Annals of Coloproctology

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Efficacy and Feasibility of Adding Induction Chemotherapy to Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer: A Phase II Clinical Trial: Hamid Nasrolahi, Sepideh Mirzaei, Mohammad Mohammadianpanah, Ali Mohammad Bananzadeh, Maral Mokhtari, Mohammad Reza Sasani, Ahmad Mosalaei, Shapour Omidvari, Mansour Ansari, Niloofar Ahmadloo, Seyed Hasan Hamedi, Nezhat Khanjani; Ann Coloproctol. 2019;35(5):242-248. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.09.06

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Purpose
Currently, neoadjuvant chemoradiation (CRT) followed by total mesorectal resection is considered the standard of care for treating locally advanced rectal cancer. This study aimed to investigate the efficacy and feasibility of adding induction chemotherapy to neoadjuvant CRT in locally advanced rectal cancer.
Methods
This phase-II clinical trial included 54 patients with newly diagnosed, locally advanced (clinical T3–4 and/or N1–2, M0) rectal cancer. All patients were treated with 3 cycles of preoperative chemotherapy using the XELOX (capecitabine + oxaliplatin) regimen before and after a concurrent standard long course of CRT (45–50.4 Gy) followed by standard radical surgery. Pathologic complete response (PCR) rate and toxicity were the primary and secondary endpoints, respectively.
Results
The study participants included 37 males and 17 females, with a median age of 59 years (range, 20–80 years). Twenty-nine patients (54%) had clinical stage-II disease, and 25 patients (46%) had clinical stage-III disease. Larger tumor size (P = 0.006) and distal rectal location (P = 0.009) showed lower PCR compared to smaller tumor size and upper rectal location. Pathologic examinations showed significant tumor regression (6.1 ± 2.7 cm vs. 1.9 ± 1.8 cm, P < 0.001) with 10 PCRs (18.5%) compared to before the intervention. The surgical margin was free of cancer in 52 patients (96.3%). Treatment-related toxicities were easily tolerated, and all patients completed their planned treatment without interruption. Grade III and IV toxicities were infrequent.
Conclusion
The addition of induction chemotherapy to neoadjuvant CRT is an effective and well-tolerated treatment approach in patients with rectal cancer.

Citations

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Nanomedicine integrating the lipidic derivative of 5-fluorouracil, miriplatin and PD-L1 siRNA for enhancing tumor therapy
An Lu, Yuhao Guo, Yi Yan, Lin Zhai, Xiangyu Wang, Weiran Cao, Zijie Li, Zhixia Zhao, Yujie Shi, Yuanjun Zhu, Xiaoyan Liu, Huining He, Zhiyu Wang, Jian-Cheng Wang
Chinese Chemical Letters.2024; 35(6): 108928. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Intensified Total Neoadjuvant Therapy in Patients With Locally Advanced Rectal Cancer: A Phase II Trial
F. De Felice, G. D'Ambrosio, F. Iafrate, A. Gelibter, F.M. Magliocca, D. Musio, S. Caponetto, G. Casella, I. Clementi, A. Picchetto, G. Sirgiovani, M. Parisi, C. Orciuoli, G. Torrese, G. De Toma, V. Tombolini, E. Cortesi
Clinical Oncology.2021; 33(12): 788. CrossRef
Efficacy and safety of sequential neoadjuvant chemotherapy and short-course radiation therapy followed by delayed surgery in locally advanced rectal cancer: a single-arm phase II clinical trial with subgroup analysis between the older and young patients
Alimohammad Bananzadeh, Ali Akbar Hafezi, NamPhong Nguyen, Shapour Omidvari, Ahmad Mosalaei, Niloofar Ahmadloo, Mansour Ansari, Mohammad Mohammadianpanah
Radiation Oncology Journal.2021; 39(4): 270. CrossRef
Induction Chemotherapy in Patients With Anal Canal Cancer: A Pilot Study
Francesca De Felice, Daniela Musio, Vincenzo Tombolini
Clinical Colorectal Cancer.2020; 19(3): e137. CrossRef

Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer: Sare Hosseini, Ali Mohammad Bananzadeh, Roham Salek, Mohammad Zare-Bandamiri, Ali Taghizadeh Kermani, Mohammad Mohammadianpanah; Ann Coloproctol. 2017;33(2):57-63. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.57

6,445 View
52 Download
20 Web of Science
14 Citations

Abstract PDF

Purpose

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

Methods

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

Results

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

Conclusion

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

Citations

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Association between lymphovascular invasion and lymph node metastases in colon cancer: A National Cancer Database analysis
Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Anjelli Wignakumar, Marylise Boutros, Steven D. Wexner
Colorectal Disease.2025;[Epub] CrossRef
Comprehensive Overview of Molecular, Imaging, and Therapeutic Challenges in Rectal Mucinous Adenocarcinoma
Mihaela Berar, Andra Ciocan, Emil Moiș, Luminița Furcea, Călin Popa, Răzvan Alexandru Ciocan, Florin Zaharie, Cosmin Puia, Nadim Al Hajjar, Cosmin Caraiani, Ioana Rusu, Florin Graur
International Journal of Molecular Sciences.2025; 26(2): 432. CrossRef
Clinicopathological and prognostic features of colorectal mucinous adenocarcinomas: a systematic review and meta-analysis
Xiao Wang, Haoran Wang, Haoqing He, Kai Lv, Wenguang Yuan, Jingbo Chen, Hui Yang
BMC Cancer.2024;[Epub] CrossRef
Multi gene mutation signatures in colorectal cancer patients: predict for the diagnosis, pathological classification, staging and prognosis
Yan Zhuang, Hailong Wang, Da Jiang, Ying Li, Lixia Feng, Caijuan Tian, Mingyu Pu, Xiaowei Wang, Jiangyan Zhang, Yuanjing Hu, Pengfei Liu
BMC Cancer.2021;[Epub] CrossRef
Clinicopathological Features and Survival of Signet-Ring Cell Carcinoma and Mucinous Adenocarcinoma of Right Colon, Left Colon, and Rectum
Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
Pathology and Oncology Research.2021;[Epub] CrossRef
Identification of Potential Biomarkers and Biological Pathways for Poor Clinical Outcome in Mucinous Colorectal Adenocarcinoma
Chang Woo Kim, Jae Myung Cha, Min Seob Kwak
Cancers.2021; 13(13): 3280. CrossRef
Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study
Chuanwang Yan, Hui Yang, Lili Chen, Ran Liu, Wei Shang, Wenguang Yuan, Fei Yang, Qing Sun, Lijian Xia
BMC Cancer.2021;[Epub] CrossRef
Incidence and prognosis of pulmonary metastasis in colorectal cancer: a population-based study
Yizhi Ge, Shijun Lei, Bo Cai, Xiang Gao, Guobin Wang, Lin Wang, Zheng Wang
International Journal of Colorectal Disease.2020; 35(2): 223. CrossRef
Association between aberrant dynein cytoplasmic�1 light intermediate chain�1 expression levels, mucins and chemosensitivity in colorectal cancer
Chun‑Chao Chang, Kuo‑Ching Chao, Chi‑Jung Huang, Chih‑Sheng Hung, Yen‑Chieh Wang
Molecular Medicine Reports.2020;[Epub] CrossRef
Clinical impact of non-predominant histopathological subtypes on the long-term prognosis of colorectal cancer patients in Japan
Heita Ozawa, Shinichi Yamauchi, Hiroki Nakanishi, Junichi Sakamoto, Shin Fujita, Kenichi Sugihara
International Journal of Colorectal Disease.2020; 35(12): 2257. CrossRef
Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
SCF/c-KIT Signaling Increased Mucin2 Production by Maintaining Atoh1 Expression in Mucinous Colorectal Adenocarcinoma
Ping Shen, Shu Yang, Haimei Sun, Guilan Li, Bo Wu, Fengqing Ji, Tingyi Sun, Deshan Zhou
International Journal of Molecular Sciences.2018; 19(5): 1541. CrossRef
Mucinous Subtype in Patients With Colorectal Cancer
Hyung Jin Kim
Annals of Coloproctology.2017; 33(2): 44. CrossRef

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