Citation: 王林,顾晋. Downstaging and Tumor Regression in Rectal Cancer Following Neo-Adjuvant Chemoradiotherapy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(11): 1147-1150. doi: Copy
1. | Clinical pactice gidlines of rectal cancer 2011v1 [Z]. Available at http://www.nccn.org/professionals/physician_gls/PDF/rectal.pdf. |
2. | BeetsTan RG. MRI in rectal cancer: the T stage and circumferential resection margin [J]. Colorectal Dis, 2003, 5(5): 392395. |
3. | Brown G, Kirkham A, Williams GT, et al. Highresolution MRI of the anatomy important in total mesorectal excision of the rectum [J]. AJR Am J Roentgenol, 2004, 182(2): 431439. |
4. | Brown G, Daniels IR. Preoperative staging of rectal cancer: the MERCURY research project [J]. Recent Results Cancer Res, 2005, 165: 5874. |
5. | Salerno G, Daniels IR, Moran BJ, et al. Clarifying margins in the multidisciplinary management of rectal cancer: the MERCURY experience [J]. Clin Radiol, 2006, 61(11): 916923. |
6. | Guo M, Gao C, Li D, et al. MRI anatomy of the anal region[J]. Dis Colon Rectum, 2010, 53(11): 15421548. |
7. | Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer [J]. N Engl J Med, 2004, 351(17): 17311740. |
8. | Larsen SG, Wiig JN, Emblemsvaag HL, et al. Extended total mesorectal excision in locally advanced rectal cancer (T4a) and the clinical role of MRIevaluated neoadjuvant downstaging [J]. Colorectal Dis, 2009, 11(7): 759767. |
9. | Das P, Skibber JM, RodriguezBigas MA, et al. Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer [J]. Cancer, 2007, 109(9): 17501755. |
10. | Kim NK, Baik SH, Seong JS, et al. Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumorspecific mesorectal excision for fixed locally advanced rectal cancer: Impact of postirradiated pathologic downstaging on local recurrence and survival [J]. Ann Surg, 2006, 244(6): 10241030. |
11. | Theodoropoulos G, Wise WE, Padmanabhan A, et al. Tlevel downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved diseasefree survival [J]. Dis Colon Rectum, 2002, 45(7): 895903. |
12. | Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphinctersparing surgery for rectal cancer: the Lyon R9001 randomized trial [J]. J Clin Oncol, 1999, 17(8): 2396. |
13. | Hiotis SP, Weber SM, Cohen AM, et al. Assessing the predictive value of clinical complete response to neoadjuvant therapy for rectal cancer: an analysis of 488 patients [J]. J Am Coll Surg, 2002, 194(2): 131135. |
14. | Guillem JG, Chessin DB, Cohen AM, et al. Longterm oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer [J]. Ann Surg, 2005, 241(5): 829836. |
15. | Hughes R, GlynneJones R, Grainger J, et al. Can pathological complete response in the primary tumour following preoperative pelvic chemoradiotherapy for T3T4 rectal cancer predict for sterilisation of pelvic lymph nodes, a low risk of local recurrence and the appropriateness of local excision? [J]. Int J Colorectal Dis, 2006, 21(1): 1117. |
16. | Onaitis MW, Noone RB, Fields R, et al. Complete response to neoadjuvant chemoradiation for rectal cancer does not influence survival [J]. Ann Surg Oncol, 2001, 8(10): 801806. |
17. | Carlo C, Vincenzo V, Luca C, et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: longterm analysis of 566 ypCR patients [J]. Int J Radiat Oncol Biol Phys, 2008, 72(1): 99107. |
18. | Stipa F, Chessin DB, Shia J, et al. A pathologic complete response of rectal cancer to preoperative combinedmodality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography [J]. Ann Surg Oncol, 2006, 13(8): 10471053. |
19. | Engelen SM, BeetsTan RG, Lahaye MJ, et al. MRI after chemoradiotherapy of rectal cancer: a useful tool to select patients for local excision[J]. Dis Colon Rectum, 2010, 53(7): 979986. |
20. | Yeo SG, Kim DY, Kim TH, et al. Local excision following preoperative chemoradiotherapyinduced downstaging for selected cT3 distal rectal cancer [J]. Jpn J Clin Oncol, 2010, 40(8): 754760. |
21. | Vincenzo V, Claudio C, Aurelio P, et al. Does downstaging predict improved outcome after preoperative chemoradiation for extraperitoneal locally advanced rectal cancer? A longterm analysis of 165 patients [J]. Int J Radiat Oncol Biol Phys, 2002, 53(3): 664674. |
22. | Huh JW, Kim HR. Postoperative chemotherapy after neoadjuvant chemoradiation and surgery for rectal cancer: is it essential for patients with ypT02N0?[J]. J Surg Oncol, 2009, 100(5): 387391. |
23. | Fietkau R, Barten M, Klautke G, et al. Postoperative chemotherapy may not be necessary for patients with ypN0category after neoadjuvant chemoradiotherapy of rectal cancer [J]. Dis Colon Rectum, 2006, 49(9): 12841292. |
24. | Pasetto LM, Basso U, Sinigaglia G, et al. Rectal cancer adjuvant chemotherapy: when is more useful? [J]. Anticancer Res, 2008, 28(3B): 18051812. |
25. | CamposLobato CL, Stocchi L, da Luz MA, et al. Downstaging without complete pathologic response after neoadjuvant treatment improves cancer outcomes for cⅢ but not cⅡ rectal cancers [J]. Ann Surg Oncol, 2010, 17(7): 17581766. |
26. | Rullier A, Laurent C, Vendrely V, et al. Impact of colloid response on survival after preoperative radiotherapy in locally advanced rectal carcinoma [J]. Am J Surg Pathol, 2005, 29(5): 602606. |
27. | Kalady MF, de CamposLobato LF, Stocchi L, et al. Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer [J]. Ann Surg, 2009, 250(4): 582589. |
28. | Moore HG, Gittleman AE, Minsky BD, et al. Rate of pathologic complete response with increased interval between preoperative combined modality therapy and rectal cancer resection [J]. Dis Colon Rectum, 2004, 47(3): 279286. |
29. | Tulchinsky H, Shmueli E, Figer A, et al. An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and diseasefree survival in patients with locally advanced rectal cancer [J]. Ann Surg Oncol, 2008, 15(10): 26612667. |
30. | HabrGama A, Perez RO, Proscurshim I, et al. Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer: does delayed surgery have an impact on outcome? [J]. Int J Radiat Oncol Biol Phys, 2008, 71(4): 11811188. |
31. | Lim SB, Choi HS, Jeong SY, et al. Optimal surgery time after preoperative chemoradiotherapy for locally advanced rectal cancers [J]. Ann Surg, 2008, 248(2): 243251. |
32. | Marijnen CA, Nagtegaal ID, Klein Kranenbarg E, et al. No downstaging after shortterm preoperative radiotherapy in rectal cancer patients[J]. J Clin Oncol, 2001, 19(7): 19761984. |
33. | Bosset JF, Calais G, Mineur L, et al. Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary resultsEORTC 22921 [J]. J Clin Oncol, 2005, 23(24): 56205627. |
34. | Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations [J]. Cancer, 1994, 73(11): 26802686. |
35. | Vecchio FM, Vincenzo V, Minsky BD, et al. The relationship of pathologic tumor regression grade (TRG) and outcomes after preoperative therapy in rectal cancer [J]. Int J Radiat Oncol Biol Phys, 2005, 62(3): 752760. |
36. | Vironen J, Juhola M, Kairaluoma M, et al. Tumour regression grading in the evaluation of tumour response after different preoperative radiotherapy treatments for rectal carcinoma [J]. Int J Colorectal Dis, 2005, 20(5): 440445. |
37. | Twu CM, Wang HM, Chen JB, et al. Neoadjuvant concurrent chemoradiotherapy in treating locally advanced rectal cancer [J]. J Chin Med Assoc, 2009, 72(4): 179182. |
38. | Wheeler JM, Dodds E, Warren BF, et al. Preoperative chemoradiotherapy and total mesorectal excision surgery for locally advanced rectal cancer: correlation with rectal cancer regression grade [J]. Dis Colon Rectum, 2004, 47(12): 20252031. |
39. | Ryan R, Gibbons D, Hyland JM, et al. Pathological response following longcourse neoadjuvant chemoradiotherapy for locally advanced rectal cancer [J].Histopathology, 2005, 47(2): 141146. |
40. | Dworak O, Keilholz L, Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy [J]. Int J Colorectal Dis, 1997, 12(1): 1923. |
41. | Wheeler JM, Warren BF, Mortensen NJ, et al. Quantification of histologic regression of rectal cancer after irradiation: a proposal for a modified staging system [J]. Dis Colon Rectum, 2002, 45(8): 10511056. |
42. | Bateman AC, Jaynes E, Bateman AR. Rectal cancer staging post neoadjuvant therapy—how should the changes be assessed? [J]. Histopathology, 2009, 54(6): 713721. |
43. | American Joint Committee on Cancer. AJCC cancer staging handbook [Z]. 7th ed. New York: Springer, 2010: 718. |
44. | Nagtegaal ID, van de Velde CJ, van der Worp E, et al. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control [J]. J Clin Oncol, 2002, 20(7): 17291734. |
45. | Wibe A, Rendedal PR, Svensson E, et al. Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer [J]. Br J Surg, 2002, 89(3): 327334. |
46. | SebagMontefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCICCTG C016): a multicentre, randomised trial [J]. Lancet, 2009, 373(9666): 811820. |
47. | Marijnen CA, Nagtegaal ID, Kapiteijn E, et al. Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial [J]. Int J Radiat Oncol Biol Phys, 2003, 55(5): 13111320. |
48. | Gérard JP, Azria D, GourgouBourgade S, et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase Ⅲ trial ACCORD 12/0405Prodige 2 [J]. J Clin Oncol, 2010, 28(10): 16381644. |
- 1. Clinical pactice gidlines of rectal cancer 2011v1 [Z]. Available at http://www.nccn.org/professionals/physician_gls/PDF/rectal.pdf.
- 2. BeetsTan RG. MRI in rectal cancer: the T stage and circumferential resection margin [J]. Colorectal Dis, 2003, 5(5): 392395.
- 3. Brown G, Kirkham A, Williams GT, et al. Highresolution MRI of the anatomy important in total mesorectal excision of the rectum [J]. AJR Am J Roentgenol, 2004, 182(2): 431439.
- 4. Brown G, Daniels IR. Preoperative staging of rectal cancer: the MERCURY research project [J]. Recent Results Cancer Res, 2005, 165: 5874.
- 5. Salerno G, Daniels IR, Moran BJ, et al. Clarifying margins in the multidisciplinary management of rectal cancer: the MERCURY experience [J]. Clin Radiol, 2006, 61(11): 916923.
- 6. Guo M, Gao C, Li D, et al. MRI anatomy of the anal region[J]. Dis Colon Rectum, 2010, 53(11): 15421548.
- 7. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer [J]. N Engl J Med, 2004, 351(17): 17311740.
- 8. Larsen SG, Wiig JN, Emblemsvaag HL, et al. Extended total mesorectal excision in locally advanced rectal cancer (T4a) and the clinical role of MRIevaluated neoadjuvant downstaging [J]. Colorectal Dis, 2009, 11(7): 759767.
- 9. Das P, Skibber JM, RodriguezBigas MA, et al. Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer [J]. Cancer, 2007, 109(9): 17501755.
- 10. Kim NK, Baik SH, Seong JS, et al. Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumorspecific mesorectal excision for fixed locally advanced rectal cancer: Impact of postirradiated pathologic downstaging on local recurrence and survival [J]. Ann Surg, 2006, 244(6): 10241030.
- 11. Theodoropoulos G, Wise WE, Padmanabhan A, et al. Tlevel downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved diseasefree survival [J]. Dis Colon Rectum, 2002, 45(7): 895903.
- 12. Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphinctersparing surgery for rectal cancer: the Lyon R9001 randomized trial [J]. J Clin Oncol, 1999, 17(8): 2396.
- 13. Hiotis SP, Weber SM, Cohen AM, et al. Assessing the predictive value of clinical complete response to neoadjuvant therapy for rectal cancer: an analysis of 488 patients [J]. J Am Coll Surg, 2002, 194(2): 131135.
- 14. Guillem JG, Chessin DB, Cohen AM, et al. Longterm oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer [J]. Ann Surg, 2005, 241(5): 829836.
- 15. Hughes R, GlynneJones R, Grainger J, et al. Can pathological complete response in the primary tumour following preoperative pelvic chemoradiotherapy for T3T4 rectal cancer predict for sterilisation of pelvic lymph nodes, a low risk of local recurrence and the appropriateness of local excision? [J]. Int J Colorectal Dis, 2006, 21(1): 1117.
- 16. Onaitis MW, Noone RB, Fields R, et al. Complete response to neoadjuvant chemoradiation for rectal cancer does not influence survival [J]. Ann Surg Oncol, 2001, 8(10): 801806.
- 17. Carlo C, Vincenzo V, Luca C, et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: longterm analysis of 566 ypCR patients [J]. Int J Radiat Oncol Biol Phys, 2008, 72(1): 99107.
- 18. Stipa F, Chessin DB, Shia J, et al. A pathologic complete response of rectal cancer to preoperative combinedmodality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography [J]. Ann Surg Oncol, 2006, 13(8): 10471053.
- 19. Engelen SM, BeetsTan RG, Lahaye MJ, et al. MRI after chemoradiotherapy of rectal cancer: a useful tool to select patients for local excision[J]. Dis Colon Rectum, 2010, 53(7): 979986.
- 20. Yeo SG, Kim DY, Kim TH, et al. Local excision following preoperative chemoradiotherapyinduced downstaging for selected cT3 distal rectal cancer [J]. Jpn J Clin Oncol, 2010, 40(8): 754760.
- 21. Vincenzo V, Claudio C, Aurelio P, et al. Does downstaging predict improved outcome after preoperative chemoradiation for extraperitoneal locally advanced rectal cancer? A longterm analysis of 165 patients [J]. Int J Radiat Oncol Biol Phys, 2002, 53(3): 664674.
- 22. Huh JW, Kim HR. Postoperative chemotherapy after neoadjuvant chemoradiation and surgery for rectal cancer: is it essential for patients with ypT02N0?[J]. J Surg Oncol, 2009, 100(5): 387391.
- 23. Fietkau R, Barten M, Klautke G, et al. Postoperative chemotherapy may not be necessary for patients with ypN0category after neoadjuvant chemoradiotherapy of rectal cancer [J]. Dis Colon Rectum, 2006, 49(9): 12841292.
- 24. Pasetto LM, Basso U, Sinigaglia G, et al. Rectal cancer adjuvant chemotherapy: when is more useful? [J]. Anticancer Res, 2008, 28(3B): 18051812.
- 25. CamposLobato CL, Stocchi L, da Luz MA, et al. Downstaging without complete pathologic response after neoadjuvant treatment improves cancer outcomes for cⅢ but not cⅡ rectal cancers [J]. Ann Surg Oncol, 2010, 17(7): 17581766.
- 26. Rullier A, Laurent C, Vendrely V, et al. Impact of colloid response on survival after preoperative radiotherapy in locally advanced rectal carcinoma [J]. Am J Surg Pathol, 2005, 29(5): 602606.
- 27. Kalady MF, de CamposLobato LF, Stocchi L, et al. Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer [J]. Ann Surg, 2009, 250(4): 582589.
- 28. Moore HG, Gittleman AE, Minsky BD, et al. Rate of pathologic complete response with increased interval between preoperative combined modality therapy and rectal cancer resection [J]. Dis Colon Rectum, 2004, 47(3): 279286.
- 29. Tulchinsky H, Shmueli E, Figer A, et al. An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and diseasefree survival in patients with locally advanced rectal cancer [J]. Ann Surg Oncol, 2008, 15(10): 26612667.
- 30. HabrGama A, Perez RO, Proscurshim I, et al. Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer: does delayed surgery have an impact on outcome? [J]. Int J Radiat Oncol Biol Phys, 2008, 71(4): 11811188.
- 31. Lim SB, Choi HS, Jeong SY, et al. Optimal surgery time after preoperative chemoradiotherapy for locally advanced rectal cancers [J]. Ann Surg, 2008, 248(2): 243251.
- 32. Marijnen CA, Nagtegaal ID, Klein Kranenbarg E, et al. No downstaging after shortterm preoperative radiotherapy in rectal cancer patients[J]. J Clin Oncol, 2001, 19(7): 19761984.
- 33. Bosset JF, Calais G, Mineur L, et al. Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary resultsEORTC 22921 [J]. J Clin Oncol, 2005, 23(24): 56205627.
- 34. Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations [J]. Cancer, 1994, 73(11): 26802686.
- 35. Vecchio FM, Vincenzo V, Minsky BD, et al. The relationship of pathologic tumor regression grade (TRG) and outcomes after preoperative therapy in rectal cancer [J]. Int J Radiat Oncol Biol Phys, 2005, 62(3): 752760.
- 36. Vironen J, Juhola M, Kairaluoma M, et al. Tumour regression grading in the evaluation of tumour response after different preoperative radiotherapy treatments for rectal carcinoma [J]. Int J Colorectal Dis, 2005, 20(5): 440445.
- 37. Twu CM, Wang HM, Chen JB, et al. Neoadjuvant concurrent chemoradiotherapy in treating locally advanced rectal cancer [J]. J Chin Med Assoc, 2009, 72(4): 179182.
- 38. Wheeler JM, Dodds E, Warren BF, et al. Preoperative chemoradiotherapy and total mesorectal excision surgery for locally advanced rectal cancer: correlation with rectal cancer regression grade [J]. Dis Colon Rectum, 2004, 47(12): 20252031.
- 39. Ryan R, Gibbons D, Hyland JM, et al. Pathological response following longcourse neoadjuvant chemoradiotherapy for locally advanced rectal cancer [J].Histopathology, 2005, 47(2): 141146.
- 40. Dworak O, Keilholz L, Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy [J]. Int J Colorectal Dis, 1997, 12(1): 1923.
- 41. Wheeler JM, Warren BF, Mortensen NJ, et al. Quantification of histologic regression of rectal cancer after irradiation: a proposal for a modified staging system [J]. Dis Colon Rectum, 2002, 45(8): 10511056.
- 42. Bateman AC, Jaynes E, Bateman AR. Rectal cancer staging post neoadjuvant therapy—how should the changes be assessed? [J]. Histopathology, 2009, 54(6): 713721.
- 43. American Joint Committee on Cancer. AJCC cancer staging handbook [Z]. 7th ed. New York: Springer, 2010: 718.
- 44. Nagtegaal ID, van de Velde CJ, van der Worp E, et al. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control [J]. J Clin Oncol, 2002, 20(7): 17291734.
- 45. Wibe A, Rendedal PR, Svensson E, et al. Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer [J]. Br J Surg, 2002, 89(3): 327334.
- 46. SebagMontefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCICCTG C016): a multicentre, randomised trial [J]. Lancet, 2009, 373(9666): 811820.
- 47. Marijnen CA, Nagtegaal ID, Kapiteijn E, et al. Radiotherapy does not compensate for positive resection margins in rectal cancer patients: report of a multicenter randomized trial [J]. Int J Radiat Oncol Biol Phys, 2003, 55(5): 13111320.
- 48. Gérard JP, Azria D, GourgouBourgade S, et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase Ⅲ trial ACCORD 12/0405Prodige 2 [J]. J Clin Oncol, 2010, 28(10): 16381644.