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  1. Article: Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature.

    Coco, Claudio / Tondolo, Vincenzo / Amodio, Luca Emanuele / Pafundi, Donato Paolo / Marzi, Federica / Rizzo, Gianluca

    Journal of clinical medicine

    2023  Volume 12, Issue 23

    Abstract: The creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a ... ...

    Abstract The creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a protective loop ileostomy in terms of short- and long-term postoperative morbidity, quantifying the stoma-related complications arising after stoma creation and stoma closure and the risk of permanent stoma. From January 2009 to January 2020, 149 patients with rectal cancer treated by anterior resection and protective ileostomy were enrolled in the study. A total of 113 (75.84%) patients were preoperatively treated with neoadjuvant radiochemotherapy. A clinically relevant anastomotic leak occurred in two patients (1.34%). The postoperative stoma complication rate was 6%. According to the Clavien classification, the stoma-related complication grade was I in seven patients (4.7%) and II in two patients (1.3%). A late stoma-related parastomal hernia occurred in one patient (0.67%). In 129 patients (86.57%), it was possible to close the stoma. Postoperative complications of stoma closure occurred in 12 patients (9.3%). The stoma closure complication grade was I in seven cases (5.43%), II in two cases (1.55%), and ≥3 in three cases (2.33%). Incisional hernia was the only late complication recorded in seven cases (5.42%). The permanent stoma rate was 13.43%. A protective ileostomy has a nonnegligible complication rate, but the rate of severe complications is low. Every effort should be made to clearly identify patients in whom the risk of anastomotic leakage justifies the stoma.
    Language English
    Publishing date 2023-11-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12237229
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transanal Endoscopic Microsurgery Versus Total Mesorectal Excision in ypT0-1 Rectal Cancer After Preoperative Radiochemotherapy: Postoperative Morbidity, Functional Results, and Long-term Oncologic Outcome.

    Rizzo, Gianluca / Pafundi, Donato P / Sionne, Francesco / Pietricola, Giulia / D'Agostino, Luca / Gambacorta, Maria A / Valentini, Vincenzo / Coco, Claudio

    Diseases of the colon and rectum

    2022  Volume 65, Issue 11, Page(s) 1306–1315

    MeSH term(s) Follow-Up Studies ; Humans ; Morbidity ; Neoplasm Staging ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/surgery ; Retrospective Studies ; Transanal Endoscopic Microsurgery
    Language English
    Publishing date 2022-01-20
    Publishing country United States
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Completion total mesorectal excision after neoadjuvant radiochemotherapy and local excision for rectal cancer.

    Coco, Claudio / Delrio, Paolo / Rega, Daniela / Amodio, Luca Emanuele / Pucciarelli, Salvatore / Spolverato, Gaya / Belluco, Claudio / Lauretta, Andrea / Poggioli, Gilberto / Rocco, Giuseppe / Bianco, Francesco / Marsanic, Patrizia / Sica, Giuseppe / Tondolo, Vincenzo / Rizzo, Gianluca

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2023  Volume 26, Issue 2, Page(s) 281–289

    Abstract: Aim: Local excision (LE) in selected cases after neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer in clinically complete or major responders has been recently reported as an alternative to standard radical resection. Completion ... ...

    Abstract Aim: Local excision (LE) in selected cases after neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer in clinically complete or major responders has been recently reported as an alternative to standard radical resection. Completion total mesorectal excision (cTME) is generally performed when high-risk pathological features are found in LE surgical specimens. The aim of this study was to evaluate the incidence of residual tumour and lymph node metastases after cTME in patients previously treated by RCT + LE. The secondary aims were to quantify the rate of postoperative morbidity and mortality and to evaluate the long-term oncological outcome of this group of patients.
    Methods: All patients treated from 2007 to 2020 by LE for locally advanced rectal cancer with a clinically complete or major response to RCT who had a subsequent cTME for high-risk pathological factors (ypT >1 and/or TRG >2 and/or positive margins) were included in this multicentre retrospective study. Pathological data, postoperative short-term morbidity (classified according to Clavien-Dindo) and mortality and oncological long-term outcome after cTME were recorded in a database. Statistical analysis was performed using Wizard for iOS version 1.9.31.
    Results: A total of 47 patients were included in the study. The rate of R0 resection was 95.7%, and a sphincter-saving procedure was performed in 37 patients (78.7%), with a protective stoma rate of 78.4%. In 28 cases (59.6%), it was possible to perform a minimally invasive approach. A residual tumour (pT and/or pN) on cTME specimens was found in 21 cases (44.7%). The rate of lymph node metastases was 12.8%. The overall short-term (within 30 days) postoperative morbidity was 34%, but grade >2 postoperative complications occurred in only nine patients (19.1%), with a reoperation rate of 6.4%. No short-term postoperative deaths occurred. At a median follow-up of 57 months (range: 21-174), the long-term stoma-free rate was 70.2%, and the actuarial 5-year overall survival (OS), disease-free survival (DFS) and local control (LC) were 86.7%, 88.9% and 95.7%, respectively.
    Conclusion: When patients exhibit high-risk pathological factors after RCT + LE, cTME should be suggested due to the high risk of residual tumour or lymph node involvement (44.7%). The results after cTME in terms of the rate of R0 resection, sphincter-saving procedure, postoperative morbidity and mortality and long-term oncological outcome seem to be acceptable and do not represent a contraindication to use LE as a first-step treatment in patients with major or complete clinical response after RCT.
    MeSH term(s) Humans ; Neoadjuvant Therapy/adverse effects ; Lymphatic Metastasis ; Neoplasm, Residual/drug therapy ; Neoplasm, Residual/etiology ; Neoplasm, Residual/pathology ; Treatment Outcome ; Rectal Neoplasms/surgery ; Rectal Neoplasms/drug therapy ; Chemoradiotherapy ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging
    Language English
    Publishing date 2023-12-22
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16834
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Four steps in the evolution of rectal cancer managements through 40 years of clinical practice: Pioneering, standardization, challenges and personalization.

    Valentini, Vincenzo / Alfieri, Sergio / Coco, Claudio / D'Ugo, Domenico / Crucitti, Antonio / Pacelli, Fabio / Persiani, Roberto / Sofo, Luigi / Picciocchi, Aurelio / Doglietto, Giovanni Battista / Barbaro, Brunella / Vecchio, Fabio Maria / Ricci, Riccardo / Damiani, Andrea / Savino, Maria Chiara / Boldrini, Luca / Cellini, Francesco / Meldolesi, Elisa / Romano, Angela /
    Chiloiro, Giuditta / Gambacorta, Maria Antonietta

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2024  Volume 194, Page(s) 110190

    MeSH term(s) Humans ; Rectal Neoplasms/therapy ; Rectal Neoplasms/radiotherapy ; Precision Medicine
    Language English
    Publishing date 2024-03-02
    Publishing country Ireland
    Document type Editorial
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2024.110190
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Effectiveness and Validation of the Italian Translation of the Low Anterior Resection Syndrome Score in an Italian High-Volume University Hospital.

    De Simone, Veronica / Litta, Francesco / Persiani, Roberto / Rizzo, Gianluca / Sofo, Luigi / Menghi, Roberta / Santullo, Francesco / Biondi, Alberto / Coco, Claudio / Sacchetti, Franco / Longo, Fabio / Attalla El Halabieh, Miriam / Moroni, Rossana / Ratto, Carlo

    Frontiers in surgery

    2022  Volume 9, Page(s) 917224

    Abstract: Background: The low anterior resection syndrome (LARS) score is a validated questionnaire developed in Denmark to measure the severity of bowel dysfunction after low anterior resection. This retrospective study aimed to assess the effectiveness of the ... ...

    Abstract Background: The low anterior resection syndrome (LARS) score is a validated questionnaire developed in Denmark to measure the severity of bowel dysfunction after low anterior resection. This retrospective study aimed to assess the effectiveness of the LARS score in the Italian language in a population of Italian patients who underwent low anterior resection for rectal cancer. The convergent and discriminative validity and the test-retest reliability of the score were investigated.
    Methods: A cohort of two hundred and five patients treated with low anterior resection were enrolled in an Italian high-volume university hospital between January 2000 and April 2018. The Italian version of the LARS score (tested twice), as translated from English original version, a single question on quality of life and the EORTC QLQ-C30 questionnaire were submitted to patients.
    Results: A high proportion of patients showed a perfect or moderate fit between the LARS score and QoL categories (convergent validity,
    Conclusion: The Italian translation of the LARS score is an easy and reliable tool for assessing bowel dysfunction after low anterior resection and its routine use in clinical practice should be recommended.
    Language English
    Publishing date 2022-06-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2022.917224
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Craniosynostosis-microphthalmia syndrome belongs to the spectrum of BCOR-related disorders.

    Cinnirella, Giacomo / Taylor, Rachel L / Coco, Claudio / Piludu, Francesca / Vidiri, Antonello / Sinibaldi, Lorenzo / Kornak, Uwe / Black, Graeme / Brancati, Francesco

    Clinical genetics

    2020  Volume 98, Issue 4, Page(s) 413–415

    Abstract: Craniosynostosis-microphthalmia linked to BCOR haploinsufficiency. ...

    Abstract Craniosynostosis-microphthalmia linked to BCOR haploinsufficiency.
    MeSH term(s) Adolescent ; Child ; Chromosomes, Human, X/genetics ; Craniosynostoses/complications ; Craniosynostoses/genetics ; Craniosynostoses/pathology ; Eye Abnormalities/complications ; Eye Abnormalities/genetics ; Eye Abnormalities/pathology ; Female ; Genes, X-Linked ; Genetic Predisposition to Disease ; Haploinsufficiency/genetics ; Humans ; Microphthalmos/complications ; Microphthalmos/genetics ; Microphthalmos/pathology ; Proto-Oncogene Proteins/genetics ; Repressor Proteins/genetics
    Chemical Substances BCOR protein, human ; Proto-Oncogene Proteins ; Repressor Proteins
    Language English
    Publishing date 2020-08-03
    Publishing country Denmark
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 221209-2
    ISSN 1399-0004 ; 0009-9163
    ISSN (online) 1399-0004
    ISSN 0009-9163
    DOI 10.1111/cge.13808
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Anti-TNF alpha in the treatment of ulcerative colitis: a valid approach for organ-sparing or an expensive option to delay surgery?

    Rizzo, Gianluca / Pugliese, Daniela / Armuzzi, Alessandro / Coco, Claudio

    World journal of gastroenterology

    2014  Volume 20, Issue 17, Page(s) 4839–4845

    Abstract: Ulcerative colitis (UC) is an inflammatory bowel disease affecting large bowel with variable clinical course. The history of disease has been modified by the introduction of biologic therapy, in particular Infliximab (IFX), that has demonstrated efficacy ...

    Abstract Ulcerative colitis (UC) is an inflammatory bowel disease affecting large bowel with variable clinical course. The history of disease has been modified by the introduction of biologic therapy, in particular Infliximab (IFX), that has demonstrated efficacy in inducing fast symptoms remission, promoting mucosal healing and maintaining long-term remission. However, surgery is still needed for UC patients: in case of failure of medical therapy and if acute complications or a malignancy occurred. Surgical treatment is associated with a short-term post-operative mortality and morbidity respectively of 0%-4% and 30%. In this study we systematically analyzed: the role of IFX in reducing the colectomy rate, the risk of post-operative morbidity in pre-operatively IFX-treated patients and the cost-effectiveness of IFX therapy. Four of 5 analyzed randomized controlled trials demonstrated that therapy with IFX significantly reduces the colectomy rate. Moreover, pre-operative treatment with IFX doesn't seem to increase post-operative infectious complications. By an economic point of view, the cost-effectiveness of IFX-therapy was demonstrated for UC patients suffering from moderate to severe UC in a study based on a cost estimation of the National Health Service of England and Wales. However, the argument is debated.
    MeSH term(s) Anti-Inflammatory Agents/economics ; Anti-Inflammatory Agents/therapeutic use ; Colectomy ; Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/economics ; Colitis, Ulcerative/immunology ; Colitis, Ulcerative/surgery ; Cost-Benefit Analysis ; Disease Progression ; Drug Costs ; Gastrointestinal Agents/economics ; Gastrointestinal Agents/therapeutic use ; Humans ; Observational Studies as Topic ; Randomized Controlled Trials as Topic ; Remission Induction ; State Medicine/economics ; Time Factors ; Treatment Outcome ; Tumor Necrosis Factor-alpha/antagonists & inhibitors ; United Kingdom
    Chemical Substances Anti-Inflammatory Agents ; Gastrointestinal Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2014-04-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v20.i17.4839
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: THUNDER 2: THeragnostic Utilities for Neoplastic DisEases of the Rectum by MRI guided radiotherapy.

    Chiloiro, Giuditta / Cusumano, Davide / Boldrini, Luca / Romano, Angela / Placidi, Lorenzo / Nardini, Matteo / Meldolesi, Elisa / Barbaro, Brunella / Coco, Claudio / Crucitti, Antonio / Persiani, Roberto / Petruzziello, Lucio / Ricci, Riccardo / Salvatore, Lisa / Sofo, Luigi / Alfieri, Sergio / Manfredi, Riccardo / Valentini, Vincenzo / Gambacorta, Maria Antonietta

    BMC cancer

    2022  Volume 22, Issue 1, Page(s) 67

    Abstract: Background: Neoadjuvant chemoradiation therapy (nCRT) is the standard treatment modality in locally advanced rectal cancer (LARC). Since response to radiotherapy (RT) is dose dependent in rectal cancer, dose escalation may lead to higher complete ... ...

    Abstract Background: Neoadjuvant chemoradiation therapy (nCRT) is the standard treatment modality in locally advanced rectal cancer (LARC). Since response to radiotherapy (RT) is dose dependent in rectal cancer, dose escalation may lead to higher complete response rates. The possibility to predict patients who will achieve complete response (CR) is fundamental. Recently, an early tumour regression index (ERI) was introduced to predict pathological CR (pCR) after nCRT in LARC patients. The primary endpoints will be the increase of CR rate and the evaluation of feasibility of delta radiomics-based predictive MRI guided Radiotherapy (MRgRT) model.
    Methods: Patients affected by LARC cT2-3, N0-2 or cT4 for anal sphincter involvement N0-2a, M0 without high risk features will be enrolled in the trial. Neoadjuvant CRT will be administered using MRgRT. The initial RT treatment will consist in delivering 55 Gy in 25 fractions on Gross Tumor Volume (GTV) plus the corresponding mesorectum and 45 Gy in 25 fractions on the drainage nodes. Chemotherapy with 5-fluoracil (5-FU) or oral capecitabine will be administered continuously. A 0.35 Tesla MRI will be acquired at simulation and every day during MRgRT. At fraction 10, ERI will be calculated: if ERI will be inferior than 13.1, the patient will continue the original treatment; if ERI will be higher than 13.1 the treatment plan will be reoptimized, intensifying the dose to the residual tumor at the 11
    Discussion: This clinical trial investigates the impact of RT dose escalation in poor responder LARC patients identified using ERI, with the aim of increasing the probability of CR and consequently an organ preservation benefit in this group of patients.
    Trial registration: ClinicalTrials.gov Identifier: NCT04815694 (25/03/2021).
    MeSH term(s) Adult ; Antineoplastic Agents/administration & dosage ; Capecitabine/administration & dosage ; Feasibility Studies ; Female ; Fluorouracil/administration & dosage ; Humans ; Magnetic Resonance Imaging ; Male ; Neoadjuvant Therapy/methods ; Neoplasm Staging ; Prospective Studies ; Radiotherapy, Image-Guided/methods ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Rectum/pathology ; Treatment Outcome
    Chemical Substances Antineoplastic Agents ; Capecitabine (6804DJ8Z9U) ; Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2022-01-15
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2041352-X
    ISSN 1471-2407 ; 1471-2407
    ISSN (online) 1471-2407
    ISSN 1471-2407
    DOI 10.1186/s12885-021-09158-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis.

    Chiloiro, Giuditta / Meldolesi, Elisa / Giraffa, Martina / Capocchiano, Nikola Dino / Barbaro, Brunella / Coco, Claudio / Corvari, Barbara / De Franco, Paola / D'Ugo, Domenico / Alfieri, Sergio / Manfredi, Riccardo / Valentini, Vincenzo / Gambacorta, Maria Antonietta

    Clinical and translational radiation oncology

    2021  Volume 28, Page(s) 1–9

    Abstract: Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the ... ...

    Abstract Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the conservative approach by comparing patients' survival outcomes and quality of life with those who had surgical resection.
    Methods: A single-institution and retrospective study including RC patients who reached a near complete or complete clinical response after nCRT from January 2010 to September 2019. Conservative approaches included local excision or watch and wait strategy; surgery approaches included anterior resection or abdominal-perineal resection.Local regrowth (LR), overall survival, disease free survival, metastasis free survival and colostomy free survival were evaluated through Kaplan-Meier curves and compared trough log-rank tests. Quality of life was measured by the following validated questionnaires: EORTC QLC30, EORTC QLQ - CR29 and Fecal Incontinence Quality of Life scale.
    Results: Overall 157 patients were analyzed: 105 (66,9%) underwent radical surgery and 52 (33,1%) had a conservative approach. With a median follow-up of 51 months, 2 patients in the surgical group had a local recurrence and 8 in the conservative group had a LR, respectively. Distance metastasis occurred in 7 and 1 patients of surgical and conservative group, respectively. No differences were detected in terms of survival outcomes except for colostomy free survival (p: 0,01). The conservative group showed better intestinal (p < 0.01) and sexual (p: 0,04) function and emotional status (p: 0,02).
    Conclusions: Conservative approach seems to be safe in terms of survival outcomes with a significant advantage on quality of life in RC patients who achieved clinical complete response after nCRT.
    Language English
    Publishing date 2021-02-25
    Publishing country Ireland
    Document type Journal Article
    ISSN 2405-6308
    ISSN (online) 2405-6308
    DOI 10.1016/j.ctro.2021.02.009
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  10. Article: The Role of Simultaneous Integrated Boost in Locally Advanced Rectal Cancer Patients with Positive Lateral Pelvic Lymph Nodes.

    Meldolesi, Elisa / Chiloiro, Giuditta / Giannini, Roberta / Menghi, Roberta / Persiani, Roberto / Corvari, Barbara / Coco, Claudio / Manfrida, Stefania / Ratto, Carlo / De Luca, Viola / Sofo, Luigi / Reina, Sara / Crucitti, Antonio / Masiello, Valeria / Dinapoli, Nicola / Valentini, Vincenzo / Gambacorta, Maria Antonietta

    Cancers

    2022  Volume 14, Issue 7

    Abstract: Aims: Between 11 to 14% of patients with locally advanced rectal cancer (LARC) have positive lateral pelvic lymph nodes (LPLN) at diagnosis, related to a worse prognosis with a 5-year survival rate between 30 to 40%. The best treatment choice for this ... ...

    Abstract Aims: Between 11 to 14% of patients with locally advanced rectal cancer (LARC) have positive lateral pelvic lymph nodes (LPLN) at diagnosis, related to a worse prognosis with a 5-year survival rate between 30 to 40%. The best treatment choice for this group of patients is still a challenge. The optimal radiotherapy (RT) dose for LPLN patients has been investigated. Methods: We retrospectively collected data from LARC patients with LPLN at the primary staging MRI, treated in our center from March 2003 to December 2020. Patients underwent a neoadjuvant concomitant chemo-radiotherapy (CRT) treatment on the primary tumor (T), mesorectum, and pelvic nodes, associated with a fluoride-based chemotherapy. The total reached dose was 45 Gy at 1.8 Gy/fr on the elective sites and 55 Gy at 2.2 Gy/fr on the disease and mesorectum. Patients were divided in two groups based on whether they received a simultaneous integrated RT boost on the LPLN or not. Overall Survival (OS), Disease Free Survival (DFS), Metastasis Free Survival (MFS), and Local Control (LC) were evaluated in the whole group and then compared between the two groups. Results: A total of 176 patients were evaluated: 82 were included in the RT boost group and 94 in the non-RT boost group. The median follow-up period was 57.8 months. All the clinical endpoint (OS, DFS, MFS, LC), resulted were affected by the simultaneous integrated boost on LPLN with a survival rate of 84.7%, 79.5%, 84.1%, and 92%, respectively, in the entire population. From the comparison of the two groups, there was a statistical significance towards the RT boost group with a p < 0.006, 0.030, 0.042, 0.026, respectively. Conclusions: Concomitant radiotherapy boost on positive LPLN has shown to be beneficial on the survival outcomes (OS, DFS, MFR, and LC) in patients with LARC and LPLN. This analysis demonstrates that a higher dose of radiotherapy on positive pelvic lymph nodes led not only to a higher local control but also to a better survival rate. These results, if validated by future prospective studies, can bring a valid alternative to the surgery dissection without the important side effects and permanent disabilities observed during the years.
    Language English
    Publishing date 2022-03-24
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers14071643
    Database MEDical Literature Analysis and Retrieval System OnLINE

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