Oncologic Risk of Rectal Preservation Against Medical Advice After Chemoradiotherapy for Rectal Cancer: A Multicenter Comparative Cross-Sectional Study with Rectal Preservation as Supported by Surgeon

This study aimed to compare the oncologic outcomes of patients undergoing rectal preservation as intended by the surgeon, and the outcomes of patients refusing rectal resection against medical advice.MethodsThe study population consisted of patients in whom the rectum was preserved after neoadjuvant chemoradiotherapy for clinical stage I –III mid or low rectal cancer between May 2003 and August 2017 (n  =  2883); these patients were divided into those in whom rectal preservation was intended by their surgeon (intended rectal preservation, group A,n  =  41) and those in whom the rectum was not resected against medical advice (unintended rectal preservation, group B,n  =  101), defined as non-operative management or local excision.ResultsThe tumor distance, age, and performance status of patients were not significantly different between the groups, while the clinical T stage before chemoradiotherapy was lower in group A than in group B (P 
Source: World Journal of Surgery - Category: Surgery Source Type: research

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AbstractPurposeRectal cancer resections can be associated with long and complicated postoperative recoveries. Many patients undergoing these operations are discharged to rehabilitation or skilled nursing facilities. The purpose of this study was to identify preoperative and intraoperative factors associated with increased risk for non-home discharge after rectal cancer resection.MethodsRectal cancer resections were identified in the National Surgical Quality Improvement Program Targeted Proctectomy Dataset (years 2016 through 2017) by ICD code. Patients with unknown discharge destination or who experienced in-hospital mort...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Abstract Chemoradiotherapy (CRT) is a valuable treatment option for localized esophageal cancer. Conventional baseline chemotherapy for this type of cancer includes cisplatin and fluorouracil. Recently, CRT with leucovorin-fluorouracil-oxaliplatin (FOLFOX) has become popular due to its convenience and lower toxicity. In Japan, the use of oxaliplatin for esophageal cancer is not yet approved, so experience with this treatment is limited to cases with colorectal cancer. As such patients are not usually included in clinical trials, little is known on the efficacy and safety of this treatment for this patient subpopul...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Mol Clin Oncol Source Type: research
ConclusionAnalysis of the local CD8 and IDO1 expression influences prognosis in nodal-positive LARC patients after multimodal therapy and may be a helpful tool in specifying individual adjuvant treatment strategies according to different immune profiles.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
AbstractRobotic surgery became more popularly in the colorectal surgical field. The aim of the study was to evaluate of the oncological outcomes which patients who underwent the robotic total mesorectal excision for rectal cancer. A series of 140 consecutive patients who underwent robotic rectal surgery between January 2012 and June 2019 was analyzed retrospectively in terms of demographics, pathological data, and surgical and oncological outcomes. There were 104 (74.28%) male and 36 (25.71%) female patients. The tumor was located in the lower rectum in 84 (60%) cases, in the mid rectum in 38 (27.14%) cases, and in the upp...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
ConclusionBecause of its association with improved prognosis, AC should be considered for stage IV CRC patients after curative resection regardless of initial resectability status and preoperative therapy.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Conclusions. Patients' characteristics cannot be changed, but several steps were used to avoid routine PI creation. The present protocol could be a valuable option to avoid PI in selected patients. Further studies with a wider sample size, and defined criteria to stratify the patients based on the risk to develop AL, are required. PMID: 31789117 [PubMed - as supplied by publisher]
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
ConclusionThe random forest classifier based on radiomics features derived from pre-treatment ADC images have the potential to predict tumor resistance to NCRT in patients with LARC, and the use of predicting model may facilitate individualized management of rectal cancer.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
This study inv...
Source: World Journal of Surgical Oncology - Category: Cancer & Oncology Authors: Tags: Research Source Type: research
AbstractPurpose of ReviewContrarily to what happens with rectal cancer, the role of magnetic resonance imaging (MRI) in the assessment of colon cancer has been limited. However, we may witness a ‘paradigm shift’ in the future. Classically, colon cancer has been assessed by computed tomography (CT) which is considered the workhorse for evaluating this neoplasm as it provides insights not only about local and regional disease as well as about distant metastases. However, as the accuracy o f CT is somewhat limited, recent reports about the use of MRI in colon cancers have been published. In this review we will ass...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research
ConclusionCRT should be considered for cT3N0 patients, but its timing (neoadjuvant vs. adjuvant) seems not to affect the disease-free survival in the present cohort of patients.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
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