Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer
Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches...
Gespeichert in:
| Veröffentlicht in: | Surgical oncology 2022-12, Vol.45, p.101862-101862, Article 101862 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 101862 |
|---|---|
| container_issue | |
| container_start_page | 101862 |
| container_title | Surgical oncology |
| container_volume | 45 |
| creator | Strous, M.T.A. Faes, T.K.E. Heemskerk, J. Lohman, B.G.P.M. Simons, P.C.G. Janssen Heijnen, M.L.G. Vogelaar, F.J. de Bruïne, A.P. |
| description | Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches the degree of actual pathological response. In order to select patients with major pathological response without surgical resection, it is of importance to define tumour markers predicting the degree of pathological response to nCRT. The intra-tumoural tumour-stroma ratio (TSR) might be this marker.
TSR in pre-treatment biopsies was estimated according to the method described by van Pelt et al. The degree of pathological response was assessed on the tumour resection according to tumour regression grading (TRG) by Mandard. The primary endpoint of this study was the difference in pathological response to nCRT between TSR-high and TSR-low groups.
We found that 26.2% of patients with major response was classified as TSR-high, while 73.8% of patients were classified as TSR-low. A high TSR in pre-treatment biopsies was associated with a lower chance of major-response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.
In rectal cancer, TSR in pre-treatment biopsies predicts pathologic response to nCRT, with a high TSR bringing twice the risk of poor to no response compared to low TSR. In future, assessment of TSR may fulfil a role in a therapeutic algorithm identifying patients who will or will not respond to nCRT prior to treatment initiation.
•TSR-assessment is easy and low cost, and the degree of intra- and inter-observer agreement is substantial.•26.2% of patients with major pathological response of rectal cancer to nCRT is classified as TSR-high in pre-treatment biopsies.•High-TSR in pre-treatment biopsies of rectal cancer is associated with a lower chance of major pathological response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery. |
| doi_str_mv | 10.1016/j.suronc.2022.101862 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2732543363</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0960740422001578</els_id><sourcerecordid>2743489354</sourcerecordid><originalsourceid>FETCH-LOGICAL-c343t-4ee41098adefb863c9dbc8f2a35709bdd949487a487ae1349d231442f6480b7d3</originalsourceid><addsrcrecordid>eNp9kEtLxDAQgIMouK7-Aw8FL1665rVtcxFk8QULXtZzSJOpprRNTdIF_70p9eTBwzDD8M0w8yF0TfCGYFLctZsweTfoDcWUzq2qoCdoRapS5IxRfIpWWBQ4Lznm5-gihBZjXJSUrJA8TL2bfB6id73KvIrWZdFlowdjdcxGFT9d5z6sVl3mIYxuCDADA7hcmXY6qiFm0YOKPaTKDonSMcFaDRr8JTprVBfg6jev0fvT42H3ku_fnl93D_tcM85izgE4waJSBpq6KpgWptZVQxXblljUxggueFWqOYAwLgxlhHPaFLzCdWnYGt0ue0fvviYIUfY2aOg6lQ6dgqQlo1vOWMESevMHbZOBIV2XKM54JVgi14gvlPYuBA-NHL3tlf-WBMvZumzlYl3O1uViPY3dL2OQnj1a8DJoC8mEsbMXaZz9f8EPdPaNng</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2743489354</pqid></control><display><type>article</type><title>Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer</title><source>Elsevier ScienceDirect Journals</source><creator>Strous, M.T.A. ; Faes, T.K.E. ; Heemskerk, J. ; Lohman, B.G.P.M. ; Simons, P.C.G. ; Janssen Heijnen, M.L.G. ; Vogelaar, F.J. ; de Bruïne, A.P.</creator><creatorcontrib>Strous, M.T.A. ; Faes, T.K.E. ; Heemskerk, J. ; Lohman, B.G.P.M. ; Simons, P.C.G. ; Janssen Heijnen, M.L.G. ; Vogelaar, F.J. ; de Bruïne, A.P.</creatorcontrib><description>Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches the degree of actual pathological response. In order to select patients with major pathological response without surgical resection, it is of importance to define tumour markers predicting the degree of pathological response to nCRT. The intra-tumoural tumour-stroma ratio (TSR) might be this marker.
TSR in pre-treatment biopsies was estimated according to the method described by van Pelt et al. The degree of pathological response was assessed on the tumour resection according to tumour regression grading (TRG) by Mandard. The primary endpoint of this study was the difference in pathological response to nCRT between TSR-high and TSR-low groups.
We found that 26.2% of patients with major response was classified as TSR-high, while 73.8% of patients were classified as TSR-low. A high TSR in pre-treatment biopsies was associated with a lower chance of major-response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.
In rectal cancer, TSR in pre-treatment biopsies predicts pathologic response to nCRT, with a high TSR bringing twice the risk of poor to no response compared to low TSR. In future, assessment of TSR may fulfil a role in a therapeutic algorithm identifying patients who will or will not respond to nCRT prior to treatment initiation.
•TSR-assessment is easy and low cost, and the degree of intra- and inter-observer agreement is substantial.•26.2% of patients with major pathological response of rectal cancer to nCRT is classified as TSR-high in pre-treatment biopsies.•High-TSR in pre-treatment biopsies of rectal cancer is associated with a lower chance of major pathological response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.</description><identifier>ISSN: 0960-7404</identifier><identifier>EISSN: 1879-3320</identifier><identifier>DOI: 10.1016/j.suronc.2022.101862</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adjuvant therapy ; Algorithms ; Biopsy ; Cancer ; Chemoradiotherapy ; Chemotherapy ; Colorectal cancer ; Metastasis ; Neoadjuvant chemoradiotherapy ; Pathological response ; Patients ; Pretreatment ; Radiation therapy ; Rectal cancer ; Rectum ; Stroma ; Surgery ; TSR ; Tumors ; Tumour regression ; Tumour-stroma ratio</subject><ispartof>Surgical oncology, 2022-12, Vol.45, p.101862-101862, Article 101862</ispartof><rights>2022 The Authors</rights><rights>2022. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-4ee41098adefb863c9dbc8f2a35709bdd949487a487ae1349d231442f6480b7d3</citedby><cites>FETCH-LOGICAL-c343t-4ee41098adefb863c9dbc8f2a35709bdd949487a487ae1349d231442f6480b7d3</cites><orcidid>0000-0001-7116-4465</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0960740422001578$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Strous, M.T.A.</creatorcontrib><creatorcontrib>Faes, T.K.E.</creatorcontrib><creatorcontrib>Heemskerk, J.</creatorcontrib><creatorcontrib>Lohman, B.G.P.M.</creatorcontrib><creatorcontrib>Simons, P.C.G.</creatorcontrib><creatorcontrib>Janssen Heijnen, M.L.G.</creatorcontrib><creatorcontrib>Vogelaar, F.J.</creatorcontrib><creatorcontrib>de Bruïne, A.P.</creatorcontrib><title>Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer</title><title>Surgical oncology</title><description>Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches the degree of actual pathological response. In order to select patients with major pathological response without surgical resection, it is of importance to define tumour markers predicting the degree of pathological response to nCRT. The intra-tumoural tumour-stroma ratio (TSR) might be this marker.
TSR in pre-treatment biopsies was estimated according to the method described by van Pelt et al. The degree of pathological response was assessed on the tumour resection according to tumour regression grading (TRG) by Mandard. The primary endpoint of this study was the difference in pathological response to nCRT between TSR-high and TSR-low groups.
We found that 26.2% of patients with major response was classified as TSR-high, while 73.8% of patients were classified as TSR-low. A high TSR in pre-treatment biopsies was associated with a lower chance of major-response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.
In rectal cancer, TSR in pre-treatment biopsies predicts pathologic response to nCRT, with a high TSR bringing twice the risk of poor to no response compared to low TSR. In future, assessment of TSR may fulfil a role in a therapeutic algorithm identifying patients who will or will not respond to nCRT prior to treatment initiation.
•TSR-assessment is easy and low cost, and the degree of intra- and inter-observer agreement is substantial.•26.2% of patients with major pathological response of rectal cancer to nCRT is classified as TSR-high in pre-treatment biopsies.•High-TSR in pre-treatment biopsies of rectal cancer is associated with a lower chance of major pathological response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.</description><subject>Adjuvant therapy</subject><subject>Algorithms</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Metastasis</subject><subject>Neoadjuvant chemoradiotherapy</subject><subject>Pathological response</subject><subject>Patients</subject><subject>Pretreatment</subject><subject>Radiation therapy</subject><subject>Rectal cancer</subject><subject>Rectum</subject><subject>Stroma</subject><subject>Surgery</subject><subject>TSR</subject><subject>Tumors</subject><subject>Tumour regression</subject><subject>Tumour-stroma ratio</subject><issn>0960-7404</issn><issn>1879-3320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLxDAQgIMouK7-Aw8FL1665rVtcxFk8QULXtZzSJOpprRNTdIF_70p9eTBwzDD8M0w8yF0TfCGYFLctZsweTfoDcWUzq2qoCdoRapS5IxRfIpWWBQ4Lznm5-gihBZjXJSUrJA8TL2bfB6id73KvIrWZdFlowdjdcxGFT9d5z6sVl3mIYxuCDADA7hcmXY6qiFm0YOKPaTKDonSMcFaDRr8JTprVBfg6jev0fvT42H3ku_fnl93D_tcM85izgE4waJSBpq6KpgWptZVQxXblljUxggueFWqOYAwLgxlhHPaFLzCdWnYGt0ue0fvviYIUfY2aOg6lQ6dgqQlo1vOWMESevMHbZOBIV2XKM54JVgi14gvlPYuBA-NHL3tlf-WBMvZumzlYl3O1uViPY3dL2OQnj1a8DJoC8mEsbMXaZz9f8EPdPaNng</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Strous, M.T.A.</creator><creator>Faes, T.K.E.</creator><creator>Heemskerk, J.</creator><creator>Lohman, B.G.P.M.</creator><creator>Simons, P.C.G.</creator><creator>Janssen Heijnen, M.L.G.</creator><creator>Vogelaar, F.J.</creator><creator>de Bruïne, A.P.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7116-4465</orcidid></search><sort><creationdate>202212</creationdate><title>Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer</title><author>Strous, M.T.A. ; Faes, T.K.E. ; Heemskerk, J. ; Lohman, B.G.P.M. ; Simons, P.C.G. ; Janssen Heijnen, M.L.G. ; Vogelaar, F.J. ; de Bruïne, A.P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-4ee41098adefb863c9dbc8f2a35709bdd949487a487ae1349d231442f6480b7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adjuvant therapy</topic><topic>Algorithms</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Metastasis</topic><topic>Neoadjuvant chemoradiotherapy</topic><topic>Pathological response</topic><topic>Patients</topic><topic>Pretreatment</topic><topic>Radiation therapy</topic><topic>Rectal cancer</topic><topic>Rectum</topic><topic>Stroma</topic><topic>Surgery</topic><topic>TSR</topic><topic>Tumors</topic><topic>Tumour regression</topic><topic>Tumour-stroma ratio</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strous, M.T.A.</creatorcontrib><creatorcontrib>Faes, T.K.E.</creatorcontrib><creatorcontrib>Heemskerk, J.</creatorcontrib><creatorcontrib>Lohman, B.G.P.M.</creatorcontrib><creatorcontrib>Simons, P.C.G.</creatorcontrib><creatorcontrib>Janssen Heijnen, M.L.G.</creatorcontrib><creatorcontrib>Vogelaar, F.J.</creatorcontrib><creatorcontrib>de Bruïne, A.P.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strous, M.T.A.</au><au>Faes, T.K.E.</au><au>Heemskerk, J.</au><au>Lohman, B.G.P.M.</au><au>Simons, P.C.G.</au><au>Janssen Heijnen, M.L.G.</au><au>Vogelaar, F.J.</au><au>de Bruïne, A.P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer</atitle><jtitle>Surgical oncology</jtitle><date>2022-12</date><risdate>2022</risdate><volume>45</volume><spage>101862</spage><epage>101862</epage><pages>101862-101862</pages><artnum>101862</artnum><issn>0960-7404</issn><eissn>1879-3320</eissn><abstract>Management of rectal cancer has advanced, with an increasing use of neoadjuvant chemoradiotherapy (nCRT). This opens options for organ preserving treatment for those with a major response to nCRT. However, the degree of clinical response, based on MRI and post-treatment biopsies, only poorly matches the degree of actual pathological response. In order to select patients with major pathological response without surgical resection, it is of importance to define tumour markers predicting the degree of pathological response to nCRT. The intra-tumoural tumour-stroma ratio (TSR) might be this marker.
TSR in pre-treatment biopsies was estimated according to the method described by van Pelt et al. The degree of pathological response was assessed on the tumour resection according to tumour regression grading (TRG) by Mandard. The primary endpoint of this study was the difference in pathological response to nCRT between TSR-high and TSR-low groups.
We found that 26.2% of patients with major response was classified as TSR-high, while 73.8% of patients were classified as TSR-low. A high TSR in pre-treatment biopsies was associated with a lower chance of major-response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.
In rectal cancer, TSR in pre-treatment biopsies predicts pathologic response to nCRT, with a high TSR bringing twice the risk of poor to no response compared to low TSR. In future, assessment of TSR may fulfil a role in a therapeutic algorithm identifying patients who will or will not respond to nCRT prior to treatment initiation.
•TSR-assessment is easy and low cost, and the degree of intra- and inter-observer agreement is substantial.•26.2% of patients with major pathological response of rectal cancer to nCRT is classified as TSR-high in pre-treatment biopsies.•High-TSR in pre-treatment biopsies of rectal cancer is associated with a lower chance of major pathological response to nCRT (OR = 0.37, 95%CI; 0.19–0.73), p = 0.004), independent of tumour stage and time between nCRT and surgery.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><doi>10.1016/j.suronc.2022.101862</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-7116-4465</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-7404 |
| ispartof | Surgical oncology, 2022-12, Vol.45, p.101862-101862, Article 101862 |
| issn | 0960-7404 1879-3320 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2732543363 |
| source | Elsevier ScienceDirect Journals |
| subjects | Adjuvant therapy Algorithms Biopsy Cancer Chemoradiotherapy Chemotherapy Colorectal cancer Metastasis Neoadjuvant chemoradiotherapy Pathological response Patients Pretreatment Radiation therapy Rectal cancer Rectum Stroma Surgery TSR Tumors Tumour regression Tumour-stroma ratio |
| title | Tumour-stroma ratio to predict pathological response to neo-adjuvant treatment in rectal cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T07%3A34%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Tumour-stroma%20ratio%20to%20predict%20pathological%20response%20to%20neo-adjuvant%20treatment%20in%20rectal%20cancer&rft.jtitle=Surgical%20oncology&rft.au=Strous,%20M.T.A.&rft.date=2022-12&rft.volume=45&rft.spage=101862&rft.epage=101862&rft.pages=101862-101862&rft.artnum=101862&rft.issn=0960-7404&rft.eissn=1879-3320&rft_id=info:doi/10.1016/j.suronc.2022.101862&rft_dat=%3Cproquest_cross%3E2743489354%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2743489354&rft_id=info:pmid/&rft_els_id=S0960740422001578&rfr_iscdi=true |