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Recurrent rectal cancer

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https://www.readbyqxmd.com/read/28105657/a-nomogram-to-predict-distant-metastasis-after-neoadjuvant-chemoradiotherapy-and-radical-surgery-in-patients-with-locally-advanced-rectal-cancer
#1
Yanwu Sun, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Shenghui Huang, Xiaojie Wang, Pan Chi
PURPOSE: To compare distant metastasis (DM) in locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (nCRT) and surgery alone, and to develop a predictive nomogram for DM following nCRT. METHODS: Propensity-scoring match analysis was performed to compare DM in LARC treated with nCRT (n = 375) and surgery alone (n = 375). Cox regression was performed to identify predictors of DM following nCRT. A nomogram was developed and validated by internal (n = 425) and external validation (n = 97)...
January 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28104993/synchronous-quintuple-primary-gastrointestinal-tract-malignancies-case-report
#2
Soo-Hong Kim, Byung-Soo Park, Hyun Sung Kim, Jae Hun Kim
Multiple primary malignancy is defined as two or more malignancies detected in an individual person. In particular, synchronous quintuple primary malignancy is extremely rare. A 52-year-old male with anal pain and intermittent blood-tinged stool was diagnosed with malignancies in the stomach, jejunum, ascending colon, transverse colon and rectum. He underwent a subtotal gastrectomy, segmental resection of the jejunum and total protocolectomy with end ileostomy. The postoperative pathologic findings were moderate differentiated gastric adenocarcinoma (pT1bN0M0, pStageIA), combined adenocarcinoma and neuroendocrine carcinoma of the jejunum (pT3N0M0, pStageIIA), three mucinous adenocarcinoma of the ascending colon (pT3N0M0, pStageIIA), transverse colon (pT1N0M0, pStageI) and rectum (pT3N1aM0, pStageIIIB)...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28103579/the-combination-of-early-treatment-response-and-ypt-stage-is-a-novel-metric-to-stage-rectal-cancer-patients-treated-with-neoadjuvant-chemoradiotherapy
#3
Jian Cui, Lin Yang, Lei Guo, Yongfu Shao, Dongfeng Tan, Ni Li, Haizeng Zhang
Rectal cancer patients receiving neoadjuvant chemoradiotherapy (NCRT) are currently classified using the same Tumor-Node-Metastasis staging system as those patients without NCRT. We determined whether the combination of tumor treatment response (TRG) and ypT stage more accurately assesses primary tumors in rectal cancer after NCRT. We analyzed data from 329 rectal cancer patients treated with NCRT followed by radical resection. Cox proportional hazards models were used to evaluate the effects of different staging parameters on disease-free survival (DFS)...
January 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28099961/perineural-invasion-is-associated-with-poor-survival-after-preoperative-chemoradiation-therapy-for-advanced-lower-rectal-cancer
#4
Shozo Yokoyama, Kenji Matsuda, Takashi Watanabe, Yasuyuki Mitani, Junji Ieda, Hiromitsu Iwamoto, Tsukasa Hotta, Katsunari Takifuji, Hiroki Yamaue
BACKGROUND: Preoperative chemoradiation therapy (pCRT) is a standard procedure for patients with advanced lower rectal cancer. It has been reported that pCRT cannot prolong the survival of patients with advanced lower rectal cancer. The aim of this study is to address the controllable and uncontrollable pathological factors of pCRT in predicting local and distant recurrences. METHODS: One hundred two patients with stages 2 and 3 cancer were consecutively enrolled to the study...
January 19, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28099070/laparoscopic-rectal-dissection-assisted-by-transanal-endoluminal-videoendoscopy-through-a-blunt-tip-trocar
#5
Emanuele Asti, Andrea Lovece, Luigi Bonavina
BACKGROUND AND AIMS: Laparoscopic resection is a well-established approach for colorectal cancer surgery. In patients with rectal cancer treated by neoadjuvant chemoradiotherapy, it may be difficult to identify a clear safety margin for endostapling and subsequent anastomosis. We designed an innovative technical approach to assist colorectal anastomosis in these patients. TECHNIQUE: A four-trocar laparoscopic approach is used. After exploration of the abdominal cavity, the left colic flexure is completely mobilized...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28091845/comparison-of-the-clinical-results-of-abdominoperanal-intersphincteric-resection-and-abdominoperineal-resection-for-lower-rectal-cancer
#6
Shunsuke Tsukamoto, Yukihide Kanemitsu, Dai Shida, Hiroki Ochiai, Junichi Mazaki
BACKGROUND: The aim of this study was to compare the oncologic results of abdominoperanal intersphincteric resection (ISR) and abdominoperineal resection (APR). METHODS: Between 2003 and 2014, 277 consecutive patients with stage I-III low rectal cancer located within 5 cm from the anal verge underwent curative ISR and APR. A retrospective comparison of these two procedures was performed. RESULTS: Overall, 128 patients underwent ISR and 149 underwent APR...
January 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28089690/mri-evaluation-of-rectal-cancer-staging-and-restaging
#7
REVIEW
Courtney C Moreno, Patrick S Sullivan, Pardeep K Mittal
Magnetic resonance imaging (MRI) plays an important role in the staging and restaging of rectal cancer. Multiplanar high-resolution (≤3-mm section thickness) T2-weighted images are the primary sequences used for rectal cancer staging. No preprocedural bowel cleansing regimen, intravenous contrast material, nor endorectal coil is necessary. MRI is highly accurate for differentiating T1-T2 disease from T3 and T4 disease, an important distinction as patients with T3 and T4 tumors typically undergo preoperative neoadjuvant chemoradiation before resection...
November 21, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28087988/cpg-island-methylator-phenotype-is-an-independent-predictor-of-survival-after-curative-resection-for-colorectal-cancer-a-prospective-cohort-study
#8
Chang Hyun Kim, Jung Wook Huh, Hyeong Rok Kim, Young Jin Kim
BACKGROUND AND AIMS: The CpG island methylator phenotype (CIMP) is found in approximately 30% of colorectal cancer (CRC) cases. However, the role of CIMP status in predicting oncologic outcomes in curatively resected CRC is still unclear. STUDY: Between January 2006 and December 2006, we retrospectively reviewed 157 consecutive patients who underwent curative surgery for CRC. Prognostic significance of CIMP status was evaluated using reverse transcriptase-polymerase chain reaction...
January 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28087370/laparoscopic-versus-open-surgery-for-rectal-cancer-a-meta-analysis-of-classic-randomized-controlled-trials-and-high-quality-nonrandomized-studies-in-the-last-5-years
#9
REVIEW
Ke Chen, Guodong Cao, Bo Chen, Mingqing Wang, Xingyu Xu, Wenwen Cai, Yicheng Xu, Maoming Xiong
OBJECTIVE: To present a meta-analysis of high-quality published reports comparing laparoscopic rectal resection (LRR) and open rectal resection (ORR) for rectal cancer. METHODS: Studies that compared LRR and ORR and were published within the last 5 years were identified. All eligible randomized controlled trials (RCTs) and non-randomized comparative trials (NRCTs) were evaluated based on the Jadad score, the Cochrane risk of bias assessment tool and modified Methodological Indices for Nonrandomized Studies (MINORS)...
January 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28078113/results-of-intraoperative-electron-beam-radiotherapy-containing-multimodality-treatment-for-locally-unresectable-t4-rectal-cancer-a-pooled-analysis-of-the-mayo-clinic-rochester-and-catharina-hospital-eindhoven
#10
Fabian A Holman, Michael G Haddock, Leonard L Gunderson, Miranda Kusters, Grard A P Nieuwenhuijzen, Hetty A van den Berg, Heidi Nelson, Harm J T Rutten
BACKGROUND: The aim of this study is to analyse the pooled results of intraoperative electron beam radiotherapy (IOERT) containing multimodality treatment of locally advanced T4 rectal cancer, initially unresectable for cure, from the Mayo Clinic, Rochester, USA (MCR) and Catharina Hospital, Eindhoven, The Netherlands (CHE), both major referral centers for locally advanced rectal cancer. A rectal tumor is called locally unresectable for cure if after full clinical work-up infiltration into the surrounding structures or organs has been demonstrated, which would result in positive surgical margins if resection was the initial component of treatment...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077144/intraoperative-radiation-therapy-for-colon-and-rectal-cancers-a-clinical-review
#11
REVIEW
Michael G Haddock
Although there have been significant advances in the adjuvant therapy of colorectal cancer, results for patients have historically been poor when complete resection is unlikely or not possible. Similarly, locally recurrent colorectal cancer patients often experience significant tumor related morbidity and disease control and long term survival have historically been poor with standard therapies. Intraoperative radiation therapy (IORT) has been proposed as a possible tool for dose escalation in patients with locally advanced colorectal cancer...
January 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28070232/abdominosacral-resection-for-locally-recurring-rectal-cancer
#12
Filiberto Belli, Alessandro Gronchi, Carlo Corbellini, Massimo Milione, Ermanno Leo
AIM: To investigate feasibility and outcome of abdominal-sacral resection for treatment of locally recurrent rectal adenocarcinoma. METHODS: A population of patients who underwent an abdominal-sacral resection for posterior recurrent adenocarcinoma of the rectum at the National Cancer Institute of Milano, between 2005 and 2013, is considered. Retrospectively collected data includes patient characteristics, treatment and pathology details regarding the primary and the recurrent rectal tumor surgical resection...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28068158/follow-up-after-rectal-cancer-developing-and-testing-a-novel-patient-led-follow-up-program-study-protocol
#13
Ida Hovdenak Jakobsen, Therese Juul, Inge Bernstein, Peter Christensen, Frank Svendsen Jensen, Christoffer Johansen, Susie Lindhardt Larsen, Søren Laurberg, Mogens Rørbæk Madsen, Ole Thorlacius-Ussing, Henriette Vind Thaysen
BACKGROUND: The main treatment for non-metastatic rectal cancer (RC) is surgical resection. Late adverse effects that are highly prevalent and negatively impact patients' symptom burden and quality of life are: bowel-, urological and sexual dysfunctions; psychological distress; fear of recurrence. Patients and clinicians have requested a more patient-centred follow-up, balancing the focus on detection of recurrence, and physiological and psychological late adverse effects. The current follow-up program primarily focuses on detection of recurrence, with less attention on late adverse effects...
January 9, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28063191/salvage-high-intensity-focused-ultrasound-hifu-for-locally-recurrent-prostate-cancer-after-failed-radiation-therapy-multi-institutional-analysis-of-418-patients
#14
Sebastien Crouzet, Andreas Blana, Francois J Murat, Gilles Pasticier, Stephen C W Brown, Giario N Conti, Roman Ganzer, Olivier Chapet, Albert Gelet, Christian G Chaussy, Cary N Robertson, Stefan Thuroff, John F Ward
OBJECTIVE: To report the oncological outcome of Salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer (PCa) following External Beam Radiotherapy (EBRT) from a multicenter database. MATERIALS AND METHODS: This retrospective study comprises patients from 9 centers with local recurrent disease following EBRT treated with S-HIFU from 1995 to 2009. Biochemical free survival rates (BFSR) was based on the "Phoenix" definition (nadir+2)...
January 7, 2017: BJU International
https://www.readbyqxmd.com/read/28060748/is-the-pathological-regression-level-of-metastatic-lymph-nodes-associated-with-oncologic-outcomes-following-preoperative-chemoradiotherapy-in-rectal-cancer
#15
Jung Pil Choi, Seong Joo Kim, In Ja Park, Seung Mo Hong, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jung Bok Lee, Chang Sik Yu, Jin Cheon Kim
PURPOSE: The oncologic impact of the lymph node (LN) regression level after preoperative chemoradiotherapy (PCRT) has not been thoroughly evaluated. Hence, this study aimed to examine whether the regression level of metastatic LNs following PCRT is associated with oncologic outcomes in rectal cancer. RESULTS: The optimal number of cut points for LRG sum was determined to be three. The three LRG groups demonstrated different distributions according to the ypT and ypN stages (p < 0...
January 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28059920/local-excision-techniques-for-rectal-cancer-after-neoadjuvant-chemoradiotherapy-what-are-we-doing
#16
Fraser McLean Smith, Abdul Ahad, Rodrigo Oliva Perez, John Marks, Krzysztof Bujko, Richard J Heald
BACKGROUND: Recent evidence shows that the majority of rectal cancers demonstrate occult tumor scatter after neoadjuvant chemoradiotherapy that can extend for several centimeters under adjacent normal-appearing mucosa beside the residual mucosal abnormality or scar. OBJECTIVE: This systematic review aimed to determine all of the published selection criteria and technical descriptions for local excision to date with regard to this phenomenon. DATA SOURCES: PubMed, MEDLINE, and Embase were searched using the following key words: rectal cancer, local excision, radiotherapy, and neoadjuvant...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059911/transanal-endoscopic-microsurgery-for-early-rectal-cancer-a-single-center-experience
#17
Conor H O'Neill, Joseph Platz, Jesse S Moore, Peter W Callas, Peter A Cataldo
BACKGROUND: There is debate regarding the appropriate use of transanal endoscopic microsurgery for rectal cancer. OBJECTIVE: This study analyzed our single-center experience with transanal endoscopic microsurgery for early rectal cancer. DESIGN: Medical charts of patients who underwent transanal endoscopic microsurgery were reviewed to determine lesion characteristics, as well as operative and treatment characteristics. Complications and recurrences were recorded...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059910/validation-of-mri-and-surgical-decision-making-to-predict-a-complete-resection-in-pelvic-exenteration-for-recurrent-rectal-cancer
#18
Wendy E Brown, Cherry E Koh, Tim Badgery-Parker, Michael J Solomon
BACKGROUND: The main predictor of long-term survival in patients with recurrent rectal cancer is surgical resection with a clear resection margin. MRI plays a role in patient selection and surgical planning. OBJECTIVE: This study aimed to validate MRI in determining pelvic involvement by comparing MRI to histological outcomes, to assess the effect of MRI on surgical planning by comparing MRI findings with the surgical procedure, and to compare MRI anatomical involvement with resection outcome to assess if MRI can predict a clear resection margin...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28057329/hyperfractionated-accelerated-reirradiation-for-rectal-cancer-an-analysis-of-outcomes-and-toxicity
#19
Randa Tao, Chiaojung Jillian Tsai, Garrett Jensen, Cathy Eng, Scott Kopetz, Michael J Overman, John M Skibber, Miguel Rodriguez-Bigas, George J Chang, Yi-Qian Nancy You, Brian K Bednarski, Bruce D Minsky, Marc E Delclos, Eugene Koay, Sunil Krishnan, Christopher H Crane, Prajnan Das
BACKGROUND AND PURPOSE: To evaluate outcomes and toxicity in patients treated with hyperfractionated pelvic reirradiation for recurrent rectal cancer. MATERIALS AND METHODS: 102 patients with recurrent rectal adenocarcinoma were treated with pelvic reirradiation with a hyperfractionated accelerated approach, consisting of 1.5Gy twice daily fractions to a total dose of 30-45Gy (median 39Gy), with the most common total dose 39Gy (n=90, 88%). The median dose of prior pelvic radiation therapy (RT) was 50...
January 2, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28057090/-ct-guidance-125-i-seed-implantation-for-pelvic-recurrent-rectal-cancer-assisted-by-3d-printing-individual-non-coplanar-template
#20
H Wang, J J Wang, Y L Jiang, S Q Tian, Z Ji, F X Guo, H T Sun, J H Fan, Y P Xu
Objective: To analyze the difference of dosimetric parameters between pre-plan and post-plan of (125)I radioactive seed implantation assisted by 3D printing individual non-coplanar template (3D printing template) for locally recurrent rectal cancer (LRRC). Methods: From February 2016 to April 2016, a total of 10 patients with locally recurrent rectal cancer received (125)I seeds implantation under CT guidance assisted by 3D printing template in Department of Radiation Oncology, Peking University Third Hospital...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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