The role of some clinical and morphological factors in evaluating the efficiency of neoadjuvant chemoradiotherapy for rectal adenocarcinoma

Vologirova M.A.; Volchenko N.N.; Droshneva I.V.; Sidorov D.V.

doi:https://doi.org/10.17116/onkolog20221106126

Vologirova M.A.

P.A Herzen Moscow Research Oncology Institute — Branch of the National Medical Radiology Research Center

Volchenko N.N.

P.A. Herzen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Center of the Ministry of Health of Russia

RSCI AuthorID: 290657
Scopus AuthorID: 7004119203
ORCID: 0000-0002-4873-4455

Droshneva I.V.

P.A Herzen Moscow Research Oncology Institute — Branch of the National Medical Radiology Research Center of the Ministry of Health of Russia. Moscow, Russi

Sidorov D.V.

City Clinical Oncology Hospital One Moscow City Healthcare Department

ORCID: 0000-0002-8282-9351

The role of some clinical and morphological factors in evaluating the efficiency of neoadjuvant chemoradiotherapy for rectal adenocarcinoma

Authors:

Vologirova M.A., Volchenko N.N., Droshneva I.V., Sidorov D.V.

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Journal: P.A. Herzen Journal of Oncology. 2022;11(6): 26‑30

DOI: 10.17116/onkolog20221106126

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To cite this article:

Vologirova MA, Volchenko NN, Droshneva IV, Sidorov DV. The role of some clinical and morphological factors in evaluating the efficiency of neoadjuvant chemoradiotherapy for rectal adenocarcinoma. P.A. Herzen Journal of Oncology. 2022;11(6):26‑30. (In Russ.)
https://doi.org/10.17116/onkolog20221106126

Подписка 2026 Онкология. Журнал им. П.А. Герцена (P.A. Herzen Journal of Oncology)

Использование инфографики авторами научных работ

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OBJECTIVE

To study the prognostic role of several clinical and morphological factors in the efficiency of chemoradiotherapy for rectal adenocarcinoma.

SUBJECTS AND METHODS

The investigation enrolled 122 patients with locally advanced rectal cancer (LARC). At the first stage of combination treatment, the patients received neoadjuvant chemoradiotherapy (nCRT) as a dynamic dose-fractionation regimen combined with radiomodification with the chemotherapy drugs Cisplatin and 5-FU, followed by surgery after 8 to 12 weeks. Biopsy material was immunohistochemically studied to estimate the level of expression of biomarkers in tumor cells and their effectiveness in assessing the radiosensitivity of adenogenic rectal cancer.

RESULTS

Statistical analysis revealed that clinical and morphological factors, such as a distance of more than 35 mm from the anal verge; expression levels of COX2 (>12.5%), Ki-67 (>81%), and P53 (>47%), significantly influenced grades III-IV therapeutic pathomorphism of a tumor. Analysis of long-term treatment results showed that the 5-year overall survival (OS) rates in the groups of grades I—II and III—IV therapeutic pathomorphism were 61.8±8.3 and 94.4±5.4%, respectively. The 5-year relapse-free survival (RFS) rates in these groups were 54.4±8.7 and 89.5±7.0%, respectively.

CONCLUSION

The investigation has identified predictors for the efficiency of nCLT for LARC, such as a distal tumor border of more than 35 mm from the anus; expression levels of Ki-67 (>81%), p53 (>47%), and COX2 (>12.5%). The 5-year OS and RFS rates are expectedly high in the group of complete and partial tumor pathomorphism.

Keywords:

rectal cancer

chemoradiotherapy

biomarkers

COX2

Ki-67

P53

Authors:

Vologirova M.A.

P.A Herzen Moscow Research Oncology Institute — Branch of the National Medical Radiology Research Center

Volchenko N.N.

P.A. Herzen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Center of the Ministry of Health of Russia

RSCI AuthorID: 290657
Scopus AuthorID: 7004119203
ORCID: 0000-0002-4873-4455

Droshneva I.V.

P.A Herzen Moscow Research Oncology Institute — Branch of the National Medical Radiology Research Center of the Ministry of Health of Russia. Moscow, Russi

Sidorov D.V.

City Clinical Oncology Hospital One Moscow City Healthcare Department

ORCID: 0000-0002-8282-9351

Received:

15.09.2022

Accepted:

19.09.2022

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References:

Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, Cantor SB, Chang GJ. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975—2010. JAMA Surg. 2015;150(1):17-22. https://doi.org/10.1001/jamasurg.2014.1756
Rasulov AO, Dzhumabaev KhE, Kulushev VM, Mamedli ZZ, Kozlov NA, Gordeev SS, Rakhimov OA. Results of transanal mesorectumectomy in patients with rectal cancer. Onkologicheskaya koloproktologiya. 2017;1:11—17. (In Russ.). https://doi.org/10.17650/2220-3478-2017-7-1-11-17
Dmitriev AV, Khoron’ko YuV, Pereskokov SV, Groshilin VS, Kozyrevskii MA, Afunts LS, Kuznetsov II. Comparative evaluation of direct results of low anterior rectal resection with total mesorectumectomy using laparoscopic and laparotomic methods. Experimental and clinical gastroenterology. 2020;12(issue 184):31—37. (In Russ.). https://doi.org/10.31146/1682-8658-ecg-184-12-3
Yang Y, Meng WJ, Wang ZQ. MicroRNAs in colon and rectal cancer — novel biomarkers from diagnosis to therapy. Endocr Metab Immune Disord Drug Targets. 2020;20(8):1211-1226. https://doi.org/10.2174/1871530320666200506075219
Azimov EG, Aliev SA. Total mesorectumectomy in the surgical treatment of rectal cancer: open or laparoscopic? Grekov’s Bulletin of Surgery. 2019;178(5):81-88. (In Russ.). https://doi.org/10.24884/0042-4625-2019-178-5-81-88
Kaprin AD, Starinskii VV, Shakhzadova AO, eds. Malignant neoplasms in Russia in 2020 (morbidity and mortality). Moscow: MNIOI im. P.A. Gertsena — filial FGBU «NMIRTs radioologii» Ministerstva zdravookhraneniya Rossiiskoi Federatsii; 2021. (In Russ.).
Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rödel C, Cervantes A, Arnold D; ESMO Guidelines Committee. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl 4):22-40. https://doi.org/10.1093/annonc/mdx224
Dalle Fratte C, Mezzalira S, Polesel J, De Mattia E, Palumbo A, Buonadonna A, Palazzari E, De Paoli A, Belluco C, Canzonieri V, et al. A panel of tumor biomarkers to predict complete pathological response to neoadjuvant treatment in locally advanced rectal cancer. Oncol Res. 2022;28(9):847-855. https://doi.org/10.3727/096504021X16232280278813
Smith FM, Reynolds JV, Miller N, Stephens RB, Kennedy MJ. Pathological and molecular predictors of the response of rectal cancer to neoadjuvant radiochemotherapy. Eur J Surg Oncol. 2006;32(1):55-64. https://doi.org/10.1016/j.ejso.2005.09.010
Negri FV, Campanini N, Camisa R, Pucci F, Bui S, Ceccon G, Martinelli R, Fumagalli M, Losardo PL, Crafa PC, et al. Biological predictive factors in rectal cancer treated with preoperative radiotherapy or radiochemotherapy. Br J Cancer. 2008;98(1):143-147. https://doi.org/10.1038/sj.bjc.6604131
Peng Wang, Jianwei Liang, Zheng Wang, Huirong Hou, Lei Shi, Zhixiang Zhou. The prognostic value of p53 positive in colorectal cancer: A retrospective cohort study. Tumour Biol. 2017;39(5):1010428317703651. https://doi.org/10.1177/1010428317703651
Guojun Tong, Guiyang Zhang, Jian Liu, Zhaozheng Zheng, Yan Chen, Pingping Niu, Xuting Xu. Cutoff of 25% for Ki67 expression is a good classification tool for prognosis in colorectal cancer in the AJCC-8 stratification. Oncol Rep. 2020;43(4):1187-1198. https://doi.org/10.3892/or.2020.7511
E Shinto, J Omata, A Sikina, A Sekizawa, Y Kajiwara, K Hayashi, Y Hashiguchi, K Hase, H Ueno. Predictive immunohistochemical features for tumour response to chemoradiotherapy in rectal cancer. BJS Open. 2020;4(2):301-309. https://doi.org/10.1002/bjs5.50251