Purpose: For years, 5-fluorouracil (5-FU) has been the backbone of radiochemotherapy (RCT) of locally advanced rectal cancer. Its main target, thymidylate synthase (TS), is speculated to be an important biomarker for response prediction and long-term prognosis. In this study, we analyzed TS expression in the rectal cancer tissue of 208 patients to evaluate its predictive/prognostic potential.
Methods: All patients included were diagnosed with locally advanced adenocarcinoma of the rectum (UICC II and III) and were treated within randomized clinical trials of the German Rectal Cancer Study Group. Preoperative RCT (50.4 Gy and concomitant either 5-FU or 5-FU and oxaliplatin) was administered in 167 patients followed by surgical resection with total mesorectal excision (TME). Another 41 patients received postoperative RCT. TS levels and further clinicopathological parameters were assessed in univariate and multivariate analyses. Additionally, a TS gene polymorphism was analyzed with respect to the intratumoral protein levels.
Results: Low TS expression in pretreatment biopsies correlated with impaired patient survival (p = 0.015). Analysis of a 28-bp repeat revealed a correlation between the *3/*3 genotype and high TS expression in pretherapeutic biopsies. In this study, a correlation of TS expression and grade of RCT-induced tumor regression was not found. Histopathological examination confirmed a complete tumor remission in 16 patients (9.6%). Analyses of the resection specimen indicated an unfavorable prognosis for patients with low intratumoral TS expression in case of detected lymph node metastases (p = 0.04).
Conclusions: TS can serve as a prognostic biomarker indicating an unfavorable prognosis for patients with low TS expression.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162628 | PMC |
| http://dx.doi.org/10.1245/s10434-011-1608-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prediction model construction for the occurrence of LARS after neoadjuvant therapy combined with laparoscopic total mesorectal excision in male patients with mid-low rectal cancer.
Front Oncol
December 2024
Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China.
Background: Neoadjuvant chemoradiotherapy for rectal cancer improves surgical outcomes and reduces recurrence but can cause low anterior resection syndrome (LARS), affecting quality of life. This study aims to predict the risk of LARS in male patients with mid-low rectal cancer after laparoscopic total mesorectal excision (TME).
Methods: Clinical data from 203 male patients with mid-low rectal cancer who underwent neoadjuvant therapy and laparoscopic resection were collected.
Addressing Colorectal Cancer Disparities in Unhoused Populations: A Call for Equitable Access and Compassionate Care.
Clin Colon Rectal Surg
January 2025
Department of Surgery, University of California San Francisco, San Francisco, California.
Housing is essential for health. Unhoused individuals have markedly worse health status than the general population culminating in higher rates of premature mortality. Cancer is a leading cause of death in older unhoused adults.
View Article and Find Full Text PDFConsiderations for the Treatment of Sexual and Gender Minority Individuals in Colon and Rectal Surgery.
Clin Colon Rectal Surg
January 2025
Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington.
Sexual and gender minorities (SGMs) experience critical barriers to health care access and have unique health care needs that are often overlooked. Given the rise in individuals identifying as lesbian, gay, bisexual, transgender, and queer, colorectal surgeons are likely to care for increasing numbers of such individuals. Here, we discuss key barriers to health care access and research among SGM populations and outline approaches to address these barriers in clinical practice.
View Article and Find Full Text PDFChallenges and Strategies in Colorectal Surgery among Patients with Morbid Obesity.
Clin Colon Rectal Surg
January 2025
Division of General Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
This chapter explores the interplay between morbid obesity and the challenges encountered in colorectal surgery. Understanding the unique considerations in preoperative and intraoperative management along with weight optimization tools such as bariatric surgery emerges as potential mitigators, demonstrating benefits in reducing colorectal cancer risk and improving perioperative outcomes. Furthermore, the pervasive stigma associated with morbid obesity further complicates patient care, emphasizing the need for empathetic and nuanced approaches.
View Article and Find Full Text PDFDifficulties and Disparities in Colorectal Cancer End-of-Life Care: A Patient's Story.
Clin Colon Rectal Surg
January 2025
Divisions of Colon and Rectal Surgery and Hospice and Palliative Medicine, Virginia Commonwealth University, Richmond, Virginia.
Patients with advanced colorectal cancer nearing the end of life require a multidisciplinary approach to address the unique challenges they face. Using a case vignette, we outline the various stages of a patient's journey with advanced rectal cancer and the common obstacles to their care as they interface with the medical system. We highlight how Black persons might be vulnerable to differences in screening, treatment, procedural interventions, end-of-life care, and health care decision-making.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!