Multiparametric Imaging for the Locoregional Follow-up of Rectal Cancer
AbstractPurpose of ReviewTo discuss the potential of multiparametric imaging for the locoregional follow-up of rectal cancer by outlining the strengths/weaknesses of anatomical imaging in specific MRI and highlighting the potential of the most relevant functional imaging and novel image post-processing techniquesRecent findingsIn addition to anatomical imaging, diffusion-weighted imaging (DWI) and PET have been most extensively studied for the locoregional follow-up of rectal cancer. Fewer (and more recent) studies have focused on the use of other functional MRI techniques, advanced post-processing methods such as Radiomic...
Source: Current Colorectal Cancer Reports - February 26, 2020 Category: Cancer & Oncology Source Type: research
Interventional Radiology for Colorectal Liver Metastases
AbstractPurpose of the ReviewTo discuss the pivotal role of Interventional radiology (IR) for the management of colorectal liver metastases (CRLM).Recent FindingsIR has three main objectives for the treatment of CRLM:Complete tumor destruction using percutaneous ablation, as an alternative to or more frequently in combination with surgeryIntra-arterial therapies to improve objective response rate and to prolong survivalAll support therapies such as portal vein embolization or fiducial placement to allow or facilitate further treatmentsSummaryRadiofrequency ablation (RFA) is the most reported percutaneous ablation technique...
Source: Current Colorectal Cancer Reports - February 20, 2020 Category: Cancer & Oncology Source Type: research
Quality of Life After Radiotherapy for Rectal and Anal Cancer
AbstractPurpose of ReviewWith advances in radiation therapy (RT) techniques for rectal and anal cancers allowing for the modulation of critical normal tissues, there has been an increased emphasis on improving the quality of life (QOL) for cancer survivors. Herein, we review the literature to examine the impact of RT on QOL and patient-reported outcomes (PROs) to better inform providers about the challenges of survivorship.Recent FindingsLarge systematic reviews, recent studies, and long-term follow-up of pivotal clinical trials have shown that RT impacts QOL, particularly fecal continence and sexual function. Modern preop...
Source: Current Colorectal Cancer Reports - January 15, 2020 Category: Cancer & Oncology Source Type: research
How to Best Image Colorectal Liver Metastases
AbstractPurpose of ReviewColorectal liver metastases affect about half of the patients with colorectal cancer and have an impact on prognosis. Resection of liver metastases, even after downstaging with chemotherapy, improves patient survival. Several imaging modalities are available for initial detection and follow-up of liver metastases. Our purpose is to review the advantages and disadvantages of each modality and to determine which is the optimal way to evaluate colorectal liver metastases in each phase of the patient ’s journey.Recent FindingsThe available evidence derives mostly from comparative studies and meta-ana...
Source: Current Colorectal Cancer Reports - January 13, 2020 Category: Cancer & Oncology Source Type: research
Challenges and Promises of Radiomics for Rectal Cancer
AbstractPurpose of ReviewThis literature review aims to gather the relevant works published on the topic of Radiomics in Rectal Cancer. Research on this topic has focused on finding predictors of rectal cancer staging and chemoradiation treatment response from medical images. The methods presented may, in principle, aid clinicians with the appropriate treatment planning options. Finding appropriate automatic tools to help in this task is very important, since rectal cancer has been considered one of the most challenging oncological pathologies in recent years.Recent FindingsRadiomics is a class of methods based on the extr...
Source: Current Colorectal Cancer Reports - November 26, 2019 Category: Cancer & Oncology Source Type: research
Local Therapy Options for Recurrent Rectal and Anal Cancer: Current Strategies and New Directions
AbstractPurpose of ReviewAlthough uncommon, locally recurrent rectal cancer (LRRC) and locally recurrent anal cancer (LRAC) after definitive chemoradiation can confer high morbidity and mortality. Although surgery is critical for management, recent studies show promising results with other locally directed and/or systemic treatment approaches. Here we review the literature to examine recent advances in management of this patient population.Recent FindingsFor LRRC, studies demonstrate success with newer surgical approaches and redefine contraindications for surgery. The roles of brachytherapy, repeat external beam irradiati...
Source: Current Colorectal Cancer Reports - November 26, 2019 Category: Cancer & Oncology Source Type: research
Colon Cancer Staging: When Does High Resolution MRI Have a Role?
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 assess the ...
Source: Current Colorectal Cancer Reports - November 25, 2019 Category: Cancer & Oncology Source Type: research
The Role of Contrast-Enhanced Imaging for Colorectal Cancer Management
AbstractPurpose of ReviewImaging is fundamental in the management of colorectal cancer (CRC). Contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance (CEMR) are the imaging modalities recommended to stage and restage CRC. The aim of this review is to summarize the most relevant studies published on the role of contrast-enhanced imaging for the management of CRC.Recent FindingsThere are published data demonstrating the accuracy of CECT and CEMR for local staging of both colon and rectal cancer, as well as for the evaluation of distant metastases. Moreover, different aspects of these methods, in...
Source: Current Colorectal Cancer Reports - November 24, 2019 Category: Cancer & Oncology Source Type: research
Fusobacterium nucleatum and the Immune System in Colorectal Cancer
AbstractPurpose of ReviewTo summarize the relationship between colorectal cancer (CRC), immunity, and the gut microbiome, focusing on the population ofFusobacterium, particularlyFusobacterium nucleatum, which may mediate CRC initiation and progression by inhibiting host anti-tumor immunity.Recent FindingsThe onset and advancement of CRC involves genetic and epigenetic alterations and are modified by dietary and environmental factors. There is increasing evidence suggesting that gut bacteria, such asFusobacterium nucleatum, may promote CRC development. The mechanisms through whichFusobacterium nucleatum from the oral cavity...
Source: Current Colorectal Cancer Reports - September 5, 2019 Category: Cancer & Oncology Source Type: research
The Current Status of Nodal Staging in Rectal Cancer
AbstractPurpose of ReviewTo review current practice in MRI-based nodal staging in rectal cancer and assess the associated evidence.Recent FindingsNodal staging is less accurate than other MRI-detected prognostic markers such as circumferential resection margin status, extramural venous invasion and T stage. Previous research has focused on matching MRI and pathology findings but crucially N stage has never been shown to have prognostic importance on MRI. Recent pathological evidence suggests that tumour deposits may be more important than nodal status and these can be clearly distinguished from nodal metastases on MRI.Summ...
Source: Current Colorectal Cancer Reports - August 27, 2019 Category: Cancer & Oncology Source Type: research
Current Trends in the Surgical Management of Colorectal Cancer Liver Metastases
AbstractPurpose of ReviewCancers of colorectal origin are the second leading cause of cancer-related deaths in the USA, and with the improvements in chemotherapy and other therapeutic modalities, there are more options for the management of metastatic disease. The liver is the most common site of colorectal metastasis, and treating the disease to the liver may lead to prolonged survival and possible cure. Our understanding of tumor biology and the refinement of surgical techniques have resulted in significantly improved outcomes. The treatment of colorectal liver metastasis is complex and thus requires a multidisciplinary ...
Source: Current Colorectal Cancer Reports - July 17, 2019 Category: Cancer & Oncology Source Type: research
Immune Checkpoint Inhibitors in Metastatic Colorectal Cancer: Current Status, Recent Advances, and Future Directions
AbstractPurpose of ReviewImmune checkpoint inhibitors have shown very promising outcomes in the subset of metastatic colorectal cancers (CRCs) that are mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H). We reviewed the existing literature on immune checkpoint inhibitors in colorectal cancers to highlight the recent advances and future directions.Recent FindingsThe significance of immune check point inhibitors in dMMR/MSI-H metastatic CRCs has been validated by several studies employing anti-programmed death cell receptor (anti-PD1) and anti-PDL1 antibodies single agent or in combination with anti-CTL...
Source: Current Colorectal Cancer Reports - July 9, 2019 Category: Cancer & Oncology Source Type: research
Current Trends in Systemic Therapies in Elderly Patients With Metastatic Colorectal Cancer
AbstractPurpose of ReviewThe incidence of colorectal cancer increases with age and the population is aging, making treatment of elderly patients with metastatic colorectal cancer (mCRC) an increasingly common part of oncology practice. We review the literature regarding systemic treatment of colorectal cancer in the elderly population.Recent FindingsMost of the data for toxicity and efficacy of systemic therapies for mCRC in older patients comes from subgroup analysis of pooled phase II and III trials of both chemotherapy and targeted agents. These studies suggest that combination chemotherapy and targeted therapy are well...
Source: Current Colorectal Cancer Reports - July 8, 2019 Category: Cancer & Oncology Source Type: research
Should Anti-EGFR Agents Be Used in Right-Sided RAS Wild-type Advanced Colorectal Cancer?
AbstractPurpose of ReviewColorectal cancer is the third most common cancer worldwide with a high mortality rate at the advanced stages of the disease. Treatment options are dependent on the stage of the disease, patients ’ performance status, and the specific molecular makeup of the tumor. Adding an anti-epidermal growth factor receptor monoclonal antibody (anti-EGFR mAb) to conventional chemotherapy in molecularly selected patients (i.e., RAS wild-type) leads to a survival advantage. We aim to review the latest e vidence on the influence of primary tumor location (PTL) on treatment response to chemotherapy combined with...
Source: Current Colorectal Cancer Reports - June 16, 2019 Category: Cancer & Oncology Source Type: research
Duration of Adjuvant Chemotherapy in Colon Cancer: Current Standards and New Updates
AbstractPurpose of ReviewAdjuvant therapy for 6 months is the standard of care for stage III colon cancer. The use of oxaliplatin-based therapy over fluoropyrimidine alone increases toxicity, including dose-dependent peripheral neuropathy. Evaluation of a shorter duration of adjuvant therapy was therefore warranted, aiming to reduce toxicity wh ile maintaining clinical efficacy.Recent FindingsThe International Duration Evaluation of Adjuvant chemotherapy (IDEA) collaboration was a pivotal prospective pooled analysis of 6 randomized phase III trials across 12 countries. IDEA evaluated the non-inferiority of 3 versus 6 m...
Source: Current Colorectal Cancer Reports - June 16, 2019 Category: Cancer & Oncology Source Type: research
