#15# Reviews (all) COLORECTAL NEOPLASMS

#15#
Reviews (all)
COLORECTAL NEOPLASMS.
December 2013 - January 2014
ONCOLIT oncolit.com
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TITLE: - Use of thiopurines and risk of colorectal neoplasia in patients with inflammatory
bowel diseases: a meta-analysis.
SUMMARY: - Link
JOURNAL: - PLoS One. 2013 Nov 28;8(11):e81487. doi: 10.1371/journal.pone.0081487.
eCollection 2013.
*** Link to the complete text (free or ppv) 1371/journal.pone.0081487
AUTHOR: - Gong J; ADDRESS: - Department of General Surgery, Jinling hospital, Medical
School of Nanjing University, Nanjing, PR China.
AUTHOR: - Zhu L
AUTHOR: - Guo Z
AUTHOR: - Li Y
AUTHOR: - Zhu W
AUTHOR: - Li N
AUTHOR: - Li J
SUMMARY: - OBJECTIVE: Inflammatory bowel disease (IBD) is commonly treated with
thiopurines such as azathioprine and mercaptopurine for the maintenance of
remission. Studies examining chemopreventive of these medications on colorectal
neoplasm in IBD patients have yielded conflicting results. We performed a metaanalysis to assess the role of thiopurines for this indication. METHODS: We performed
a systematic search of PubMed, Web of Science, EMBASE and Cochrane to identify
studies reporting colorectal neoplasm from IBD patients treated with thiopurines and
conducted a meta-analysis of pooled relative risk (RR) using the random effects model.
RESULTS: Nine case-control and ten cohort studies fulfilled the inclusion criteria. The
use of thiopurines was associated with a statistically significant decreased incidence of
colorectal neoplasm (summary RR=0.71, 95% CI=0.54-0.94, p=0.017), even after
adjustment for duration and extent of the disease, but there was high heterogeneity
among studies (I(2)=68.0%, p<0.001). The RR of advanced neoplasm (high-grade
dysplasia and cancer) was 0.72 (95%CI=0.50-1.03, p=0.070) and that of cancer was 0.70
(95% CI=0.46-1.09, p=0.111) for thiopurine-treated patients. Heterogeneity of the
studies was affected by the sample size (</>/= 100 cases) and whether the patients
had longstanding colitis (>/= 7 years). CONCLUSION: The current meta-analysis
revealed that thiopurines had a chemopreventive effect of colorectal neoplasms and a
tendency of reducing advanced colorectal neoplasms in IBD. Due to the heterogeneity
of included studies, these results should be interpreted with caution.
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TITLE: - The prognostic value of micrometastases and isolated tumour cells in
histologically negative lymph nodes of patients with colorectal cancer: A systematic
review and meta-analysis.
SUMMARY: - Link
JOURNAL: - Eur J Surg Oncol. 2013 Dec 14. pii: S0748-7983(13)00940-2. doi:
10.1016/j.ejso.2013.12.002.
*** Link to the complete text (free or ppv) 1016/j.ejso.2013.12.002
AUTHOR: - Sloothaak DA; ADDRESS: - Department of Surgery, Gelre Hospital, Albert
Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands; Department of Surgery,
AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
AUTHOR: - Sahami S; ADDRESS: - Department of Surgery, AMC, Meibergdreef 9, 1105 AZ
Amsterdam, The Netherlands.
AUTHOR: - van der Zaag-Loonen HJ; ADDRESS: - Department of Epidemiology, Gelre
Hospital, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands.
AUTHOR: - van der Zaag ES; ADDRESS: - Department of Surgery, Gelre Hospital, Albert
Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands.
AUTHOR: - Tanis PJ; ADDRESS: - Department of Surgery, AMC, Meibergdreef 9, 1105 AZ
Amsterdam, The Netherlands.
AUTHOR: - Bemelman WA; ADDRESS: - Department of Surgery, AMC, Meibergdreef 9,
1105 AZ Amsterdam, The Netherlands.
AUTHOR: - Buskens CJ; ADDRESS: - Department of Surgery, AMC, Meibergdreef 9, 1105 AZ
Amsterdam, The Netherlands. Electronic address: [email protected]
SUMMARY: - INTRODUCTION: Detection of occult tumour cells in lymph nodes of
patients with stage I/II colorectal cancer is associated with decreased survival.
However, according to recent guidelines, occult tumour cells should be categorised in
micrometastases (MMs) and isolated tumour cells (ITCs). This meta-analysis evaluates
the prognostic value of MMs and of ITCs, separately. METHODS: PubMed, Embase,
Biosis and the World Health Organization International Trials Registry Platform were
searched for papers published until April 2013. Studies on the prognostic value of MMs
and ITCs in lymph nodes of stage I/II colorectal cancer patients were included. Odds
ratios (ORs) for the development of disease recurrence were calculated to analyse the
predictive value of MMs and ITCs. RESULTS: From five papers, ORs for disease
recurrence could be calculated for MMs and ITCs separately. In patients with colorectal
cancer, disease recurrence was significantly increased in the presence of MMs in
comparison with absent occult tumour cells (OR 5.63; 95%CI 2.4-13.13). This was even
more pronounced in patients with colon cancer (OR 7.25 95%CI 1.82-28.97). In
contrast, disease recurrence was not increased in the presence of ITCs (OR 1.00 95%CI
0.53-1.88). CONCLUSION: Patients with stage I/II colorectal cancer and MMs have a
worse prognosis than patients without occult tumour cells. However, ITCs do not have
a predictive value. The distinction between ITCs and MMs should be made if the
detection of occult tumour cells is incorporated in the clinical decision for adjuvant
treatment.
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TITLE: - The association of CXCR4 expression with prognosis and clinicopathological
indicators in colorectal carcinoma patients: a meta-analysis.
SUMMARY: - Link
JOURNAL: - Histopathology. 2013 Nov 6. doi: 10.1111/his.12321.
*** Link to the complete text (free or ppv) 1111/his.12321
AUTHOR: - Lv S; ADDRESS: - Department of Neurosurgery, Peking Union Medical College
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China.
AUTHOR: - Yang Y
AUTHOR: - Kwon S
AUTHOR: - Han M
AUTHOR: - Zhao F
AUTHOR: - Kang H
AUTHOR: - Dai C
AUTHOR: - Wang R
SUMMARY: - AIMS: The clinical relevance of expression of chemokine receptor 4 (CXCR4)
in colorectal carcinoma (CRC) remains controversial; our aim was to identify the
precise relationship of CXCR4 to prognosis and clinicopathological features. METHODS
AND RESULTS: A meta-analysis was performed. Original data included the hazard ratios
(HRs) of recurrence-free survival (RFS), overall survival (OS) and odds ratio (OR) in CRC
patients. We pooled HR/OR with 95% confidence intervals (CIs) to estimate the hazard.
A total of 20 published studies (including 2253 patients) were eligible. RFS and OS were
related significantly to CXCR4 expression, with HRs 1.62 (95% CI 1.24-2.11; P < 0.0001)
and 1.68 (95% CI 1.31-2.14; P < 0.0001), respectively. In addition, a significant
association was revealed between positive CXCR4 expression and age (less than
median age: OR 0.78, 95% CI 0.62-0.98; P = 0.03), stage (I and II: OR 0.46, 95% CI 0.320.66; P < 0.0001), grade (well/moderately differentiated: OR 0.74, 95% CI 0.56-0.98; P
= 0.04), location (colon: OR: 0.73, 95% CI 0.57-0.95; P = 0.02), lymph node invasion
(present: OR2.14, 95% CI 1.36-3.37; P = 0.001),and distant metastasis (present: OR
2.40; 95% CI 1.36-4.23; P = 0.003). Heterogeneity was observed among the included
studies with regard to stage (I2 = 58 %), lymph node invasiveness (I2 = 74%) and
distant metastasis (I2 = 56%). No publication bias was observed. CONCLUSIONS:
Chemokine receptor 4 expression indicates poorer prognosis in older patients and
advanced stage or poor differentiation in CRC, and also serves as an indicator of lymph
node and distal organ metastasis. Surprisingly, high CXCR4 expression may indicate
that the location of the tumour is the rectum. Thus, CXCR4 could help to predict
outcome and guide clinical therapy.
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TITLE: - Systematic review of internet patient information on colorectal cancer surgery.
SUMMARY: - Link
JOURNAL: - Dis Colon Rectum. 2014 Jan;57(1):64-9. doi:
10.1097/DCR.0000000000000011.
*** Link to the complete text (free or ppv) 1097/DCR.0000000000000011
AUTHOR: - Wasserman M; ADDRESS: - 1Department of Surgery, Northwestern University,
Feinberg School of Medicine, Chicago, Illinois 2Department of Surgery, University of
Toronto, Toronto, Ontario, Canada 3Keenan Research Centre, Li Ka Shing Knowledge
Institute, St Michael’s Hospital, Toronto, Ontario, Canada.
AUTHOR: - Baxter NN
AUTHOR: - Rosen B
AUTHOR: - Burnstein M
AUTHOR: - Halverson AL
SUMMARY: - BACKGROUND: Patients diagnosed with colorectal cancer often seek
information on the Internet to help them make treatment decisions. OBJECTIVE: The
aim of this study is to evaluate the quality of Web-based patient information regarding
surgery for colorectal cancer. DESIGN: This study is a cross-sectional survey of patientdirected Web sites. SETTINGS: The search engine Google (Mountain View, CA) and the
search terms “colorectal cancer surgery,” “colon cancer surgery,” and “rectal cancer
surgery” were used to identify Web sites. MAIN OUTCOME MEASURES: To assess
quality, we used the DISCERN instrument, a validated questionnaire developed to
analyze written consumer health information on treatment options to aid consumers
in evaluating the quality of health-related information on treatment choices for a
specific health problem. An additional colorectal cancer-specific questionnaire was
used to evaluate Web site content for colorectal cancer surgical treatment. Two
independent assessors reviewed each Web site. RESULTS: Searches revealed a total of
91 distinct Web sites, of which 37 met inclusion criteria. Web site affiliation was as
follows: 32% open-access general information, 24% hospital/health care organization,
and 19% professional medical society. Twelve (32.4%) Web sites had clear aims, 10
(27.0%) had identifiable references to their sources of information, and 9 (24.3%)
noted the date of published information. Ten sites (27.0%) provided some description
of the surgical procedure, 8 (21.6%) discussed either the risks or the benefits of
surgery, and 4 (10.8%) addressed quality-of-life issues. Nineteen (51.4%) Web sites
discussed postoperative complications, and 7 (18.9%) discussed stoma-related
maintenance/care. LIMITATIONS: The small sample size and interrater reliability bias
are limitations of this study. CONCLUSIONS: The quality of online patient information
regarding colorectal cancer treatment is highly variable, often incomplete, and does
not adequately convey the information necessary for patients to make well-informed
medical decisions regarding treatment for colorectal cancer. An opportunity exists for
professional medical societies to create more comprehensive online patient
information materials that may serve as a resource to physicians and their patients
(see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A122).
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TITLE: - Improvement of adherence to guidelines for antiemetic medication enhances
emetic control in patients with colorectal cancer receiving chemotherapy of moderate
emetic risk.
SUMMARY: - Link
JOURNAL: - Anticancer Res. 2013 Dec;33(12):5549-56.
AUTHOR: - Fujii H; ADDRESS: - Department of Pharmacy, Gifu University Hospital,
Yanagido 1-1, Gifu 501-1194, Japan. [email protected]
AUTHOR: - Iihara H
AUTHOR: - Ishihara M
AUTHOR: - Takahashi T
AUTHOR: - Yoshida K
AUTHOR: - Itoh Y
SUMMARY: - Prevention of chemotherapy-induced nausea and vomiting (CINV)
according to the clinical practice guidelines is particularly important. In the present
study, we investigated the adherence to the guidelines for antiemetic medication and
the control of CINV in 61 patients with colorectal cancer receiving the first course of
chemotherapy of moderate emetic risk at our outpatient cancer chemotherapy clinic.
Furthermore, we carried out intervention to improve evidence-based antiemetic
medication in another 64 patients. The rate of adherence to the antiemetic guidelines
was only 6.6%; non-adherence was due mostly to the lack of dexamethasone
treatment on days 2 and 3. In the interventional group, antiemetic medication
adherence was markedly enhanced to 89%, which led to a significant enhancement of
complete protection from nausea and vomiting during-delayed period (days 2-5 after
chemotherapy) from 54% to 74% (p<0.05), although the daily dose of dexamethasone
was 4 mg, lower than that recommended by the guidelines (8 mg). Finally, we
evaluated the effect of dexamethasone at a daily dose of 4 mg, since little is known
about the efficacy of such dose. Dexamethasone at this dose was found to be effective
at elevating the rate of complete protection from nausea and vomiting during-delayed
period (increase of 20%, p<0.05). These findings suggest that medication intervention
to reduce the gap between guidelines and clinical practice improves the emetic control
in patients with colorectal cancer receiving moderately-emetic chemotherapy.
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TITLE: - Radiation risks associated with serial imaging in colorectal cancer patients:
Should we worry?
SUMMARY: - Link
JOURNAL: - World J Gastroenterol. 2014 Jan 7;20(1):100-109.
*** Link to the complete text (free or ppv) 3748/wjg.v20.i1.100
AUTHOR: - Oh JS; ADDRESS: - Jeong Suk Oh, Jonathan B Koea, Department of Surgery,
North Shore Hospital, Auckland 0620, New Zealand.
AUTHOR: - Koea JB; ADDRESS: - Jeong Suk Oh, Jonathan B Koea, Department of Surgery,
North Shore Hospital, Auckland 0620, New Zealand.
SUMMARY: - To provide an overview of the radiation related cancer risk associated with
multiple computed tomographic scans required for follow up in colorectal cancer
patients. A literature search of the PubMed and Cochrane Library databases was
carried out and limited to the last 10 years from December 2012. Inclusion criteria
were studies where computed tomographic scans or radiation from other medical
imaging modalities were used and the risks associated with ionizing radiation reported.
Thirty-six studies were included for appraisal with no randomized controlled trials.
Thirty-four of the thirty-six studies showed a positive association between medical
imaging radiation and increased risk of cancer. The radiation dose absorbed and cancer
risk was greater in children and young adults than in older patients. Most studies
included in the review used a linear, no-threshold model to calculate cancer risks and
this may not be applicable at low radiation doses. Many studies are retrospective and
ensuring complete follow up on thousands of patients is difficult. There was a minor
increased risk of cancer from ionizing radiation in medical imaging studies. The
radiation risks of low dose exposure (< 50 milli-Sieverts) are uncertain. A clinically
justified scan in the context of colorectal cancer is likely to provide more benefits than
harm but current guidelines for patient follow up will need to be revised to
accommodate a more aggressive approach to treating metastatic disease.
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TITLE: - Evidence-based appraisal of the upfront treatment for unresectable metastatic
colorectal cancer patients.
SUMMARY: - Link
JOURNAL: - World J Gastroenterol. 2013 Dec 14;19(46):8474-88. doi:
10.3748/wjg.v19.i46.8474.
*** Link to the complete text (free or ppv) 3748/wjg.v19.i46.8474
AUTHOR: - Aprile G; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari,
Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi, Department of
Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Lutrino SE; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari,
Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi, Department of
Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Ferrari L; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari,
Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi, Department of
Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Casagrande M; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura
Ferrari, Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi,
Department of Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Bonotto M; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura
Ferrari, Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi,
Department of Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Ongaro E; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari,
Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi, Department of
Oncology, University and General Hospital, 33100 Udine, Italy.
AUTHOR: - Puglisi F; ADDRESS: - Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari,
Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi, Department of
Oncology, University and General Hospital, 33100 Udine, Italy.
SUMMARY: - Colorectal cancer (CRC) is a significant health problem, with around 1
million new cases and 500000 deaths every year worldwide. Over the last two
decades, the use of novel therapies and more complex treatment strategies have
contributed to progressively increase the median survival of patients with unresectable
advanced CRC up to approximately 30 mo. The availability of additional therapeutic
options, however, has created new challenges and generated more complicated
treatment algorithms. Moreover, several clinically important points are still in debate
in first-line, such as the optimal treatment intensity, the most appropriate
maintenance strategy, the preferred biologic to be used upfront in patients with KRAS
wild-type CRC, and the need for more detailed information on tumor biology. In this
moving landscape, this review analyses why the first-line treatment decision is crucial
and how the choice may impact on further treatment lines. In addition, it focuses on
results of major phase III randomized trials.
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TITLE: - Risk of prostate cancer in Lynch syndrome: a systematic review and
meta-
analysis.
SUMMARY: - Link
JOURNAL: - Cancer Epidemiol Biomarkers Prev. 2014 Jan 14.
*** Link to the complete text (free or ppv) 1158/1055-9965.EPI-13-1165
AUTHOR: - Ryan S; ADDRESS: - Centre for MEGA Epidemiology, The University of
Melbourne.
AUTHOR: - Jenkins MA
AUTHOR: - Win AK
SUMMARY: - It has been controversial that men carrying a DNA mismatch repair (MMR)
gene mutation (Lynch syndrome) are at heightened risk of prostate cancer given that
an increased risk is likely to be modest and the prevalence of prostate cancer is high.
We used PUBMED to search for “molecular studies” that reported MMR-deficiency
status of prostate cancer tumors in men with an MMR gene mutation, and “risk
studies” that reported prostate cancer risk for men known or suspected to have an
MMR gene mutation relative to that for non-carriers or the general population. Of the
six molecular studies, 32 of 44 (73%, 95% confidence interval [CI] 57-85%) prostate
cancer tumors in carriers were MMR-deficient, which equates to carriers having a 3.67fold increased risk of prostate cancer (95%CI 2.32-6.67). Of the 12 risk studies, we
estimated a 2.13-fold increased risk of prostate cancer (95%CI 1.45-2.80) for male
carriers in clinic-based retrospective cohorts, 2.11 (95%CI 1.27-2.95) for male carriers
with a prior diagnosis of colorectal cancer, and 2.28 (95%CI 1.37-3.19) for all men from
mutation carrying families. The combination of evidence from molecular and risk
studies in the current literature support consideration of prostate cancer as part of
Lynch syndrome.
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TITLE: - Dietary methionine intake and risk of incident colorectal cancer: a meta-analysis
of 8 prospective studies involving 431,029 participants.
SUMMARY: - Link
JOURNAL: - PLoS One. 2013 Dec 10;8(12):e83588. doi: 10.1371/journal.pone.0083588.
eCollection 2013.
*** Link to the complete text (free or ppv) 1371/journal.pone.0083588
AUTHOR: - Zhou ZY; ADDRESS: - Department of Gastroenterology, Renmin Hospital of
Wuhan University, Wuhan, Hubei Province, China.
AUTHOR: - Wan XY
AUTHOR: - Cao JW
SUMMARY: - BACKGROUND: Methionine is one of the key components of one carbon
metabolism. Experimental studies indicate that methionine may reduce inflammationinduced colon cancer. However, epidemiologic findings as to whether dietary
methionine intake influences colorectal cancer incidence in humans are inconsistent.
OBJECTIVE: To investigate the relationship between dietary methionine intake and risk
of colorectal cancer by performing a meta-analysis of prospective studies. METHODS:
Eligible studies were identified by searching PubMed and Embase and by reviewing the
bibliographies of the retrieved publications. The summary risk estimates were
computed using both a random- effects and a fixed-effects model. RESULTS: Eight
eligible prospective cohort studies involving 431,029 participants and 6,331 colorectal
cancer cases were identified. According to the random-effects model, the summary
relative risks (RRs) for the highest compared with the lowest intake of methionine
were 0.89 (95% confidence interval [CI] = 0.77-1.03) for colorectal cancer, 0.77 (95% CI
= 0.64-0.92) for colon cancer, and 0.88 (95% CI = 0.55-1.42) for rectal cancer. In the
stratified analysis, a significant inverse association between dietary methionine intake
and risk of colorectal cancer was observed in studies with longer follow-up time
(RR=0.81, 95% CI= 0.70-0.95), in Western studies (RR= 0.83, 95% CI = 0.73-0.95) and in
men (RR = 0.75, 95% CI= 0.57-0.99). We found no indication of publication bias.
CONCLUSION: This meta-analysis indicates that dietary methionine intake may be
associated with decreased risk of colorectal cancer, especially colon cancer. More
prospective studies with long follow-up time are needed to confirm these findings.
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TITLE: - Cruciferous vegetables and risk of colorectal neoplasms: a systematic review
and meta-analysis.
SUMMARY: - Link
JOURNAL: - Nutr Cancer. 2014;66(1):128-39. doi: 10.1080/01635581.2014.852686. Epub
2013 Dec 16.
*** Link to the complete text (free or ppv) 1080/01635581.2014.852686
AUTHOR: - Tse G; ADDRESS: - a The Whiteley-Martin Research Centre, The Discipline of
Surgery, The University of Sydney, Sydney Medical School, Nepean , Penrith , New
South Wales , Australia.
AUTHOR: - Eslick GD
SUMMARY: - Evidence shows cruciferous vegetables exhibit chemoprotective properties,
commonly attributed to their rich source of isothiocyanates. However, epidemiological
data examining the association between cruciferous vegetable intake and colorectal
neoplasms have been inconclusive. This meta-analysis examines the epidemiological
evidence to characterize the association between cruciferous vegetable intake and risk
of developing colorectal neoplasms. Thirty-three articles were included in the metaanalysis after a literature search of electronic databases. Subgroup analysis for
individual cruciferae types (n = 8 studies) and GST polymorphism (n = 8 studies) were
performed. Pooled adjusted odds ratios (ORs) comparing highest and lowest
categories of dietary pattern scores were calculated. Results show a statistically
significant inverse association between cruciferous vegetable intake and colon cancer
[OR = 0.84; 95% confidence interval (CI): 0.72-0.98; P value heterogeneity < 0.001].
Broccoli in particular exhibited protective benefits against colorectal (CRC) neoplasms
(OR = 0.80; 95% CI: 0.65-0.99; P value heterogeneity = 0.02). Stratification by GST
genotype reveals that the GSTT1 null genotype confers a reduction in CRC risk (OR =
0.78; 95% CI: 0.64-0.95; P value heterogeneity = 0.32). This study provides support to
the hypothesis that cruciferous vegetable intake protects against cancer of the colon.
This study also demonstrates the significance of gene-diet interactions and the
importance of assessing individual cruciferous vegetables.
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TITLE: - Tumor necrosis factor-a polymorphisms and colorectal cancer risk: a meta-
analysis.
SUMMARY: - Link
JOURNAL: - PLoS One. 2014 Jan 3;9(1):e85187. doi: 10.1371/journal.pone.0085187.
eCollection 2014.
*** Link to the complete text (free or ppv) 1371/journal.pone.0085187
AUTHOR: - Min L; ADDRESS: - Key Laboratory of Carcinogenesis and Translational Research
(Ministry of Education), Departments of Biochemistry and Molecular Biology, Peking
University Cancer Hospital & Institute, Beijing, China.
AUTHOR: - Chen D; ADDRESS: - Key Laboratory of Carcinogenesis and Translational
Research (Ministry of Education), Departments of Epidemiology, Peking University
Cancer Hospital & Institute, Beijing, China.
AUTHOR: - Qu L; ADDRESS: - Key Laboratory of Carcinogenesis and Translational Research
(Ministry of Education), Departments of Biochemistry and Molecular Biology, Peking
University Cancer Hospital & Institute, Beijing, China.
AUTHOR: - Shou C; ADDRESS: - Key Laboratory of Carcinogenesis and Translational
Research (Ministry of Education), Departments of Biochemistry and Molecular Biology,
Peking University Cancer Hospital & Institute, Beijing, China.
SUMMARY: - BACKGROUND AND OBJECTIVES: Tumor necrosis factor-alpha (TNF-a) was
related to inflammation and involved in the development of colorectal cancer.
Polymorphisms located in TNF-a promoter region, such as 308G/A and 238G/A, could
affect the risk of various types of cancer by regulating TNF-a production. In this study,
a meta-analysis was performed to investigate the association between common
polymorphisms of TNF-a promoter region and colorectal cancer susceptibility.
METHODS: Searching of several databases was performed for all publications on the
association between TNF-a polymorphisms and colorectal cancer. Summary odds
ratios (ORs) with their 95% confidence intervals (95% CIs) were calculated using
random-effects models. Stratified analyses based on ethnicity and control population
source were also conducted. RESULTS: Overall, TNF-a 308ª polymorphism showed a
significant association with increased risk of colorectal cancer in worldwide
populations under homozygote comparison [AA vs. GG, OR (95% CI) = 1.46 (1.07-1.97)]
other than heterozygote comparison [AG vs. GG, OR (95% CI) = 1.05 (0.93-1.19)]. TNF-a
238ª was not associated with colorectal cancer risk under homozygote or heterozygote
comparisons. In stratified analysis, significant association was observed only in
Western populations [AA vs. GG, OR (95% CI) = 1.39 (1.01-1.91)] other than in Eastern
populations under homozygote comparison. No significant difference was observed
between population-based subgroup and hospital-based subgroup. CONCLUSIONS:
TNF-a 308ª was moderately associated with an increased risk of colorectal cancer in
Western populations, and TNF-a 238ª polymorphism was not significantly associated
with colorectal cancer risk.
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TITLE: - Effect of BRAF V600E mutation on tumor response of anti-EGFR monoclonal
antibodies for first-line metastatic colorectal cancer treatment: a meta-analysis of
randomized studies.
SUMMARY: - Link
JOURNAL: - Mol Biol Rep. 2014 Jan 4.
*** Link to the complete text (free or ppv) 1007/s11033-013-2974-8
AUTHOR: - Cui D; ADDRESS: - Division of Abdominal Cancer, West China Hospital, Sichuan
University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
AUTHOR: - Cao D
AUTHOR: - Yang Y
AUTHOR: - Qiu M
AUTHOR: - Huang Y
AUTHOR: - Yi C
SUMMARY: - Anti-EGFR monoclonal antibodies (anti-EGFR MoAbs) in metastatic
colorectal cancer (mCRC) treatment are still not effective in all patients. This study
aimed to evaluate the relationship between BRAF V600E mutation and the tumor
response of anti-EGFR MoAbs for first-line treatment in mCRC patients. We searched
the MEDLINE and EMBASE databases, using the key words that included colorectal
cancer, cetuximab, panitumumab, and BRAF mutation and retrieved 445 articles.
Among them four were included in the systematic review. Relative risks (RRs) with 95
% confidence intervals (CI) for response rate were calculated. BRAF mutation carriers
had worse ORR than non-carriers in mCRC patients with KRAS wild-type in first-line
treatment whether adding anti-EGFR MoAb to chemotherapy or not (RR = 0.43, [95 %
CI 0.16-0.75]; RR = 0.38, [95 % CI 0.20-0.73]). But in the unselected patients whose
KRAS mutation were unknown, BRAF mutation carriers had similar ORR whether
adding cetuximab to chemotherapy or not (RR = 0.45, [95 % CI 0.18-1.09]; RR = 0.57,
[95 % CI 0.15-2.23]). In BRAF mutation carriers adding anti-EGFR MoAb to
chemotherapy was similar to chemotherapy alone whether in patients with wild-type
KRAS or unselected patients (RR = 1.61, [95 % CI 0.57-4.47]; RR = 0.71, [95 % CI 0.182.77]). But in the BRAF mutation non-carriers, adding anti-EGFR MoAb produced a
clear benefit in response rate than chemotherapy alone and this advantage was
restricted to KRAS wild-type patients (RR = 1.48, [95 % CI 1.28-1.71]). BRAF mutation
decreases tumor response in first-line treatment whether cetuximab was given or not
in patients with KRAS wild-type, and anti-EGFR MoAb produces a clear benefit in
response rate in patients with BRAF and KRAS wild-type.
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TITLE: - Common variation rs6983267 at 8q24.1 and risk of colorectal adenoma and
cancer: evidence based on 31 studies.
SUMMARY: - Link
JOURNAL: - Tumour Biol. 2013 Dec 28.
*** Link to the complete text (free or ppv) 1007/s13277-013-1532-2
AUTHOR: - Wang YP; ADDRESS: - Department of General Surgery, Ren Ji Hospital, School
of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Road, Shanghai, 200127,
People’s Republic of China.
AUTHOR: - Zhang J
AUTHOR: - Zhu HY
AUTHOR: - Qian CL
AUTHOR: - Liu H
AUTHOR: - Ji F
AUTHOR: - Shen ZY
SUMMARY: - Genome-wide association studies have identified 8q24.21-rs6983267 as a
new colorectal cancer (CRC) and colorectal adenoma (CRA) susceptibility locus in
populations of European descent. Since then, the relationship between 8q24.21rs6983267 and CRC/CRA has been reported in various ethnic groups; however, these
studies have yielded inconsistent results. To investigate this inconsistency and derive a
more precise estimation of the relationship, we conducted a meta-analysis of 31
studies, including 51,293 cases and 58,962 controls for CRC, and 8,148 cases and
17,065 controls for CRA. Potential sources of heterogeneity and publication bias were
also systematically explored. Overall, the summary odds ratio of G variant for CRC was
1.18 (95 % CI, 1.16-1.21; P < 10-5) and 1.17 (95 % CI, 1.11-1.23; P < 10-5) for CRA.
Significant results were observed using dominant or recessive genetic model for the
polymorphism. In the subgroup analysis by ethnicity, significantly increased risks were
found in East Asians and Caucasian populations; while no significant associations were
detected among African Americans. After stratifying by sample size and control source,
significant associations were also obtained. This meta-analysis suggests that the
8q24.21-rs6983267 polymorphism is associated with CRC/CRA susceptibility, but these
associations vary in different ethnic populations.
-------------------------------------------------------------[14]
TITLE: - The short- and long-term outcomes of laparoscopic versus open surgery for
colorectal cancer: a meta-analysis.
SUMMARY: - Link
JOURNAL: - Int J Colorectal Dis. 2014 Jan 21.
*** Link to the complete text (free or ppv) 1007/s00384-013-1827-1
AUTHOR: - Wang CL; ADDRESS: - The First Affiliated Hospital of Dalian Medical University,
Dalian, Liaoning, 116021, People’s Republic of China, [email protected]
AUTHOR: - Qu G
AUTHOR: - Xu HW
SUMMARY: - PURPOSE: The aim of the study was to compare short- and long-term
outcomes of laparoscopic surgery and conventional open surgery for colorectal cancer.
METHODS: Published randomized controlled trial (RCT) reports of laparoscopic surgery
and open surgery for colorectal cancer were searched, and short- and long-term
factors were extracted to perform meta-analysis. RESULTS: A total of 15 RCT reports
(6,557 colorectal cancer patients) were included in this study. Blood loss of
laparoscopic surgery was less by 91.06 ml than open surgery (p = 0.044). Operation
time was longer by 49.34 min (p = 0.000). The length of hospital stay was shorter by
2.64 days (p = 0.003). Incisional length was shorter by 9.23 cm (p = 0.000). Fluid intake
was shorter by 0.70 day (p = 0.001). Bowel movement was earlier by 0.95 day (p =
0.000). Incidence of complications, blood transfusion, and 30 days death were
significantly lower in laparoscopic surgery than in open surgery (p = 0.011, 0.000, 0.01).
But there was no significant difference in lymph nodes (p = 0.535) and anastomotic
leak (p = 0.924). There was also no significant difference in 3 and 5 years overall
survival (p = 0.298, 0.966), disease-free survival (p = 0.487, 0.356), local recurrence (p =
0.270, 0.649), and no difference in 5 years distant recurrence (p = 0.838).
CONCLUSIONS: Laparoscopic surgery is a mini-injured approach which can cure
colorectal cancer safely and radically, and it is not different from conventional open
surgery in long-term effectiveness, so laparoscopic surgery can be tried to widely use
in colorectal cancer.
-------------------------------------------------------------[15]
TITLE: - Meta-analysis: eating frequency and risk of colorectal cancer.
SUMMARY: - Link
JOURNAL: - Tumour Biol. 2013 Dec 5.
*** Link to the complete text (free or ppv) 1007/s13277-013-1479-3
AUTHOR: - Liu Y; ADDRESS: - Department of Clinical Laboratory, First Affiliated Hospital of
Guangxi Medical University, Nanning, Guangxi, China.
AUTHOR: - Tang W
AUTHOR: - Zhai L
AUTHOR: - Yang S
AUTHOR: - Wu J
AUTHOR: - Xie L
AUTHOR: - Wang J
AUTHOR: - Deng Y
AUTHOR: - Qin X
AUTHOR: - Li S
SUMMARY: - Eating frequency has been implicated in the risk of colorectal cancer (CRC)
in several epidemiological studies with contradictory and inconclusive findings. We
performed a meta-analysis to evaluate their relationship. The pooled relative risk (RR)
with 95 % confidence interval (CI) was calculated to estimate the effects. A total of 15
eligible studies with 141,431 subjects and 11,248 cases were retrieved after a
comprehensive search of the PubMed, Cochrane Library, and Web of Science
databases up to October 2013. The overall meta-analysis revealed no strong significant
association between eating frequency and risk of CRC in different eating occasion
categories (1 meal/day): RR = 1.01, 95 % CI 0.94-1.09, P = 0.709; 3 vs. <3 daily meals:
RR = 1.17, 95 % CI 0.93-1.46; 4 vs. <3 daily meals: RR = 1.13, 95 % CI 0.92-1.38; >/=5 vs.
<3 daily meals: RR = 0.95, 95 % CI 0.61-1.47; 4 vs. </=3 daily meals: RR = 1.18, 95 % CI
0.92-1.51; and 1-2 vs. 3 or 4 daily meals: RR = 0.82, 95 % CI 0.63-1.06). However,
modest evidence of an increased risk of CRC in case-control studies (RR = 1.30; 95 % CI,
1.11-1.52) and >/=5 vs. </=3 meals group (RR = 1.30; 95 % CI, 1.11-1.52) was observed.
Our meta-analysis results do not support the hypothesis that eating frequency strongly
reduced or increased the risk of CRC. Clinical randomized trials are required to
evaluate this relationship further.
-------------------------------------------------------------[16]
TITLE: - Meta-analysis of the ADH1B and ALDH2 polymorphisms and the risk of
colorectal cancer in East Asians.
SUMMARY: - Link
JOURNAL: - Intern Med. 2013;52(24):2693-9.
AUTHOR: - Guo XF; ADDRESS: - Department of Gastroenterology, Renmin Hospital of
Wuhan University, China.
AUTHOR: - Wang J
AUTHOR: - Yu SJ
AUTHOR: - Song J
AUTHOR: - Ji MY
AUTHOR: - Zhang JX
AUTHOR: - Cao Z
AUTHOR: - Wang J
AUTHOR: - Dong WG
SUMMARY: - OBJECTIVE: The aldehyde dehydrogenase 2 (ALDH2) and alcohol
dehydrogenase 1B (ADH1B) genes have been implicated in the development of
colorectal cancer (CRC). However, the results are inconsistent. In this study, a metaanalysis was performed to assess the associations between the ALDH2 and ADH1B
polymorphisms and the risk of CRC. METHODS: Relevant studies were identified using
PubMed, Web of Science and CNKI up to February, 2013. The pooled odds ratio (OR)
with a 95% confidence interval (CI) was calculated using the fixed- or random-effects
model. RESULTS: A total of 11 case-controlled studies were selected. Of these, 11
studies included 2,893 cases and 3,817 controls concerning the ALDH2 Glu487Lys
polymorphism and six studies included 1,864 cases and 3,502 controls concerning the
ADH1B polymorphism. The results indicated that there was a statistically significant
link between the ALDH2 polymorphism and the risk of CRC (Glu/Lys+Lys/Lys vs.
Glu/Glu: OR=0.87, 95%CI: 0.78-0.96, p=0.10; Glu/Lys vs. Glu/Glu: OR=0.87, 95%CI:
0.77-0.97, p=0.38); however, no significant associations were observed between the
ADH1B polymorphism and the risk of CRC win any of the genetic models.
CONCLUSION: This meta-analysis demonstrated that the ALDH2 polymorphism, but
not the ADH1B polymorphism, significantly increases the risk of CRC in East Asians.
-------------------------------------------------------------[17]
TITLE: - Comparison of CpG Island Methylator Phenotype (CIMP) Frequency in Colon
Cancer Using Different Probe- and Gene-Specific Scoring Alternatives on
Recommended Multi-Gene Panels.
SUMMARY: - Link
JOURNAL: - PLoS One. 2014 Jan 21;9(1):e86657. doi: 10.1371/journal.pone.0086657.
eCollection 2014 Jan 21.
*** Link to the complete text (free or ppv) 1371/journal.pone.0086657
AUTHOR: - Berg M; ADDRESS: - Department of Gastrointestinal Surgery, Stavanger
University Hospital, Stavanger, Norway ; Centre of Organelle Research, University of
Stavanger, Stavanger, Norway.
AUTHOR: - Hagland HR; ADDRESS: - Department of Gastrointestinal Surgery, Stavanger
University Hospital, Stavanger, Norway.
AUTHOR: - Soreide K; ADDRESS: - Department of Gastrointestinal Surgery, Stavanger
University Hospital, Stavanger, Norway ; Department of Clinical Medicine, University of
Bergen, Bergen, Norway.
SUMMARY: - BACKGROUND: In colorectal cancer a distinct subgroup of tumours
demonstrate the CpG island methylator phenotype (CIMP). However, a consensus of
how to score CIMP is not reached, and variation in definition may influence the
reported CIMP prevalence in tumours. Thus, we sought to compare currently
suggested definitions and cut-offs for methylation markers and how they influence
CIMP classification in colon cancer. METHODS: Methylation-specific multiplex ligationdependent probe amplification (MS-MLPA), with subsequent fragment analysis, was
used to investigate methylation of tumour samples. In total, 31 CpG sites, located in 8
different genes (RUNX3, MLH1, NEUROG1, CDKN2A, IGF2, CRABP1, SOCS1 and
CACNA1G) were investigated in 64 distinct colon cancers and 2 colon cancer cell lines.
The Ogino gene panel includes all 8 genes, in addition to the Weisenberger panel of
which only 5 of the 8 genes included were investigated. In total, 18 alternative
combinations of scoring of CIMP positivity on probe-, gene-, and panel-level were
analysed and compared. RESULTS: For 47 samples (71%), the CIMP status was constant
and independent of criteria used for scoring; 34 samples were constantly scored as
CIMP negative, and 13 (20%) consistently scored as CIMP positive. Only four of 31
probes (13%) investigated showed no difference in the numbers of positive samples
using the different cut-offs. Within the panels a trend was observed that increasing the
gene-level stringency resulted in a larger difference in CIMP positive samples than
increasing the probe-level stringency. A significant difference between positive
samples using ‘the most stringent’ as compared to ‘the least stringent’ criteria (20% vs
46%, respectively; p<0.005) was demonstrated. CONCLUSIONS: A statistical significant
variation in the frequency of CIMP depending on the cut-offs and genes included in a
panel was found, with twice as many positives samples by least compared to most
stringent definition used.
-------------------------------------------------------------[18]
TITLE: - XPC Lys939Gln and Ala499Val polymorphisms in colorectal cancer susceptibility:
a meta-analysis of case-control studies.
SUMMARY: - Link
JOURNAL: - Mol Biol Rep. 2014 Feb;41(2):1171-8. doi: 10.1007/s11033-013-2964-x. Epub
2014 Jan 3.
*** Link to the complete text (free or ppv) 1007/s11033-013-2964-x
AUTHOR: - Liu C; ADDRESS: - Department of Oncology, Changhai Hospital, Second Military
Medical University, 168 Changhai Road, Shanghai, 200433, People’s Republic of China,
[email protected]
AUTHOR: - Yin Q
AUTHOR: - Ying M
AUTHOR: - Lin J
AUTHOR: - Li L
AUTHOR: - Jiao G
AUTHOR: - Wang M
AUTHOR: - Wang Y
SUMMARY: - The XPC Lys939Gln and Ala499Val polymorphisms were likely to be
involved with the development of colorectal cancer. However, there had been
inconsistent reports of association. This meta-analysis of literatures was performed to
draw a more precise estimation of the relationship. We systematically searched
PubMed, Embase and Web of Science for relevant articles with a time limit of
December 2012. The strength of association between the XPC Lys939Gln and
Ala499Val polymorphisms and colorectal cancer susceptibility were assessed by odds
ratio (OR) with the corresponding 95 % confidence interval (95 % CI). This metaanalysis including six case-control studies evaluated the associations between the two
XPC polymorphisms (Lys939Gln, Ala499Val) and colorectal cancer susceptibility. For
XPC Lys939Gln, no obvious associations were found for all genetic models [CC vs AA:
OR (95 % CI) = 1.12 (0.94-1.32); CA vs AA: OR (95 % CI) = 1.08 (0.94-1.24); the dominant
model: OR (95 % CI) = 1.09 (0.97-1.23); the recessive model: OR (95 % CI) = 1.07 (0.921.25)]. For XPC Ala499Val, no obvious associations were also not found for all genetic
models [TT vs CC: OR (95 % CI) = 0.84 (0.65-1.10); CT vs CC: OR (95 % CI) = 1.00 (0.861.15); the dominant model: OR (95 % CI) = 0.98 (0.85-1.12); the recessive model: OR
(95 % CI) = 0.87 (0.67-1.12)]. This meta-analysis suggested that both the XPC Lys939Gln
and Ala499Val polymorphisms were not risk factors for increasing colorectal cancer.
-------------------------------------------------------------[19]
TITLE: - EURECCA consensus conference highlights about colorectal cancer clinical
management: the pathologists expert review.
SUMMARY: - Link
JOURNAL: - Virchows Arch. 2014 Feb;464(2):129-34. doi: 10.1007/s00428-013-1534-x.
Epub 2014 Jan 24.
*** Link to the complete text (free or ppv) 1007/s00428-013-1534-x
AUTHOR: - Quirke P; ADDRESS: - Department of Pathology, Anatomy and Tumour Biology,
Leeds Institute of Cancer and Pathology, School of Medicine, University of Leeds,
Leeds, UK, [email protected]
AUTHOR: - West NP
AUTHOR: - Nagtegaal ID
SUMMARY: - Care for patients with colon and rectal cancer has improved in the last 20
years; however, a considerable variation still exists in cancer management and
outcome between European countries. Large variation is also apparent between
national guidelines and patterns of cancer care in Europe. Therefore, EURECCA, which
is the acronym of European Registration of Cancer Care, is aiming at defining core
treatment strategies and developing a European audit structure in order to improve
the quality of care for all patients with colon and rectal cancer. In December 2012, the
first multidisciplinary consensus conference about cancer of the colon and rectum was
held. The expert panel consisted of representatives of European scientific
organizations involved in cancer care of patients with colon and rectal cancer and
representatives of national colorectal registries.
-------------------------------------------------------------[20]
TITLE: - Clinical, sociodemographic, and service provider determinants of guideline
concordant colorectal cancer care for appalachian residents.
SUMMARY: - Link
JOURNAL: - J Rural Health. 2014 Jan;30(1):27-39. doi: 10.1111/jrh.12033. Epub 2013 Jun
26.
*** Link to the complete text (free or ppv) 1111/jrh.12033
AUTHOR: - Fleming ST; ADDRESS: - Departments of Epidemiology & Health Services
Management, University of Kentucky College of Public Health, Lexington, Kentucky.
AUTHOR: - Mackley HB
AUTHOR: - Camacho F
AUTHOR: - Seiber EE
AUTHOR: - Gusani NJ
AUTHOR: - Matthews SA
AUTHOR: - Liao J
AUTHOR: - Yang TC
AUTHOR: - Hwang W
AUTHOR: - Yao N
SUMMARY: - BACKGROUND: Colorectal cancer represents a significant cause of
morbidity and mortality, particularly in Appalachia where high mortality from
colorectal cancer is more prevalent. Adherence to treatment guidelines leads to
improved survival. This paper examines determinants of guideline concordance for
colorectal cancer. METHODS: Colorectal cancer patients diagnosed in 2006-2008 from
4 cancer registries (Kentucky, Ohio, Pennsylvania, and North Carolina) were linked to
Medicare claims (2005-2009). Final sample size after exclusions was 2,932 stage I-III
colon, and 184 stage III rectal cancer patients. The 3 measures of guideline
concordance include adjuvant chemotherapy (stage III colon cancer, <80 years), >/=12
lymph nodes assessed (resected stage I-III colon cancer), and radiation therapy (stage
III rectal cancer, <80 years). Bivariate and multivariate analyses with clinical,
sociodemographic, and service provider covariates were estimated for each of the
measures. RESULTS: Rates of chemotherapy, lymph node assessment, and radiation
were 62.9%, 66.3%, and 56.0%, respectively. Older patients had lower rates of
chemotherapy and radiation. Five comorbidities were significantly associated with
lower concordance in the bivariate analyses: myocardial infarction, congestive heart
failure, respiratory diseases, dementia with chemotherapy, and diabetes with
adequate lymph node assessment. Patients treated by hospitals with no Commission
on Cancer (COC) designation or lower surgical volumes had lower odds of adequate
lymph node assessment. CONCLUSIONS: Clinical, sociodemographic, and service
provider characteristics are significant determinants of the variation in guideline
concordance rates of 3 colorectal cancer measures.
-------------------------------------------------------------[21]
TITLE: - An updated meta-analysis of the association between ADIPOQ rs2241766
polymorphism and colorectal cancer.
SUMMARY: - Link
JOURNAL: - Tumour Biol. 2013 Nov 30.
*** Link to the complete text (free or ppv) 1007/s13277-013-1329-3
AUTHOR: - Li P; ADDRESS: - Department of Oncology Surgery, Chinese PLA General
Hospital, Beijing, 100853, China.
AUTHOR: - Liu H
AUTHOR: - Li C
AUTHOR: - Yang B
AUTHOR: - Kong Q
AUTHOR: - Zheng W
AUTHOR: - Li B
AUTHOR: - Jia B
SUMMARY: - Adiponectin (ADIPOQ) is a cytokine produced by adipose tissue involved in
carcinogenesis. ADIPOQ SNP rs2241766 has been extensively studied in colorectal
cancer (CRC) community with contentious and conflicting conclusions. The objective of
this study was to comprehensively assess the association between SNP rs2241766 and
CRC risk. PubMed, Embase, CNKI, as well as the references of the retrieved articles
were searched to identify the eligible studies for this meta-analysis. Odds ratios (ORs)
and 95 % confidence intervals (CIs) were used to assess the association. We also
examined the heterogeneity and publication bias and performed sensitivity analyses.
Seven studies with 2,414 cases and 2,796 controls together did not show any
significant association between SNP rs2241766 and CRC risk. Subgroup analyses by
ethnicity and sample size also failed to provide statistically significant evidence. This
meta-analysis demonstrates that ADIPOQ SNP rs2241766 may not represent as an
effect modifier for the risk of CRC.
-------------------------------------------------------------[22]
TITLE: - Adherence to physician recommendations for surveillance in opportunistic
colorectal cancer screening: the necessity of organized surveillance.
SUMMARY: - Link
JOURNAL: - PLoS One. 2013 Dec 6;8(12):e82676. doi: 10.1371/journal.pone.0082676.
eCollection 2013.
*** Link to the complete text (free or ppv) 1371/journal.pone.0082676
AUTHOR: - Stock C; ADDRESS: - Division of Clinical Epidemiology and Aging Research,
German Cancer Research Center (DKFZ), Heidelberg, Germany ; Institute of Medical
Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
AUTHOR: - Holleczek B
AUTHOR: - Hoffmeister M
AUTHOR: - Stolz T
AUTHOR: - Stegmaier C
AUTHOR: - Brenner H
SUMMARY: - BACKGROUND: Limited evidence exists on the utilization of surveillance
colonoscopy in colorectal cancer (CRC) screening programs. We assessed adherence to
physician recommendations for surveillance in opportunistic CRC screening in
Germany. METHODS: A follow-up study of screening colonoscopy participants in 20072009 in Saarland, Germany, was conducted using health insurance claims data.
Utilization of additional colonoscopies through to 2011 was ascertained. Adherence to
surveillance intervals of 3, 6, 12 and 36 months, defined as having had colonoscopy at
2.5 to 4, 5 to 8, 10.5 to 16 and 33 to 48 months, respectively (i.e., tolerating a delay of
33% of each interval) was assessed. Potential predictors of non-adherence were
investigated using logistic regression analysis. RESULTS: A total of 20,058 screening
colonoscopy participants were included in the study. Of those with recommended
surveillance intervals of 3, 6, 12 and 36 months, 46.5% (95%-confidence interval [CI]:
37.3-55.7%), 38.5% (95%-CI: 29.6-47.3%), 25.4% (95%-CI: 21.2-29.6%) and 28.0% (95%CI: 25.5-30.5%), respectively, had a subsequent colonoscopy within the specified
margins. Old age, longer recommended surveillance interval, not having had
polypectomy at screening and negative colonoscopy were statistically significant
predictors of non-adherence. CONCLUSION: This study suggests frequent nonadherence to physician recommendations for surveillance colonoscopy in community
practice. Increased efforts to improve adherence, including introduction of more
elements of an organized screening program, seem necessary to assure a high-quality
CRC screening process.
-------------------------------------------------------------[23]
TITLE: - Hepatic resection for colorectal metastases.
SUMMARY: - Link
JOURNAL: - J Surg Oncol. 2014 Jan;109(1):2-7. doi: 10.1002/jso.23371. Epub 2013 Dec 7.
*** Link to the complete text (free or ppv) 1002/jso.23371
AUTHOR: - Frankel TL; ADDRESS: - Section of Hepatopancreatobiliary Surgery, Department
of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
AUTHOR: - D’Angelica MI
SUMMARY: - The liver represents a common site for metastasis in colorectal cancer.
Improvements in patient selection and surgical techniques has resulted in improved
outcomes following hepatic metastasectomy with large series reporting 5- and 10-year
overall survival rates of 40% and 20%, respectively. In recent years, criteria for
resectability has expanded with the use of forced liver hypertrophy and staged
resection. The role of perioperative chemotherapy remains controversial with a slight
increase in survival and operative morbidity.
-------------------------------------------------------------[24]
TITLE: - Anti-angiogenic therapies for metastatic colorectal cancer: current and future
perspectives.
SUMMARY: - Link
JOURNAL: - World J Gastroenterol. 2013 Nov 28;19(44):7955-71. doi:
10.3748/wjg.v19.i44.7955.
*** Link to the complete text (free or ppv) 3748/wjg.v19.i44.7955
AUTHOR: - Marques I; ADDRESS: - Ines Marques, Ramon Andrade de Mello, Faculty of
Medicine, University of Porto, 4200-319 Porto, Portugal.
AUTHOR: - Araujo A
AUTHOR: - de Mello RA
SUMMARY: - Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer and
the second leading cause of cancer death in both men and women in the United
States, with about 142820 new cases and 50830 deaths expected in 2013. Metastatic
disease (mCRC) remains a challenge for oncologists worldwide due to its potential
comorbidities. Recently, chemotherapy regimens containing 5-fluorouracil, leucovorin,
oxaliplatin and irinotecan combinations are a standard of care in the metastatic
disease. Currently, biological therapies involving vascular endothelial growth factor
and epidermal growth factor receptor pathways, such as bevacizumab and cetuximab,
have emerged as good option for improving mCRC patient survival. Now, aflibercept
plus standard chemotherapy has also been approved in second line regimen for mCRC
patients. Our review will discuss novel biological drugs and their indications for mCRC
patients and will bring future perspectives in this regard.
-------------------------------------------------------------[25]
TITLE: - ACMG technical standards and guidelines for genetic testing for inherited
colorectal cancer (Lynch syndrome, familial adenomatous polyposis, and MYHassociated polyposis).
SUMMARY: - Link
JOURNAL: - Genet Med. 2014 Jan;16(1):101-16. doi: 10.1038/gim.2013.166. Epub 2013
Dec 5.
*** Link to the complete text (free or ppv) 1038/gim.2013.166
AUTHOR: - Hegde M; ADDRESS: - Department of Human Genetics, Emory University
School of Medicine, Atlanta, Georgia, USA.
AUTHOR: - Ferber M; ADDRESS: - Mayo Clinic, Rochester, Minnesota, USA.
AUTHOR: - Mao R; ADDRESS: - Mayo Clinic, Salt Lake City, Utah, USA.
AUTHOR: - Samowitz W; ADDRESS: - Mayo Clinic, Salt Lake City, Utah, USA.
AUTHOR: - Ganguly A; ADDRESS: - University of Pennsylvania, Philadelphia, Pennsylvania,
USA.
SUMMARY: - Lynch syndrome, familial adenomatous polyposis, and Mut Y homolog
(MYH)-associated polyposis are three major known types of inherited colorectal
cancer, which accounts for up to 5% of all colon cancer cases. Lynch syndrome is most
frequently caused by mutations in the mismatch repair genes MLH1, MSH2, MSH6, and
PMS2 and is inherited in an autosomal dominant manner. Familial adenomatous
polyposis is manifested as colonic polyposis caused by mutations in the APC gene and
is also inherited in an autosomal dominant manner. Finally, MYH-associated polyposis
is caused by mutations in the MUTYH gene and is inherited in an autosomal recessive
manner but may or may not be associated with polyps. There are variants of both
familial adenomatous polyposis (Gardner syndrome-with extracolonic features-and
Turcot syndrome, which features medulloblastoma) and Lynch syndrome (Muir-Torre
syndrome features sebaceous skin carcinomas, and Turcot syndrome features
glioblastomas). Although a clinical diagnosis of familial adenomatous polyposis can be
made using colonoscopy, genetic testing is needed to inform at-risk relatives. Because
of the overlapping phenotypes between attenuated familial adenomatous polyposis,
MYH-associated polyposis, and Lynch syndrome, genetic testing is needed to
distinguish among these conditions. This distinction is important, especially for women
with Lynch syndrome, who are at increased risk for gynecological cancers. Clinical
testing for these genes has progressed rapidly in the past few years with advances in
technologies and the lower cost of reagents, especially for sequencing. To assist clinical
laboratories in developing and validating testing for this group of inherited colorectal
cancers, the American College of Medical Genetics and Genomics has developed the
following technical standards and guidelines. An algorithm for testing is also
proposed.Genet Med 16 1, 101-116.
-------------------------------------------------------------[26]
TITLE: - A systematic review on the safety and efficacy of yttrium-90 radioembolization
for unresectable, chemorefractory colorectal cancer liver metastases.
SUMMARY: - Link
JOURNAL: - J Cancer Res Clin Oncol. 2013 Dec 7.
*** Link to the complete text (free or ppv) 1007/s00432-013-1564-4
AUTHOR: - Saxena A; ADDRESS: - UNSW Department of Surgery, St George Hospital,
Kogarah, NSW, 2217, Australia, [email protected]
AUTHOR: - Bester L
AUTHOR: - Shan L
AUTHOR: - Perera M
AUTHOR: - Gibbs P
AUTHOR: - Meteling B
AUTHOR: - Morris DL
SUMMARY: - INTRODUCTION: The management of unresectable, chemorefractory
colorectal cancer liver metastases (CRCLM) is a clinical dilemma. Yttrium-90 (Y90)
radioembolization is a potentially safe and effective treatment for patients with
CRCLM who have failed conventional chemotherapy regimens. METHODS: A
systematic review of clinical studies before November 2012 was performed to examine
the radiological response, overall survival and progression-free survival of patients who
underwent Y90 radioembolization of unresectable CRCLM refractory to systemic
therapy. The secondary objectives were to evaluate the safety profile of this treatment
and identify prognostic factors for overall survival. RESULTS: Twenty studies
comprising 979 patients were examined. Patients had failed a median of 3 lines of
chemotherapy (range 2-5). After treatment, the average reported value of patients
with complete radiological response, partial response and stable disease was 0 %
(range 0-6 %), 31 % (range 0-73 %) and 40.5 % (range 17-76 %), respectively. The
median time to intra-hepatic progression was 9 months (range 6-16). The median
overall survival was 12 months (range 8.3-36). The overall acute toxicity rate ranged
from 11 to 100 % (median 40.5 %). Most cases of acute toxicity were mild (Grade I or
II) (median 39 %; range 7-100 %) which resolved without intervention. The number of
previous lines of chemotherapy (>/=3), poor radiological response to treatment, extrahepatic disease and extensive liver disease (>/=25 %) were the factors most commonly
associated with poorer overall survival. CONCLUSION: Y90 radioembolization is a safe
and effective treatment of CRCLM in the salvage setting and should be more widely
utilized.
-------------------------------------------------------------[27]
TITLE: - The rationale behind complete mesocolic excision (CME) and a central vascular
ligation for colon cancer in open and laparoscopic surgery : Proceedings of a consensus
conference.
SUMMARY: - Link
JOURNAL: - Int J Colorectal Dis. 2014 Jan 31.
*** Link to the complete text (free or ppv) 1007/s00384-013-1818-2
AUTHOR: - Sondenaa K; ADDRESS: - Department of Surgery, Haraldsplass Deaconess
Hospital, POB 6165, 5892, Bergen, Norway, [email protected]
AUTHOR: - Quirke P
AUTHOR: - Hohenberger W
AUTHOR: - Sugihara K
AUTHOR: - Kobayashi H
AUTHOR: - Kessler H
AUTHOR: - Brown G
AUTHOR: - Tudyka V
AUTHOR: - D’Hoore A
AUTHOR: - Kennedy RH
AUTHOR: - West NP
AUTHOR: - Kim SH
AUTHOR: - Heald R
AUTHOR: - Storli KE
AUTHOR: - Nesbakken A
AUTHOR: - Moran B
SUMMARY: - BACKGROUND: It has been evident for a while that the result after
resection for colon cancer may not have been optimal. Several years ago, this was
showed by some leading surgeons in the USA but a concept of improving results was
not consistently pursued. Later, surgeons in Europe and Japan have increasingly
adopted the more radical principle of complete mesocolic excision (CME) as the
optimal approach for colon cancer. The concept of CME is a similar philosophy to that
of total mesorectal excision for rectal cancer and precise terminology and optimal
surgery are key factors. METHOD: There are three essential components to CME. The
main component involves a dissection between the mesenteric plane and the parietal
fascia and removal of the mesentery within a complete envelope of mesenteric fascia
and visceral peritoneum that contains all lymph nodes draining the tumour area
(Hohenberger et al., Colorectal Disease 11:354-365, 2009; West et al., J Clin Oncol
28:272-278, 2009). The second component is a central vascular tie to completely
remove all lymph nodes in the central (vertical) direction. The third component is
resection of an adequate length of bowel to remove involved pericolic lymph nodes in
the longitudinal direction. RESULT: The oncological rationale for CME and various
technical aspects of the surgical management will be explored. CONCLUSION: The
consensus conference agreed that there are sound oncological hypotheses for a more
radical approach than has been common up to now. However, this may not necessarily
apply in early stages of the tumour stage. Laparoscopic resection appears to be equally
well suited for resection as open surgery.
-------------------------------------------------------------[28]
TITLE: - Anal canal gastrointestinal stromal tumors: Case report and literature review.
SUMMARY: - Link
JOURNAL: - World J Gastroenterol. 2014 Jan 7;20(1):319-22. doi:
10.3748/wjg.v20.i1.319.
*** Link to the complete text (free or ppv) 3748/wjg.v20.i1.319
AUTHOR: - Carvalho N; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao Giria,
Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada, Portugal.
AUTHOR: - Albergaria D; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao
Giria, Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada,
Portugal.
AUTHOR: - Lebre R; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao Giria,
Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada, Portugal.
AUTHOR: - Giria J; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao Giria,
Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada, Portugal.
AUTHOR: - Fernandes V; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao
Giria, Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada,
Portugal.
AUTHOR: - Vidal H; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao Giria,
Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada, Portugal.
AUTHOR: - Brito MJ; ADDRESS: - Nuno Carvalho, Diogo Albergaria, Rui Lebre, Joao Giria,
Department of General Surgery, Garcia de Orta Hospital, 2801-951 Almada, Portugal.
SUMMARY: - Gastrointestinal stromal tumors (GIST) are an uncommon group of tumors
of mesenchymal origin. GIST of the anal canal is extremely rare. At present, only 10
cases of c-kit positive anal GIST have been reported in the literature. There is no widely
accepted treatment approach for this neoplasia. Literature is sparse on imaging
evaluation of anal canal GIST, usually described as a lesion in the intersphincteric
space. We describe the case of a 73-year-old man with a mass in the anal canal, and no
other symptoms. Endoanal ultrasound and magnetic resonance imaging showed a well
circumscribed solid nodule in the intersphincteric space. The patient was treated by
local excision. Gross pathological examination showed a 7 cm x 3.5 cm x 3 cm mass,
and histological examination showed a proliferation of spindle cells, with prominent
nuclear palisading. The mitotic count was of 12 mitoses/50 HPF. The tumor was
positive for KIT protein, CD34 and vimentin in the majority of cells, and negative for
desmin and S100. A diagnosis of GIST, with high risk aggressive behavior was made. An
abdomino-perineal resection was discussed, but refused. The follow-up included
clinical evaluation and anal ultrasound. After 5 years the patient is well, with
maintained continence and no evidence of local recurrence.
-------------------------------------------------------------[29]
TITLE: - Observational cross-sectional study of compliance with the fast track protocol in
elective surgery for colon cancer in España.
SUMMARY: - Link
JOURNAL: - Int J Colorectal Dis. 2014 Jan 17.
*** Link to the complete text (free or ppv) 1007/s00384-013-1825-3
AUTHOR: - Alcantara-Moral M; ADDRESS: - General and Digestive Surgery Service, Hospital
Universitario Parc Tauli, Parc Tauli s/n, 08208, Sabadell, Barcelona, España,
[email protected]
AUTHOR: - Serra-Aracil X
AUTHOR: - Gil-Egea MJ
AUTHOR: - Frasson M
AUTHOR: - Flor-Lorente B
AUTHOR: - Garcia-Granero E
SUMMARY: - PURPOSE: The purpose of this study was to establish the degree of
compliance with the fast track (enhanced recovery) protocol in habitual clinical
practice and to determine which measures are fundamental for achieving the results
obtained by applying the entire protocol. METHODS: Observational, cross-sectional,
multicenter trial was conducted. Participating hospitals prospectively recorded data
from at least ten consecutive patients undergoing surgery for colon cancer who were
applied some or all of the items comprising the enhanced recovery protocol. The data
were analyzed both globally and dividing the sample into the two groups of patients.
RESULTS: Data on 363 patients from 25 hospitals were recorded, one hundred seventythree in the “non-fast track” group and 190 in the “fast track” group. The non-fast
track group complied with a mean of 5.4 (+/-1.8) items and the fast track group with a
mean of 8.4 (+/-1.8) items. The mean functional hospital stay was 7.3 (+/-5.1) days in
the non-fast track group and 6.2 (+/-5.1) days in the fast track group (p < 0.05).
Morbidity was 31.1 % in the fast track group and 24.3 % in the non-fast track group,
though the differences were not statistically significant. The only prognostic factors
that have an impact on improving the results are measures against hypothermia and
mobilization before 24 h. CONCLUSION: Compliance with the enhanced recovery
protocol is not exhaustive in habitual clinical practice. However, greater compliance
was associated with shorter hospital stay without any increase in morbidity. The only
items clearly associated with reduced functional hospital stay were measures against
hypothermia and mobilization before 24 h.
-------------------------------------------------------------[30]
TITLE: - Seminal vesicle-rectal fistula secondary to anastomotic leakage after low
anterior resection for rectal cancer: a case report and brief literature review.
SUMMARY: - Link
JOURNAL: - Int Surg. 2014 Jan-Feb;99(1):23-7. doi: 10.9738/INTSURG-D-13-00164.1.
*** Link to the complete text (free or ppv) 9738/INTSURG-D-13-00164.1
AUTHOR: - Kitazawa M; ADDRESS: - Department of Gastrointestinal Surgery of Iida
Municipal Hospital, Masato Kitazawa, Iida, Japan.
AUTHOR: - Hiraguri M
AUTHOR: - Maeda C
AUTHOR: - Yoshiki M
AUTHOR: - Horigome N
AUTHOR: - Kaneko G
SUMMARY: - Abstract We report a case of a patient with seminal vesicle-rectal fistula, an
extremely rare complication of low anterior resection of the rectum. A 53-year-old
man with rectal adenocarcinoma underwent low anterior resection in our hospital. The
patient experienced diarrhea, pneumaturia, and low-grade fever on postoperative day
13. A computed tomography scan showed emphysema in the right seminal vesicle. We
concluded that anastomotic leakage induced a seminal vesicle-rectal fistula. The
patient underwent conservative therapy with total parenteral nutrition and oral intake
of metronidazole. Diarrhea and pneumaturia rapidly improved after metronidazole
administration and the patient was successfully cured without invasive therapy such as
colostomy or surgical drainage. A seminal vesicle-rectal fistula is a rare complication of
low anterior resection, and therapeutic strategies for this condition remain elusive.
Our report provides valuable information on the successful conservative treatment of
a secondary seminal vesicle-rectal fistula that developed after low anterior resection of
the rectum in a patient.
-------------------------------------------------------------[31]
TITLE: - EURECCA consensus conference highlights about colon & rectal cancer
multidisciplinary management: The radiology experts review.
SUMMARY: - Link
JOURNAL: - Eur J Surg Oncol. 2013 Dec 14. pii: S0748-7983(13)00910-4. doi:
10.1016/j.ejso.2013.10.029.
*** Link to the complete text (free or ppv) 1016/j.ejso.2013.10.029
AUTHOR: - Tudyka V; ADDRESS: - Department of Radiology, The Royal Marsden NHS
Foundation Trust, Fulham Road, London, UK.
AUTHOR: - Blomqvist L; ADDRESS: - European Society of Radiology, Department of
Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden.
AUTHOR: - Beets-Tan RG; ADDRESS: - European Society of Radiology, Department of
Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
AUTHOR: - Boelens PG; ADDRESS: - Scientific Board CC3, Department of Surgery, Leiden
University Medical Center, The Netherlands. Electronic address: [email protected]
AUTHOR: - Valentini V; ADDRESS: - Executive Committee CC3, European Society for
Radiotherapy and Oncology (ESTRO), Department of Radiation Oncology, Universita
Cattolica S. Cuore, Rome, Italy.
AUTHOR: - van de Velde CJ; ADDRESS: - Executive Board of ECCO, European Society of
Surgical Oncology (ESSO), Department of Surgery, Leiden University Medical center,
The Netherlands.
AUTHOR: - Dieguez A; ADDRESS: - Diagnostico Medico, Junin 1023, Ciudad Autonoma de
Buenos Aires, Argentina.
AUTHOR: - Brown G; ADDRESS: - Department of Radiology, The Royal Marsden NHS
Foundation Trust, Fulham Road, London, UK. Electronic address:
[email protected]
SUMMARY: - Some interesting shifts have taken place in the diagnostic approach for
detection of colorectal lesions over the past decade. This article accompanies the
recent EURECCA consensus group reccomendations for optimal management of colon
and rectal cancers. In summary, imaging has a crucial role to play in the diagnosis,
staging assessment and follow up of patients with colon and rectal cancer. Recent
advances include the use of CT colonography instead of Barium Enema in the diagnosis
of colonoic cancer and as an alternative to colonoscopy. Modern mutlidetector CT
scanning techniques have also shown improvements in prognostic stratification of
patients with colonic cancer and clinical trials are underway testing the selective use of
neoadjuvant therapy for imaging identified high risk colon cancers. In rectal cancer,
high resolution MRI with a voxel size less or equal to 3 x 1 x 1 mm3 on T2-weighted
images has a proven ability to accurately stage patients with rectal cancer. Moreover,
preoperative identification of prognostic features allows stratification of patients into
different prognostic groups based on assessment of depth of extramural spread,
relationship of the tumour edge to the mesorectal fascia (MRF) and extramural venous
invasion (EMVI). These poor prognostic features predict an increased risk of local
recurrence and/or metastatic disease and should form the basis for preoperative local
staging and multidisciplinary preoperative discussion of patient treatment options.
-------------------------------------------------------------[32]
TITLE: - Lymph node staging in colorectal cancer: old controversies and recent
advances.
SUMMARY: - Link
JOURNAL: - World J Gastroenterol. 2013 Dec 14;19(46):8515-26. doi:
10.3748/wjg.v19.i46.8515.
*** Link to the complete text (free or ppv) 3748/wjg.v19.i46.8515
AUTHOR: - Resch A; ADDRESS: - Annika Resch, Cord Langner, Institute of Pathology,
Medical University of Graz, 8036 Graz, Austria.
AUTHOR: - Langner C; ADDRESS: - Annika Resch, Cord Langner, Institute of Pathology,
Medical University of Graz, 8036 Graz, Austria.
SUMMARY: - Outcome prediction based on tumor stage reflected by the American Joint
Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) tumor
node metastasis (TNM) system is currently regarded as the strongest prognostic
parameter for patients with colorectal cancer. For affected patients, the indication for
adjuvant therapy is mainly guided by the presence of regional lymph node metastasis.
In addition to the extent of surgical lymph node removal and the thoroughness of the
pathologist in dissecting the resection specimen, several parameters that are related
to the pathological work-up of the dissected nodes may affect the clinical significance
of lymph node staging. These include changing definitions of lymph nodes, involved
lymph nodes, and tumor deposits in different editions of the AJCC/UICC TNM system
as well as the minimum number of nodes to be dissected. Methods to increase the
lymph node yield in the fatty tissue include methylene blue injection and acetone
compression. Outcome prediction based on the lymph node ratio, defined as the
number of positive lymph nodes divided by the total number of retrieved nodes, may
be superior to the absolute numbers of involved nodes. Extracapsular invasion has
been identified as additional prognostic factor. Adding step sectioning and
immunohistochemistry to the pathological work-up may result in higher accuracy of
histological diagnosis. The clinical value of more recent technical advances, such as
sentinel lymph node biopsy and molecular analysis of lymph nodes tissue still remains
to be defined.
-------------------------------------------------------------[33]
TITLE: - Excess adiposity and survival in patients with colorectal cancer: a systematic
review.
SUMMARY: - Link
JOURNAL: - Obes Rev. 2014 Jan 17. doi: 10.1111/obr.12140.
*** Link to the complete text (free or ppv) 1111/obr.12140
AUTHOR: - Parkin E; ADDRESS: - Institute of Cancer Sciences, University of Manchester,
Manchester, UK; Department of Hepatobiliary Surgery, North Manchester General
Hospital, Manchester, UK.
AUTHOR: - O’Reilly DA
AUTHOR: - Sherlock DJ
AUTHOR: - Manoharan P
AUTHOR: - Renehan AG
SUMMARY: - Excess adiposity is an established risk factor for incident colorectal cancer
(CRC) but whether this association extrapolates to poorer survival is unclear. We
undertook a systematic review to examine relationships between measures of
adiposity and survival in patients with CRC. For distinction, we included pre-diagnosis
exposure and CRC-related mortality. We performed dose-response meta-analyses and
assessed study quality using eight domains of bias. Six study categories were identified
based on (i) timing of adiposity measurement relative to survival analysis time zero and
(ii) clinical setting. Several types of adiposity measurements were reported; body mass
index (BMI) was the commonest. For pre-diagnosis cohorts, baseline BMI negatively
impacted on CRC-related mortality in men only (risk estimate per 5 kg m-2 = 1.19, 95%
confidence intervals: 1.14-1.25). The other groups were pre-diagnosis BMI but
diagnosis as time zero; population-based cohorts; treatment cohorts; observational
analyses within adjuvant chemotherapy trials; patients with metastatic CRC - each had
several biases (e.g. treatment selection, reverse causality) and sources of confounding
(e.g. chemotherapy ‘capping’). Overall, there was insufficient evidence for a strong link
between adiposity and survival. These findings demonstrate an important principle: an
established link between an exposure (here, adiposity) and increased cancer incidence
does not necessarily extrapolate into an inferior post-treatment outcome.
-------------------------------------------------------------[34]
TITLE: - Capecitabine Plus Irinotecan Versus 5-FU/Leucovorin Plus Irinotecan in the
Treatment of Colorectal Cancer: A Meta-analysis.
SUMMARY: - Link
JOURNAL: - Clin Colorectal Cancer. 2013 Dec 27. pii: S1533-0028(13)00131-X. doi:
10.1016/j.clcc.2013.12.004.
*** Link to the complete text (free or ppv) 1016/j.clcc.2013.12.004
AUTHOR: - Guo Y; ADDRESS: - Department of Traditional Chinese Medicine, Ruijin
Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
AUTHOR: - Shi M; ADDRESS: - Department of Surgery, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China; Shanghai Institute of Digestive
Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai,
China.
AUTHOR: - Shen X; ADDRESS: - Department of Traditional Chinese Medicine, Ruijin
Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
AUTHOR: - Yang C; ADDRESS: - Department of Surgery, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China.
AUTHOR: - Yang L; ADDRESS: - Department of Surgery, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China.
AUTHOR: - Zhang J; ADDRESS: - Department of Surgery, Ruijin Hospital, Shanghai Jiaotong
University School of Medicine, Shanghai, China; Shanghai Institute of Digestive
Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai,
China. Electronic address: [email protected]
SUMMARY: - BACKGROUND: The XELIRI regimen and FOLFIRI regimen are used as the
first-line treatment of metastatic colorectal cancer. A comparison of findings from
different studies that examined the efficacy and safety of these 2 regimens often show
conflicting results. This metaanalysis compared the XELIRI and FOLFIRI regimens in the
treatment of mCRC. PATIENTS AND METHODS: Six studies comparing the safety and
efficacy of XELIRI- and FOLFIRI-based treatment of mCRC were identified from
MEDLINE, Cochrane, EMBASE, and Google Scholar (until January 31, 2013) databases.
RESULTS: No significant difference in ORR, PFS, or OS between XELIRI and FOLFIRI as
first-line therapy in patients with colorectal cancer was found in this analysis. Except
for XELIRI being associated with a higher incidence of diarrhea, both treatment
regimens had similar safety profiles. CONCLUSION: Both XELIRI and FOLFIRI regimens
had similar efficacy as first-line treatment in patients with mCRC with similar adverse
event profiles. Our findings suggest that XELIRI and FOLFIRI are appropriate first-line
treatment options for mCRC patients.
-------------------------------------------------------------[35]
TITLE: - The Role of Src in Colon Cancer and Its Therapeutic Implications.
SUMMARY: - Link
JOURNAL: - Clin Colorectal Cancer. 2014 Mar;13(1):5-13. doi:
10.1016/j.clcc.2013.10.003. Epub 2013 Nov 13.
*** Link to the complete text (free or ppv) 1016/j.clcc.2013.10.003
AUTHOR: - Chen J; ADDRESS: - School of Biomedical Sciences, University of Queensland, St
Lucia, Australia.
AUTHOR: - Elfiky A; ADDRESS: - Dana Farber Cancer Center, Boston, MA.
AUTHOR: - Han M; ADDRESS: - Illawarra Health and Medical Research Institute, University
of Wollongong, Wollongong, Australia.
AUTHOR: - Chen C; ADDRESS: - School of Biomedical Sciences, University of Queensland, St
Lucia, Australia.
AUTHOR: - Saif MW; ADDRESS: - Gastrointestinal Colorectal Oncology Program and
Experimental Therapeutics Program, Tufts Medical Center, Tufts University School of
Medicine, Boston, MA. Electronic address: [email protected]
SUMMARY: - Src is a member of a superfamily of membrane-associated nonreceptor
protein tyrosine kinases. It is stimulated by receptors of growth hormone, cytokines,
and adipokines, and it regulates multiple signaling pathways, including
phosphatidylinositide 3 kinase-Akt, mitogen-activated protein kinase, signal transducer
and activator of transcription 3, interleukin 8, and vascular endothelial growth factor
pathways, and cytoskeletal pathways to cause a cascade of cellular responses. Eighty
percent of patients with colon cancer overexpress Src in tumor tissue. Evidence has
shown that the overexpression of Src in colon cancer accelerates metastasis and
causes chemotherapeutic drug resistance via multiple downstream signaling pathways.
Therefore, the inhibition of Src may be useful for the treatment of colon cancer.
However, the inhibition of Src may also weaken immune responses that are essential
for the eradication of cancer cells. Overcoming the problem of inhibiting Src in cancer
cells while retaining immune system efficacy is the key to the successful application of
Src-inhibition therapy. Different Src family members are used by the immune system
and colon cancer. This differential use may provide a good opportunity to develop Src
family member-specific inhibitors to avoid immune inhibition.
-------------------------------------------------------------[36]
TITLE: - Systematic review and meta-analysis of published trials comparing the
effectiveness of transanal endoscopic microsurgery and radical resection in the
management of early rectal cancer.
SUMMARY: - Link
JOURNAL: - Colorectal Dis. 2014 Jan;16(1):2-14. doi: 10.1111/codi.12474.
*** Link to the complete text (free or ppv) 1111/codi.12474
AUTHOR: - Sajid MS; ADDRESS: - Department of General and Laparoscopic Colorectal
Surgery, Western Sussex Hospitals NHS Trust, Worthing Hospital, Worthing, UK.
AUTHOR: - Farag S
AUTHOR: - Leung P
AUTHOR: - Sains P
AUTHOR: - Miles WF
AUTHOR: - Baig MK
SUMMARY: - AIM: A systematic analysis was conducted of trials comparing the
effectiveness of transanal endoscopic microsurgery (TEMS) with radical resection (RR)
for T1 and T2 rectal cancer. METHOD: An electronic search was carried out of trials
reporting the effectiveness of TEMS and RR in the treatment of T1 and T2 rectal
cancers. RESULTS: Ten trials including 942 patients were retrieved. There was a trend
toward a higher risk of local recurrence (odds ratio 2.78; 95% confidence interval 1.42,
5.44; z = 2.97; P < 0.003) and overall recurrence (P < 0.01) following TEMS compared
with RR. The risk of distant recurrence, overall survival (odds ratio 0.90; 95%
confidence interval 0.49, 1.66; z = 0.33; P = 0.74) and mortality was similar. TEMS was
associated with a shorter operation time and hospital stay and a reduced risk of
postoperative complications (P < 0.0001). The included studies, however, were
significantly diverse in stage and grade of rectal cancer and the use of neoadjuvant
chemoradiotherapy. CONCLUSION: Transanal endoscopic microsurgery appears to
have clinically measurable advantages in patients with early rectal cancer. The studies
included in this review do not allow firm conclusions as to whether TEMS is superior to
RR in the management of early rectal cancer. Larger, better designed and executed
prospective studies are needed to answer this question.
-------------------------------------------------------------[37]
TITLE: - What is the optimal means of staging colon cancer?
SUMMARY: - Link
JOURNAL: - Adv Surg. 2013;47:199-211.
AUTHOR: - Arena EA; ADDRESS: - Department of Surgical Oncology, John Wayne Cancer
Institute, Saint John’s Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA
90404, USA.
AUTHOR: - Bilchik AJ
SUMMARY: - Although staging for colon cancer has become more complex over time, it
is not clear that this complexity has improved prognostic assessment. Even with
revisions in the 7th edition of the AJCC staging system, a clear rank order of prognosis
from substage to substage has not been established. Improved staging models will
need to be developed, and attempts at further identifying those high-risk patients
within each stage may be clinically useful. Through improved quality measures with
lymph node yield, advances in colon cancer staging accuracy have been made over the
last decade. Determining how to incorporate ultrastaging and molecular techniques
will be the challenge for future staging models.
-------------------------------------------------------------[38]
TITLE: - Proximal colon cancer and serrated adenomas - hunting the missing 10%.
SUMMARY: - Link
JOURNAL: - Clin Med. 2013 Dec;13(6):557-61. doi: 10.7861/clinmedicine.13-6-557.
*** Link to the complete text (free or ppv) 7861/clinmedicine.13-6-557
AUTHOR: - Gill P; ADDRESS: - Department of Cellular Pathology, Oxford University
Hospitals, Oxford, UK.
AUTHOR: - Rafferty H
AUTHOR: - Munday D
AUTHOR: - Bailey A
AUTHOR: - Wang LM
AUTHOR: - East JE
AUTHOR: - Chetty R
AUTHOR: - Leedham SJ
SUMMARY: - There is a 10% shortfall in the number of proximal colorectal cancer cases
detected by the UK Bowel Cancer Screening Programme and the actual number of UKregistered proximal colorectal cancers. Sessile serrated adenomas/polyps (SSA/P) are
common premalignant lesions in the proximal colon and are notoriously difficult to
spot endoscopically. Missed or dismissed SSA/Ps might contribute to this UK proximal
colon cancer detection disparity. In Oxfordshire, a service evaluation audit and
histological review has shown a linear increase in the detection rate of these lesions
over the past 4 years. This is the result of increased endoscopist and pathologist
awareness of these lesions and improved interdisciplinary communication. This is the
result of increased endoscopist and pathologist awareness of these lesions, together
with improved interdisciplinary communication, and we predict that this will lead to a
comparable detection increase nationwide. Ongoing surveillance of an increasing
number of these premalignant lesions could become a significant endoscopic resource
requirement once UK guidelines on serrated lesion follow up are established.
-------------------------------------------------------------[39]
TITLE: - Laparoscopic Versus Open Surgery Following Neoadjuvant Chemoradiotherapy
for Rectal Cancer: a Systematic Review and Meta-analysis.
SUMMARY: - Link
JOURNAL: - J Gastrointest Surg. 2014 Jan 15.
*** Link to the complete text (free or ppv) 1007/s11605-014-2452-1
AUTHOR: - Chen H; ADDRESS: - Department of General Surgery, Nanfang Hospital,
Southern Medical University, No.1838, North Guangzhou Avenue, Guangzhou, 510515,
China.
AUTHOR: - Zhao L
AUTHOR: - An S
AUTHOR: - Wu J
AUTHOR: - Zou Z
AUTHOR: - Liu H
AUTHOR: - Li G
SUMMARY: - BACKGROUND: This meta-analysis aimed to evaluate the short-term and
pathological outcomes of laparoscopic surgery (LS) versus open surgery (OS) following
neoadjuvant chemoradiotherapy (NCRT) for rectal cancer. METHODS: PubMed,
Embase, Web of Science, Cochrane Library, and Chinese Biomedicine Literature
databases were searched for eligible studies published up to July 2013. The rates of
postoperative complication, positive circumferential resection margin (CRM), and the
number of lymph nodes harvested were evaluated. RESULTS: Three randomized
controlled trials (RCTs) and five non-RCTs enrolling 953 patients were included.
Compared to OS, LS had similar rate of postoperative complication [odds ratio (OR)
0.86; 95 % confidence interval (CI), 0.60 to 1.22], comparable rate of positive CRM (OR
0.41; 95 % CI, 0.16 to 1.02), and smaller number of lymph nodes (weighted mean
difference -0.8; 95 % CI, -1.1 to -0.5). LS also had significantly less blood loss, faster
bowel movement recovery, and shorter postoperative hospitalization than those of
OS. CONCLUSION: LS is associated with favorable short-term benefits, similar
postoperative complication rate, and comparable pathological outcomes for rectal
cancer after NCRT compared to OS despite a slight difference in the number of lymph
nodes. Additional high-quality studies are needed to validate long-term outcomes of LS
following NCRT.
-------------------------------------------------------------[40]
TITLE: - Laparoscopic colon resection: is it being utilized?
SUMMARY: - Link
JOURNAL: - Adv Surg. 2013;47:29-43.
AUTHOR: - Langenfeld SJ; ADDRESS: - Department of Surgery, University of Nebraska
Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, USA.
AUTHOR: - Thompson JS
AUTHOR: - Oleynikov D
SUMMARY: - Since its inception, the use of laparoscopy for colon surgery has slowly
increased, albeit at a slower rate than for cholecystectomy. Initial concerns about the
safety and efficacy of laparoscopy have been addressed, and it is now known to have
several potential short-term and long-term benefits for the patient. Early studies likely
underestimated use of laparoscopy because of coding error. Currently, 40% to 50% of
colectomies in the United States are performed laparoscopically, with a 10% to 20%
rate of conversion to an open operation. The definitions oflaparoscopy and conversion
to open remain at the discretion of the surgeons and their coders. Disparities still exist
among use based on several patient, hospital, and surgeon factors. In the future, we
will likely see a continuing increase in use as the new generation of surgeons enters
practice, and there will be an increasing role for laparoscopy in rectal surgery. The
benefit and extent of robotic surgery, natural orifice surgery, and single-incision
surgery for minimally invasive colectomies are yet to be defined.
-------------------------------------------------------------[41]
TITLE: - Efficacy and safety of first-line chemotherapy plus bevacizumab in patients with
metastatic colorectal cancer: a meta-analysis.
SUMMARY: - Link
JOURNAL: - Chin Med J (Engl). 2014 Feb;127(3):538-46.
AUTHOR: - Wang M; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated
Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Zheng X; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated
Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Ruan X; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated
Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Ye B; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated Hospital
of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Cai L; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated Hospital
of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Lin F; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated Hospital
of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Tu J; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated Hospital
of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Jiang F; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated
Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
AUTHOR: - Li S; ADDRESS: - Department of Laparoscopic Surgery, First Affiliated Hospital
of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China. Email:
[email protected]
SUMMARY: - BACKGROUND: What benefits and toxicities patients acquire from the use
of bevacizumab combined with firstline chemotherapy remains controversial. This
study was performed to evaluate the efficacy and safety of first-line chemotherapy
plus bevacizumab in patients with metastatic colorectal cancer (mCRC). METHODS:
Several databases, including PubMed, Embase, and Cochrane Library, were searched
up to April 30, 2013. Eligible studies were only randomized, controlled trials (RCTs)
with a direct comparison between mCRC patients treated with and without
bevacizumab. Overall risk ratio (RR), hazard ratio (HR), odds ratio (OR), and 95%
confidence intervals (CI) were calculated employing fixed or random-effects models
depending on the heterogeneity of the included trials. RESULTS: Six RCTs, including
1582 patients in chemotherapy plus bevacizumab group and 1484 patients in
chemotherapyalone group, were included. Overall, the addition of bevacizumab to
first-line chemotherapy increased overall response rate (ORR) by 4.5%, prolonged both
progression-free survival (PFS) and overall survival (OS), and increased the rate of total
Grades 3 or 4 adverse events (G3/4AEs) by 6.9%. Significant differences were found in
ORR (RR = 1.22 (95% CI 1.01-1.46), P = 0.03), PFS (HR = 0.60 (95% CI 0.47-0.77), P <
0.0001), OS (HR = 0.83 (95% CI 0.70-0.97), P = 0.02), and any G3/4AEs (OR = 1.56 (95%
CI 1.29-1.89), P < 0.00001). CONCLUSION: Bevacizumab is a valuable addition to the
current first-line chemotherapy regimens used in patients with mCRC, because of
conferring a significant improvement in ORR, PFS, and OS, even though it increased
adverse events.
-------------------------------------------------------------[42]
TITLE: - Current treatment of rectal cancer adapted to the individual patient.
SUMMARY: - Link
JOURNAL: - Rep Pract Oncol Radiother. 2013 Oct 3;18(6):353-362. eCollection 2013.
*** Link to the complete text (free or ppv) 1016/j.rpor.2013.08.005
AUTHOR: - Cerezo L; ADDRESS: - Department of Radiation Oncology, Hospital Universitario
de la Princesa, Madrid, España.
AUTHOR: - Ciria JP; ADDRESS: - Department of Radiation Oncology, Instituto de
Oncohematologia, Hospital Universitario Donostia, Donostia, España.
AUTHOR: - Arbea L; ADDRESS: - Departmet of Radiation Oncology, Clinica Universidad de
Navarra, España.
AUTHOR: - Linan O; ADDRESS: - Department of Radiation Oncology, Hospital Universitario
de la Princesa, Madrid, España.
AUTHOR: - Cafiero S; ADDRESS: - Department of Radiation Oncology, Instituto de
Oncohematologia, Hospital Universitario Donostia, Donostia, España.
AUTHOR: - Valentini V; ADDRESS: - Department of Radiotherapy, Universita Cattolica del
Sacro Cuore, Policlinico A.Gemelli, Rome, Italy.
AUTHOR: - Cellini F; ADDRESS: - Department of Radiation Oncology, Universita Campus
Bio-Medico, Rome, Italy.
SUMMARY: - Preoperative radiochemotherapy and total mesorectal excision surgery is a
recommended standard therapy for patients with locally advanced rectal cancer.
However, some subgroups of patients benefit more than others from this approach. In
order to avoid long-term complications of radiation and chemotherapy, efforts are
being made to subdivide T3N0 stage using advanced imaging techniques, and to
analyze prognostic factors that help to define subgroup risk patients. Long-course
radiochemotherapy has the potential of downsizing the tumor before surgery and may
increase the chance of sphincter preservation in some patients. Short-course
radiotherapy (SCRT), on the other hand, is a practical schedule that better suits
patients with intermediated risk tumors, located far from the anal margin. SCRT is also
increasingly being used among patients with disseminated disease, before resection of
the rectal tumor. Improvements in radiation technique, such as keeping the irradiation
target below S2/S3 junction, and the use of IMRT, can reduce the toxicity associated
with radiation, specially long-term small bowel toxicity.
-------------------------------------------------------------[43]
TITLE: - Helicobacter pylori Infection and the Risk of Colorectal Adenoma and
Adenocarcinoma: an Updated Meta-analysis of Different Testing Methods.
SUMMARY: - Link
JOURNAL: - Asian Pac J Cancer Prev. 2013;14(12):7613-9.
AUTHOR: - Chen YS; ADDRESS: - Department of Gastroenterology, Yangzhou NO.1
People’s Hospital, Yangzhou, China E-mail : [email protected]
AUTHOR: - Xu SX
AUTHOR: - Ding YB
AUTHOR: - Huang XE
AUTHOR: - Deng B
SUMMARY: - Background and Aims: Helicobacter pylori infection may be associated with
an increased risk of colorectal carcinoma. However, as most studies on this subject
were relatively small in size and differed at least partially in their designs, their results
remain controversial. In this study, we aimed to carry out a meta-analysis to evaluate
the potential association of H. pylori infection with colorectal adenoma and
adenocarcinoma risk, covering all of the different testing methods. Methods: We
conducted a search in PubMed, Medline, EBSCO, High Wire Press, OVID, and EMBASE
covering all published papers up to March 2013. According to the established inclusion
criteria, essential data were then extracted from the included studies and further
analyzed by a systematic meta-analysis. Odds ratios were employed to evaluate the
relationship between H. pylori infection and the risk of colorectal neoplasms. Results:
Twenty-two studies were included, and the odds ratio for the association between H.
pylori infection and colorectal cancer was 1.49 (95% confidence interval 1.30-1.72). No
statistically significant heterogeneity was observed. Publication bias was ruled out.
Conclusion: The pooled data suggest H. pylori infection indeed increases the risk of
colorectal adenoma and adenocarcinoma.
-------------------------------------------------------------[44]
TITLE: - Panitumumab in the management of patients with KRAS wild-type metastatic
colorectal cancer.
SUMMARY: - Link
JOURNAL: - Therap Adv Gastroenterol. 2014 Jan;7(1):20-37.
*** Link to the complete text (free or ppv) 1177_1756283X13498660 [pii
*** Link to the complete text (free or ppv) 1177/1756283X13498660
AUTHOR: - Hocking CM; ADDRESS: - Department of Medical Oncology, The Queen
Elizabeth Hospital, Woodville, SA, Australia.
AUTHOR: - Price TJ; ADDRESS: - Department of Medical Oncology, TQEH, Woodville,
Woodville Road, Woodville, SA 5011, Australia.
SUMMARY: - The past 15 years has seen a marked increase in available therapeutic
options for patients with metastatic colorectal cancer resulting in improvements in
median survival from 12 to 24 months. One of these new options is panitumumab,
which is a fully humanized monoclonal antibody that binds to the epidermal growth
factor receptor of tumor cells and inhibits downstream cell signaling with antitumor
effects of inhibition of tumor growth, induction of apoptosis and inhibition of
angiogenesis. Large randomized clinical trials have demonstrated significant
improvements in tumor response rates and progression-free survival when
panitumumab is combined with chemotherapy and as monotherapy in
chemorefractory metastatic colorectal cancer. Clinical benefit with panitumumab is
limited to patients with nonmutated KRAS tumors. Rash is a common toxicity of
panitumumab treatment but can potentially be ameliorated with the use of
prophylactic strategies. The role of panitumumab in the overall treatment of
metastatic colorectal cancer is evolving and future clinical trials will focus on improved
patient selection through use of novel predictive biomarkers, and the optimal timing of
treatment.
-------------------------------------------------------------[45]
TITLE: - Per magna-ovarian metastases from primary locally advanced colorectal
cancer—a review of the literature with a description of three clinical cases.
SUMMARY: - Link
JOURNAL: - Khirurgiia (Sofiia). 2013;(3):39-47.
AUTHOR: - Sokolov M; ADDRESS: - Department of Surgery, Medical University of Sofia,
“Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria.
[email protected]
AUTHOR: - Toshev S; ADDRESS: - Department of Surgery, Medical University of Sofia,
“Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria.
AUTHOR: - Todorov G; ADDRESS: - Department of Surgery, Medical University of Sofia,
“Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria.
AUTHOR: - Velev G; ADDRESS: - Department of Surgery, Medical University of Sofia,
“Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria.
AUTHOR: - Maslyankov C; ADDRESS: - Department of Surgery, Medical University of Sofia,
“Alexandrovska” University Hospital, Medical University, Sofia, Bulgaria.
SUMMARY: - Krukenberg tumor is defined as metastatic lesions of gastrointestinal
cancers. Several specific immunohistochemical methods can identify the main focus of
malignant neoplasm. Ovarian metastases from colorectal cancer are rarely seen
phenomenon. The authors examine in detail the literature on this issue and describe
three own clinical cases of metachronous ovarian meta lesions in women undergoing
surgery for locally advanced colorectal cancer—two of these metastases are unilateral,
while one—bilateral established in a short time interval despite the casuistic nature of
the pathology. One of the patients died in the early postoperative period of co-morbid
complications unrelated to the underlying disease, and the other two monitoring
continues during the adjuvant. Krukenberg-metastases from colorectal cancer occur in
the blood-vascular pattern in time without damage to the left or right ovary.
Metachronous development and operative treatment of ovarian metastases is far
better prognosis of the cases with and operated simultaneously established
metastases in the ovaries.
-------------------------------------------------------------[46]
TITLE: - Health related quality of life in colorectal cancer patients: state of the art.
SUMMARY: - Link
JOURNAL: - BMC Surg. 2013;13 Suppl 2:S15. doi: 10.1186/1471-2482-13-S2-S15. Epub
2013 Oct 8.
*** Link to the complete text (free or ppv) 1186/1471-2482-13-S2-S15
AUTHOR: - Marventano S
AUTHOR: - Forjaz M
AUTHOR: - Grosso G
AUTHOR: - Mistretta A
AUTHOR: - Giorgianni G
AUTHOR: - Platania A
AUTHOR: - Gangi S
AUTHOR: - Basile F
AUTHOR: - Biondi A
SUMMARY: - BACKGROUND: Colorectal cancer (CRC) is the third most commonly
diagnosed cancer in males and the second in females with a progressive increase in
prevalence in industrialized countries. The loss of health due to the cancer and/or the
consequence of the treatment may result in psychophysical, functional and social
impairment; all of these affect health-related quality of life (QoL). DESCRIPTION: The
most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only
important for the well-being of cancer patient but it also influences survival and
response to therapy. Many studies investigated various determinants involved in the
assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the
number of comorbidity significantly affected QoL. CONCLUSION: Despite that CRC
patients have a relatively good QoL compared with the general population, a wide
range of intervention could be undertaken to improve their QoL. The finding of this
review may be useful for cancer clinicians in taking therapy and surveillance-related
decisions. However, future research should be directed to large-scale prospective
studies using well validated QoL instruments to facilitate comparison of results.
-------------------------------------------------------------[47]
TITLE: - Effects of common polymorphisms rs2910164 in miR-146ª and rs11614913 in
miR-196ª2 on susceptibility to colorectal cancer: a systematic review meta-analysis.
SUMMARY: - Link
JOURNAL: - Clin Transl Oncol. 2014 Jan 8.
*** Link to the complete text (free or ppv) 1007/s12094-013-1150-x
AUTHOR: - Wan D; ADDRESS: - Department of Hepatobiliary Surgery, The First Affiliated
Hospital of Sun Yat-sen University, Guangzhou, 510006, Guangdong, China.
AUTHOR: - Gu W
AUTHOR: - Xu G
AUTHOR: - Shen C
AUTHOR: - Ding D
AUTHOR: - Shen S
AUTHOR: - Wang S
AUTHOR: - Gong X
AUTHOR: - He S
AUTHOR: - Zhi Q
SUMMARY: - PURPOSE: Emerging evidence has shown that single nucleotide
polymorphisms occurred in microRNAs may contribute to the development of
colorectal cancer (CRC). rs2910164 in miR-146ª and rs11614913 in miR-196ª2 are
suggested to be associated with the susceptibility to CRC, but individually published
studies revealed inconclusive results. To systematically summarize the possible
correlationship between these polymorphisms and CRC risk, we performed this metaanalysis. METHODS: We retrieved the relevant articles of the associations between
these two microRNA polymorphisms and susceptibility to CRC for the period up to July
1, 2013. A total of seven articles were identified with 2,143 cases and 2,457 controls
for miR-146ª rs2910164, 1,594 cases and 2,252 controls for miR-196ª2 rs11614913.
Odds ratio and 95 % confidence interval were calculated to investigate the strength of
the association. RESULTS: The pooled analysis showed that miR-146ª rs2910164 did
not reveal any correlation with CRC susceptibility. However, a decreased risk was
observed between miR-196ª2 rs11614913 and CRC in all genetic models.
CONCLUSION: Our current meta-analysis demonstrates that miR-196ª2 rs11614913
most likely contributes to decreased risk of CRC, whereas miR-146ª rs2910164 may not
be associated with the susceptibility to CRC.
-------------------------------------------------------------[48]
TITLE: - Metastatic colorectal cancer-prolonging overall survival with targeted therapies.
SUMMARY: - Link
JOURNAL: - South Asian J Cancer. 2013 Jul;2(3):179-185.
*** Link to the complete text (free or ppv) 4103/2278-330X.114152
AUTHOR: - Dattatreya S; ADDRESS: - Department of Medical Oncology, Omega Hospital,
Hyderabad, Andhra Pradesh, India.
SUMMARY: - This review provides an updated overview of the management of
metastatic colorectal cancer (CRC). With widespread application of personalized
therapy based on specific patient and tumor characteristics, this will enable the
oncologists to optimize overall survival while maintaining quality of life. The role of kras and braf testing in helping select systemic therapy that includes cetuximab or
bevacizumab is clarified. Current management of metastatic CRC is based on careful
attention to these finer points, explained in this article.
-------------------------------------------------------------[49]
TITLE: - Dietary non-nutritive factors in targeting of regulatory molecules in colorectal
cancer: an update.
SUMMARY: - Link
JOURNAL: - Asian Pac J Cancer Prev. 2013;14(10):5543-52.
AUTHOR: - Pandurangan AK; ADDRESS: - Department of Nutrition and Dietetics, Faculty of
Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia E-mail :
[email protected]
AUTHOR: - Esa NM
SUMMARY: - Colorectal cancer (CRC), a complex multi-step process involving progressive
disruption of homeostatic mechanisms controlling intestinal epithelial
proliferation/inflammation, differentiation, and programmed cell death, is the third
most common malignant neoplasm worldwide. A number of promising targets such as
inducible nitric acid (iNOS), cyclooxygenase (COX)-2, NF-E2-related factor 2 (Nrf2),
Wnt/beta-catenin, Notch and apoptotic signaling have been identified by researchers
as useful targets to prevent or therapeutically inhibit colon cancer development. In this
review article, we aimed to explore the current targets available to eliminate colon
cancer with an update of dietary and non-nutritional compounds that could be of
potential use for interaction with regulatory molecules to prevent CRC.
-------------------------------------------------------------[50]
TITLE: - Colorectal cancer liver metastasis presenting as pneumoperitoneum: case
report and literature review.
SUMMARY: - Link
JOURNAL: - Indian J Surg. 2013 Jun;75(Suppl 1):266-8. doi: 10.1007/s12262-012-0666-6.
Epub 2012 Jul 6.
*** Link to the complete text (free or ppv) 1007/s12262-012-0666-6
AUTHOR: - Raghavendra GK; ADDRESS: - Wansbeck General Hospital, 8, Meadowvale,
Shiremoor, Newcastle upon Tyne, NE27 0BF UK.
AUTHOR: - Carr M; ADDRESS: - Department of Surgery, Wansbeck General Hospital,
Woodhorne Lane, Ashington, NE66 9JJ UK.
AUTHOR: - Dharmadhikari R; ADDRESS: - Department of Radiology, Wansbeck General
Hospital, Woodhorne Lane, Ashington, NE66 9JJ UK.
SUMMARY: - Pneumoperitoneum presenting as air under diaphragm on erect chest X-ray
is usually a result of hollow viscous perforation but can be a result of many other
diagnoses including necrotising enterocolitis and ruptured liver abscess. We report a
case of colon cancer with liver metastases presenting as pneumoperitoneum. This was
a result of infection of the metastases with Clostridium septicum with resultant
rupture in to sub diaphragmatic space.
-------------------------------------------------------------[51]
TITLE: - Hepatocellular carcinoma with colonic metastasis: a rare case report and review
of literature.
SUMMARY: - Link
JOURNAL: - Singapore Med J. 2014 Jan 3. doi: 10.11622/smedj.2013262.
*** Link to the complete text (free or ppv) 11622/smedj.2013262
AUTHOR: - Ou TM
AUTHOR: - Tsai WC
AUTHOR: - Hsieh TY
AUTHOR: - Shih YL
SUMMARY: - Hepatocellular carcinoma with colonic metastasis is rare. It mainly occurs
by direct invasion and presents with bloody stools. We describe a patient with
haematogenous metastasis to the rectum who presented with tenesmus. To the
authors’ knowledge, such an association has not been reported previously. Colonic
metastasis should be considered when patients with hepatocellular carcinoma present
with bloody stools or tenesmus.
-------------------------------------------------------------[52]
TITLE: - Cutaneous metastasis of colon adenocarcinoma: case report and review of the
literature.
SUMMARY: - Link
JOURNAL: - An Bras Dermatol. 2013 Nov-Dec;88(6 Suppl 1):56-8. doi: 10.1590/abd1806-
4841.20132441.
*** Link to the complete text (free or ppv) 1590/abd1806-4841.20132441
AUTHOR: - Nesseris I; ADDRESS: - Andreas Sygros Hospital, Pathology Department, Athens,
Greece.
AUTHOR: - Tsamakis C; ADDRESS: - Attikon Hospital, Xaidari, Greece.
AUTHOR: - Gregoriou S; ADDRESS: - University of Athens Medical School, Attikon Hospital,
Dermatology Department, Xaidari, Greece.
AUTHOR: - Ditsos I; ADDRESS: - University of Athens Medical School, Attikon Hospital,
Dermatology Department, Xaidari, Greece.
AUTHOR: - Christofidou E; ADDRESS: - Andreas Sygros Hospital, Pathology Department,
Athens, Greece.
AUTHOR: - Rigopoulos D; ADDRESS: - AdHoc University of Athens, Attikon Hospital,
Department of Dermatology, Xaidari, Greece.
SUMMARY: - Skin metastases from colorectal carcinoma are rare and signal advanced
disease. We present a case of an 80-year-old male with a large skin metastatic focus in
the lower abdomen, a year after resection of a colonic adenocarcinoma. The patient
had already finished receiving his first cycle of chemotherapy shortly before the
discovery of the abdominal nodules and at the same period a chest X-ray, revealed
shadows at the base of the right lung.
-------------------------------------------------------------[53]
TITLE: - Personalized treatment for advanced colorectal cancer: KRAS and beyond.
SUMMARY: - Link
JOURNAL: - Cancer Manag Res. 2013 Nov 21;5:387-400. doi: 10.2147/CMAR.S35025.
eCollection 2013.
*** Link to the complete text (free or ppv) 2147/CMAR.S35025
AUTHOR: - Patel GS; ADDRESS: - Department of Medical Oncology, Flinders Medical
Centre, Flinders University, Bedford Park, Adelaide, SA, Australia.
AUTHOR: - Karapetis CS
SUMMARY: - Targeted therapies have improved the survival of patients with advanced
colorectal cancer (CRC). However, further improvements in patient outcomes may be
gained by the development of predictive biomarkers in order to select individuals who
are most likely to benefit from treatment, thus personalizing treatment. Using the
epidermal growth-factor receptor (EGFR) pathway, we discuss the existing and
potential predictive biomarkers in clinical development for use with EGFR-targeted
agents in metastatic CRC. The data and technological issues surrounding such
biomarkers as expression of EGFR or its family members or ligands, KRAS-, NRAS-, and
BRAF-mutation status, PI3K/PTEN expression, and imaging and clinical biomarkers,
such as rash and hypomagnesemia, are summarized. Although the discovery of KRAS
mutations has improved patient selection for EGFR-targeted treatments, further
biomarkers are required, especially for those patients who exhibit KRAS mutations
rather than the wild-type gene.
-------------------------------------------------------------[54]
TITLE: - A Novel Opportunity in Minimally Invasive Colorectal Cancer Therapy: Defining
a Role for Endoscopic Submucosal Dissection in the United States.
SUMMARY: - Link
JOURNAL: - Diagn Ther Endosc. 2013;2013:681783. Epub 2013 Nov 6.
*** Link to the complete text (free or ppv) 1155/2013/681783
AUTHOR: - Cohen J; ADDRESS: - Department of Medicine, Beth Israel Deaconess Medical
Center and Harvard Medical School, 1st Floor Atrium Suite, 330 Brookline Avenue,
Boston, MA 02215, USA.
SUMMARY: - Colorectal cancer is the third most common cancer among both men and
women in the United States and the second leading cause of cancer death. Endoscopic
submucosal dissection (ESD) is an innovative advanced endoscopic therapy for
superficial gastrointestinal neoplasms which is rapidly becoming standard of care
particularly in Asia. ESD was first developed for the resection of early gastric cancers;
yet ESD for colon tumors has gained increasing attention in recent years. The
advantage of ESD over conventional endoscopic resection lies in its potential to
achieve en bloc resection regardless of tumor size, leading to more precise histological
evaluation and greater potential for cure. Selecting appropriate patients for this
procedure involves identifying colorectal cancers with nul risk of lymph node spread.
For colorectal ESD to engraft in the United States, the prevalence of such early stage
lesions must be defined so that centers of excellence can be developed for high
volume clinical practice to offer patients the safest and most efficacious outcomes.
This review discusses the endoscopic staging of colorectal neoplasms, indications for
colorectal ESD, and the epidemiology of early stage ESD-amenable colorectal cancer in
America to better define an opportunity for this important minimally invasive therapy.
-------------------------------------------------------------[55]
TITLE: - Current Approaches and Challenges for Monitoring Treatment Response in
Colon and Rectal Cancer.
SUMMARY: - Link
JOURNAL: - J Cancer. 2014 Jan 1;5(1):31-43. eCollection 2014.
*** Link to the complete text (free or ppv) 7150/jca.7987
AUTHOR: - McKeown E; ADDRESS: - 1. Department of Surgery, Swedish Medical Center,
Seattle, WA, USA.
AUTHOR: - Nelson DW; ADDRESS: - 2. Department of Surgery, Madigan Army Center,
Tacoma, WA, USA.
AUTHOR: - Johnson EK; ADDRESS: - 2. Department of Surgery, Madigan Army Center,
Tacoma, WA, USA.
AUTHOR: - Maykel JA; ADDRESS: - 3. Division of Colorectal Surgery, UMass Medical Center,
Worcester, MA, USA.
AUTHOR: - Stojadinovic A; ADDRESS: - 4. Department of Surgery, Division of Surgical
Oncology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
AUTHOR: - Nissan A; ADDRESS: - 5. Department of Surgery, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel.
AUTHOR: - Avital I; ADDRESS: - 6. Bon Secours Cancer Institute, Richmond, VA, USA.
AUTHOR: - Brucher BL; ADDRESS: - 6. Bon Secours Cancer Institute, Richmond, VA, USA.
AUTHOR: - Steele SR; ADDRESS: - 2. Department of Surgery, Madigan Army Center,
Tacoma, WA, USA.
SUMMARY: - Introduction: With the advent of multidisciplinary and multimodality
approaches to the management of colorectal cancer patients, there is an increasing
need to define how we monitor response to novel therapies in these patients. Several
factors ranging from the type of therapy used to the intrinsic biology of the tumor play
a role in tumor response. All of these can aid in determining the ideal course of
treatment, and may fluctuate over time, pending down-staging or progression of
disease. Therefore, monitoring how disease responds to therapy requires
standardization in order to ultimately optimize patient outcomes. Unfortunately, how
best to do this remains a topic of debate among oncologists, pathologists, and
colorectal surgeons. There may not be one single best approach. The goal of the
present article is to shed some light on current approaches and challenges to
monitoring treatment response for colorectal cancer. Methods: A literature search was
conducted utilizing PubMed and the OVID library. Key-word combinations included
colorectal cancer metastases, neoadjuvant therapy, rectal cancer, imaging modalities,
CEA, down-staging, tumor response, and biomarkers. Directed searches of the
embedded references from the primary articles were also performed in selected
circumstances. Results: Pathologic examination of the post-treatment surgical
specimen is the gold standard for monitoring response to therapy. Endoscopy is useful
for evaluating local recurrence, but not in assessing tumor response outside of the
limited information gained by direct examination of intra-lumenal lesions. Imaging is
used to monitor tumors throughout the body for response, with CT, PET, and MRI
employed in different circumstances. Overall, each has been validated in the
monitoring of patients with colorectal cancer and residual tumors. Conclusion:
Although there is no imaging or serum test to precisely correlate with a tumor’s
response to chemo- or radiation therapy, these modalities, when used in combination,
can aid in allowing clinicians to adjust medical therapy, pursue operative intervention,
or (in select cases) identify complete responders. Improvements are needed, however,
as advances across multiple modalities could allow appropriate selection of patients
for a close surveillance regimen in the absence of operative intervention.
-------------------------------------------------------------[56]
TITLE: - Future Directions for Monitoring Treatment Response in Colorectal Cancer.
SUMMARY: - Link
JOURNAL: - J Cancer. 2014 Jan 5;5(1):44-57. eCollection 2014.
*** Link to the complete text (free or ppv) 7150/jca.7809
AUTHOR: - Walker AS; ADDRESS: - 1. Department of Surgery, Madigan Army Medical
Center, 9040 Fitzsimmons Dr., Fort Lewis, WA, USA.
AUTHOR: - Zwintscher NP; ADDRESS: - 1. Department of Surgery, Madigan Army Medical
Center, 9040 Fitzsimmons Dr., Fort Lewis, WA, USA.
AUTHOR: - Johnson EK; ADDRESS: - 1. Department of Surgery, Madigan Army Medical
Center, 9040 Fitzsimmons Dr., Fort Lewis, WA, USA.
AUTHOR: - Maykel JA; ADDRESS: - 2. University of Massachusetts Memorial Medical
Center, Worcester, MA, USA.
AUTHOR: - Stojadinovic A; ADDRESS: - 3. Department of Surgery, Division of Surgical
Oncology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
AUTHOR: - Nissan A; ADDRESS: - 4. Department of Surgery, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel.
AUTHOR: - Avital I; ADDRESS: - 5. Bon Secours Cancer Institute, Richmond, VA, USA.
AUTHOR: - Brucher BL; ADDRESS: - 5. Bon Secours Cancer Institute, Richmond, VA, USA.
AUTHOR: - Steele SR; ADDRESS: - 1. Department of Surgery, Madigan Army Medical
Center, 9040 Fitzsimmons Dr., Fort Lewis, WA, USA.
SUMMARY: - Treatment of advanced colon and rectal cancer has significantly evolved
with the introduction of neoadjuvant chemoradiation therapy so much that, along with
more effective chemotherapy regimens, surgery has been considered unnecessary
among some institutions for select patients. The tumor response to these treatments
has also improved and ultimately has been shown to have a direct effect on prognosis.
Yet, the best way to monitor that response, whether clinically, radiologically, or with
laboratory findings, remains controversial. The authors’ aim is to briefly review the
options available and, more importantly, examine emerging and future options to
assist in monitoring treatment response in cases of locally advanced rectal cancer and
metastatic colon cancer.
-------------------------------------------------------------[57]
TITLE: - Current and Novel Treatment Options for Metastatic Colorectal Cancer:
Emphasis on Aflibercept.
SUMMARY: - Link
JOURNAL: - Biol Ther. 2013;3:25-33. Epub 2013 Feb 28.
*** Link to the complete text (free or ppv) 1007/s13554-013-0009-6
AUTHOR: - Dietvorst MH; ADDRESS: - Department of Medical Oncology, Erasmus
University Medical Center, Daniel den Hoed Cancer Center, Room HE120, PO BOX
2040, 3000 CA Rotterdam, The Netherlands.
AUTHOR: - Eskens FA; ADDRESS: - Department of Medical Oncology, Erasmus University
Medical Center, Daniel den Hoed Cancer Center, Room HE120, PO BOX 2040, 3000 CA
Rotterdam, The Netherlands.
SUMMARY: - Worldwide, colorectal cancer (CRC) is the third most frequently diagnosed
cancer in men and the second in women. Metastatic disease develops in more than
half of the patients and carries a poor prognosis. Over the past three decades,
significant advances have been made in the treatment of metastatic colorectal cancer
(mCRC). The development of new cytotoxic agents and the incorporation of targetspecific agents in first-, second-, third-, and nowadays even fourth-line treatment has
prolonged median overall survival up to 24-28 months. However, 5-year survival rates
remain disappointingly low. This review summarizes the currently available cytotoxic
treatment options for mCRC, and highlights the further emerging role of vascular
endothelial growth factor (VEGF)-inhibiting strategies, emphasizing the role of
aflibercept. Aflibercept is a recombinant fusion protein with high VEGF affinity, and is
the second antiangiogenic agent to obtain registration in the treatment of mCRC.
-------------------------------------------------------------[58]
TITLE: - Intra-Arterial Therapies for Metastatic Colorectal Cancer.
SUMMARY: - Link
JOURNAL: - Semin Intervent Radiol. 2013 Mar;30(1):12-20.
*** Link to the complete text (free or ppv) 1055/s-0033-1333649
AUTHOR: - Wang DS; ADDRESS: - Division of Interventional Radiology, Department of
Radiology, Stanford University Medical Center, Stanford, California.
AUTHOR: - Louie JD; ADDRESS: - Division of Interventional Radiology, Department of
Radiology, Stanford University Medical Center, Stanford, California.
AUTHOR: - Sze DY; ADDRESS: - Division of Interventional Radiology, Department of
Radiology, Stanford University Medical Center, Stanford, California.
SUMMARY: - Intra-arterial therapies for unresectable hepatic metastases from colorectal
cancer include radioembolization (RE) with yttrium-90 microspheres, transarterial
chemoembolization (TACE), hepatic arterial infusion, and percutaneous hepatic
perfusion using an organ isolation system. In this article, we discuss our approach
toward treatment selection, followed by details of how RE and TACE are performed at
our institution.
-------------------------------------------------------------[59]
TITLE: - Colorectal neuroendocrine neoplasms - management guidelines (recommended
by the Polish Network of Neuroendocrine Tumours).
SUMMARY: - Link
JOURNAL: - Endokrynol Pol. 2013;64(6):494-504. doi: 10.5603/EP.2013.0032.
*** Link to the complete text (free or ppv) 5603/EP.2013.0032
AUTHOR: - Starzynska T
AUTHOR: - Deptala A
AUTHOR: - Krolicki L
AUTHOR: - Kunikowska J
AUTHOR: - Londzin-Olesik M
AUTHOR: - Nasierowska-Guttmejer A
AUTHOR: - Ruchala M
AUTHOR: - Strzelczyk J
AUTHOR: - Szawlowski A
AUTHOR: - Zgliczynski W
AUTHOR: - Kos-Kudla B; ADDRESS: - Division of Endocrinology, Department of
Pathophysiology and Endocrinology, Medical University of Silesia, Katowice, Poland.
[email protected]
SUMMARY: - Neuroendocrine neoplasms of the large intestine account for 20% of all
neuroendocrine neoplasms (NENs) and are most commonly found in the rectum. The
rate of detection of colorectal NENs is increasing, and this tendency will continue due
to the widespread use of colonoscopy as a screening tool and the removal of all
diagnosed lesions. This paper provides updated guidelines for the management of
patients with colorectal NENs. Recent data on epidemiology, clinical characteristics,
biochemical, and pathomorphological diagnosis as well as useful imaging techniques
are presented. We look in detail at novel methods of treatment including endoscopic
and surgical management, pharmacological and radioisotope therapy. We summarise
monitoring of the treatment. (Endokrynol Pol 2013; 64 (6): 494-504).
-------------------------------------------------------------[60]
TITLE: - Functions and Regulation of the PTEN Gene in Colorectal Cancer.
SUMMARY: - Link
JOURNAL: - Front Oncol. 2014 Jan 16;3:326. eCollection 2013.
*** Link to the complete text (free or ppv) 3389/fonc.2013.00326
AUTHOR: - Molinari F; ADDRESS: - Laboratory of Molecular Pathology, Institute of
Pathology , Locarno , Switzerland.
AUTHOR: - Frattini M; ADDRESS: - Laboratory of Molecular Pathology, Institute of
Pathology , Locarno , Switzerland.
SUMMARY: - Phosphatase and TENsin homolog deleted on chromosome 10 (PTEN) is a
tumor suppressor gene located at chromosome 10q23.31, encoding for a 403-amino
acid protein that possesses both lipid and protein phosphatase activities. The main
function of PTEN is to block the PI3K pathway by dephosphorylating
phosphatidylinositol (PI) 3,4,5-triphosphate to PI-4,5-bisphosphate thus counteracting
PI3K function. PTEN inactivation is a frequent event in many cancer types and can
occur through various genetic alterations including point mutations, large
chromosomal deletions, and epigenetic mechanisms. In colorectal cancer (CRC) PTEN is
altered through mixed genetic/epigenetic mechanisms (typically: mutations and
promoter hypermethylation or 10q23 LOH and promoter hypermethylation), which
lead to the biallelic inactivation of the protein in 20-30% of cases. The role of PTEN as a
prognostic and predictive factor in CRC has been addressed by relatively few works.
This review is focused on the report and on the discussion of the studies investigating
these aspects. Overall, at the moment, there are conflicting results and, therefore it
has not been clarified whether PTEN might play a prognostic role in CRC. The same is
valid also for the predictive role, leading to the fact that PTEN evaluation cannot be
used in routinely diagnosis for the early identification of patients who might be
addressed to the treatment with EGFR-targeted therapies, at odds with other genetic
alterations belonging to EGFR-downstream pathways. The reason of discordant results
may be attributable to several issues: (1) the size of the analyzed cohort, (2) patients
inclusion criteria, (3) the methods of assessing PTEN alteration. In particular, there are
no standardized methods to evaluate this marker, especially for
immunohistochemistry, a technique suffering of intra and inter-observer variability
due to the semi-quantitative character of such an analysis. In conclusion, much work,
especially in large and homogeneous cohorts of cases from different laboratories, has
to be done before the establishment of PTEN as prognostic or predictive marker in
CRC.
-------------------------------------------------------------[61]
TITLE: - Population-based colorectal cancer screening: comparison of two fecal occult
blood test.
SUMMARY: - Link
JOURNAL: - Front Pharmacol. 2014 Jan 10;4:175. eCollection 2014 Jan 10.
*** Link to the complete text (free or ppv) 3389/fphar.2013.00175
AUTHOR: - Zubero MB; ADDRESS: - Clinical Epidemiology Unit, Cruces University Hospital,
Basque Health Service Barakaldo, Bizkaia, España.
AUTHOR: - Arana-Arri E; ADDRESS: - Clinical Epidemiology Unit, Cruces University Hospital,
Basque Health Service Barakaldo, Bizkaia, España ; BioCruces Health Research Institute
Bizkaia, España.
AUTHOR: - Pijoan JI; ADDRESS: - Clinical Epidemiology Unit, Cruces University Hospital,
Basque Health Service Barakaldo, Bizkaia, España ; BioCruces Health Research Institute
Bizkaia, España ; Biomedical Research Center Network for Epidemiology and Public
Health Bizkaia, España.
AUTHOR: - Portillo I; ADDRESS: - Colorectal Cancer Screening Programme Coordinating
Centre, Basque Health Service Bizkaia, España.
AUTHOR: - Idigoras I; ADDRESS: - Colorectal Cancer Screening Programme Coordinating
Centre, Basque Health Service Bizkaia, España.
AUTHOR: - Lopez-Urrutia A; ADDRESS: - Clinical Biochemistry Service, Cruces University
Hospital, Basque Health Service Barakaldo, Bizkaia, España.
AUTHOR: - Samper A; ADDRESS: - Clinical Biochemistry Service, Donostia University
Hospital, Basque Health Service Donostia, Gipuzkoa, España.
AUTHOR: - Uranga B; ADDRESS: - Digestive Department, Donostia University Hospital,
Basque Health Service Donostia, Gipuzkoa, España.
AUTHOR: - Rodriguez C; ADDRESS: - Clinical Biochemistry Service, Araba University
Hospital, Basque Health Service Gasteiz, Araba, España.
AUTHOR: - Bujanda L; ADDRESS: - Digestive Department, Donostia University Hospital,
Basque Health Service Donostia, Gipuzkoa, España ; Biodonostia Research Institute
Donostia, España.
SUMMARY: - Background: The aim of screening for colorectal cancer is to improve
prognosis by the detection of cancer at its early stages. In order to inform the decision
on the specific test to be used in the population-based program in the Basque
Autonomous Region (Spain), we compared two immunochemical fecal occult blood
quantitative tests (I-FOBT). Methods: Residents of selected study areas, aged 50-69
years, were invited to participate in the screening. Two tests based on latex
agglutination (OC-Sensor and FOB Gold) were randomly assigned to different study
areas. A colonoscopy was offered to patients with a positive test result. The cut-off
point used to classify a result as positive, according to manufacturer’s
recommendations, was 100 ng/ml for both tests. Results: The invited population
included 37,999 individuals. Participation rates were 61.8% (n = 11,162) for OC-Sensor
and 59.1% (n = 11,786) for FOB Gold (p = 0.008). Positive rate for OC-Sensor was 6.6%
(n = 737) and 8.5% (n = 1,002) for FOB Gold (p < 0.0001). Error rates were higher for
FOB gold (2.3%) than for OC-Sensor (0.2%; p < 0.0001). Predictive positive value (PPV)
for total malignant and premalignant lesions was 62.4% for OC-Sensor and 58.9% for
FOB Gold (p = 0.137), respectively. Conclusion: OC-Sensor test appears to be superior
for I-FOBT-based colorectal cancer screening, given its acceptance, ease of use,
associated small number of errors and its screening accuracy. FOB Gold on the other
hand, has higher rate of positive values, with more colonoscopies performed, it shows
higher detection incidence rates, but involves more false positives.
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TITLE: - Factors influencing choice of chemotherapy in metastatic colorectal cancer
(mCRC).
SUMMARY: - Link
JOURNAL: - Cancer Manag Res. 2013 Nov 19;5:377-385. eCollection 2013.
*** Link to the complete text (free or ppv) 2147/CMAR.S47986
AUTHOR: - Rossi L; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Vakiarou F; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Zoratto F; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Bianchi L; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Papa A; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Basso E; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Verrico M; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Russo GL; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Evangelista S; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Rinaldi G; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Perrone-Congedi F; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Spinelli GP; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Stati V; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Caruso D; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Prete A; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
AUTHOR: - Tomao S; ADDRESS: - Department of Medico-Surgical Sciences and
Biotechnologies, “Sapienza” University of Rome, Rome, Italy; Oncology Unit, ICOT,
Latina, Italy.
SUMMARY: - Management of metastatic colorectal cancer requires a multimodal
approach and must be performed by an experienced, multidisciplinary expert team.
The optimal choice of the individual treatment modality, according to disease
localization and extent, tumor biology, and patient clinical characteristics, will be one
that can maintain quality of life and long-term survival, and even cure selected
patients. This review is an overview of the different therapeutic approaches available
in metastatic colorectal cancer, for the purpose of defining personalized therapeutic
algorithms according to tumor biology and patient clinical features.
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TITLE: - Recent advances in oral anticancer agents for colon cancer.
SUMMARY: - Link
JOURNAL: - Future Oncol. 2013 Dec;9(12):1893-908. doi: 10.2217/fon.13.137.
*** Link to the complete text (free or ppv) 2217/fon.13.137
AUTHOR: - Shukla RK; ADDRESS: - School of Pharmaceutical Sciences, Rajiv Gandhi
Proudyogiki Vishwavidyalaya, (Rajiv Gandhi Technological University), The State
Technical University of Madhya Pradesh, Airport Bypass Road Gandhi Nagar-462036,
Bhopal, India. [email protected]
SUMMARY: - To provide therapeutic alternatives to intravenous colon chemotherapy
major recent research is focusing on the development of oral chemotherapeutic
agents with the intention to improve the quality of life of patients. Initially 5fluorouracil was most commonly used for the treatment of colorectal cancer but
currently oxaliplatin and irinotecan are also available. The majority of these new drugs
are pyrimidines and their analogs. The rationale for using oral anticancer agents is
discussed and new drugs, such as farnesyl protein transferase inhibitor S-1, rubitecan,
ZD9331, MMI-166, eflornithine, sulindac, and oral camptothecin analogs, among
others, are presented with the results of their preclinical and clinical developments.
This article focuses on the advancement of clinical development and also discusses the
relative merits and demerits of these agents. The accelerated approval of these agents
by regulatory authorities is supported by survival benefit, response rate and time to
progression.
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TITLE: - Meta-Analysis of ABCB1 3435C>T Polymorphism and Colorectal Cancer.
SUMMARY: - Link
JOURNAL: - Pak J Med Sci. 2013 Sep;29(5):1269-1274.
AUTHOR: - Zhang D; ADDRESS: - Dan Zhang, Department of Gastrointestinal Surgery, West
China Hospital, Sichuan University, No. 37 on Guoxue Xiang, Chengdu, Sichuan
Province, China.
AUTHOR: - Wang C; ADDRESS: - Cun Wang, Department of Gastrointestinal Surgery, West
China Hospital, Sichuan University, No. 37 on Guoxue Xiang, Chengdu, Sichuan
Province, China.
AUTHOR: - Zhou Z; ADDRESS: - Zongguang Zhou Department of Gastrointestinal Surgery,
West China Hospital, Sichuan University, No. 37 on Guoxue Xiang, Chengdu, Sichuan
Province, China.
SUMMARY: - Objective: Many studies have focused on the association between the
ABCB1 3435C>T polymorphism and colorectal cancer (CRC) risk. However, the results
were conflicting. The aim of this meta-analysis is to evaluate the precise association
between this polymorphism and CRC risk. Methods: We formally reviewed the
literature at Pubmed, EMBASE and the Cochrane Library with the key words as follows:
ABCB1/MDR1/P-glycoprotein, polymorphism, colorectal and cancer/neoplasm/tumor.
This meta-analysis was assessed by Review manager 5.0. The fixed-effects model was
used to pool the odds ratios (OR) with 95% confidence intervals (CI) for CRC risk.
Results: There were 8 studies identified. The pooled OR with 95% CI of CC+CT versus TT
genotype of the ABCB1 3435C>T polymorphism for CRC risk was 1.01 [0.90-1.13]. The
sensitivity analysis further confirmed the result. Heterogeneity and publication bias
were not observed in this meta-analysis. Conclusions: In summary, there was no
significant association between the ABCB1 3435C>T polymorphism and CRC risk.
Abbreviations used: the ATP-binding cassette, subfamily B, member 1 (ABCB1);
multidrug resistance gene 1 (MDR1); P-glycoprotein (P-gp); colorectal cancer (CRC);
single nucleotide polymorphisms (SNPs); odds ratio (OR); confidence interval (CI);
Hardy-Weinberg equilibrium (HWE).
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TITLE: - Diet and supplements and their impact on colorectal cancer.
SUMMARY: - Link
JOURNAL: - J Gastrointest Oncol. 2013 Dec;4(4):409-23. doi: 10.3978/j.issn.20786891.2013.003.
*** Link to the complete text (free or ppv) 3978/j.issn.2078-6891.2013.003
AUTHOR: - Pericleous M; ADDRESS: - Centre for Gastroenterology, Royal Free Hospital,
London, NW3 2QG, UK.
AUTHOR: - Mandair D
AUTHOR: - Caplin ME
SUMMARY: - BACKGROUND: Colorectal cancer is the third commonest cancer and the
third leading cause of cancer death among men and women. It has been proposed that
dietary factors are responsible for 70-90% of colorectal cancer and diet optimization
may prevent most cases. AIM: To evaluate the role of dietary components and
supplements in colorectal cancer. METHODS: Bibliographical searches were performed
in Pubmed for the terms “diet and colorectal cancer”, “diet and colon cancer”, “diet
and rectal cancer”, “nutrition and colorectal cancer”, “probiotics and colorectal
cancer”, “prebiotics and colorectal cancer”, “alcohol and cancer” and “colorectal
cancer epidemiology”. RESULTS: Consumption of processed or red meat, especially
when cooked at high temperatures may be associated with increased risk of colorectal
cancer. The evidence for dietary fibre is unclear but foods that contain high amounts of
fibre are usually rich in polyphenols which have been shown to alter molecular
processes that can encourage colorectal carcinogenesis. Meta-analyses provide
evidence on the benefits of circulating, diet-derived and supplemented, vitamin D and
Calcium. We also found that diets rich in Folate may prevent colorectal carcinoma. The
evidence on dietary micronutrients such as Zinc and Selenium in association with
colorectal cancer is not conclusive. It has been suggested that there may be a direct
association between alcohol intake and colorectal cancer. In vitro and in vivo studies
have highlighted a possible protective role of prebiotics and probiotics. CONCLUSIONS:
The lack of randomized trials and the presence of confounding factors including
smoking, physical activity, obesity and diabetes may often yield inconclusive results.
Carefully designed randomized trials are recommended.
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TITLE: - Tissue-based biomarkers predicting outcomes in metastatic colorectal cancer: a
review.
SUMMARY: - Link
JOURNAL: - Clin Transl Oncol. 2014 Jan 24.
*** Link to the complete text (free or ppv) 1007/s12094-013-1154-6
AUTHOR: - Ung L; ADDRESS: - UNSW Department of Surgery, St. George Clinical School,
University of New South Wales, Kensington, NSW, 2217, Australia.
AUTHOR: - Lam AK
AUTHOR: - Morris DL
AUTHOR: - Chua TC
SUMMARY: - Although there have been recent advances in the treatment of metastatic
colorectal cancer, particularly with systemic chemotherapy, new biological agents and
surgical metastasectomy, the disease remains difficult to treat. To personalise the
management of mCRC and optimise patient outcomes, it is vital to acquire a deeper
understanding of its natural history and mechanisms behind disease progression. This
may be achieved by extensive study of tumour biomarkers: proteins or genetic
alterations within neoplastic cells or their surrounding stroma that may be used to
predict patient outcomes, disease trajectory and response to various therapies. The
discovery of mutant Kirsten-RAS in determining patients who may be refractory to
anti-epidermal growth factor receptor treatments has reinvigorated and reiterated the
importance of our attempts to individualise cancer care. While many biomarkers have
been studied and shown promise in the setting of mCRC, they are, with the exception
of K-ras testing not used currently in a clinical setting due to conflicting results, small
patient samples and methodological variations. Larger, multi-centric studies with
uniform methods of tumour marker study are required to effectively tailor systemic
therapies and select appropriate candidates for surgical metastasectomy.
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TITLE: - Ziv-aflibercept in metastatic colorectal cancer.
SUMMARY: - Link
JOURNAL: - Biologics. 2014;8:13-25. Epub 2013 Dec 16.
*** Link to the complete text (free or ppv) 2147/BTT.S39360
AUTHOR: - Patel A; ADDRESS: - Division of Hematology-Oncology, University of Pittsburgh
Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
AUTHOR: - Sun W; ADDRESS: - Division of Hematology-Oncology, University of Pittsburgh
Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
SUMMARY: - The combination of cytotoxic chemotherapy and antiangiogenic agents has
become a conventional treatment option for patients with metastatic colorectal
cancer. Ziv-aflibercept is a fusion protein which acts as a decoy receptor for vascular
endothelial growth factor (VEGF)-A, VEGF-B, and placental growth factor (PlGF); it was
approved in combination with 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) for
the treatment of patients with metastatic colorectal cancer that is resistant to or has
progressed after an oxaliplatin-containing fluoropyrimidine-based regimen. Herein we
review the role of tumor angiogenesis as the rationale for antiangiogenic therapy, the
clinical data associated with ziv-aflibercept, and its current role as a treatment option
compared to other antiangiogenic agents, such as bevacizumab and regorafenib.
-------------------------------------------------------------[68]
TITLE: - Toward a Molecular Classification of Colorectal Cancer: The Role of BRAF.
SUMMARY: - Link
JOURNAL: - Front Oncol. 2013 Nov 15;3:281. eCollection 2013.
*** Link to the complete text (free or ppv) 3389/fonc.2013.00281
AUTHOR: - Thiel A; ADDRESS: - Division of Pathology, HUSLAB and Haartman Institute,
Helsinki University Central Hospital, University of Helsinki , Helsinki , Finland ; GenomeScale Biology, Research Programs Unit, University of Helsinki , Helsinki , Finland.
AUTHOR: - Ristimaki A
SUMMARY: - Different genetic aberrations of BRAF have been reported in various
malignancies. BRAF is member of the RAS/RAF/MEK/ERK pathway and constitutive
activity of this pathway can lead to increased cellular growth, invasion, and metastasis.
The most common activating BRAF mutation in colorectal cancer is the V600E
mutation, which is present in 5-15% of all tumors, and up to 80% of tumors with high
microsatellite instability (MSI) harbor this mutation. BRAF mutation is associated with
proximal location, higher age, female gender, MSI-H, high grade, and mucinous
histology, and is a marker of poor prognosis in colorectal cancer. The role of BRAF
mutation as a predictive marker in respect of EGFR targeted treatments is
controversial. BRAF V600 selective inhibitors have been approved for the treatment of
V600 mutation positive metastatic melanoma, but the response rates in colorectal
cancer are poor. This might be due to innate resistance mechanisms of colorectal
cancers against the treatment solely targeting BRAF. To overcome resistance the
combination of treatments, simultaneous inhibition of BRAF and MEK or PI3K/mTOR,
might emerge as a successful therapeutic concept.
-------------------------------------------------------------[69]
TITLE: - Triple synchronous malignant tumors of colon, appendix and liver: A case report
with literature review.
SUMMARY: - Link
JOURNAL: - Pak J Med Sci. 2013 Jan;29(1):237-8. doi: 10.12669/pjms.291.2277.
*** Link to the complete text (free or ppv) 12669/pjms.291.2277
AUTHOR: - Guoliang S; ADDRESS: - Dr. Shen Guoliang, Zhejiang Provincial People’s
Hospital, Shangtang Road Number 168, Hangzhou, Zhejiang Province, China.
AUTHOR: - Dongsheng H; ADDRESS: - Dr. Huang Dongsheng, Zhejiang Provincial People’s
Hospital, Shangtang Road Number 168, Hangzhou, Zhejiang Province, China.
SUMMARY: - Synchronous cancers are defined as malignant tumors that occur
simultaneously. Each tumor must be primary which eliminate the possibility of being
metastatic lesion of the other. If three separate organs are involved, that is so-called
triple synchronous malignancy with very low morbidity. We report a case of a 33 year
old male patient with triple synchronous malignancies at the colon, appendix and liver.
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TITLE: - Perivascular epithelioid cell tumor of the rectum: report of a case and review of
the literature.
SUMMARY: - Link
JOURNAL: - World J Surg Oncol. 2014 Jan 13;12(1):12. doi: 10.1186/1477-7819-12-12.
*** Link to the complete text (free or ppv) 1186/1477-7819-12-12
AUTHOR: - Kanazawa A; ADDRESS: - Gastroenterological Center, Yokohama City University
Medical Center, 4-57 Urafune-cho Minami-ku, Yokohama-shi, Kanagawa-ken 232-0024,
Japan. [email protected]
AUTHOR: - Fujii S
AUTHOR: - Godai TI
AUTHOR: - Ishibe A
AUTHOR: - Oshima T
AUTHOR: - Fukushima T
AUTHOR: - Ota M
AUTHOR: - Yukawa N
AUTHOR: - Rino Y
AUTHOR: - Imada T
AUTHOR: - Ito J
AUTHOR: - Nozawa A
AUTHOR: - Masuda M
AUTHOR: - Kunisaki C
SUMMARY: - We report a case of perivascular epithelioid cell tumor arising in the rectum
of a 55-year-old woman. The tumor was treated by transanal endoscopic microsurgery.
After 1 year follow-up, the patient is alive with no radiologic or endoscopic evidence of
recurrence. Perivascular epithelioid cell tumor is a rare mesenchymal tumor
characterized by co-expression of melanocytic and smooth muscle markers. This rare
tumor can arise in various organs, including the falciform ligament, uterus, uterine
cervix, liver, kidney, lung, breast, cardiac septum, pancreas, prostate, thigh, and
gastrointestinal tract. Perivascular epithelioid cell tumor of the gastrointestinal tract is
very rare, with only 23 previously reported cases. We review the literature on
perivascular epithelioid cell tumors arising in the gastrointestinal tract.
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TITLE: - Laparoscopic surgery for rectal cancer: Current status and future perspective.
SUMMARY: - Link
JOURNAL: - Asian J Endosc Surg. 2014 Jan;7(1):2-10. doi: 10.1111/ases.12074. Epub
2013 Dec 3.
*** Link to the complete text (free or ppv) 1111/ases.12074
AUTHOR: - Toda S; ADDRESS: - Department of Gastroenterological Surgery, Toranomon
Hospital, Tokyo, Japan.
AUTHOR: - Kuroyanagi H
SUMMARY: - Although laparoscopic surgery for colon cancer is accepted in the
treatment guidelines, the laparoscopic approach for rectal cancer is recommended
only in clinical trials. Thus far, several trials have shown favorable short-term results
such as early recovery and short hospital stay, but long-term results remain a critical
concern for laparoscopic rectal cancer surgery. To date, no randomized control trials
have shown an increased local recurrence after laparoscopic surgery for rectal cancer.
Additionally, according to previous studies, open conversion, which is more frequent in
laparoscopic rectal surgery than in laparoscopic colon surgery, may affect short-term
and long-term survival. The evidence on male sexual function has been contradictory.
Long-term results from ongoing multicenter trials will be available within several years.
Based on accumulated evidence from well-organized clinical trials, laparoscopic
surgery will likely be accepted as a treatment choice for rectal cancer. In the future,
extended laparoscopic rectal surgery might be feasible for additional procedures such
as laparoscopic lateral pelvic lymph node dissection and laparoscopic total pelvic
exenteration for rectal cancer invading the adjacent pelvic organ.
-------------------------------------------------------------[72]
TITLE: - Squamous cell carcinoma of middle rectum: Literature review.
SUMMARY: - Link
JOURNAL: - Int J Surg Case Rep. 2014;5(2):86-90. doi: 10.1016/j.ijscr.2013.12.011. Epub
2013 Dec 21.
*** Link to the complete text (free or ppv) 1016/j.ijscr.2013.12.011
AUTHOR: - Kassir R; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France. Electronic address:
[email protected]
AUTHOR: - Baccot S; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
AUTHOR: - Bouarioua N; ADDRESS: - Department of Hepato-Gastroenterology, CHU
Hospital, Jean Monnet University, Saint Etienne, France.
AUTHOR: - Petcu CA; ADDRESS: - Department of Pathology, CHU Hospital, Jean Monnet
University, Saint Etienne, France.
AUTHOR: - Dubois J; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
AUTHOR: - Boueil-Bourlier A; ADDRESS: - Department of General Surgery, CHU Hospital,
Jean Monnet University, Saint Etienne, France.
AUTHOR: - Patoir A; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
AUTHOR: - Epin A; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
AUTHOR: - Ripamonti B; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
AUTHOR: - Tiffet O; ADDRESS: - Department of General Surgery, CHU Hospital, Jean
Monnet University, Saint Etienne, France.
SUMMARY: - INTRODUCTION: Squamous cell carcinoma SCC of the rectum is a distinct
entity. We report a very rare case of squamous cell carcinoma of the middle rectum.
PRESENTATION OF CASE: The patient was a 62-year-old woman who presented with a
history of rectal bleeding and discomfort. Colonoscopy revealed a polypoid tumour of
the middle rectum. Biopsies of this mass revealed a poorly differentiated SCC of the
rectum. CT scan of the chest, abdomen and pelvis was negative for distal metastases.
The patient received combined chemo-radiation followed by surgical excision. The
postoperative period was uncomplicated. DISCUSSION: The pathogenesis of rectal SCC
remains unclear and diagnosis is often delayed. Diagnostic criteria have been
proposed. MRI of the rectum and trans-rectal endoscopic ultrasound R-EUS provide
essential information to plan a therapeutic approach. The squamous cell carcinoma
antigen level is not suitable for initial diagnosis of rectal SCC. Most authors conclude
that the surgery is the gold standard treatment. Tumour stage is the most important
prognostic predictor of SCC. CONCLUSION: Squamous cell carcinoma of the rectum is a
distinct entity. Before the final choice of treatment is made, digestive surgeons should
bear in mind this rare tumour.
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