Grey areas and evidence gaps in the management of rectal cancer as revealed by comparing recommendations from clinical guidelines

Rectal cancers account for 39% of colorectal tumours, and represent the 8th most common malignancy and the 9th leading cause of cancer-related deaths [1]. In 2018, 704,376 new diagnoses and 310,394 deaths for this disease were registered worldwide [1]. The global distribution of rectal cancer is characterised by some geographic variation with incidence rates being higher in Eastern Europe, Australia/New Zealand and Eastern Asia while lower in most African regions and Southern Asia [1]. Rectal cancers are the most common colorectal tumour among people
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Systematic or Meta-analysis Studies Source Type: research

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ConclusionThe incidence rate of metastasis V is correlated with tumor staging factors and occurs more frequently in advanced-stage patients.
Source: World Journal of Surgery - Category: Surgery Source Type: research
Authors: Takeuchi N, Koike K, Yoshida S, Fujiwara M Abstract Recent therapeutic advancements have prolonged the survival duration of patients with metastatic or recurrent colorectal cancer even during salvage treatment. Although treatment with regorafenib and trifluridine/tipiracil combination has exhibited apparent survival benefits, clear and objective evidence of a response to these drugs is scarce. Herein, the present study reports the case of a patient with rectal cancer refractory to multiple surgical interventions and standard chemotherapy. Treatment with regorafenib resulted in immediate improvement of resp...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
This study reviewed the applicability of laparoscopy in this challenging setting.MethodsRetrospective analysis of patients who underwent trans-abdominal re-operative rectal surgery from 2010-2019 was performed.ResultsSeventy-eight patients [35 females (45%); BMI 25kg/m2) were included. Reasons for reoperation were recurrent cancer in 18 (43%) patients and anastomotic failure in 57 (73%). Twenty-two (28%) had laparoscopic surgery and 4 had attempted laparoscopy converted to laparotomy. A higher success rate was noted for laparoscopy with prior laparoscopic surgery. Benefits of laparoscopy included significant reduction in l...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Risk increased for colon cancer 10 to 14 years after surgery; no increase in risk found for rectal cancer
Source: The Doctors Lounge - Oncology - Category: Cancer & Oncology Tags: Family Medicine, Gastroenterology, Internal Medicine, Oncology, Surgery, Journal, Source Type: news
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
Authors: Zhang G, Xu Q, Wang Z, Sun L, Lv Z, Liu J, Xing C, Yuan Y Abstract Low rectal cancer is a subtype of colorectal cancer at a special anatomic site with distinct biological behavior. TP53 is one of the most important cancer suppressor genes, and its structural variation and abnormal expression has been revealed to be associated with multiple cancer types. However, to the best of our knowledge, the association of p53 protein expression with its gene polymorphism, biological behavior and prognosis in low rectal cancer has not been clarified. Therefore, the current study aimed to explore these associations. In ...
Source: Oncology Letters - Category: Cancer & Oncology Tags: Oncol Lett Source Type: research
JC, Sjo O, Rashid G Abstract BACKGROUND: Transanal total mesorectal excision (TaTME) for rectal cancer has emerged as an alternative to the traditional abdominal approach. However, concerns have been raised about local recurrence. The aim of this study was to evaluate local recurrence after TaTME. Secondary aims included postoperative mortality, anastomotic leak and stoma rates. METHODS: Data on all patients who underwent TaTME were recorded and compared with those from national cohorts in the Norwegian Colorectal Cancer Registry (NCCR) and the Norwegian Registry for Gastrointestinal Surgery (NoRGast). Kapla...
Source: The British Journal of Surgery - Category: Surgery Authors: Tags: Br J Surg Source Type: research
ConclusionsThis framework is developed with our clinical partner, based on actual clinical conditions. The experimental protocol and the high level of accuracy show the feasibility of seamlessly integrating this framework within the surgical workflow.
Source: International Journal of Computer Assisted Radiology and Surgery - Category: Intensive Care 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
The association between physical activity (PA) and colorectal cancer (CRC) patients’ survival is inconsistent. We conducted a systematic review and meta-analysis to summarize published articles on this issue. We performed a comprehensive search of the PubMed, Embase, and Web of Science databases for relevant articles through 28 February 2018. The summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Eighteen prospective cohort studies were included in the meta-analysis, with a total of 9257 cases of total mortality (TM) and 4015 cases of colorectal cancer-specific...
Source: European Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Gastrointestinal Cancer Source Type: research
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