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Metastatic colorectal cancer surgery

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https://www.readbyqxmd.com/read/28643319/-progress-of-the-application-of-optical-coherence-tomography-in-gastrointestinal-tumor-surgery
#1
Yongsheng Li, Hao Liu, Haipeng Huang, Yu Zhu, Haijun Deng, Jiang Yu, Site Luo, Li Huo, Li Lin, Huikai Xie, Guoxin Li
Optical coherence tomography (OCT) is a real-time, cross-sectional optical imaging technology. It is analogous to ultrasonography, except that OCT uses light waves instead of sound waves, and can provide three-dimensional morphological images of living tissues with a micrometer resolution. Through the use of endoscopes, needles, catheters and laparoscopes, OCT has demonstrated tremendous imaging potential in tumor surgery. The current studies suggest that OCT has potential for clinical applications in the following fields of gastrointestinal tumor surgery: (1) Early tumor detection and diagnosis: OCT can distinguish differences between polyp tissue, normal tissue and malignant tissue...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28643310/-establishment-of-a-prognostic-nomogram-to-predict-long-term-survival-in-non-metastatic-colorectal-cancer-patients
#2
Xiaojie Wang, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Shenghui Huang, Yanwu Sun, Daoxiong Ye
OBJECTIVE: To establish a nomogram to predict long-term survival in non-metastatic colorectal cancer patients. METHODS: A retrospective analysis was conducted in patients with non-metastatic colorectal cancer who underwent radical surgery in the Department of Colorectal Surgery of Affiliated Union Hospital of Fujian Medical University between January 2000 and December 2014. Univariate and multivariate analyses on disease-free survival (DFS) were performed using the Cox proportional regression model...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#3
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28633089/first-line-panitumumab-plus-folfox4-or-folfiri-in-colorectal-cancer-with-multiple-or-unresectable-liver-metastases-a-randomised-phase-ii-trial-planet-ttd
#4
Alfredo Carrato, Albert Abad, Bartomeu Massuti, Cristina Grávalos, Pilar Escudero, Federico Longo-Muñoz, José-Luis Manzano, Auxiliadora Gómez, María José Safont, Javier Gallego, Beatriz García-Paredes, Carles Pericay, Rosario Dueñas, Fernando Rivera, Ferrán Losa, Manuel Valladares-Ayerbes, Encarnación González, Enrique Aranda
BACKGROUND: In first-line wild-type (WT)-Kirsten rat sarcoma viral oncogene homologue (KRAS) metastatic colorectal cancer (mCRC), panitumumab (Pmab) improves outcomes when added to FOLFOX [folinic acid, 5-fluorouracil, and oxaliplatin] or FOLFIRI [folinic acid, 5-fluorouracil, and irinotecan]. However no trial has directly compared these combinations. METHODS: Multicentre, open-label study in untreated patients ≥ 18 years with (WT)-KRAS mCRC and multiple or unresectable liver-limited disease (LLD) randomised to either Pmab-FOLFOX4 or Pmab-FOLFIRI...
June 17, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28619086/patterns-of-venous-thromboembolism-risk-in-patients-with-localized-colorectal-cancer-undergoing-adjuvant-chemotherapy-or-active-surveillance-an-observational-cohort-study
#5
Jakob Michael Riedl, Florian Posch, Angelika Bezan, Joanna Szkandera, Maria Anna Smolle, Thomas Winder, Christopher H Rossmann, Renate Schaberl-Moser, Martin Pichler, Michael Stotz, Herbert Stöger, Armin Gerger
BACKGROUND: Venous thromoboembolism (VTE) is a frequent and burdensome complication of metastatic colorectal cancer (CRC). However, the epidemiology of VTE in patients with localized CRC after surgery in curative intent is incompletely understood. In this single-center observational cohort study, we investigate patterns of VTE risk in localized CRC, and define its relationship with baseline risk factors, adjuvant chemotherapy and CRC recurrence. METHODS: Five-hundred-sixteen patients with stage II/III CRC were included retrospectively at the time of surgery, and followed until the occurrence of VTE, CRC recurrence, or death (median age = 65...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28617240/what-carcinoembryonic-antigen-level-should-trigger-further-investigation-during-colorectal-cancer-follow-up-a-systematic-review-and-secondary-analysis-of-a-randomised-controlled-trial
#6
Bethany Shinkins, Brian D Nicholson, Tim James, Indika Pathiraja, Sian Pugh, Rafael Perera, John Primrose, David Mant
BACKGROUND: Following primary surgical and adjuvant treatment for colorectal cancer, many patients are routinely followed up with blood carcinoembryonic antigen (CEA) testing. OBJECTIVE: To determine how the CEA test result should be interpreted to inform the decision to undertake further investigation to detect treatable recurrences. DESIGN: Two studies were conducted: (1) a Cochrane review of existing studies describing the diagnostic accuracy of blood CEA testing for detecting colorectal recurrence; and (2) a secondary analysis of data from the two arms of the FACS (Follow-up After Colorectal Surgery) trial in which CEA testing was carried out...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28601828/colorectal-cancer-with-synchronous-liver-limited-metastases-the-protocol-of-an-inception-cohort-study-cosmic
#7
Ajith K Siriwardena, Anthony K C Chan, Agnieszka M Ignatowicz, James M Mason
INTRODUCTION: Colorectal cancer is the fourth most common cancer in the UK and an important cause of cancer-related death. In 20% of patients, there is metastasis to the liver or beyond at the time of diagnosis. The management of synchronous disease is complex. Conventional surgery removes the colorectal primary first, followed by chemotherapy, with resection of liver metastases as a final step. Advances in the availability and safety of liver surgery, anaesthesia and critical care have made two alternative options feasible...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28579357/indocyanine-green-fluorescence-guided-surgery-after-iv-injection-in-metastatic-colorectal-cancer-a-systematic-review
#8
REVIEW
G Liberale, P Bourgeois, D Larsimont, M Moreau, V Donckier, T Ishizawa
OBJECTIVE: Indocyanine green fluorescence-guided surgery (ICG-FGS) has emerged as a potential new imaging modality for improving the detection of hepatic, lymph node (LN), and peritoneal metastases in colorectal cancer (CRC) patients. The aim of this paper is to review the available literature in the clinical setting of ICG-FGS for tumoral detection in various fields of metastatic colorectal disease. METHODS: PubMed and Medline literature databases were searched for original articles on the use of ICG in the setting of clinical studies on colorectal cancer...
May 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28578125/efficient-fluorescence-detection-of-protoporphyrin-ix-in-metastatic-lymph-nodes-of-murine-colorectal-cancer-stained-with-indigo-carmine
#9
Hisataka Matsuo, Yoshinori Harada, Takeo Minamikawa, Yoshiyuki Kato, Yasutoshi Murayama, Eigo Otsuji, Tetsuro Takamatsu, Hideo Tanaka
Protoporphyrin IX (PpIX), a biochemical converted from 5-aminolevulinc acid (5-ALA) in living cells, is useful for intraoperative fluorescent detection of cancer metastasis in lymph nodes (LNs). However, unknown is whether the fluorescence of PpIX can be detected in the LNs when they coexist with indigo carmine, a blue dye commonly used for identification of sentinel LNs during surgery. To address this issue, we sought to evaluate the diagnostic usefulness of PpIX fluorescence in the presence of indigo carmine in a mouse LN metastasis model of rectal cancer after administration of 5-ALA...
May 31, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28561714/personalizing-adjuvant-therapy-for-stage-ii-iii-colorectal-cancer
#10
Nadine Jackson McCleary, Al B Benson, Rodrigo Dienstmann
This review focuses on three areas of interest with respect to the treatment of stage II and III colon and rectal cancer, including (1) tailoring adjuvant therapy for the geriatric population, (2) the controversy as to the optimal adjuvant therapy strategy for patients with locoregional rectal cancer and for patients with colorectal resectable metastatic disease, and (3) discussion of the microenvironment, molecular profiling, and the future of adjuvant therapy. It has become evident that age is the strongest predictive factor for receipt of adjuvant chemotherapy, duration of treatment, and risk of treatment-related toxicity...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28551650/cytotrack-analysis-reveals-low-presence-of-circulating-tumor-cells-in-the-perioperative-period-in-patients-with-non-metastatic-colorectal-cancer
#11
Mikail Gogenur, Thore Hillig, Ismail Gogenur
BACKGROUND/AIM: Detection of circulating tumor cells in the perioperative period predicts poor prognosis in patients with colorectal cancer. There is only one Food and Drug Administration-approved method for such detection, CellSearch, for which results have been inconsistent. A new immunological method, CytoTrack, has shown promising results in patients with breast cancer. The aim of this study was to evaluate detection of circulating tumor cells in the peripheral blood of patients with non-metastatic colorectal cancer with CytoTrack, and investigate if there is a correlation between presence of circulating tumor cells and Union for International Cancer Control (UICC) stage and if surgery itself results in the release of circulating tumor cells...
June 2017: Anticancer Research
https://www.readbyqxmd.com/read/28545226/emergence-of-cd26-cancer-stem-cells-with-metastatic-properties-in-colorectal-carcinogenesis
#12
Alvin Ho-Kwan Cheung, Deepak Narayanan Iyer, Colin Siu-Chi Lam, Lui Ng, Sunny K M Wong, Hung-Sing Lee, Timothy Wan, Johnny Man, Ariel K M Chow, Ronnie T Poon, Roberta Pang, Wai-Lun Law
Colorectal cancer results from genetic aberrations which accumulate over a long period of time, with malignant and metastatic properties acquired at a relatively late stage. A subpopulation of CD26+ colorectal cancer stem cells are known to be implicated in metastasis. We quantified CD26+ cancer cells in 11 primary tumor samples by flow cytometry, and showed that tumors having confirmed or suspected metastases harbored a relatively high CD26+ level in these samples. We hypothesized that this subpopulation of cancer stem cells arises in the late stage of carcinogenesis from the bulk of tumor daughter cells which are CD26-...
May 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28542671/folfoxiri-plus-bevacizumab-as-conversion-therapy-for-patients-with-initially-unresectable-metastatic-colorectal-cancer-a-systematic-review-and-pooled-analysis
#13
Gianluca Tomasello, Fausto Petrelli, Michele Ghidini, Alessandro Russo, Rodolfo Passalacqua, Sandro Barni
Importance: The combination of fluorouracil, oxaliplatin, and irinotecan plus bevacizumab (FOLFOXIRI-Bev) is an established and effective first-line chemotherapy regimen for metastatic colorectal cancer. However, resection rates of metastases and overall survival with this schedule have never been systematically evaluated in published studies including, but not limited to, the TRIBE (TRIplet plus BEvacizumab) trial. Objective: To assess the clinical efficacy of FOLFOXIRI-Bev, including outcomes and rates of surgical conversions...
May 25, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28540831/ninety-percent-of-the-adverse-outcomes-occur-in-ten-percent-of-patients-can-we-identify-the-populations-at-high-risk-of-developing-peritoneal-metastases-after-curative-surgery-for-colorectal-cancer
#14
Charles Honoré, Maximiliano Gelli, Julie Francoual, Léonor Benhaim, Dominique Elias, Diane Goéré
BACKGROUND: Peritoneal metastases (PM) occur in 3.4% to 6.3% after curative surgery for non-metastatic colorectal cancer. Systematic "2(nd) look" surgery help overcoming the diagnostic problem but can be only proposed to selected patients. The aim of this study was to update the knowledge on risk factors of developing PM after curative surgery for colorectal cancer. METHODS: A systematic review of the literature published between 2011 and 2016 was made, searching for all clinical studies reporting the incidence of recurrent PM after curative surgery for colorectal cancer and factors associated with the primary tumor that were likely to influence this recurrence rate...
March 29, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28529719/contemporary-surgical-management-of-synchronous-colorectal-liver-metastases
#15
REVIEW
Danielle Collins, Heidi Chua
Historically, the 5-year survival rates for patients with stage 4 (metastatic) colorectal cancer were extremely poor (5%); however, with advances in systemic chemotherapy combined with an ability to push the boundaries of surgical resection, survival rates in the range of 25-40% can be achieved. This multimodal approach of combining neo-adjuvant strategies with surgical resection has raised a number of questions regarding the optimal management and timing of surgery. For the purpose of this review, we will focus on the treatment of stage 4 colorectal cancer with synchronous liver metastases...
2017: F1000Research
https://www.readbyqxmd.com/read/28527628/multidisciplinary-clinics-for-colorectal-cancer-care-reduces-treatment-time
#16
Vanessa N Kozak, Alok A Khorana, Sudha Amarnath, Katherine E Glass, Matthew F Kalady
INTRODUCTION: Management of locally advanced and metastatic colorectal cancer (CRC) requires the expertise of multiple specialists. Multidisciplinary clinics (MDCs) are a working model designed to facilitate delivery of coordinated care. The present study evaluated the effects of MDC on the time to treatment (TTT). PATIENTS AND METHODS: Patients with CRC or locally advanced anal cancer who were evaluated at a single-institution MDC from January 2014 to October 2015 were identified from an institutional registry...
April 19, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28501254/cytoreduction-and-hyperthermic-intraperitoneal-chemotherapy-in-the-management-of-colorectal-peritoneal-metastasis
#17
REVIEW
Bradley Hall, James Padussis, Jason M Foster
Historically, patients with peritoneal carcinomatosis secondary to colorectal cancer have a poor overall prognosis. Recent data support the use of cytoreductive surgery and heated intraperitoneal chemotherapy (CRS + HIPEC) to specifically address the peritoneal disease. Retrospective studies on CRS + HIPEC have been promising, showing significant improvements in OS compared with systemic chemotherapy alone. However, CRS + HIPEC carries morbidity similar to other advance oncology procedures such as liver resection and pancreatoduonectomy...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28501253/resection-of-the-primary-tumor-in-stage-iv-colorectal-cancer-when-is-it-necessary
#18
REVIEW
Leandro Feo, Michael Polcino, Garrett M Nash
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28488528/future-perspectives-of-circulating-tumor-dna-in-colorectal-cancer
#19
C Nadal, T Winder, A Gerger, David Tougeron
Tumor biopsy is currently the gold standard for diagnosis and in determining cell signaling pathways involved in the development of treatment resistance. However, there are major challenges with this technique, including the need for serial sampling to monitor treatment resistance, which is invasive and also has the potential for selection bias due to intra-tumoral and inter-tumoral heterogeneity. These challenges highlight the need for more effective methods for obtaining Tumor samples. Liquid biopsy analyzes genetic material or tumor cells shed into the blood from the primary tumor and metastatic sites and consequently provides a comprehensive, real-time picture of the tumor burden in an individual patient...
May 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/28462853/comparing-clinical-characteristics-and-outcomes-of-young-onset-and-late-onset-colorectal-cancer-an-international-collaborative-study
#20
Young Soo Rho, Marine Gilabert, Karol Polom, Archil Aladashvili, Katerina Kopeckova, Vera Megdanova, Niamh Coleman, Megan Greally, Daniele Marrelli, Franco Roviello, Ray McDermott, Veneta Petrova, Zhasmina Mihaylova, Zbynek Bortlicek, Jana Prausova, Gerald Batist, Laurent Azoulay, Petr Kavan
BACKGROUND: Compared with the general population, the incidence of young-onset (YO) colorectal cancer (CRC) is increasing. However, a significant knowledge gap exists in the clinical characteristics, treatment patterns, and outcomes for these patients. MATERIALS AND METHODS: Six international tertiary cancer centers conducted a retrospective study. Patients with YO CRC (aged 18-44 years) and LO CRC (aged > 44 years) diagnosed with histologically proven colorectal adenocarcinoma from June 2003 to June 2014 were enrolled...
March 21, 2017: Clinical Colorectal Cancer
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