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Recurrent rectal cancer

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https://www.readbyqxmd.com/read/29924454/prognostic-impact-of-doublecortin-like-kinase-1-expression-in-locally-advanced-rectal-cancer-treated-with-preoperative-chemoradiotherapy
#1
Yuzo Harada, Shinsuke Kazama, Teppei Morikawa, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Keisuke Hata, Hiroaki Nozawa, Soichiro Ishihara, Toshiaki Watanabe
Preoperative chemoradiotherapy (CRT) is a standard therapy for locally advanced rectal cancer; however, the response varies depending on cases. Therefore, CRT-response predictors need to be elucidated. Cancer stem cells (CSCs), comprising a small part of tumors, are associated with tumor progression and recurrence due to their self-renewal and proliferation abilities. Doublecortin-like kinase 1 (DCLK1) is one of the several putative CSC markers; however, the clinical impact of its expression in rectal cancer has not been evaluated...
June 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/29922520/magnetic-resonance-guided-inter-fraction-monitoring-opens-doors-to-delivering-safer-reirradiation-an-illustrative-case-report-and-discussion
#2
Rebecca Levin-Epstein, Minsong Cao, Percy Lee, Michael L Steinberg, James Lamb, Ann C Raldow
Locoregional recurrence in the pelvis after definitive treatment for rectal cancer can lead to significant morbidity. Furthermore, the toxicity associated with reirradiation may also negatively impact the quality of life and even survival. Here we present the case of a 39-year-old male with locoregionally recurrent rectal cancer in a left pelvic sidewall lymph node, treated with stereotactic magnetic resonance (MR)-guided ablative radiotherapy after previously receiving long-course chemoradiation that had already exceeded ideal bowel dose constraints...
April 14, 2018: Curēus
https://www.readbyqxmd.com/read/29920909/a-qualitative-study-of-the-development-of-a-multidisciplinary-case-conference-review-methodology-to-reduce-involved-margins-in-pelvic-exenteration-surgery-for-recurrent-rectal-cancer
#3
Gabrielle H van Ramshorst, Sarah 'o Shannassy, Wendy E Brown, James G Kench, Michael J Solomon
AIM: Pelvic exenteration surgery remains the only curative option for recurrent rectal cancer. Microscopically involved surgical margins (R1) are associated with a higher risk of local recurrence and decreased survival. Our study aimed to develop a post hoc multidisciplinary case conference review and investigate its potential for identifying areas for improvement. METHOD: Patients who underwent pelvic exenteration surgery for recurrent rectal cancer with R1 resections at a tertiary referral center between April 2014- January 2016 were retrospectively reviewed from a prospectively maintained database...
June 19, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29909419/outcomes-of-local-excision-plus-chemoradiotherapy-in-patients-with-t1-rectal-cancer
#4
Toshiyuki Suzuki, Sotaro Sadahiro, Akira Tanaka, Kazutake Okada, Gota Saito, Hiroshi Miyakita, Takeshi Akiba, Hiroshi Yamamuro
OBJECTIVE: The National Comprehensive Cancer Network (NCCN) guidelines recommend local excision and observation as standard treatment for selected patients with clinical T1N0M0 rectal cancer. In patients with pathological T1 (pT1) rectal cancer who received local excision, the local recurrence rate is at least 10%. We studied oncological outcomes in patients with pT1 rectal cancer who received chemoradiotherapy (CRT) after local excision. METHODS: Local excision was performed in 65 patients with clinical T1N0M0 rectal cancer (≤8 cm from the anal verge, tumor size < 30 mm, well or moderately differentiated adenocarcinoma)...
June 15, 2018: Oncology
https://www.readbyqxmd.com/read/29902950/the-future-of-rectal-cancer-surgery-a-narrative-review-of-an-international-symposium
#5
F Borja de Lacy, Sami A Chadi, Mariana Berho, Richard J Heald, Jim Khan, Brendan Moran, Yves Panis, Rodrigo Perez, Paris Tekkis, Neil J Mortensen, Antonio M Lacy, Steven D Wexner, Manish Chand
Surgery remains the mainstay of curative treatment for primary rectal cancer. For mid and low rectal tumors, optimal oncologic surgery requires total mesorectal excision (TME) to ensure the tumor and locoregional lymph nodes are removed. Adequacy of surgery is directly linked to survival outcomes and, in particular, local recurrence. From a technical perspective, the more distal the tumor, the more challenging the surgery and consequently, the risk for oncologically incomplete surgery is higher. TME can be performed by an open, laparoscopic, robotic or transanal approach...
June 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29896400/carcinoma-in-the-residual-rectum-of-a-long-standing-crohn-s-disease-patient-following-subtotal-colectomy-a-case-report
#6
Kazuaki Shibuya, Shigenori Homma, Tadashi Yoshida, Yosuke Ohno, Nobuki Ichikawa, Hideki Kawamura, Teppei Imamoto, Yoshihiro Matsuno, Akinobu Taketomi
The development of colorectal cancer in long-standing Crohn's disease (CD) patients has become a major complication. Therapeutic guidelines for CD-associated cancer (CDAC) have already been established in Western countries; however, specific guidelines are not currently available in Japan. Surveillance of the residual intestine for cancer screening is important for long-standing CD patients. The present case report describes the occurrence of rectal carcinoma in a patient with a 25-year history of CD. A 37-year-old male with a 17-year history of CD underwent semi-emergent subtotal colectomy and ileostomy for bowel obstruction secondary to the transverse colon stenosis, and multiple severe stenosis and inflammation...
July 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29893988/magnetic-resonance-tumour-regression-grade-and-pathological-correlates-in-patients-with-rectal-cancer
#7
J K Jang, J L Lee, S H Park, H J Park, I J Park, J H Kim, S H Choi, J Kim, C S Yu, J C Kim
BACKGROUND: Evidence to support the specific use of magnetic resonance tumour regression grade (mrTRG) is inadequate. The aim of this study was to investigate the pathological characteristics of mrTRG after chemoradiotherapy (CRT) for rectal cancer and the implications for surgery. METHODS: Patients undergoing long-course CRT (45-50 Gy plus a booster dose of 4-6 Gy) for mid or low rectal cancer (cT3-4 or cN+ without metastasis) between 2011 and 2015 who had post-CRT rectal MRI before surgery were included retrospectively...
June 12, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29887692/incidence-and-predictive-model-for-lateral-pelvic-lymph-node-metastasis-in-lower-rectal-cancer
#8
Kapil Dev, K V Veerenderkumar, Swamyvelu Krishnamurthy
The lateral pelvic lymph node recurrence after curative resection in rectal cancer has been reported in more than 20% of cases and the lateral pelvic lymph node (LPLN) metastasis is an independent risk factor for local recurrence. A prospective cohort study with diagnosis of lower rectal cancer stages II and III performed to identify the factors with significant correlation with LPLN metastasis was categorised based on the number of positive factors and proposed a risk stratification model to uncover a possible benefit of LPLD in specific patient subgroups...
June 2018: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29878679/session-1-colon-cancer-10-years-behind-the-rectum
#9
V Tudyka, R Madoff, A Wale, S Laurberg, H Yano, G Brown
The improvements in surgical technique brought about by the widespread adoption of total mesorectal excision plane dissection in rectal cancer has substantially improved survival and recurrence rates from this disease. For the first time in 50 years, the outcomes in rectal cancer have overtaken those of colon cancer. Professor Madoff's overview lecture and the experts' round table discussion address whether applying the surgical principles already achieved in rectal cancer can meet with similar success in colon cancer, how this can be achieved and the challenges we face...
May 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29878674/session-3-boosting-primary-and-recurrent-rectal-cancer-how-far-can-we-push-the-radiotherapy-envelope
#10
S Balyasnikova, T Vuong, A Wale, I Chong, H Rutten, G Brown
Neoadjuvant pelvic radiotherapy is widely used for patients with advanced rectal cancer. The trade-off between dose and response is well-established, yet little consensus remains on the precise methods of delivery and doses given in different scenarios. Professor Vuong reviews the evidence base and trial evidence on the escalation of radiotherapy dose and the methods of achieving this.
May 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29876002/evaluation-of-appropriate-follow-up-after-curative-surgery-for-patients-with-colorectal-cancer-using-time-to-recurrence-and-survival-after-recurrence-a-retrospective-multicenter-study
#11
Tomoki Yamano, Shinichi Yamauchi, Kiyoshi Tsukamoto, Masafumi Noda, Masayoshi Kobayashi, Michiko Hamanaka, Akihito Babaya, Kei Kimura, Chihyon Son, Ayako Imada, Shino Tanaka, Masataka Ikeda, Naohiro Tomita, Kenichi Sugihara
Introduction: The follow-up schedule for colorectal cancer patients after curative surgery is inconsistent among the guidelines. Evaluation of time to recurrence (TTR) and survival after recurrence (SAR) may provide evidence for appropriate follow-up. Methods: We assessed 3039 colon cancer (CC) and 1953 rectal cancer (RC) patients who underwent curative surgery between 2007 and 2008. We evaluated the pre- and post-recurrent clinicopathological factors associated with TTR and SAR in each stage of CC and RC...
May 22, 2018: Oncotarget
https://www.readbyqxmd.com/read/29874375/association-of-plane-of-total-mesorectal-excision-with-prognosis-of-rectal-cancer-secondary-analysis-of-the-cao-aro-aio-04-phase-3-randomized-clinical-trial
#12
Julia Kitz, Emmanouil Fokas, Tim Beissbarth, Philipp Ströbel, Christian Wittekind, Arndt Hartmann, Josef Rüschoff, Thomas Papadopoulos, Elisabeth Rösler, Peter Ortloff-Kittredge, Ulrich Kania, Hans Schlitt, Karl-Heinrich Link, Wolf Bechstein, Hans-Rudolf Raab, Ludger Staib, Christoph-Thomas Germer, Torsten Liersch, Rolf Sauer, Claus Rödel, Michael Ghadimi, Werner Hohenberger
Importance: Previous retrospective studies have shown that surgical quality affects local control in rectal cancer.. Objective: In this secondary end point analysis, we evaluated the prognostic effect of the total mesorectal excision (TME) plane in the CAO/ARO/AIO-04 phase 3 randomized clinical trial. Design, Setting, and Participants: The CAO/ARO/AIO-04 trial enrolled 1236 patients with cT3-4 and/or node-positive rectal adenocarcinoma from 88 centers in Germany between July 25, 2006, and February 26, 2010...
June 6, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29873684/impact-of-age-on-the-efficacy-of-oxaliplatin-in-the-preoperative-chemoradiotherapy-and-adjuvant-chemotherapy-of-rectal-cancer-a-post-hoc-analysis-of-the-cao-aro-aio-04-phase-3-trial
#13
R-D Hofheinz, D Arnold, E Fokas, M Kaufmann, T Hothorn, G Folprecht, R Fietkau, W Hohenberger, M Ghadimi, T Liersch, G G Grabenbauer, R Sauer, C Rödel, U Graeven
Background: The German rectal cancer trial CAO/ARO/AIO-04 has shown a significant benefit in 3-year disease-free survival (DFS) of adding oxaliplatin to a standard preoperative 5-fluorouracil-based chemoradiotherapy (CRT) and adjuvant chemotherapy in patients with locally advanced rectal cancer. The use of oxaliplatin as adjuvant treatment in elderly patients with colon cancer is controversial . We therefore investigated the impact of age on clinical outcome in the CAO/ARO/AIO-04 phase 3 trial...
June 4, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29869844/transanal-minimally-invasive-surgery-for-local-excision-of-early-rectal-tumor
#14
Mami Yoshitomi, Suguru Hasegawa, Ryo Takahashi, Koya Hida, Kenji Kawada, Yoshiharu Sakai
INTRODUCTION: Local excision (LE) is used in early rectal cancer and other pathologies for diagnostic purposes and curative treatment, as well as for palliative surgery in patients who are medically unfit for radical resection. Recently, transanal minimally invasive surgery (TAMIS) has been increasingly accepted as a means for performing LE. Here, we present a TAMIS technique for LE to which endoscopic submucosal dissection was applied. MATERIALS AND SURGICAL TECHNIQUE: We used conventional laparoscopic instruments, including a 10-mm 30° camera...
May 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29866049/clinical-outcomes-of-endoscopic-mucosal-resection-for-rectal-neuroendocrine-tumor
#15
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BACKGROUND: The incidence of rectal neuroendocrine tumors (NETs) is rapidly increasing because of the frequent use of endoscopic screening for colorectal cancers. However, the clinical outcomes of endoscopic resection for rectal NETs are still unclear. The aim of this study was to assess the rates of histologically complete resection (H-CR) and recurrence after endoscopic mucosal resection (EMR) for rectal NETs. METHODS: A retrospective analysis was performed on patients who underwent EMR for rectal NETs between January 2002 and March 2015 at Seoul National University Hospital...
June 5, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29863157/local-control-of-sphincter-preserving-procedures-and-abdominoperineal-resection-for-locally-advanced-low-rectal-cancer-propensity-score-matched-analysis
#16
Ryosuke Okamura, Koya Hida, Tomohiro Yamaguchi, Tomonori Akagi, Tsuyoshi Konishi, Michio Yamamoto, Mitsuyoshi Ota, Shuichiro Matoba, Hiroyuki Bando, Saori Goto, Yoshiharu Sakai, Masahiko Watanabe, Kazuteru Watanabe, Koki Otsuka, Ichiro Takemasa, Keitaro Tanaka, Masataka Ikeda, Chu Matsuda, Meiki Fukuda, Junichi Hasegawa, Shintaro Akamoto, Manabu Shiozawa, Atsushi Tsuruta, Takashi Akiyoshi, Takeshi Kato, Shunsuke Tsukamoto, Masaaki Ito, Masaki Naito, Akiyoshi Kanazawa, Takao Takahashi, Takashi Ueki, Yuri Hayashi, Satoshi Morita, Takashi Yamaguchi, Masayoshi Nakanishi, Hirotoshi Hasegawa, Ken Okamoto, Fuminori Teraishi, Yasuo Sumi, Jo Tashiro, Toshimasa Yatsuoka, Yoji Nishimura, Kenji Okita, Takaya Kobatake, Hisanaga Horie, Yasuyuki Miyakura, Hisashi Ro, Kunihiko Nagakari, Eiji Hidaka, Takehiro Umemoto, Hideaki Nishigori, Kohei Murata, Fuminori Wakayama, Ryoji Makizumi, Shoichi Fujii, Eiji Sunami, Hirotoshi Kobayashi, Ryosuke Nakagawa, Toshiyuki Enomoto, Shinobu Ohnuma, Jun Higashijima, Heita Ozawa, Keigo Ashida, Fumihiko Fujita, Keisuke Uehara, Satoshi Maruyama, Masato Ohyama, Seiichiro Yamamoto, Takao Hinoi, Masanori Yoshimitsu, Masazumi Okajima, Shu Tanimura, Masayasu Kawasaki, Yoshihito Ide, Shoichi Hazama, Jun Watanabe, Daisuke Inagaki, Akihiro Toyokawa
Sphincter-preserving procedures (SPPs) for surgical treatment of low-lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II-III rectal cancer between 2010 and 2011. Patients with tumors 2-5 cm from the anal verge and clinical stage T3-4 were eligible. Primary outcome was 3-year local recurrence rate, and confounding effects were minimized by propensity score matching...
September 2017: Annals of gastroenterological surgery
https://www.readbyqxmd.com/read/29861612/long-term-outcomes-in-patients-with-ypt0-rectal-cancer-after-neoadjuvant-chemoradiotherapy-and-curative-resection
#17
Zhao Lu, Pu Cheng, Fu Yang, Zhaoxu Zheng, Xishan Wang
Objective: For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy (NCRT), significant pathological response of the primary tumor has been proposed to identify candidates for organ preservation. However, this does not address metastatic lymph nodes in the mesorectum. The aim of this study was to assess the incidence of lymph node metastases in ypT0 patients treated with NCRT and curative resection and to explore risk factors associated with survival...
April 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/29859761/salvage-brachytherapy-as-a-modern-reirradiation-technique-for-local-cancer-failure-the-phoenix-is-reborn-from-its-ashes
#18
REVIEW
M Quivrin, K Peignaux-Casasnovas, É Martin, M Rouffiac, D Thibouw, C Chevalier, N Vulquin, L Aubignac, G Truc, G Créhange
The treatment of local recurrence of a previously irradiated cancer or a second cancer arising in-field remains challenging. Ultimately, the objective of salvage therapy is to control disease while ensuring minimal collateral damage, thereby optimizing both cancer and toxicity outcomes. Reirradiation has historically been associated with unacceptable toxicity and a limited benefit. Brachytherapy offers the best dose distribution and a high radiation dose to the target volume while better protecting surrounding previously irradiated healthy tissues...
May 30, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29846017/long-term-prognostic-impact-of-surgical-complications-in-the-german-rectal-cancer-trial-cao-aro-aio-94
#19
T Sprenger, T Beißbarth, R Sauer, J Tschmelitsch, R Fietkau, T Liersch, W Hohenberger, L Staib, J Gaedcke, H-R Raab, C Rödel, M Ghadimi
BACKGROUND: The influence of postoperative complications on survival in patients with locally advanced rectal cancer undergoing combined modality treatment is debatable. This study evaluated the impact of surgical complications on oncological outcomes in patients with locally advanced rectal cancer treated within the randomized CAO/ARO/AIO-94 (Working Group of Surgical Oncology/Working Group of Radiation Oncology/Working Group of Medical Oncology of the Germany Cancer Society) trial. METHODS: Patients were assigned randomly to either preoperative chemoradiotherapy (CRT) followed by total mesorectal excision (TME) or postoperative CRT between 1995 and 2002...
May 30, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29806756/the-evolution-of-pelvic-dissection-for-rectal-cancer-from-blunt-dissection-to-total-mesorectal-excision
#20
Dimitri Krizzuk, Aaron S Rickles, Steven D Wexner
"Modern" rectal cancer treatment began in the 18th century. However, first results of the pioneer surgeons of the era were very poor. During the next several decades, significant progress was made towards the cure of rectal cancer. Improvements sought have included lowering mortality, reducing recurrence, and optimizing functional outcomes. This article reviews the individuals and their advancements in rectal cancer treatment. It describes the changes in the surgical approach for tumor resection, the study of the lymphatic spread of rectal cancer and the advances in sphincter preservation procedures from the era of blunt dissection until the paradigm changing revolution of total mesorectal excision (TME)...
May 25, 2018: Minerva Chirurgica
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