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01 Dec 2020
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Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
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Jairia Dela Cruz, 3 days ago
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Complete response to preoperative chemoradiotherapy improves survival in rectal cancer

07 Dec 2020

Patients with pathological complete response to preoperative chemoradiotherapy have longer relapse-free (RFS) and overall survival (OS) rates than those with residual disease, suggests a recent study.

The authors retrospectively reviewed medical records of patients with locally advanced rectal cancer, who were treated with preoperative chemoradiotherapy followed by surgery between 2002 and 2016.

They also classified tumour regression grade (TRG) into five categories based on the pathological response: TRG1 (no viable cancer cell), TRG2 (single cancer cell or small groups of cancer cells), TRG3 (residual tumour outgrown by fibrosis), TRG4 (residual tumour outgrowing fibrosis), TRG5 (diffuse residual tumour without regression). TRG1, TRG2+ TRG3, and TRG4+ TRG5 were grouped as complete response, intermediate response, and no response, respectively.

A total of 182 patients with locally advanced rectal cancer (mean age, 54.4 years; 61.5 percent male) were analysed. Of these, 24 (13.2 percent) had complete response, 105 (57.7 percent) intermediate response, and 53 (29.1 percent) no response. The corresponding 5-year RFS and OS rates were 79.8–92.3 percent, 74.7–79.4 percent, and 55.7–55.8 percent (RFS: p<0.05; OS: p<0.05).

According to ypTNM stage, no significant difference in RFS was seen among TRG groups in ypStage I and II patients (p>0.05). In ypStage III patients, RFS was 62 months in the no response group and was not reached in the intermediate response group (p<0.05). No significant difference was also observed in OS among TRG groups in ypStage I, II, and III patients (p>0.05).

Multivariate analysis revealed that pathological complete response was an independent variable for RFS (hazard ratio [HR], 0.34, 95 percent confidence interval [CI], 0.17–6.77) and OS (HR, 0.39, 95 percent CI, 0.18–0.83).

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Jairia Dela Cruz, 3 days ago
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