#15# Reviews (all) COLORECTAL NEOPLASMS. December 2013 - January 2014 ONCOLIT oncolit.com -------------------------------------------------------------[1] 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. -------------------------------------------------------------[2] 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. -------------------------------------------------------------[3] 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. -------------------------------------------------------------[4] 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). -------------------------------------------------------------[5] 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. -------------------------------------------------------------[6] 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. -------------------------------------------------------------[7] 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. -------------------------------------------------------------[8] 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. -------------------------------------------------------------[9] 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. -------------------------------------------------------------[10] 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. -------------------------------------------------------------[11] 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. -------------------------------------------------------------[12] 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. -------------------------------------------------------------[13] 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. -------------------------------------------------------------[62] 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. -------------------------------------------------------------[63] 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. -------------------------------------------------------------[64] 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). -------------------------------------------------------------[65] 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. -------------------------------------------------------------[66] 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. -------------------------------------------------------------[67] 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. -------------------------------------------------------------[70] 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. -------------------------------------------------------------[71] 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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