015-2321-8</identifier><identifier>PMID: 26206348</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Cancer patients ; Care and treatment ; Chemoradiotherapy ; Colorectal cancer ; Comparative analysis ; Female ; Gastroenterology ; Hepatology ; Humans ; Internal Medicine ; Lymph Nodes - drug effects ; Lymph Nodes - pathology ; Lymph Nodes - radiation effects ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Proctology ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Rectal Neoplasms - therapy ; Surgery ; Time Factors ; Treatment Outcome</subject><ispartof>International journal of colorectal disease, 2015-10, Vol.30 (10), p.1339-1347</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>COPYRIGHT 2015 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-f55ce5a70e422336038c0b489ff7fd7fda7ac92b6a5aca60cd64c5c620bbd0643</citedby><cites>FETCH-LOGICAL-c439t-f55ce5a70e422336038c0b489ff7fd7fda7ac92b6a5aca60cd64c5c620bbd0643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-015-2321-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-015-2321-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26206348$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beppu, Naohito</creatorcontrib><creatorcontrib>Kobayashi, Masayoshi</creatorcontrib><creatorcontrib>Matsubara, Nagahide</creatorcontrib><creatorcontrib>Noda, Masashi</creatorcontrib><creatorcontrib>Yamano, Tomoki</creatorcontrib><creatorcontrib>Doi, Hiroshi</creatorcontrib><creatorcontrib>Kamikonya, Norihiko</creatorcontrib><creatorcontrib>Kakuno, Ayako</creatorcontrib><creatorcontrib>Kimura, Fumihiko</creatorcontrib><creatorcontrib>Yamanaka, Naoki</creatorcontrib><creatorcontrib>Yanagi, Hidenori</creatorcontrib><creatorcontrib>Tomita, Naohiro</creatorcontrib><title>Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background
The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer.
Method
The resected primary tumor specimens following the two different approaches were assessed utilizing the tumor regression grade (TRG 0–4), and each positive lymph node was assessed according to the lymph node regression grade (LRG 1–3), with TRG 4 and LRG 3 indicating total regression. The lymph node sizes were measured to elucidate any correlation with LRG scores.
Results
Seventy-four patients with ypN-positive rectal cancer had 220 positive lymph nodes following the SCRT-delay, and 48 patients had 141 positive lymph nodes following the LC-CRT. The distribution of LRG 1/2/3 in the two groups was 123/72/25 and 60/31/50 (
p
< 0.001), respectively, and the distribution of TRG 0/1/2/3/4 in the two groups was 36/19/19/0 and 12/15/20/1 (
p
= 0.005), respectively. The requirements of total regression of positive lymph nodes were a primary tumor degenerated to TRG 3 with a size less than 6 mm in SCRT-delay (sensitivity, 60.9 %) or a primary tumor degenerated to TRG 2–4 with a size less than 5 mm at TRG 2 (sensitivity, 57.6 %) or 6 mm at TRG 3 and 4 (sensitivity, 84.2 %) in LC-CRT as indicated by the receiver operating characteristic curve analysis.
Conclusion
The tumor regression effect of LC-CRT on the primary tumor and positive nodes was more favorable than SCRT-delay, and LC-CRT is able to predict the LRG 3 response with a high sensitivity.</description><subject>Aged</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Chemoradiotherapy</subject><subject>Colorectal cancer</subject><subject>Comparative analysis</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Lymph Nodes - drug effects</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - radiation effects</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectal Neoplasms - therapy</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1Us2O1SAUJkbjXEcfwI0hceOmI1Ba2uXkRkeTSdzomlA4vWXSQgXq5D7gvJd0ese_OIGEwPeTcw4fQq8puaCEiPeRkLLhBaFVwUpGi-YJ2lFesoKymj1FO0JFW9C2as7QixhvSL7Xgj9HZxkmdcmbHbrb-2lWwUbvsO9xGgDPKg1-9Aer1YgDxNm7CA_gBNEH0ClDs4822R-AnTcQcQfpFsDhOPiQCu2XkFV6gMkHZazP4qDmI761acAGRnUEg-MSDhCOWDmDR-8Oj8usW-uy4FLcLE5FaOU0hJfoWa_GCK9O5zn69vHD1_2n4vrL1ef95XWhedmmoq8qDZUSBDhjZVnn6WnS8abte9GbvJVQumVdrSqlVU20qbmudB5W1xlS8_Icvdt85-C_LxCTnGzUMI7KgV-ipIKWbfZuSaa-_Yd6k3tzubp7lmCiadvfrIMaQVrX-xSUXk3lpaCcZ6NqZV38h5WXgclq76C3-f0vAd0EOvgYA_RyDnZS4SgpkWt05BYdmaMj1-jIJmvenApeugnML8VDVjKBbYSYIZf_7Y-OHnX9CVBX020</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Beppu, Naohito</creator><creator>Kobayashi, Masayoshi</creator><creator>Matsubara, Nagahide</creator><creator>Noda, Masashi</creator><creator>Yamano, Tomoki</creator><creator>Doi, Hiroshi</creator><creator>Kamikonya, Norihiko</creator><creator>Kakuno, Ayako</creator><creator>Kimura, Fumihiko</creator><creator>Yamanaka, Naoki</creator><creator>Yanagi, Hidenori</creator><creator>Tomita, Naohiro</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer</title><author>Beppu, Naohito ; Kobayashi, Masayoshi ; Matsubara, Nagahide ; Noda, Masashi ; Yamano, Tomoki ; Doi, Hiroshi ; Kamikonya, Norihiko ; Kakuno, Ayako ; Kimura, Fumihiko ; Yamanaka, Naoki ; Yanagi, Hidenori ; Tomita, Naohiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-f55ce5a70e422336038c0b489ff7fd7fda7ac92b6a5aca60cd64c5c620bbd0643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Chemoradiotherapy</topic><topic>Colorectal cancer</topic><topic>Comparative analysis</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Lymph Nodes - drug effects</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - radiation effects</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectal Neoplasms - therapy</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beppu, Naohito</creatorcontrib><creatorcontrib>Kobayashi, Masayoshi</creatorcontrib><creatorcontrib>Matsubara, Nagahide</creatorcontrib><creatorcontrib>Noda, Masashi</creatorcontrib><creatorcontrib>Yamano, Tomoki</creatorcontrib><creatorcontrib>Doi, Hiroshi</creatorcontrib><creatorcontrib>Kamikonya, Norihiko</creatorcontrib><creatorcontrib>Kakuno, Ayako</creatorcontrib><creatorcontrib>Kimura, Fumihiko</creatorcontrib><creatorcontrib>Yamanaka, Naoki</creatorcontrib><creatorcontrib>Yanagi, Hidenori</creatorcontrib><creatorcontrib>Tomita, Naohiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beppu, Naohito</au><au>Kobayashi, Masayoshi</au><au>Matsubara, Nagahide</au><au>Noda, Masashi</au><au>Yamano, Tomoki</au><au>Doi, Hiroshi</au><au>Kamikonya, Norihiko</au><au>Kakuno, Ayako</au><au>Kimura, Fumihiko</au><au>Yamanaka, Naoki</au><au>Yanagi, Hidenori</au><au>Tomita, Naohiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>30</volume><issue>10</issue><spage>1339</spage><epage>1347</epage><pages>1339-1347</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Background
The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer.
Method
The resected primary tumor specimens following the two different approaches were assessed utilizing the tumor regression grade (TRG 0–4), and each positive lymph node was assessed according to the lymph node regression grade (LRG 1–3), with TRG 4 and LRG 3 indicating total regression. The lymph node sizes were measured to elucidate any correlation with LRG scores.
Results
Seventy-four patients with ypN-positive rectal cancer had 220 positive lymph nodes following the SCRT-delay, and 48 patients had 141 positive lymph nodes following the LC-CRT. The distribution of LRG 1/2/3 in the two groups was 123/72/25 and 60/31/50 (
p
< 0.001), respectively, and the distribution of TRG 0/1/2/3/4 in the two groups was 36/19/19/0 and 12/15/20/1 (
p
= 0.005), respectively. The requirements of total regression of positive lymph nodes were a primary tumor degenerated to TRG 3 with a size less than 6 mm in SCRT-delay (sensitivity, 60.9 %) or a primary tumor degenerated to TRG 2–4 with a size less than 5 mm at TRG 2 (sensitivity, 57.6 %) or 6 mm at TRG 3 and 4 (sensitivity, 84.2 %) in LC-CRT as indicated by the receiver operating characteristic curve analysis.
Conclusion
The tumor regression effect of LC-CRT on the primary tumor and positive nodes was more favorable than SCRT-delay, and LC-CRT is able to predict the LRG 3 response with a high sensitivity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26206348</pmid><doi>10.1007/s00384-015-2321-8</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2015-10, Vol.30 (10), p.1339-1347 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1713942290 |
| source | MEDLINE; Springer Online Journals |
| subjects | Aged Cancer patients Care and treatment Chemoradiotherapy Colorectal cancer Comparative analysis Female Gastroenterology Hepatology Humans Internal Medicine Lymph Nodes - drug effects Lymph Nodes - pathology Lymph Nodes - radiation effects Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Original Article Proctology Rectal Neoplasms - pathology Rectal Neoplasms - surgery Rectal Neoplasms - therapy Surgery Time Factors Treatment Outcome |
| title | Comparison of the pathological response of the mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery and long-course chemoradiotherapy in patients with rectal cancer |
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