The predictive value of clinical evaluation of response to neoadjuvant chemoradiation therapy for rectal cancer
Multimodality therapy has become the standard treatment for patients with locally advanced (T3 and T4) rectal carcinoma. Accurate preoperative staging of the patients with rectal cancer has increased in importance because the selection of patients with transmural rectal cancer (T3 or T4) or node-pos...
Saved in:
Published in | Tumori Vol. 91; no. 5; p. 401 |
---|---|
Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.09.2005
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Multimodality therapy has become the standard treatment for patients with locally advanced (T3 and T4) rectal carcinoma. Accurate preoperative staging of the patients with rectal cancer has increased in importance because the selection of patients with transmural rectal cancer (T3 or T4) or node-positive disease leads to a previous nonsurgical neoadjuvant treatment. The purpose of this study was to evaluate the predictive value of the clinical response to neoadjuvant therapy on the basis of pathological results obtained on rectal cancer patients treated by chemoradiotherapy and surgery.
From 1994 to 2003, 58 patients with a primary diagnosis of rectal cancer were studied at our department and enrolled in a neoadjuvant protocol of chemoradiotherapy followed by surgery. All patients were treated by 30 days of chemoradiotherapy. At the end of the chemoradiotherapy, each patient underwent clinical examination, including digital rectal examination, proctoscopy and abdominal-pelvic computerized tomography to define the clinical response to the chemoradiotherapy. Surgical resection was performed in all patients three weeks after the end of chemoradiotherapy, and histological analysis was performed on all resected specimens.
The clinical complete response rate corresponded to the pathological complete response rate, whereas the clinical evaluation overestimated partial response and stable disease. The pathologic examination revealed that 3.5% of clinical partial responses and 3.4% of clinical stable disease were really pathological progressive disease. Clinical partial response and clinical stable disease positive predictive values were 92.8% and 90.9%, respectively, whereas the clinical progressive disease negative predictive value was 20%. Then, 6.9% of patients believed to have responded to the therapy, or not to have responded or worsened, actually had worsened by the end of the chemoradiotherapy.
Positive and negative predictive values, in particular for partial response and stable disease, of clinical evaluation of the response to chemoradiotherapy were not high enough to consider clinical evaluation accurate enough to make treatment decisions. |
---|---|
AbstractList | Multimodality therapy has become the standard treatment for patients with locally advanced (T3 and T4) rectal carcinoma. Accurate preoperative staging of the patients with rectal cancer has increased in importance because the selection of patients with transmural rectal cancer (T3 or T4) or node-positive disease leads to a previous nonsurgical neoadjuvant treatment. The purpose of this study was to evaluate the predictive value of the clinical response to neoadjuvant therapy on the basis of pathological results obtained on rectal cancer patients treated by chemoradiotherapy and surgery.
From 1994 to 2003, 58 patients with a primary diagnosis of rectal cancer were studied at our department and enrolled in a neoadjuvant protocol of chemoradiotherapy followed by surgery. All patients were treated by 30 days of chemoradiotherapy. At the end of the chemoradiotherapy, each patient underwent clinical examination, including digital rectal examination, proctoscopy and abdominal-pelvic computerized tomography to define the clinical response to the chemoradiotherapy. Surgical resection was performed in all patients three weeks after the end of chemoradiotherapy, and histological analysis was performed on all resected specimens.
The clinical complete response rate corresponded to the pathological complete response rate, whereas the clinical evaluation overestimated partial response and stable disease. The pathologic examination revealed that 3.5% of clinical partial responses and 3.4% of clinical stable disease were really pathological progressive disease. Clinical partial response and clinical stable disease positive predictive values were 92.8% and 90.9%, respectively, whereas the clinical progressive disease negative predictive value was 20%. Then, 6.9% of patients believed to have responded to the therapy, or not to have responded or worsened, actually had worsened by the end of the chemoradiotherapy.
Positive and negative predictive values, in particular for partial response and stable disease, of clinical evaluation of the response to chemoradiotherapy were not high enough to consider clinical evaluation accurate enough to make treatment decisions. |
Author | Cojutti, Alessandro Benzoni, Enrico Chiaulon, Germana Sacco, Cosimo Pontello, Daniele Bresadola, Vittorio Milan, Elisa Cerato, Franz Terrosu, Giovanni |
Author_xml | – sequence: 1 givenname: Enrico surname: Benzoni fullname: Benzoni, Enrico email: enricobenzoni@yahoo.it organization: University Hospital of Udine, Department of Surgery, Italy. enricobenzoni@yahoo.it – sequence: 2 givenname: Franz surname: Cerato fullname: Cerato, Franz – sequence: 3 givenname: Alessandro surname: Cojutti fullname: Cojutti, Alessandro – sequence: 4 givenname: Elisa surname: Milan fullname: Milan, Elisa – sequence: 5 givenname: Daniele surname: Pontello fullname: Pontello, Daniele – sequence: 6 givenname: Germana surname: Chiaulon fullname: Chiaulon, Germana – sequence: 7 givenname: Cosimo surname: Sacco fullname: Sacco, Cosimo – sequence: 8 givenname: Vittorio surname: Bresadola fullname: Bresadola, Vittorio – sequence: 9 givenname: Giovanni surname: Terrosu fullname: Terrosu, Giovanni |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/16459636$$D View this record in MEDLINE/PubMed |
BookMark | eNo1kM1qwzAQhHVIaX7aF-ih6AXcrixblo8ltE0h0Et6DmtpTRQcychKIG9fm7SXHfiYGZhdspkPnhh7EvAiRFW9ggTQtVBQQi1gvMWMLSaYTXTOlsNwBCggV-qezYUqylpJtWBhdyDeR7LOJHchfsHuTDy03HTOO4MdpwlhcsFPONLQBz8QT4F7CmiP5wv6xM2BTiGidTdnOlDE_srbEMeISWOPQW8oPrC7FruBHv90xX4-3nfrTbb9_vxav20zI0GkDHVrDSmsSmGLqpbSapSoweSyNcqUsrIlNDju1KIpRV40ppHjHxSqVuca8hV7vvX25-ZEdt9Hd8J43f8vz38B9LpdMw |
CitedBy_id | crossref_primary_10_1007_DCR_0b013e31819eefba crossref_primary_10_1177_02841851211065925 crossref_primary_10_1245_s10434_021_11121_8 crossref_primary_10_1007_s10350_007_9080_8 crossref_primary_10_1016_j_ctrv_2020_101964 crossref_primary_10_1016_j_suronc_2022_101862 crossref_primary_10_1016_j_ijrobp_2010_02_025 crossref_primary_10_1111_codi_13081 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1177/030089160509100504 |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
Discipline | Medicine |
ExternalDocumentID | 16459636 |
Genre | Journal Article |
GroupedDBID | --- -TM 0R~ 123 2WC 53G 54M 5RE 5Z9 AABMB AACMV AADUE AAEWN AAGGD AAHPS AAJQC AAKGS AAPEO AARIX AATAA AAZBJ ABCCA ABDWY ABFWQ ABJNI ABKRH ABLUO ABPNF ABRHV ABVFX ABYTW ACARO ACDXX ACFEJ ACFMA ACGBL ACGFS ACJER ACLFY ACLHI ACOFE ACOXC ACROE ACSIQ ACUAV ACUIR ACVIN ACXKE ACXMB ADBBV ADEIA ADMPF ADRRZ ADUKL AENEX AESZF AEWDL AEWHI AEXNY AFKRG AFMOU AFQAA AFUIA AGKLV AGNHF AIEWD AIGRN AIOMO AJEFB AJMMQ AJUZI AJXAJ AKSRI ALKWR ALMA_UNASSIGNED_HOLDINGS ALTZF ANDLU ARTOV B8M BBRGL BDDNI BKIIM BKSCU BPACV BSEHC BWJAD CBRKF CDWPY CFDXU CGR CORYS CQQTX CUTAK CUY CVF DC- DOPDO DV7 EBS ECM EIF EJD F5P FHBDP GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION GX1 H13 J8X JCYGO K.F M4V NPM O0M OVD Q1R SAFTQ SCNPE SFC SHG SPQ SPV TEORI UDS UGK ZGI ZONMY ZPPRI ZRKOI ZSSAH ~31 |
ID | FETCH-LOGICAL-c301t-a8fdce6a751d47933d8a3a80c23fc6c537d50ba05081b5124bcb31776a6f82802 |
ISSN | 0300-8916 |
IngestDate | Sat Sep 28 08:48:35 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 5 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c301t-a8fdce6a751d47933d8a3a80c23fc6c537d50ba05081b5124bcb31776a6f82802 |
PMID | 16459636 |
ParticipantIDs | pubmed_primary_16459636 |
PublicationCentury | 2000 |
PublicationDate | 2005-09-01 |
PublicationDateYYYYMMDD | 2005-09-01 |
PublicationDate_xml | – month: 09 year: 2005 text: 2005-09-01 day: 01 |
PublicationDecade | 2000 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States |
PublicationTitle | Tumori |
PublicationTitleAlternate | Tumori |
PublicationYear | 2005 |
SSID | ssj0040266 |
Score | 1.7650176 |
Snippet | Multimodality therapy has become the standard treatment for patients with locally advanced (T3 and T4) rectal carcinoma. Accurate preoperative staging of the... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 401 |
SubjectTerms | Adult Aged Chemotherapy, Adjuvant Disease Progression Female Humans Male Middle Aged Neoadjuvant Therapy - methods Neoplasm Staging Palpation Predictive Value of Tests Proctoscopy Radiotherapy, Adjuvant Rectal Neoplasms - diagnostic imaging Rectal Neoplasms - drug therapy Rectal Neoplasms - pathology Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Rectal Neoplasms - therapy Tomography, X-Ray Computed Treatment Outcome |
Title | The predictive value of clinical evaluation of response to neoadjuvant chemoradiation therapy for rectal cancer |
URI | https://www.ncbi.nlm.nih.gov/pubmed/16459636 |
Volume | 91 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1La8JAEF5sC6WX0ve77KE3SdkY8zpKsUhBTwreZDfZgKJZsfHiD-jv7sxuEqO2pe1lkV2zJPk-x5nZeRDyZDeS2Hccx5LcxhZmwraECF1L-IwHoN9z6WA2crfndQbNt6E7rNU-KlFLy0w8R6sv80r-gyrMAa6YJfsHZMtNYQI-A74wAsIw_hrj-QKPWnQAEBbu1i6AMt1xXcsbpxcmHlY3y0il4vFkCXp0VgfcZsCE2KBUNylZJpAT5SFWEEFuLKqKbH8Jl4xLY16mK6WbQ9XbKUhWVR5tYM1mVWjIq3JaTZaZCSRoTbEJC5ZNKLEfT41Xtj0dv_MNt4Rbxl2V6ViMWUFoEikLURvaFUq5FbnZNJfuynN9oox74VZMazcwNqtfBkzmM42wjZVxPFNQ5efVrRrbxdIe2fMDlJM99PmY_3MwsPMT7_yBitQrLNu1c2NYhDbfbMtQ0QpL_4Qc55YGbRnanJKaTM_IYTePpTgnCthD1-yhmj1UJbRgD12zB6cL9tBM0Qp76CZ7aM4eCuyhhj3UsOeCDF7b_ZeOlbffsCKQ-pnFgySOpMd9147R_-rEAXd4wKKGk0Re5Dp-7DLB4anB9AG9sSkiAdqo73EvATueNS7JfqpSeU2okCEswYboUEhkEHhcehFL_JDFYUO6N-TKvKrR3NRYGRUv8fbblTtytObdPTlI4EctH0BDzMSjBvATmdZmxA |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+predictive+value+of+clinical+evaluation+of+response+to+neoadjuvant+chemoradiation+therapy+for+rectal+cancer&rft.jtitle=Tumori&rft.au=Benzoni%2C+Enrico&rft.au=Cerato%2C+Franz&rft.au=Cojutti%2C+Alessandro&rft.au=Milan%2C+Elisa&rft.date=2005-09-01&rft.issn=0300-8916&rft.volume=91&rft.issue=5&rft.spage=401&rft_id=info:doi/10.1177%2F030089160509100504&rft_id=info%3Apmid%2F16459636&rft_id=info%3Apmid%2F16459636&rft.externalDocID=16459636 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0300-8916&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0300-8916&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0300-8916&client=summon |