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Recurrent rectal cancer

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https://www.readbyqxmd.com/read/29234923/non-inferiority-multicenter-prospective-randomized-controlled-study-of-rectal-cancer-t2-t3s-superficial-n0-m0-undergoing-neoadjuvant-treatment-and-local-excision-tem-vs-total-mesorectal-excision-tme
#1
X Serra-Aracil, C Pericay, T Golda, L Mora, E Targarona, S Delgado, A Reina, F Vallribera, J M Enriquez-Navascues, S Serra-Pla, J C Garcia-Pacheco
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29232533/laparoscopic-abdominal-transanal-proctocolectomy-with-coloanal-anastomosis-is-a-good-surgical-option-in-selective-patients-with-low-lying-rectal-cancer-a-retrospective-analysis-based-on-a-single-surgeon-s-experience
#2
Bong-Hyeon Kye, Jun-Gi Kim, Hyeon-Min Cho, Hyung-Jin Kim, Chung-Soo Chun
PURPOSE: We intended to identify the oncological outcome for rectal cancer over the past 20 years and whether or not sphincter-preserving surgery is an appropriate approach for low-lying rectal cancer. MATERIALS AND METHODS: The oncological outcomes from a total of 418 patients who electively underwent rectal cancer surgery for a lesion located within 8 cm of the anal verge by a single colorectal surgeon were reviewed retrospectively. RESULTS: Of 418 patients, 175 patients underwent low anterior resection (LAR), 172 laparoscopic abdominal transanal proctocolectomy with coloanal anastomosis (LATA), and 71 abdominoperineal resection (APR)...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29229359/pelvic-exenteration-with-rectal-resection-for-different-types-of-malignancies-at-two-tertiary-referral-centres
#3
Alvaro Garcia-Granero, Sebastiano Biondo, Eloy Espin-Basany, Ana González-Castillo, Silvia Valverde, Loris Trenti, Antonio Gil-Moreno, Esther Kreisler
INTRODUCTION: Pelvic exenteration (PE) offers the best chance of cure for locally advanced primary or recurrent pelvic organ malignancies invading adjacent organs. The aims of this study were to analyse results for any pelvic exenteration that includes rectal resection and the analysis of results of fecal and urinary reconstruction. METHOD: From January 2000 to April 2014, 111 PE with rectal resection for any pelvic cancer were analysed retrospectively at two national tertiary referral centers...
December 8, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29229310/tumor-volume-predicts-local-recurrence-in-early-rectal-cancer-treated-with-radical-resection-a-retrospective-observational-study-of-270-patients
#4
Yanhui Jiang, Kaiyun You, Xingsheng Qiu, Zhuofei Bi, Huaqian Mo, Liting Li, Yimin Liu
OBJECTIVE: Radical resection is regarded as the primary treatment for early rectal cancer, and tumor volume is an independent predictor of many other types of cancer. The purpose of the present study is to assess the effect of tumor volume on the survival of patients with early rectal cancer treated with radical surgery. METHODS: A total of 270 patients with histologically confirmed stage T1/2 N0 rectal cancer who underwent radical resection between September 2006 and September 2014 were enrolled in this study...
December 8, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29224985/management-and-prognosis-of-locally-recurrent-rectal-cancer-a-national-population-based-study
#5
Karin Westberg, Gabriella Palmer, Fredrik Hjern, Hemming Johansson, Torbjörn Holm, Anna Martling
BACKGROUND: The rate of local recurrence of rectal cancer (LRRC) has decreased but the condition remains a therapeutic challenge. This study aimed to examine treatment and prognosis in patients with LRRC in Sweden. Special focus was directed towards potential differences between geographical regions and time periods. METHOD: All patients with LRRC as first event, following primary surgery for rectal cancer performed during the period 1995-2002, were included in this national population-based cohort-study...
November 26, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29224901/external-beam-re-irradiation-in-rectal-cancer
#6
R Owens, R Muirhead
Locally recurrent rectal cancer results in significant symptoms and is associated with prognosis of less than 1 year unless radical resection can be offered. Unfortunately, radical resection rates are low and therefore strategies to palliate symptoms and to maximise downstaging are of significant interest. As the majority of those presenting with locally recurrent rectal cancer will have received previous irradiation for their primary tumour, re-irradiation may offer benefit in this setting. The literature to date is considered in both palliative patients and those with potentially operable disease...
December 7, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29223019/are-pathological-high-risk-features-in-locally-advanced-rectal-cancer-a-useful-selection-tool-for-adjuvant-chemotherapy
#7
Marloes Swets, Peter J K Kuppen, Erik J Blok, Hans Gelderblom, Cornelis J H van de Velde, Iris D Nagtegaal
BACKGROUND: Several histological high-risk factors are used as an indication for adjuvant therapy in stage II colon cancer. Those and other factors, including lymphatic invasion, perineural invasion (PNI), venous invasion and tumour budding are associated with decreased outcome. In this study, we evaluated the prognostic and predictive values of these biomarkers in a cohort of rectal cancer patients. MATERIALS AND METHODS: The trial-based cohort consisted of 221npTNM stage II-III rectal cancer patients, included in the PROCTOR/SCRIPT trial, a multicentre randomised phase III trial...
December 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29221920/treatment-of-infected-aneurysm-with-combined-endovascular-aneurysm-repair-and-abscess-drainage
#8
Ken Nakajima, Noriyuki Kato, Takashi Hashimoto, Shuji Chino, Takatoshi Higashigawa, Takafumi Ouchi, Toshiya Tokui, Yoichiro Miyake, Hajime Sakuma
PURPOSE: To evaluate the clinical utility of combination therapy with endovascular aneurysm repair (EVAR) and abscess drainage for the treatment of infected aneurysms. MATERIALS AND METHODS: Between July 2009 and May 2015, 8 patients underwent combination therapy with EVAR and abscess drainage. There were 5 men and 3 women, with a mean age of 75 years ± 7. Aneurysms were of the thoracic aorta in 5 patients, the abdominal aorta in 2, and the internal iliac artery in 1...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29221180/pelvic-recurrence-after-definitive-surgery-for-locally-advanced-rectal-cancer-a-retrospective-investigation-of-implications-for-precision-radiotherapy-field-design
#9
Chao Li, Yinju Zhu, Tong Tong, Ye Xu, Yun Guan, Jingwen Wang, Huankun Wang, Ji Zhu
Background: To analyze the local distribution of pelvic recurrence after total mesorectal excision, with a view to simplifying the formulation of optimal individualized radiotherapy plans. Methods: We retrospectively investigated the data of 168 patients diagnosed with recurrent pelvic cancer treated at Fudan University Shanghai Cancer Center between January 2008 and December 2012. The following were collected depending on availability: operative report, histological report, specimen photographs, initial preoperative images, images confirming local recurrence, and clinical history...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29217398/is-neoadjuvant-chemoradiation-with-dose-escalation-and%C3%A2-consolidation-chemotherapy-sufficient-to-increase-surgery-free-and-distant-metastases-free-survival-in-baseline%C3%A2-ct3-rectal-cancer
#10
Guilherme Pagin São Julião, Angelita Habr-Gama, Bruna Borba Vailati, Patricia Bailão Aguilar, Jorge Sabbaga, Sérgio Eduardo Alonso Araújo, Adrian Mattacheo, Flavia Andrea Alexandre, Laura Melina Fernandez, Diogo Bugano Gomes, Joaquim Gama-Rodrigues, Rodrigo Oliva Perez
Patients with cT3 rectal cancer are less likely to develop complete response to neoadjuvant chemoradiation (nCRT) and still face significant risk for systemic relapse. In this setting, radiation (RT) dose-escalation and consolidation chemotherapy in "extended" nCRT regimens have been suggested to improve primary tumor response and decrease the risks of systemic recurrences. For these reasons we compared surgery-free and distant-metastases free survival among cT3 patients undergoing standard or extended nCRT...
November 26, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29212503/synergistic-antitumor-interaction-between-valproic-acid-capecitabine-and-radiotherapy-in-colorectal-cancer-critical-role-of-p53
#11
Manuela Terranova-Barberio, Biagio Pecori, Maria Serena Roca, Serena Imbimbo, Francesca Bruzzese, Alessandra Leone, Paolo Muto, Paolo Delrio, Antonio Avallone, Alfredo Budillon, Elena Di Gennaro
BACKGROUND: Recurrence with distant metastases has become the predominant pattern of failure in locally advanced rectal cancer (LARC), thus the integration of new antineoplastic agents into preoperative fluoropyrimidine-based chemo-radiotherapy represents a clinical challenge to implement an intensified therapeutic strategy. The present study examined the combination of the histone deacetylase inhibitor (HDACi) valproic acid (VPA) with fluoropyrimidine-based chemo-radiotherapy on colorectal cancer (CRC) cells...
December 6, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/29205364/effects-of-local-multivisceral-resection-for-clinically-locally-advanced-rectal-cancer-on-long-term-outcomes
#12
Anne M Dinaux, Lieve G J Leijssen, Liliana G Bordeianou, Hiroko Kunitake, David L Berger
INTRODUCTION: Multivisceral resection is occasionally needed to obtain clear margins in patients with transmural rectal cancer. Most series demonstrate equivalent outcomes between those patients who undergo multivisceral resections and those who do not, provided an R0-resection is achieved. This study focuses solely on patients who received neoadjuvant treatment for clinically transmural rectal cancers and underwent a local multivisceral R0-resection. METHODS: A retrospective, single center analysis of consecutive series of patients who received a surgical R0-resection after neoadjuvant treatment for a clinically transmural, non-metastatic, primary rectal cancer...
December 4, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29203977/radical-treatment-of-rectal-cancer-in-elderly-is-feasible-than-feared-results-from-a-tertiary-care-centre
#13
Madhu Muralee, Rajesh Singh, Arun Peter Mathew, Kurian Cherian, K Chandramohan, Paul Augustine, S Roshni, Iqbal Ahamed
The thought of subjecting an elderly patient with rectal cancer to protocol-based neoadjuvant chemoradiation (NACTRT), surgery and adjuvant chemotherapy is sought with fear due to their multiple comorbidities and impaired functional status associated with the process of ageing. Hence, many a times the treatment is compromised and it is a fact that this subgroup of patients is underrepresented in most of the clinical trials. This study was aimed at analysing the perioperative and oncologic outcomes after protocol-based treatment of rectal cancer in the elderly patients, defined here as those with age ≥70 years...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29203973/long-term-functional-and-oncological-outcomes-following-intersphincteric-resection-for-low-rectal-cancers
#14
Sivakumar Mahalingam, Ramakrishnan Ayloor Seshadri, Surendran Veeraiah
Surgery for low rectal cancer often involves a permanent stoma. Intersphincteric resection (ISR) with colo-anal anastomosis is a valuable sphincter sparing surgical procedure that avoids the need for permanent stoma in patients with low rectal cancer. The aim of this study was to analyze the long-term functional and oncological outcomes following ISR. This was a retrospective analysis of patients with low rectal cancer who underwent ISR with colo-anal anastomosis in our institution between 2007 and 2015. All patients had a diversion stoma...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29191471/nerve-sparing-approach-improves-outcomes-of-patients-undergoing-minimally-invasive-radical-hysterectomy-a-systematic-review-and-meta-analysis
#15
REVIEW
Giorgio Bogani, Diego Oreste Rossetti, Antonino Ditto, Mauro Signorelli, Fabio Martinelli, Lavinia Mosca, Cono Scaffa, Umberto Leone Roberti Maggiore, Valentina Chiappa, Ilaria Sabatucci, Domenica Lorusso, Francesco Raspagliesi
Few studies investigated the efficacy and safety of nerve sparing approach via minimally invasive surgery for the treatment of cervical cancer. We aimed to review the current evidence comparing nerve sparing minimally invasive radical hysterectomy (NS-MRH) and conventional minimally invasive radical hysterectomy (MRH). This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD#57655). Overall, 675 patients were included: 350 (51.9%) and 325 (48.1%) patients undergoing MRH and NS-MRH, respectively...
November 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29188785/-outcome-after-surgical-resection-for-rectal-cancer-and-its-precursors-in-landspitali-university-hospital-2008-2012
#16
Hordur Mar Kolbeinsson, Elsa Bjork Valsdottir, Pall Helgi Moller
Backround: Rectal cancer makes up 2-3% of all cancers in Iceland and surgery is the mainstay of its treatment. Information regarding those who undergo resection of the rectum because of rectal cancer or its precursors in Iceland today is lacking. The aim of this study was to evaluate what kind of surgical treatment rectal cancer patients receive at Landspitali University Hospital along with peri-operative and long-term outcomes. METHODS: The study was retrospective. All patients undergoing total or partial resection of the rectum for rectal cancer or its precursor from 2008-2012 in Landspitali University hospital were included...
2017: Læknablađiđ
https://www.readbyqxmd.com/read/29184690/correlation-of-tumor-mutational-burden-and-treatment-outcomes-in-patients-with-colorectal-cancer
#17
Sachin G Pai, Benedito A Carneiro, Young Kwang Chae, Ricardo L Costa, Aparna Kalyan, Hiral A Shah, Irene Helenowski, Alfred W Rademaker, Devalingam Mahalingam, Francis J Giles
Background: The Cancer Genome Atlas (TCGA) showed that 16% of colorectal cancers (CRCs) display DNA repair mechanisms and high tumor mutational burden (TMB). Although, there is accumulating evidence of greater benefit of immunotherapy in tumors with high-TMB, its impact on response to chemotherapy is unknown. Methods: In this retrospective cohort study, we investigated the impact of TMB on progression-free survival (PFS) of CRC patients treated at tertiary care oncology clinics who had their tumors profiled by next-generation sequencing (NGS)...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29184474/neoadjuvant-strategies-locally-advanced-rectal-cancer
#18
REVIEW
Shahab Ahmed, Cathy Eng
Colorectal cancer is one of the major leading causes of death in both men and women. The successful management of colon or rectal cancer demands a multidisciplinary approach. In the last few years, significant improvement has been noticed in the management of localized rectal cancer to reduce local recurrence and obtain complete pathological response following appropriate surgical steps, if necessary. Implementation of neoadjuvant therapy not only enhances disease control, it may also ensure sphincter preserving procedures or organ-preserving options...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184467/the-perfect-total-mesorectal-excision-obviates-the-need-for-anything-else-in-the-management-of-most-rectal-cancers
#19
REVIEW
Richard John Heald, Ines Santiago, Oriol Pares, Carlos Carvalho, Nuno Figueiredo
This article discusses the local control of primary rectal cancer and its locoregional spread in the light of modern advances. In recent years, the use of neoadjuvant chemoradiation has spread widely. However, its true benefit is not always balanced with its morbidities. Often total mesorectal excision (TME) is the best option. We will discuss the indications for immediate surgery for chemoradiation in advance and the importance of a delay in the management plan. To understand this selection, it is mandatory to know the true extent of tissue at risk for tumor dissemination and spread...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29183892/treatment-of-advanced-colorectal-cancer-in-a-patient-with-cardiotoxic-reactions-to-5-fluorouracil-and-capecitabine-using-suboptimal-doses
#20
Joseph H Cioffi, Derek J Estes, Vaia Florou, Bach Ardalan
A 32-year-old female with stage IV colorectal cancer and metastasis to the liver experienced cardiotoxic reactions after treatment with 5-fluorouracil and its oral prodrug capecitabine even at two-thirds the recommended dose. After careful considerations, the decision was made to attempt capecitabine retrial at a further suboptimal dose with combination chemotherapy where she no longer experienced cardiac events. As a result, the liver tumour shrank and rectal mass stabilised, tumour markers dropped and she underwent surgical resection of both masses...
November 27, 2017: BMJ Case Reports
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