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MRI predicts survival in locally advanced rectal cancer
Date:8/29/2011

ly designated either a "good" or "poor" responder to chemoradiation, according to MRI, and researchers compared survival of the two groups.

Investigators found that 72 percent of good responders to chemotherapy/radiation were alive after five years compared to 27 percent of those who were poor responders. The disease-free survival for those with good responses was 64 percent versus 31 percent for the poor responders. In addition, local recurrence rates at five years for those patients for whom there was MRI-predicted CRM involvement was 28 percent compared to 12 percent for patients with predicted cancer-free tumor margins.

Rectal cancer is commonly found in advanced stages, and as a result, neoadjuvant chemoradiation is frequently given to try to shrink tumors and make them easier to remove. While surgeons attempt to completely remove the cancer in order to minimize the chances of cancer returning, advanced tumors are more difficult to completely remove and more likely to have unseen cancer remaining at the edges of tissue at the surgery site. A positive surgical margin (tumor that remains at the borders of the surgical resection) is considered a strong predictor of local recurrence.

Of the 111 patients in the study, 73 percent (81 patients) were expected to have cancer left in the surgical margins prior to initial treatment. After neoadjuvant therapy, only 42 percent (47 patients) were predicted to have disease left in the surgery margins, meaning this group was still at risk for recurrence prior to surgery.

"The next step is to take these tumor response grades and decide what the best treatment approach could be based on the degree of responses," Brown said.

She noted that future trials investigating neoadjuvant chemotherapy followed by chemoradiotherapy may be able to identify a subgroup of patients that has a good response and for whom chemotherapy alone might be enough, while also identifying those who needed furt
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Contact: Nicole Fernandes
nicole.fernandes@asco.org
571-483-1354
American Society of Clinical Oncology
Source:Eurekalert

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