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Cyclooxygenase-2 expression in pretreatment biopsy as a predictor of tumor responses after preoperative chemoradiation in rectal cancer

Authors
 Byung Soh Min  ;  Yoon Jung Choi  ;  Hong Ryull Pyo  ;  Hogeun Kim  ;  JinSil Seong  ;  Hyun Cheol Chung  ;  Sun Young Rha  ;  Nam Kyu Kim 
Citation
 ARCHIVES OF SURGERY , Vol.143(11) : 1091-1097, 2008 
Journal Title
 ARCHIVES OF SURGERY 
ISSN
 0004-0010 
Issue Date
2008
MeSH
Adult ; Aged ; Angiogenic Proteins/metabolism ; Antineoplastic Agents/administration & dosage ; Cohort Studies ; Cyclooxygenase 2/metabolism* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Predictive Value of Tests ; Radiotherapy, Adjuvant ; Rectal Neoplasms/metabolism* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy* ; Remission Induction ; Treatment Outcome ; Tumor Burden
Keywords
Adult ; Aged ; Angiogenic Proteins/metabolism ; Antineoplastic Agents/administration & dosage ; Cohort Studies ; Cyclooxygenase 2/metabolism* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Predictive Value of Tests ; Radiotherapy, Adjuvant ; Rectal Neoplasms/metabolism* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy* ; Remission Induction ; Treatment Outcome ; Tumor Burden
Abstract
OBJECTIVE: To determine whether cyclooxygenase-2 (COX-2) expression in pretreatment biopsy specimens is a useful predictive marker of tumor response to preoperative chemoradiation (CRT) in rectal cancer. DESIGN: Case series. SETTING: Colorectal cancer clinic. PATIENTS: Thirty patients with locally advanced rectal cancer were given preoperative CRT of 5040 cGy for 6 weeks with concurrent administration of 5-fluorouracil and leucovorin. MAIN OUTCOME MEASURES: Immunohistochemical staining for COX-2 and angiogenesis markers (vascular endothelial growth factor, thymidine phosphorylase, and CD34) were performed on biopsy specimens obtained before preoperative CRT. The responses to preoperative CRT were assessed by radiologic downsizing (measured using magnetic resonance imaging volumetry), histopathologic downstaging, and a 3-point tumor regression grade (TRG) evaluation, based on the ratio of residual cancer to fibrosis. RESULTS: Tumor downstaging was seen in 15 patients (50.0%) and nodal downstaging was noted in 14 patients (46.7%). Tumor regression grade 1 (good response) was shown by 7 patients (23.3%); TRG2 (moderate response) in 15 patients (50.0%); and TRG3 (poor response) in 8 patients (26.7%). Patients with COX-2 overexpression were more likely to show a poor TRG (P = .003) and were less likely to achieve histopathologic nodal downstaging (P = .03) than those with normal COX-2 expression. Vascular endothelial growth factor overexpression was found to be associated with COX-2 overexpression (P = .02). CONCLUSIONS: Overexpression of COX-2 in pretreatment biopsies might be predictive of poor tumor regression after preoperative CRT. Administration of COX-2 inhibitors to patients with COX-2 overexpression, in an attempt to improve response rate to preoperative CRT, warrants assessment in clinical trials.
Full Text
http://archsurg.jamanetwork.com/article.aspx?articleid=402135
DOI
10.1001/archsurg.143.11.1091
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Hogeun(김호근)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107804
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