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Rectal cancer node

Matthew D Hall, Timothy E Schultheiss, David D Smith, Marwan G Fakih, Jeffrey Y C Wong, Yi-Jen Chen
BACKGROUND: Neoadjuvant chemoradiation therapy (CRT) increases pathological complete response (pCR) rates compared to radiotherapy alone in patients with stage II-III rectal cancer. Limited evidence addresses whether radiotherapy dose escalation further improves pCR rates. Our purpose is to measure the effects of radiotherapy dose and other factors on post-therapy pathologic tumor (ypT) and nodal stage in rectal cancer patients treated with neoadjuvant CRT followed by mesorectal excision...
October 20, 2016: Acta Oncologica
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
Kyung Ha Lee, Jin Soo Kim, Ji Yeon Kim
PURPOSE: Oral capecitabine has demonstrated to be safe and efficient as neoadjuvant concurrent chemoradiotherapy (NCRT) for locally advanced rectal cancers. The aim of this study was to evaluate the long-term oncologic outcomes of NCRT with capecitabine and radical surgery. METHODS: From January 2000 to June 2010, 238 patients were treated at our center for locally advanced rectal cancers using conventional NCRT with capecitabine and radical surgery. Univariate and multivariate analyses were used to evaluate the factors associated with oncologic outcomes with log rank and Cox regression tests...
October 2016: Annals of Surgical Treatment and Research
Vincenza Granata, Roberta Fusco, Alfonso Reginelli, Luca Roberto, Francesco Granata, Daniela Rega, Antonio Rotondo, Roberto Grassi, Francesco Izzo, Antonella Petrillo
Anal cancer is uncommon neoplasm with an incidence of 2 new cases per 100,000 per year in the USA, accounting approximately 0.4 % of all tumors and 2.5 % of gastrointestinal malignancies. An early detection of the anal cancer is crucial for the patient management, whereas the diagnosis at an early stage allows conservative management with sphincter sparing, on the contrary a delays in diagnosis might lead to an advance cancer stage at presentation with worst survival. According to National Comprehensive Cancer Network (NCCN) Anal Carcinoma guidelines the patients should be subjected to a careful clinical examination, including a digital rectal examination (DRE), an anoscopic examination, and palpation of inguinal nodes...
2016: Infectious Agents and Cancer
Atsushi Ogura, Takashi Akiyoshi, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno, Hiroya Kuroyanagi
BACKGROUND: The feasibility of additional lateral pelvic lymph node dissection (LPLND) compared with total mesorectal excision (TME) alone in patients treated with preoperative chemoradiotherapy (CRT) is controversial, especially in laparoscopic surgery. This study was performed to evaluate the feasibility of adding laparoscopic LPLND to TME in patients with advanced lower rectal cancer and swollen LPLNs treated with preoperative CRT. METHODS: We reviewed 327 patients with lower rectal cancer without distant metastasis who underwent preoperative CRT followed by laparoscopic TME...
October 11, 2016: World Journal of Surgery
Toshiya Nagasaki, Takashi Akiyoshi, Yoshiya Fujimoto, Tsuyoshi Konishi, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
BACKGROUND: Preoperative chemoradiotherapy (CRT) is a standard treatment for locally advanced low rectal cancer (LALRC). However, the prognostic significance of CRT in patients with lateral lymph node metastasis (LLNM) is unknown. The present study aimed to examine the prognostic impact of preoperative CRT in patients with LALRC and LLNM. METHODS: We retrospectively analyzed data for 73 patients with LALRC and LLNM who underwent total mesorectal excision and lateral lymph node dissection from 1985 to 2012...
October 11, 2016: World Journal of Surgery
Naohito Beppu, Ayako Kakuno, Hiroshi Doi, Norihiko Kamikonya, Nagahide Matsubara, Naohiro Tomita, Hidenori Yanagi, Naoki Yamanaka
BACKGROUND: Although preoperative chemoradiotherapy exerts a destructive effect on positive lymph nodes, microscopic examination reveals different degrees of tumor regression. The aim of the present study is to investigate the impact of the radiation-induced regression of positive nodes on survival in patients with rectal cancer treated with preoperative chemoradiotherapy. METHODS: From 2001 to 2015, 229 patients with T3 rectal cancer underwent total mesorectal excision after preoperative chemoradiotherapy...
October 7, 2016: Surgery
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Shigeru Yamada, Toshiaki Watanabe
BACKGROUND: The need for surveillance of rare late recurrence of rectal cancer has not yet been established. Local control of unresectable skeletal metastasis is important for palliation of symptoms and support for systemic chemotherapy. CASE PRESENTATION: A Japanese man underwent preoperative pelvic irradiation (50.4 Gy/28 Fr) and low anterior resection at the age of 57 years. The pathological stage was II (T3N0M0). Nine years after the surgery, his carcinoembryonic antigen (CEA) level showed rapid elevation, although he had no symptoms...
December 2016: Surgical Case Reports
Y Sun, P Chi, H Lin, X Lu, Y Huang, Z Xu, S Huang, X Wang
AIM: To assess the effect of neoadjuvant chemoradiotherapy (nCRT) on inferior mesenteric artery (IMA) nodal metastasis and identify predictors for IMA nodal metastasis in locally advanced rectal cancer (LARC) after nCRT. METHOD: Propensity score matching of 1167 patients with LARC was performed. Clinicopathological predictors and survival rates were analyzed using univariate and multivariate analyses. RESULTS: Compared to surgery alone, nCRT reduced the incidence of IMA nodal metastasis (before matching, 4...
September 24, 2016: European Journal of Surgical Oncology
Ben Huang, Mengdong Ni, Chen Chen, Guoxiang Cai, Sanjun Cai
PURPOSE: Yielding pathologic-lymph node ratio (yp-LNR) was considered to be a better staging system than yp-N stage in rectal cancer patients treated with preoperative radiotherapy (pre-RT). We aimed to compare the predictive ability of yielding pathologic log odds of positive lymph nodes (yp-LODDS) with that of yp-LNR for cancer-specific survival (CSS) in stage III rectal cancer patients treated with pre-RT. METHODS: We analyzed stage III rectal cancer patients treated with pre-RT in the Surveillance, Epidemiology and End Results (SEER) database...
October 3, 2016: Tumori
Christoph A Maurer, Daniel Dietrich, Martin K Schilling, Urs Metzger, Urban Laffer, Peter Buchmann, Bruno Lerf, Peter Villiger, Gian Melcher, Christian Klaiber, Christian Bilat, Peter Brauchli, Luigi Terracciano, Katharina Kessler
PURPOSE: This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers. METHODS: One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204)...
October 7, 2016: International Journal of Colorectal Disease
Leonardo S Lino-Silva, Rosa A Salcedo-Hernández, Erika B Ruiz-García, Leticia García-Pérez, Ángel Herrera-Gómez
BACKGROUND: Several studies have reported that an elevation in neutrophils/lymphocyte ratio (NLR) is correlated with poor survival in patients with colorectal cancer, but in rectal cancer (RC), it has been reported only in a few studies. It is necessary to separate colon cancer and rectal cancer to clarify the prognostic significance of NLR, especially in patients who received chemoradiotherapy. METHODS: It is a comparative, observational retrospective study of a cohort of 175 patients...
July 27, 2016: Medical Archives
W Xu, Z Xu, H Cheng, J Ying, F Cheng, W Xu, J Cao, J Luo
AIM: The objective of this meta-analysis was to evaluate the feasibility, safety, and short-term clinical outcomes of transanal total mesorectal excision (TaTME) comparing with laparoscopy total mesorectal excision (LapTME) for mid and low rectal cancer. METHODS: Relevant studies were searched from the databases of Pubmed, Embase, and the Cochrane Library. The qualities of all of the included studies were evaluated using Newcastle-Ottawa Scale (NOS). The synthesized outcomes were pooled using fixed-effects models or random-effects models, which weighted the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (95% CI)...
September 19, 2016: European Journal of Surgical Oncology
Takeshi Nishikawa, Soichiro Ishihara, Tetsuo Ushiku, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Toshiaki Watanabe
The metastasis of rectal cancer to the anus is rare. Here, we report a case of advanced rectal cancer, which had a diffuse venous invasion with anal metastasis and multiple lymph node and liver metastases. The patient was a 72-year-old woman who complained of perianal pain and fresh blood in the stools for 6 months. She had neither history of fistula-in-ano nor anal surgery. Digital examination revealed a 2-cm tumor at the 7 o'clock position, and the barium enema and colonoscopy confirmed advanced rectal cancer...
October 1, 2016: Clinical Journal of Gastroenterology
N M Ormsby, H N Bermingham, H M Joshi, M Chadwick, A Samad, D Maitra, M Scott, S Kelly, K Whitmarsh, R Rajaganeshan
BACKGROUND AND AIMS: Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer. MATERIAL AND METHODS: Retrospective study of all patients operatively managed within our institution between April 2008 and April 2013 for rectal cancer. Baseline demographics and multiple outcome measures recorded...
October 1, 2016: International Journal of Colorectal Disease
E Onjukka, J Uzan, C Baker, L Howard, A Nahum, I Syndikus
AIMS: For patients with high-risk, locally bulky prostate cancer, an intra-prostatic boost to tumour volumes (dose-painting) offers a risk-adapted dose escalation. We evaluated the feasibility of hypofractionated dose-painting radiotherapy and the associated toxicity. The possibility to streamline a radiobiologically optimised planning protocol was also investigated. MATERIALS AND METHODS: Twenty-eight patients were treated using a dose-painting approach; boost volumes were identified with functional magnetic resonance imaging scans...
September 29, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Christine H Feng, Yasmin Hasan, Malgorzata Kopec, Hania A Al-Hallaq
We performed a dosimetric comparison of sequential IMRT (sIMRT) and simul-taneously integrated boost (SIB) IMRT to boost PET-avid lymph nodes while concurrently treating pelvic targets to determine the potential of SIB IMRT to reduce overall treatment duration in locally advanced cervical cancer. Ten patients receiving definitive radiation therapy were identified retrospectively. RTOG consensus guidelines were followed to delineate the clinical target volume and organs at risk (OAR), which were then expanded per IMRT consortium guidelines to yield the planning target volume (PTV)...
2016: Journal of Applied Clinical Medical Physics
Quanquan Zhao, Xiaohui Shi, Chuangang Fu, Enda Yu, Wei Zhang, Ronggui Meng, Hantao Wang, Liqiang Hao, Hao Wang
OBJECTIVE: To identify the risk factors associated with lymph node metastasis in rectal cancer after neoadjuvant chemoradiotherapy (CRT). METHODS: From January 2005 to December 2013, the clinical data of 178 patients with advanced rectal cancer undergoing radical excision after neoadjuvant CRT in our department were reviewed retrospectively. A total of 11 clinicopathologic factors relating to lymph node metastasis were studied using univariate and multivariate Logistic regression analyses...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Xue-Feng Yang, Ji-Feng Zhang, Jun-Jun Li, Shuang Zhao, Shuai Shi, Ji-Cheng Wu, Lei Fang, Hua-Mao Jiang, Hua-Chuan Zheng
Here, we collected the information of 17304 and 2014 inpatients with colorectal cancer (CRC) from general hospitals of China and Japan respectively, and analyzed microscopic and macroscopic aspects, even stratified by the age and gender. It was found that Chinese CRC patients showed younger prone, more rectal and ascending cancers, less sigmoid and transverse cancers, larger size, less invasion into lymphatic system or metastasis into lymph node, and poorer differentiation than Japanese ones (p < 0.05). TNM staging was employed as an independent factor for the prognosis of the CRC patients regardless of the country (p < 0...
September 24, 2016: Oncotarget
Rainer Kimmig, Peter Rusch, Paul Buderath, Bahriye Aktas
Superior hypogastric plexus (SHG) contains mainly sympathetic and most probably also postganglionic parasympathetic fibers. Thus, surgical damage of SHG may cause autonomic pelvic organ dysfunction (Kraima et al., 2015). As already shown for rectal cancer, preservation of the autonomic nerves is facilitated by robotic surgery and may avoid sexual dysfunctions and voiding disorders (Kim et al., 2015). In this educational video, we demonstrate left lower paraaortic lymph node dissection preserving the SHG using ICG fluorescence to label the lymphatic compartment...
November 2016: Gynecologic Oncology Reports
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