Your browser doesn't support javascript.
loading
Prognostic Value of Tumor Volume, Tumor Volume Reduction Rate and Magnetic Resonance Tumor Regression Grade in Rectal Cancer.
Pikuniene, Ingrida; Straksyte, Vestina; Basevicius, Algidas; Zilinskas, Justas; Ambraziene, Rita; Janciauskiene, Rasa; Saladzinskas, Zilvinas.
Afiliación
  • Pikuniene I; Department of Radiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
  • Straksyte V; Department of Radiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
  • Basevicius A; Department of Radiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
  • Zilinskas J; Department of Surgery, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
  • Ambraziene R; The Institute of Oncology of the Faculty of Medicine, Lituanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
  • Janciauskiene R; The Institute of Oncology of the Faculty of Medicine, Lituanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
  • Saladzinskas Z; Department of Surgery, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, LT-50161 Kaunas, Lithuania.
Medicina (Kaunas) ; 59(12)2023 Dec 18.
Article en En | MEDLINE | ID: mdl-38138297
ABSTRACT
Background and

Objectives:

Rectal cancer poses significant treatment challenges, especially in advanced stages. Radiologic assessment, particularly with MRI, is critical for surgeons and oncologists to understand tumor dynamics and tailor treatment strategies to improve patient outcomes. The purpose of this study was to correlate MRI-based tumor volumetric and tumor regression grade analysis in patients with advanced rectal cancer, assessing the impact of preoperative chemotherapy (CT) alone or chemoradiotherapy (CRT) on surgical technique choices. Materials and

Methods:

Between 2015 and 2022, a prospective study was enrolled, including a cohort of 89 patients diagnosed with rectal cancer at stage II or III. The participants were divided into two distinct therapy groups, ensuring an equal distribution with a ratio of 11. The initial group was treated with the contemporary preoperative chemotherapy protocol FOLFOX4. In contrast, the alternative group received conventional preoperative chemoradiotherapy. Before surgery, each patient underwent a rectal MRI scan at 1.5 T, including T2-weighted and diffusion-weighted imaging (DWI) sequences.

Results:

The CT group showed a 36.52% tumor volume reduction rate (TVRR), and the CRT group showed 54.87%, with varying magnetic resonance and pathological tumor regression grades (mrTRG and pTRG). Analysis revealed a significant interaction between mrTRG and tumor volumetrics (volume and VRR) in both groups, especially CRT, underscoring the complexity of tumor response. Both treatment groups had similar initial tumor volumes, with CRT displaying a higher TVRR, particularly in higher pathological TRG (3/4) cases. This interaction and the strong correlation between mrTRG and pTRG suggest mrTRG's role as a non-invasive predictor for treatment response, highlighting the need for personalized treatment plans.

Conclusions:

Rectal tumor volume, volume reduction rate, and mrTRG are not just abstract measures; they are concrete indicators that have a direct and practical impact on surgical decision-making, planning, and prognosis, ultimately influencing the quality of care and life expectancy of patients with rectal cancer.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Imagen por Resonancia Magnética Límite: Humans Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article País de afiliación: Lituania Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Imagen por Resonancia Magnética Límite: Humans Idioma: En Revista: Medicina (Kaunas) Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article País de afiliación: Lituania Pais de publicación: Suiza