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Recurrent rectal cancer

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https://www.readbyqxmd.com/read/27931837/an-update-on-the-multimodality-of-localized-rectal-cancer
#1
REVIEW
Mehmet Artac, Levent Korkmaz, Bassel El-Rayes, Philip A Philip
New strategies have reduced the local recurrence (LR) rate and extended the duration of overall survival (OS) in patients with localized rectal cancer (RC) in recent decades. The mainstay of curative treatment remains radical surgery; however, downsizing the tumor by neo-adjuvant chemo-radiotherapy and adjuvant cytotoxic therapy for systemic disease has shown significant additional benefit. The standardization of total mesorectal excision (TME), radiation treatment (RT) dose and fractionation, and optimal timing and sequencing of treatment modalities with the use of prolonged administration of fluoropyrimidine concurrent with RT have significantly decreased the rates of LR in locally advanced rectal cancer (LARC) patients...
December 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27903247/preoperative-conventional-chemoradiotherapy-versus-short-course-radiotherapy-with-delayed-surgery-for-rectal-cancer-results-of-a-randomized-controlled-trial
#2
Tadas Latkauskas, Henrikas Pauzas, Laura Kairevice, Aleksandras Petrauskas, Zilvinas Saladzinskas, Rasa Janciauskiene, Jurate Gudaityte, Paulius Lizdenis, Saulius Svagzdys, Algimantas Tamelis, Dainius Pavalkis
BACKGROUND: There still is no evidence which neoadjuvant therapy regimen for stage II-III rectal cancer is superior. The aim of this study was to compare results achieved after long-course chemoradiotherapy (CRT) with short-term radiotherapy (RT) followed by delayed surgery. METHODS: A randomized trial was carried out between 2007-2013. One hundred fifty patients diagnosed with stage II-III rectal cancer were randomized into one of two neoadjuvant treatment arms: conventional chemoradiotherapy (CRT) and short-term radiotherapy (RT) followed by surgery after 6-8 weeks...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27900522/oncologic-outcomes-in-rectal-cancer-patients-with-a-%C3%A2-1-cm-distal-resection-margin
#3
Dong Woo Kang, Han Deok Kwak, Nak Song Sung, In Soo Yang, Se Jin Baek, Jung Myun Kwak, Jin Kim, Seon Hahn Kim
PURPOSE: Recently, common application of sphincter-saving resection in rectal cancer has led to acceptance of a 1-cm distal resection margin (DRM). The aim of this study was to evaluate oncologic outcomes of a DRM ≤1 cm in sphincter-saving resection for rectal cancer. The outcomes of a DRM ≤0.5 cm was also evaluated. METHODS: We reviewed prospectively collected data from 415 patients who underwent sphincter-saving resection for mid and low rectal cancer between September 2006 and December 2012 at Korea University Anam Hospital...
November 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27893653/adjuvant-radiotherapy-for-the-treatment-of-stage-iv-rectal-cancer-after-curative-resection-a-propensity-score-matched-analysis-and-meta-analysis
#4
Min Jung Kim, Sang Jin Kim, Sung-Chan Park, Dae Yong Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Heung Kwon Oh, Duck-Woo Kim, Sung-Bum Kang, Jung Nam Joo, Jae Hwan Oh
The role of pelvic radiotherapy (RT) in stage IV rectal cancer with total mesorectal excision (TME) has not been defined. We evaluated the impact of RT on oncologic outcomes among patients with stage IV rectal cancer who underwent TME and performed a meta-analysis of published studies.The records of stage IV rectal cancer patients who underwent TME between August 2001 and December 2011 were reviewed. Patients who received pelvic RT (RT group) and those who did not (non-RT group) were matched using a propensity score...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27892668/transanal-endoscopic-microsurgery-in-the-treatment-of-large-rectal-adenomas
#5
Mario Guerrieri, Monica Ortenzi, Giovanni Lezoche, Stefano Mancini, Roberto Ghiselli
BACKGROUND: Transanal endoscopic microsurgery (TEM) is a minimally invasive technique allowing to excise large rectal adenomas by local approach. This study shows the feasibility and results of a long term experience of TEM applied in this field. METHODS: A retrospective investigation was performed in patients affected by rectal adenomas (5-11 cm in diameter) who had undergone transanal endoscopic microsurgery from 1992 to 2015. A series of 207 patients met the inclusion criteria and were analyzed for characteristics, intraoperative and postoperative results and long-term follow-up...
December 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27889822/does-the-depth-of-mesorectal-invasion-have-prognostic-significance-in-patients-with-ypt3-lower-rectal-cancer-treated-with-preoperative-chemoradiotherapy
#6
Atsushi Ogura, Takashi Akiyoshi, Noriko Yamamoto, Hiroshi Kawachi, Yuichi Ishikawa, Hisashi Noma, Masato Nagino, Yosuke Fukunaga, Masashi Ueno
PURPOSE: The prognostic significance of the depth of mesorectal invasion (DMI) in patients with ypT3 rectal cancer who undergo preoperative chemoradiotherapy (CRT) is unclear. The purpose of this study was to evaluate the prognostic significance of DMI in ypT3 rectal cancer. METHODS: A total of 168 (y)pT3 patients were evaluated, of whom 93 received preoperative CRT and 75 underwent surgery alone. Patients were subdivided into two groups according to the DMI (T3ab = DMI ≤5 mm and T3cd = DMI >5 mm)...
November 26, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27888300/analysis-of-local-recurrences-after-transanal-endoscopic-microsurgery-for-low-risk-rectal-carcinoma
#7
Theodor Junginger, Ursula Goenner, Mirjam Hitzler, Tong T Trinh, Achim Heintz, Wilfried Roth, Maria Blettner, Daniel Wollschlaeger
AIM: Rates of local recurrence (LR) after transanal endoscopic microsurgery (TEM) for rectal carcinoma vary; the reasons remain unclear. We analyzed LR after TEM for low-risk pT1 (G1/2/X, L0/X) rectal carcinoma to investigate the influence of completeness of resection and occult lymph node metastasis on risk of LR. METHOD: LR location and stage, completeness of resection of primary carcinoma (minimal distance between tumor and resection line ≤1 mm vs >1 mm), and incidence of involved lymph nodes in resected LR specimens were collected, and tumor characteristics of LR were compared with primary carcinoma...
November 25, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27887734/two-countries-two-treatment-strategies-for-rectal-cancer
#8
Bengt Glimelius, Tor Åge Myklebust, Kristina Lundqvist, Arne Wibe, Marianne G Guren
BACKGROUND AND PURPOSE: Trials in rectal cancer have shown that radiotherapy (RT) decreases local recurrence rates, whereas the effects on survival are uncertain. Swedish and Norwegian oncologists have had different treatment recommendations. The aim was to evaluate local recurrence rates and survival in the two countries. PATIENTS AND METHODS: Between 1995 and 2012 rectal cancer patients registered in Sweden and Norway were analyzed, presenting population-based "real world" data...
November 22, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27885479/wait-and-see-approach-for-rectal-cancer-with-a-clinically-complete-response-after-neoadjuvant-concurrent-chemoradiotherapy
#9
Hyun Jung Kim, Jin Ho Song, Hyeong Sik Ahn, Bong-Hoi Choi, Hojin Jeong, Hoon Sik Choi, Yun Hee Lee, Ki Mun Kang, Bae Kwon Jeong
PURPOSE: Rectal cancer patients with a pathological complete response (pCR) after neoadjuvant concurrent chemoradiotherapy (CCRT) have a better prognosis compared to those without a pCR. Therefore, the "Wait and See" (W&S) approach in those who achieved clinically complete response (cCR) after CCRT was introduced as an alternative modality to the total mesorectal excision (TME). The aim of this study was to compare the oncological outcomes between W&S and TME via meta-analysis. METHODS: We performed a comprehensive literature search on January 14, 2016, using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus...
November 24, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27884204/lateral-pelvic-lymph-node-dissection-after-neoadjuvant-chemo-radiation-for-preoperative-enlarged-lateral-nodes-in-advanced-low-rectal-cancer-study-protocol-for-a-randomized-controlled-trial
#10
Mingtian Wei, Qingbin Wu, Chuanwen Fan, Yan Li, Xiangzheng Chen, Zongguang Zhou, Junhong Han, Ziqiang Wang
BACKGROUND: Lateral lymph node (LLN) metastasis is a major cause of local recurrence of advanced rectal cancer. Although there is much controversy between Western and Eastern countries on whether lateral pelvic lymph node dissection (LLND) or neoadjuvant chemo-radiation (nCRT) is preferable for the treatment of LLN metastases, existing retrospective cohorts mainly focus on all middle/low advanced rectal cancer patients, not the specific individuals with suspicion of LLN metastases. The aim of this trial is to assess the efficacy and safety of LLND for rectal cancer patients with suspicion of LLN metastases...
November 25, 2016: Trials
https://www.readbyqxmd.com/read/27883254/the-degree-of-extramural-spread-of-t3-rectal-cancer-an-appeal-to-the-ajcc
#11
R Zinicola, G Pedrazzi, N Haboubi, R J Nicholls
AIM: The T3 category of the TNM classification includes over 60% of all rectal tumours and encompasses the greatest variance in cancer specific end points than any other T category. The most recent edition of the cancer staging handbook of the American Joint Committee on Cancer (AJCC) (1) dated 2010 does not divide T3 tumours into subgroups which reflect cancer specific outcome more sensitively. The original aim of the present study was to review the literature to assess the influence of the degree of extramural extent of T3 rectal cancer on local recurrence and survival...
November 24, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27876339/diagnosis-and-treatment-of-clostridium-difficile-c-diff-colitis-review-of-the-literature-and-a-perspective-in-gynecologic-oncology
#12
REVIEW
Kristin N Taylor, Michael T McHale, Cheryl C Saenz, Steven C Plaxe
Clostridium difficile infection (CDI) is a major cause of nosocomial diarrhea with the potential for significant morbidity and mortality. Colonization in a susceptible individual, with risk factors such as prior antibiotic use, advanced age, or medical comorbidities, may result in symptomatic infection. Although patients with a gynecologic malignancy may be at a higher risk of developing CDI due to an increased likelihood of having one or more risk factors, data do not consistently support the idea that chemotherapy or cancer itself are independently associated with CDI...
November 19, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27872975/identification-of-recurrence-predictive-indicators-in-stage-i-colorectal-cancer
#13
Jun Ho Lee, Jong Lyul Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
BACKGROUND: Patients with stage I colorectal cancer (CRC) rarely experience recurrences; therefore, few risk factors for recurrence are known. This study was designed to evaluate oncologic outcomes of patients with stage I CRC and to identify risk factors for recurrence after curative surgery. METHODS: A retrospective cohort of 860 patients from a single institution who underwent curative surgery for stage I CRC between July 1995 and June 2010 was enrolled. Patients who were diagnosed with hereditary, synchronous, or metachronous cancer and those who received preoperative chemoradiotherapy were excluded...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27872117/protocol-for-a-multicentre-randomised-feasibility-trial-evaluating-early-surgery-alone-in-low-rectal-cancer-sailor
#14
Dean A Harris, Kymberley Thorne, Hayley Hutchings, Saiful Islam, Gail Holland, Olivia Hatcher, Sarah Gwynne, Ian Jenkins, Peter Coyne, Michael Duff, Melanie Feldman, Des C Winter, Simon Gollins, Phil Quirke, Nick West, Gina Brown, Deborah Fitzsimmons, Alan Brown, John Beynon
INTRODUCTION: There are 11 500 rectal cancers diagnosed annually in the UK. Although surgery remains the primary treatment, there is evidence that preoperative radiotherapy (RT) improves local recurrence rates. High-quality surgery in rectal cancer is equally important in minimising local recurrence. Advances in MRI-guided prediction of resection margin status and improvements in abdominoperineal excision of the rectum (APER) technique supports a reassessment of the contribution of preoperative RT...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27863343/acrometastasis-following-colorectal-cancer-a-case-report-and-review-of-literature
#15
Kozar Agha, Khalid Akbari, Syed Husain Abbas, Simon Middleton, Daniel McGrath
INTRODUCTION: Colorectal cancer commonly metastasises to the liver, peritoneum and lungs. Bony metastases are uncommon in colorectal cancer and in particular metastases to the hands or feet (acrometastasis) are an extremely rare occurrence. CASE PRESENTATION: A 65-year-old male with a colonic malignancy underwent elective anterior resection. Intra-operatively he was found to have a pelvic collection necessitating an end colostomy. Histology confirmed complete Dukes B tumour excision with no evidence of lymph node metastases...
November 10, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27858861/laparoscopic-assisted-low-anterior-resection-for-advanced-rectal-cancer-in-a-kidney-transplant-recipient-a-case-report
#16
Zenan Xia, Weijie Chen, Ru Yao, Guole Lin, Huizhong Qiu
INTRODUCTION: Development of de novo malignancy has become a major cause of late mortality in solid organ transplant recipients. Surgery is currently the most important treatment of choice for transplant patients with resectable CRC. However, conventional open surgery represents a great risk to these high-risk patients. They seem to benefit more from laparoscopic surgery, based on the favorable oncological outcome and remarkable short-term advantages of this approach. PATIENT CONCERNS: In this study, we have reported a case of a 50-year-old man who had underwent kidney transplantation for 4 years...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27845566/the-potential-predictive-value-of-mri-and-pet-ct-in-mucinous-and-nonmucinous-rectal-cancer-to-identify-patients-at-high-risk-of-metastatic-disease
#17
Brunella Barbaro, Lucia Leccisotti, Fabio M Vecchio, Marialuisa Di Matteo, Teresa Serra, Marco Salsano, Andrea Poscia, Claudio Coco, Roberto Persiani, Sergio Alfieri, Maria Antonietta Gambacorta, Vincenzo Valentini, Alessandro Giordano, Lorenzo Bonomo
OBJECTIVES: To correlate imaging parameters from baseline magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and -2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) with synchronous and metachronous metastases in mucinous (MC) and nonmucinous (NMC) rectal cancer. METHODS: 111 patients with extraperitoneal locally advanced rectal cancer who underwent pelvic MRI, DWI and FDG PET-CT were stratified into MC (n=23) and NMC (n=88)...
November 15, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27834929/prostate-specific-antigen-psa-as-predicting-marker-for-clinical-outcome-and-evaluation-of-early-toxicity-rate-after-high-dose-rate-brachytherapy-hdr-bt-in-combination-with-additional-external-beam-radiation-therapy-ebrt-for-high-risk-prostate-cancer
#18
Thorsten H Ecke, Hui-Juan Huang-Tiel, Klaus Golka, Silvia Selinski, Berit Christine Geis, Stephan Koswig, Katrin Bathe, Steffen Hallmann, Holger Gerullis
High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50...
November 10, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27830368/adjuvant-treatment-for-resected-rectal-cancer-impact-of-standard-and-intensified-postoperative-chemotherapy-on-disease-free-survival-in-patients-undergoing-preoperative-chemoradiation-a-propensity-score-matched-analysis-of-an-observational-database
#19
Benjamin Garlipp, Henry Ptok, Frank Benedix, Ronny Otto, Felix Popp, Karsten Ridwelski, Ingo Gastinger, Christoph Benckert, Hans Lippert, Christiane Bruns
AIMS: Adjuvant chemotherapy for resected rectal cancer is widely used. However, studies on adjuvant treatment following neoadjuvant chemoradiotherapy (CRT) and total mesorectal excision (TME) have yielded conflicting results. Recent studies have focused on adding oxaliplatin to both preoperative and postoperative therapy, making it difficult to assess the impact of adjuvant oxaliplatin alone. This study was aimed at determining the impact of (i) any adjuvant treatment and (ii) oxaliplatin-containing adjuvant treatment on disease-free survival in CRT-pretreated, R0-resected rectal cancer patients...
November 9, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27830030/vnn1-overexpression-is-associated-with-poor-response-to-preoperative-chemoradiotherapy-and-adverse-prognosis-in-patients-with-rectal-cancers
#20
Chi-Yung Chai, Yimin Zhang, Junlong Song, Shih-Chun Lin, Shengrong Sun, I-Wei Chang
BACKGROUND: Colorectal cancer is prevalent worldwide and it is also the fourth most common cause of cancer mortality. For rectal cancer, neoadjuvant concurrent chemoradiotherapy (CCRT) followed by radical proctectomy is gold standard treatment for patients with stage II/III rectal cancer. By data mining a public dataset of rectal cancer transcriptome (GSE35452) from Gene Expression Omnibus, National Center of Biotechnology Information (GEO, NCBI), we identified that VNN1 was the most significantly upregulated gene among those related to nitrogen compound metabolic process (GO:0006807)...
2016: American Journal of Translational Research
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