Pub Date : 2019-01-10DOI: 10.31487/J.JSO.2018.01.005
G. R. Caravaca, Ignacio Juez-Martel, Ma Victoria De-Torres-Olombrada, M. Durán-Poveda
Objective To study the effect of the pathologic complete response (pCR) on the survival of patients treated with surgery and neoadjuvant chemo-radiotherapy in locally advanced non-metastatic rectal carcinoma (LARC). Materials and methodology We underwent an observational retrospective analysis of cohorts. The recruitment was carried out by means of non-probabilistic consecutive inclusion of patients with rectal cancer treated between January 2009 and December 2016 with surgery and neoadjuvant chemo-radiotherapy. The patients recruited had been diagnosed with locally advanced non-metastatic rectal cancer. cT3-4 o N+. based on the American Joint Committee on Cancer (AJCC) 2010. with histological confirmation of adenocarcinoma and no treatment with induction chemotherapy. The pathologic response was calibrated in accordance with the Ryan system. Survival was calculated with multivariate Cox regression analysis Results Pathologic complete response was reached by 19.2% Patients. The disease free survival was significantly lower in the no pathologic complete response (HR 0.099. p value 0.025). The progression in the group of patients with pathological complete response occurred in only one patient and have local and distal component compared to 39 patients in no pCR 21.2% distant metastases and 3.8% locally relapse. Perineural invasion and adjuvant chemotherapy were also significatly associated with disease free survival Conclusions The pathological complete response is a good prognosis factor in patients treated with surgery and nCRT in LARC with distal and local relapse. Perineural invasion and adjuvant chemotherapy were also good prognostic factors.
目的探讨病理完全缓解(pCR)对局部晚期非转移性直肠癌(LARC)手术加新辅助化疗患者生存的影响。材料和方法我们对队列进行了观察性回顾性分析。招募是通过非概率连续纳入2009年1月至2016年12月期间接受手术和新辅助化疗的直肠癌患者进行的。招募的患者被诊断为局部晚期非转移性直肠癌。cT3-4 o N+。基于美国癌症联合委员会(AJCC) 2010。组织学证实为腺癌，未接受诱导化疗。病理反应按照Ryan系统进行校准。采用多因素Cox回归分析计算生存率。结果19.2%的患者达到病理完全缓解。无病理完全缓解组的无病生存期明显低于无病理完全缓解组(HR 0.099)。P值0.025)。病理完全缓解组的进展仅发生在1例患者中，有局部和远端成分，而无pCR的39例患者中有21.2%的远处转移和3.8%的局部复发。结论在远端和局部复发的LARC患者中，病理完全缓解是一个良好的预后因素。神经周围浸润和辅助化疗也是预后良好的因素。
{"title":"Role of the complete pathological response in rectal cancer: Value as a prognostic factor","authors":"G. R. Caravaca, Ignacio Juez-Martel, Ma Victoria De-Torres-Olombrada, M. Durán-Poveda","doi":"10.31487/J.JSO.2018.01.005","DOIUrl":"https://doi.org/10.31487/J.JSO.2018.01.005","url":null,"abstract":"Objective \u0000To study the effect of the pathologic complete response (pCR) on the survival of patients treated with \u0000surgery and neoadjuvant chemo-radiotherapy in locally advanced non-metastatic rectal carcinoma (LARC). \u0000Materials and methodology \u0000We underwent an observational retrospective analysis of cohorts. The recruitment was carried out by means \u0000of non-probabilistic consecutive inclusion of patients with rectal cancer treated between January 2009 and \u0000December 2016 with surgery and neoadjuvant chemo-radiotherapy. The patients recruited had been \u0000diagnosed with locally advanced non-metastatic rectal cancer. cT3-4 o N+. based on the American Joint \u0000Committee on Cancer (AJCC) 2010. with histological confirmation of adenocarcinoma and no treatment \u0000with induction chemotherapy. The pathologic response was calibrated in accordance with the Ryan system. \u0000Survival was calculated with multivariate Cox regression analysis \u0000Results \u0000Pathologic complete response was reached by 19.2% Patients. The disease free survival was significantly \u0000lower in the no pathologic complete response (HR 0.099. p value 0.025). The progression in the group of \u0000patients with pathological complete response occurred in only one patient and have local and distal \u0000component compared to 39 patients in no pCR 21.2% distant metastases and 3.8% locally relapse. \u0000Perineural invasion and adjuvant chemotherapy were also significatly associated with disease free survival \u0000Conclusions \u0000The pathological complete response is a good prognosis factor in patients treated with surgery and nCRT \u0000in LARC with distal and local relapse. Perineural invasion and adjuvant chemotherapy were also good \u0000prognostic factors.","PeriodicalId":320469,"journal":{"name":"Endoprosthetic Total Scapula Replacement Versus Suspension Arthroplasty Following Tumor Resection","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125349680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-29DOI: 10.31487/J.JSO.2018.01.003
F. Patterson, J. Thomson, J. Benevenia, Kathleen S Beebe, Michael N. Kang
Peri-acetabular metastasis presents the risk of fracture. However, the relationship between bone loss and fracture risk is unknown. Utilizing fresh frozen intact cadaver pelves, Harrington class I lesions were simulated. Lesions were categorized as small ( 40%) Axial loading was applied in a quasistatic mechanism by a mechanical testing system to catastrophic failure, with the load-to-failure force being measured. There was statistical difference in the load-to-failure force between hemi-pelves with large defects and their matched controls. It was found that mean load-to-failure strength of a hemi-pelvis with a Class I defect was more than 2.3-2.45 times the calculated hip joint reactive force. Thus, it was concluded that a pelvis with a peri-acetabular defect of greater than 40% has a significantly lower load-to-failure strength compared to an intact pelvis. However, even this large Class I defect will fracture only at supraphysiologic loads and the hip joint may not normally be exposed to forces that high.
{"title":"Biomechanical Study of Simulated Metastatic Peri-Acetabular Defects","authors":"F. Patterson, J. Thomson, J. Benevenia, Kathleen S Beebe, Michael N. Kang","doi":"10.31487/J.JSO.2018.01.003","DOIUrl":"https://doi.org/10.31487/J.JSO.2018.01.003","url":null,"abstract":"Peri-acetabular metastasis presents the risk of fracture. However, the relationship between bone loss and \u0000fracture risk is unknown. Utilizing fresh frozen intact cadaver pelves, Harrington class I lesions were \u0000simulated. Lesions were categorized as small ( 40%) Axial loading was applied in a quasistatic mechanism by a mechanical testing system to catastrophic failure, with the load-to-failure force being \u0000measured. There was statistical difference in the load-to-failure force between hemi-pelves with large \u0000defects and their matched controls. It was found that mean load-to-failure strength of a hemi-pelvis with a \u0000Class I defect was more than 2.3-2.45 times the calculated hip joint reactive force. Thus, it was concluded \u0000that a pelvis with a peri-acetabular defect of greater than 40% has a significantly lower load-to-failure \u0000strength compared to an intact pelvis. However, even this large Class I defect will fracture only at supraphysiologic loads and the hip joint may not normally be exposed to forces that high.","PeriodicalId":320469,"journal":{"name":"Endoprosthetic Total Scapula Replacement Versus Suspension Arthroplasty Following Tumor Resection","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121274489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：