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Recurrent rectal cancer

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https://www.readbyqxmd.com/read/28819989/evaluating-the-addition-of-oxaliplatin-to-single-agent-fluoropyrimidine-in-the-treatment-of-locally-advanced-rectal-cancer-a-systematic-review-and-meta-analysis
#1
Subotheni Thavaneswaran, Peey Sei Kok, Timothy Price
INTRODUCTION: Multimodality treatment of patients with locally advanced rectal cancer has significantly improved local disease control, however the unaltered overall survival (OS) implicates an inability to further control micrometastases, providing rationale for intensified systemic treatment. A systematic review was conducted to evaluate the efficacy and toxicity of adding oxaliplatin to a fluoropyrimidine (intervention) compared with fluoropyrimidine alone (control) in the treatment of resectable rectal cancer...
August 18, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28819868/one-level-step-section-histological-analysis-is-insufficient-to-confirm-complete-pathological-response-after-neoadjuvant-chemoradiation-for-rectal-cancer
#2
M A Pereira, A R Dias, S F Faraj, C S R Nahas, A R Imperiale, C F S Marques, G C Cotti, B C Camargo, S C Nahas, E S de Mello, U Ribeiro
BACKGROUND: Neoadjuvant chemoradiation therapy (nCRT) for rectal cancer may lead to cure. As we currently lack reliable methods to clinically confirm the absence of disease, some patients undergo radical resection and have pathological complete response (pCR) still undergo surgery. Furthermore, it is uncertain if conventional one-level histopathological analysis is accurate enough to determine complete response. Confirming pCR is essential to determine the prognosis and to consider the patient's inclusion in trials of adjuvant therapy...
August 17, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28819391/a-critical-reappraisal-for-the-value-of-tumor-size-as-a-prognostic-variable-in-rectal-adenocarcinoma
#3
Chien-Hsin Chen, Mao-Chih Hsieh, Ping-Kun Hsiao, En-Kwang Lin, Yen-Jung Lu, Szu-Yuan Wu
Background and Objectives: To investigate critical prognostic factors for local recurrence in patients with rectal adenocarcinoma. Methods: We enrolled 221 consecutive patients who had histologically confirmed adenocarcinoma of the rectum and underwent surgery in our hospital between January 2000 and December 2014. Total mesorectal excision was performed in all patients undergoing a sphincter-sparing procedure or abdominal perineal resection of rectal cancer. To evaluate prognostic factors for local recurrence, we performed univariate and multivariate Cox regression analyses of the local recurrence rate in all patients...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28816139/total-mesorectal-excision-versus-local-excision-after-favorable-response-to-preoperative-chemoradiotherapy-in-early-clinical-t3-rectal-cancer-a-propensity-score-analysis
#4
COMPARATIVE STUDY
Young Seob Shin, Chang Sik Yu, Jin-Hong Park, Jin Cheon Kim, Seok-Byung Lim, In Ja Park, Tae Won Kim, Yong Sang Hong, Kyu-Pyo Kim, Sang Min Yoon, Ji Hyeon Joo, Jong Hoon Kim
PURPOSE: To compare oncological outcomes of total mesorectal excision (TME) and local excision (LE) in patients with "early" clinical T3 rectal cancer who received preoperative chemoradiotherapy (PCRT). METHODS AND MATERIALS: "Early" clinical T3 rectal cancer was radiologically defined as tumors with extramural extension of <5 mm without mesorectal fascia involvement and lateral lymph node metastasis. Patients with "early" clinical T3 rectal cancer who received PCRT followed by TME or LE between January 2007 and December 2013 were retrospectively analyzed...
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28808931/robotic-total-pelvic-exenteration-video-illustrated-technique
#5
Ioannis T Konstantinidis, William Chu, Federico Tozzi, Clayton Lau, Mark Wakabayashi, Kevin Chan, Byrne Lee
BACKGROUND: Robotic-assisted total pelvic exenteration (TPE) can offer a minimally invasive approach to a major multi-organ operation. METHODS: In this video, we summarize a stepwise approach to robotic TPE in a 70 year-old female Jehovah's witness with a history of cervical cancer post-chemoradiation and radical hysterectomy who experienced local recurrence at the vaginal cuff involving the rectum and bladder. RESULTS: The patient was placed in the lithotomy position...
August 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28803718/total-neoadjuvant-therapy-a-shifting-paradigm-in-locally-advanced-rectal-cancer-management
#6
REVIEW
Aaron J Franke, Hiral Parekh, Jason S Starr, Sanda A Tan, Atif Iqbal, Thomas J George
Colorectal carcinoma is the second leading cause of cancer-related deaths in the United States, with rectal cancer accounting for approximately one-third of newly diagnosed cases, thus representing a major socioeconomic health burden. Although minimally invasive procedures (ie, transanal excision) may be appropriate for a subset of patients with small, superficially invasive tumors, a more comprehensive trimodality approach with neoadjuvant chemoradiotherapy, total mesorectal excision, and systemic chemotherapy is recommended for medically operable patients with nonmetastatic, locally advanced rectal cancer (LARC)...
June 27, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28797999/long-term-results-of-post-operative-pelvic-image-guided-intensity-modulated-radiotherapy-in-gynecological-malignancies
#7
Rashi Agrawal, Sowmiya Prithiviraj, Dinesh Singh, Vaishali Zamre, Sandeep Agrawal, Arun Kumar Goel, Kanika Gupta, Bala Subramanian
OBJECTIVE: To assess late clinical outcomes with image guided intensity modulated radiotherapy (IG- IMRT) in gynecological malignancies. PATIENTS AND METHODS: We have been practicing IG IMRT for gynecological malignancies since January 2009. Here we are presenting our experience with this modern technique at median follow up of 38 months. During whole treatment bladder filling protocol was followed. Both target volumes and critical structures were contoured according to RTOG guidelines...
May 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28796729/postoperative-chemoradiotherapy-after-local-resection-for-high-risk-t1-to-t2-low-rectal-cancer-results-of-a-single-arm-multi-institutional-phase-ii-clinical-trial
#8
Takeshi Sasaki, Yoshinori Ito, Masayuki Ohue, Yukihide Kanemitsu, Takaya Kobatake, Masaaki Ito, Yoshihiro Moriya, Norio Saito
BACKGROUND: After treatment with local excision for TNM stage I low rectal cancer, the risk of local recurrence is not only high for T2 lesions but also for T1 lesions with features of massive invasion to the submucosal layer and/or lymphovascular invasion. OBJECTIVE: The purpose of this study was to determine the efficacy of chemoradiotherapy combined with local excision in the treatment of T1 to T2 low rectal cancer. DESIGN: We conducted a prospective, single-arm, phase II trial...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28795243/there-is-no-difference-in-outcome-between-laparoscopic-and-open-surgery-for-rectal-cancer-a-systematic-review-and-meta-analysis-on-short-and-long-term-oncologic-outcomes
#9
REVIEW
M Pędziwiatr, P Małczak, M Mizera, J Witowski, G Torbicz, P Major, M Pisarska, M Wysocki, A Budzyński
BACKGROUND: Until recently there has been little data available about long-term outcomes of laparoscopic rectal cancer surgery. But new randomized controlled trials regarding laparoscopic colorectal surgery have been published. The aim of this study was to compare the short- and long-term oncologic outcomes of laparoscopy and open surgery for rectal cancer through a systematic review of the literature and a meta-analysis of relevant RCTs. METHODS: A systematic review of Medline, Embase and the Cochrane library from January 1966 to October 2016 with a subsequent meta-analysis was performed...
August 9, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28794690/gender-related-prognostic-significance-of-clinical-and-biological-tumor-features-in-rectal-cancer-patients-receiving-short-course-preoperative-radiotherapy
#10
Anna Gasinska, Zbigniew Darasz, Agnieszka Adamczyk, Beata Biesaga, Joanna Niemiec, Marian Reinfuss
AIM: To study the prognostic value of clinical and biological features of rectal cancer and potential gender differences in patients' overall survival (OS), local recurrence-free survival (RFS) and metastasis-free survival (MFS) after short-course preoperative radiotherapy (SCRT) with short or long interval between RT and surgery (break). BACKGROUND: The length of the interval between RT and surgery in SCRT is debatable and gender-related differences in patients survival are not established yet...
September 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28791628/mitomycin-c-hypoxic-pelvic-perfusion-for-unresectable-recurrent-rectal-cancer-pharmacokinetic-comparison-of-surgical-and-percutaneous-techniques
#11
Stefano Guadagni, Giammaria Fiorentini, Marco Clementi, Paola Palumbo, Andrea Mambrini, Francesco Masedu
Patients with unresectable recurrent rectal cancer that progresses after standard and multi-modular treatments are candidates for hypoxic pelvic perfusion. Hypoxic pelvic perfusion can be performed using a surgical or percutaneous approach. The aim of this study was to examine whether the surgical and percutaneous approaches are comparable with respect to tumor drug exposure in the pelvis. A pharmacokinetic study was performed in 18 patients. Both the surgical and percutaneous procedures were performed using mitomycin C (MMC) at a dose of 25 mg/m(2)...
August 8, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28790267/-a-case-of-recurrent-colorectal-cancer-with-bilateral-ovarian-metastases-that-were-reduced-with-regorafenib-therapy
#12
Shiro Nakae, Yuya Nogi, Jun Arima, Daiki Okamoto, Naoki Urakawa, Masataka Fujikawa, Hidetoshi Gon, Atsushi Takebe, Makoto Shinzeki, Kenichi Tanaka, Hideto Senzaki
A 63-year-old woman had recurrences of metastatic rectal cancer in the lung, peritoneum, and ovary. Regorafenib was administered at 160mg/day as third-line chemotherapy. The patient developed Grade(Gr)3 hand-foot syndrome(HFS) and Gr 2 rash, but the abdominal distension and pain were relieved by the 1st course. Analgesics could be reduced and regorafenib was administrated at reduced dosage. The patient received keishi-bukuryo-gan(EK-25)and sai-rei-tou(TJ-114) for HFS. At the beginning of therapy, ovarian metastases were not reduced and showed poor contrast enhancement on CT...
July 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28775079/invasive-lobular-breast-carcinoma-metastasising-to-the-rectum
#13
Nishant Cherian, Nafees Ahmad Qureshi, Callum Cairncross, Mamoon Solkar
Gastrointestinal (GI) metastasis from a primary breast carcinoma is uncommon, with the rectum being one of the least reported sites in the literature. We report a case of a 79-year-old woman who underwent treatment for an infiltrative lobular carcinoma of the right breast with nodal involvement, and 10 years later developed recurrence in the form of rectal metastasis. Spread to the GI tract is most commonly seen with lobular breast carcinomas. Any patient with a history of breast cancer presenting typically or atypically with abdominal symptoms or altered bowel habit should raise a high index of suspicion for recurrent or metastatic disease...
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28770270/-r1-resection-in-rectal-cancer
#14
REVIEW
H-R Raab
R1 resections in rectal cancer particularly affect the circumferential resection margin (CRM) and lead to increased local recurrence rates, more distant metastases and a poorer prognosis. The proximity of the tumor to the CRM is already sufficient to increases these risks; therefore, according to the guidelines, it is now necessary to distinguish between R0 wide (≥1 mm distance), R0 close (<1 mm) and R1. The surgical technique is decisive for avoiding R1 situations. The preparation follows the boundary layers and envelope fascia in a standardized radical way and if necessary deviates away from these structures and the tumor under en bloc resection of neighboring structures...
August 2, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28765616/vitamin-d-receptor-and-calcium-sensing-receptor-polymorphisms-and-colorectal-cancer-survival-in-the-newfoundland-population
#15
Yun Zhu, Peizhong Peter Wang, Guangju Zhai, Bharati Bapat, Sevtap Savas, Jennifer R Woodrow, Ishor Sharma, Yuming Li, Xin Zhou, Ning Yang, Peter T Campbell, Elizabeth Dicks, Patrick S Parfrey, John R Mclaughlin
BACKGROUND: Increased serum levels of vitamin D and calcium have been associated with lower risks of colorectal cancer (CRC) incidence and mortality. These inverse associations may be mediated by the vitamin D receptor (VDR) and the calcium-sensing receptor (CASR). We investigated genetic variants in VDR and CASR for their relevance to CRC prognosis. METHODS: A population-based cohort of 531 CRC patients diagnosed from 1999 to 2003 in Newfoundland and Labrador, Canada, was followed for mortality and cancer recurrence until April 2010...
August 1, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28748454/recurrence-with-pagetoid-spread-arising-17%C3%A2-years-after-surgery-for-intramucosal-rectal-cancer-a-case-report
#16
Taichi Matsubara, Yuta Kasagi, Kippei Ogaki, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Masahiko Sugiyama, Hideto Sonoda, Hiroshi Saeki, Eiji Oki, Yoshihiko Maehara
BACKGROUND: Perianal Paget's disease (pPD) is uncommon, with only about 180 cases documented in the literature. Anorectal carcinoma with pagetoid spread is even rarer. CASE PRESENTATION: An 81-year-old woman underwent rectal cancer extirpation with a transanal approach 17 years prior. She has since undergone two reoperations for local rectal cancer recurrence. Then, warts frequently appeared on the vulva on several occasions. Warts appeared on the vulva 1 year ago, which were diagnosed as pPD by biopsy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28745699/-sacral-resection-in-surgical-treatment-of-locally-advanced-primary-and-recurrent-rectal-and-anal-cancer-short-term-outcomes
#17
P V Tsarkov, S K Efetov, L V Sidorova, I A Tulina
AIM: To assess safety of rectum removal with distal sacral resection. MATERIAL AND METHODS: The short-term results of surgical treatment of primary and recurrent locally advanced rectal and anal cancer with sacral fixation have been analyzed. 32 patients underwent combined operations with sacral resection at the level of S2-S5. In 12 patients only one point of tumor fixation (F1) was revealed, 10 patients had two points of fixation (F2), three patients had three fixation points (F3) and in 7 cases the tumor was fixed to four points (F4) of fixation to different pelvic structures...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28743178/multicenter-analysis-of-transanal-tube-placement-for-prevention-of-anastomotic-leak-after-low-anterior-resection
#18
Saori Goto, Koya Hida, Kenji Kawada, Ryosuke Okamura, Suguru Hasegawa, Takahisa Kyogoku, Shuichi Ota, Yukito Adachi, Yoshiharu Sakai
BACKGROUND: Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL. METHODS: This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors. RESULTS: A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non-TA group)...
July 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28742703/organ-preservation-in-ct2n0-rectal-cancer-after-neoadjuvant-chemoradiation-therapy-the-impact-of-radiation-therapy-dose-escalation-and-consolidation-chemotherapy
#19
Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Jorge Sabbaga, Patricia Bailão Aguilar, Laura Melina Fernandez, Sergio Eduardo Alonso Araújo, Rodrigo Oliva Perez
OBJECTIVE: To demonstrate the difference in organ-preservation rates and avoidance of definitive surgery among cT2N0 rectal cancer patients undergoing 2 different chemoradiation (CRT) regimens. BACKGROUND: Patients with cT2N0 rectal cancer are more likely to develop complete response to neoadjuvant CRT. Organ preservation has been considered an alternative treatment strategy for selected patients. Radiation dose-escalation and consolidation chemotherapy have been associated with increased rates of response and may improve chances of organ preservation among these patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742692/oncologic-outcome-and-morbidity-in-the-elderly-rectal-cancer-patients-after-preoperative-chemoradiotherapy-and-total-mesorectal-excision-a-multi-institutional-and-case-matched-control-study
#20
Soo-Y Sung, Hong S Jang, Sung H Kim, Jae U Jeong, Songmi Jeong, Jin H Song, Mi J Chung, Hyeon M Cho, Hyung J Kim, Jun-Gi Kim, In K Lee, Jong H Lee
OBJECTIVE: To determine the toxicity and oncologic outcome of neoadjuvant chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME) in the elderly (≥70 yrs) and younger (<70 yrs) rectal cancer patients. BACKGROUND: Sufficient data for elderly rectal cancer patients who received definitive trimodality have not been accumulated yet. PATIENTS AND METHODS: A total of 1232 rectal cancer patients who received neoadjuvant CRT and TME were enrolled in this study...
July 24, 2017: Annals of Surgery
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