The "Immunoscore" in rectal cancer: could we search quality beyond quantity of life?

Oncotarget. 2022 Jan 5:13:18-31. doi: 10.18632/oncotarget.28100. eCollection 2022.

Abstract

Because of the function and anatomical environment of the rectum, therapeutic strategies for local advanced rectal cancer (LARC) must deal with two challenging stressors that are a high-risk of local and distal recurrences and a high-risk of poor quality of life (QoL). Over the last three decades, advances in screening tests, therapies, and combined-modality treatment options and strategies have improved the prognosis of patients with LARC. However, owing to the heterogeneous nature of LARC and genetic status, the patient may not respond to a specific therapy and may be at increased risk of side-effects without the life-prolonging benefit. Indeed, each therapy can cause its own side-effects, which may worsen by a combination of treatments resulting in long-term poor QoL. In LARC, QoL has become even more essential with the increasing incidence of rectal cancer in young individuals. Herein, we analyzed the value of the Immunoscore-Biopsy (performed on tumor biopsy at diagnosis) in predicting outcomes, alone or in association with clinical and imaging data, for each therapy used in LARC.

Keywords: immunoscore; prognosis; radiochemotherapy; rectal cancer; watch and wait.

MeSH terms

  • Chemoradiotherapy / methods
  • Humans
  • Neoadjuvant Therapy / methods
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Quality of Life*
  • Rectal Neoplasms* / pathology
  • Rectum / pathology
  • Treatment Outcome