• Title/Summary/Keyword: Colorectal surgery

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Value of FDG PET/Contrast-Enhanced CT in Initial Staging of Colorectal Cancer - Comparison with Contrast-Enhanced CT

  • Kunawudhi, Anchisa;Sereeborwornthanasak, Karun;Promteangtrong, Chetsadaporn;Siripongpreeda, Bunchorn;Vanprom, Saiphet;Chotipanich, Chanisa
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4071-4075
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    • 2016
  • Background: FDG PET/CT is at an equivocal stage to recommend for staging of colorectal cancer as compared to contrast-enhanced CT (ceCT). This study was intended to evaluate the value of FDG PET/ceCT in colorectal cancer staging as compared to ceCT alone. Materials and Methods: PET/ceCT was performed for 61 colorectal cancer patients who were prospectively enrolled in the study. Three patients were excluded due to loss to follow-up. PET/ceCT findings and ceCT results alone were read separately. The treatment planning was then determined by tumor board consensus. The criteria for T staging were determined by the findings of ceCT. Nodal positive by PET/ceCT imaging was determined by visual analysis of FDG uptake greater than regional background blood pool activity. The diagnostic accuracy of T and N staging was determined only in patients who received surgery without any neoadjuvant treatment. Results: Of 58 patients, there were 40 with colon cancers including sigmoid cancers and 18 with rectal cancers. PET/ceCT in pre-operative staging detected bone metastasis and metastatic inguinal lymph nodes (M1a) that were undepicted on CT in 2 patients (3%), clearly defined 19 equivocal lesions on ceCT in 18 patients (31%) and excluded 6 metastatic lesions diagnosed by ceCT in 6 patients (10%). These resulted in alteration of management plan in 15 out of the 58 cases (26%) i.e. changing from chemotherapy to surgery (4), changing extent of surgery (9) and avoidance of futile surgery (2). Forty four patients underwent surgery within 45 days after PET/CT. The diagnostic accuracy for N staging with PET/ceCT and ceCT alone was 66% and 48% with false positive rates of 24% (6/25) and 76% (19/25) and false negative rates of 47% (9/19) and 21% (4/19), respectively. All of the false negative lymph nodes from PET/ceCT were less than a centimeter in size and located in peri-lesional regions. The diagnostic accuracy for T staging was 82%. The sensitivity of the peri-lesional fat stranding sign in determining T3 stage was 94% and the specificity was 54%. Conclusions: Our study suggested promising roles of PET/ceCT in initial staging of colorectal cancer with better diagnostic accuracy facilitating management planning.

Analysis of Surgical Results for the Patients with Pulmonary Metastasis from Colorectal Carcinoma (대장암의 전이성 폐암의 수술 결과에 대한 분석)

  • Sim, Hyung-Tae;Kim, Yong-Hee;Shin, Hong-Ju;Chun, Mi-Sun;Bae, Chi-Hoon;Lee, Eung-Sirk;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.838-843
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    • 2006
  • Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

Analysis of Key Genes and Pathways Associated with Colorectal Cancer with Microarray Technology

  • Liu, Yan-Jun;Zhang, Shu;Hou, Kang;Li, Yun-Tao;Liu, Zhan;Ren, Hai-Liang;Luo, Dan;Li, Shi-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1819-1823
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    • 2013
  • Objective: Microarray data were analyzed to explore key genes and their functions in progression of colorectal cancer (CRC). Methods: Two microarray data sets were downloaded from Gene Expression Omnibus (GEO) database and differentially expressed genes (DEGs) were identified using corresponding packages of R. Functional enrichment analysis was performed with DAVID tools to uncover their biological functions. Results: 631 and 590 DEGs were obtained from the two data sets, respectively. A total of 32 common DEGs were then screened out with the rank product method. The significantly enriched GO terms included inflammatory response, response to wounding and response to drugs. Two interleukin-related domains were revealed in the domain analysis. KEGG pathway enrichment analysis showed that the PPAR signaling pathway and the renin-angiotensin system were enriched in the DEGs. Conclusions: Our study to systemically characterize gene expression changes in CRC with microarray technology revealed changes in a range of key genes, pathways and function modules. Their utility in diagnosis and treatment now require exploration.

Anorectal malformation with didelphys uterus: Extremely rare anomaly and successful neoanal sphincter reconstruction with gracilis muscle flap

  • Burusapat, Chairat;Hongkarnjanakul, Natthawoot;Wanichjaroen, Nutthapong;Panitwong, Sakchai;Sangkaewsuntisuk, Jiraporn;Boonya-ussadorn, Chinakrit
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.272-276
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    • 2020
  • Anorectal malformation or imperforate anus is a congenital anomaly of rectum and anus. Mullerian duct anomalies are abnormal development of uterus, cervix, and vagina. Imperforate anus with double uterus is extremely rare and cannot explain by normal embryologic development. Moreover, guideline in treatment is inconclusive. We report an extremely rare case of a young adult female who presented with recurrent pelvic inflammatory disease caused by rectovaginal fistula in congenital imperforate anus and didelphys uterus, and successfully neoanal reconstruction with gracilis muscle flap. Aims for treatment are closed rectovaginal fistula, and anal sphincter reconstruction. To our best knowledge, the imperforate anus with double uterus is extremely rare anomaly. Furthermore, successfully anal sphincter reconstruction with functional gracilis muscle in the imperforate anus with double uterus has never been reported in English literature.

Effect of Portal Vein Chemotherapy on Liver Metastasis after Surgical Resection of Colorectal Cancer

  • Yu, Dong-Sheng;Li, Ying;Huang, Xin-En;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Cao, Jie;Xu, Xia;Xiang, Jin;Wang, Guo-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4699-4701
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    • 2012
  • Objective: To explore the effect of portal vein chemotherapy on liver metastasis after surgical resection of colorectal cancer. Methods: Patients fulfilling the eligibility criteria were assigned to receive either surgery plus 1-week continuous infusion of 5-FU (study group) or surgery alone (observational group). Patients in the study group received portal vein chemotherapy, whereby 5-FU (1000 mg/d) and heparin (5000 IU/d) infusion was initiated from the day of surgery and lasted for 7 consecutive days. Liver metastasis was monitored during five years follow-up postoperatively. Results: Sixty four patients were recruited and assigned to the study group (12 with colon and 20 with rectal cancer) or the control group (10 with colon and 22 with rectal cancer). Liver metastasis rate was 12.5% in study and 25.0% in observational group, the difference being significant (P<0.01). Conclusion: Portal vein chemotherapy could be an effective treatment in preventing liver metastasis after surgical resection of colorectal cancer.

Anti-HER-2×anti-CD3 Bi-specific Antibodies Inhibit Growth of HCT-116 Colorectal Carcinoma Cells in Vitro and in Vivo

  • Ren, Hui;Li, Jun;Liu, Jing-Jing;Guo, Hui-Ling;Jiang, Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2795-2798
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    • 2012
  • Objective: This study is conducted to evaluate the effects of anti-HER-2${\times}$anti-CD3 bi-specific antibodies(BsAb) on HER-2/neuover-expressing human colorectal carcinoma cells. Methods: Growth was assessed by MTT assays after exposure of HCT-116 cells to Herceptin, anti-CD3 and BsAb antibodies. Immunocytochemistry was applied to test the HER-2 level of HCT-116. In a nude mouse model, HER-2${\times}$CD3 BsAb was combined with effector cells (peripheral blood lymph cells from normal human being) for observations on in Vivo growth of tumors. Results: Compared with the control group, using effector cells combined with anti-CD3 McAb, Herceptin or HER2${\times}$CD3 BsAb, tumor cell growth in vitro and in vivo was significantly inhibited (P<0.05), most remarkably in the HER2${\times}$CD3 BsAb case. The growth of xenografts with HER2${\times}$CD3 BsAb combined with effector cells was also significantly inhibited when compared with the anti-CD3 McAb or Herceptin groups (P<0.05). Conclusion: HER-2/neu might be a useful target for immunotherapy in colorectal carcinoma, anti-HER2${\times}$anti-CD3 BsAb exerting clear anti-tumor effects.

Descriptive Epidemiology of Colorectal Cancer in University Malaya Medical Centre, 2001 to 2010

  • Magaji, Bello Arkilla;Moy, Foong Ming;Roslani, April Camilla;Law, Chee Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6059-6064
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    • 2014
  • Background: Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. Materials and Methods: Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ANOVA. P-value significance was set at 0.05. Results: The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). Conclusions: Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.

The Inhibitory Effect of Gut Microbiota and Its Metabolites on Colorectal Cancer

  • Chen, Chao;Li, Huajun
    • Journal of Microbiology and Biotechnology
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    • v.30 no.11
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    • pp.1607-1613
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    • 2020
  • Colorectal cancer (CRC) is regarded as one of the most common and deadly forms of cancer. Gut microbiota is vital to retain and promote several functions of intestinal. Although previous researches have shown that some gut microbiota have the abilities to inhibit tumorigenesis and prevent cancer from progressing, they have not yet clearly identified associative mechanisms. This review not only concentrates on the antitumor effects of metabolites produced by gut microbiota, for example, SCFA, ferrichrome, urolithins, equol and conjugated linoleic acids, but also the molecules which constituted the bacterial cell wall have the antitumor effect in the host, including lipopolysaccharide, lipoteichoic acid, β-glucans and peptidoglycan. The aim of our review is to develop a possible therapeutic method, which use the products of gut microbiota metabolism or gut microbiota constituents to help treat or prevent colorectal cancer.

Combining Information of Common Metabolites Reveals Global Differences between Colorectal Cancerous and Normal Tissues

  • Chae, Young-Kee;Kang, Woo-Young;Kim, Seong-Hwan;Joo, Jong-Eun;Han, Joon-Kil;Hong, Boo-Whan
    • Bulletin of the Korean Chemical Society
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    • v.31 no.2
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    • pp.379-383
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    • 2010
  • Metabolites of colorectal cancer tissues from 12 patients were analyzed and compared with those of the normal tissues by two-dimensional NMR spectroscopy. NMR data were analyzed with the help of the metabolome database and the statistics software. Cancerous tissues showed significantly altered metabolic profiles as compared to the normal tissues. Among such metabolites, the concentrations of taurine, glutamate, choline were notably increased in the cancerous tissues of most patients, and those of glucose, malate, and glycerol were decreased. Changes in individual metabolites varied significantly from patient to patient, but the combination of such changes could be used to distinguish cancerous tissues from normal ones, which could be done by PCA analysis. The traditional chemometric analysis was also performed using AMIX software. By comparing those two results, the analysis via $^1H-^{13}C$ HSQC spectra proved to be more robust and effective in assessing and classifying global metabolic profiles of the colorectal tissues.

Longitudinal Study of Cancer-Related Fatigue in Patients with Colorectal Cancer

  • Li, Shu-Xia;Liu, Bei-Bei;Lu, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3029-3033
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    • 2014
  • Background: Dynamic changes of cancer-related fatigue (CRF) among hospitalized patients with colorectal cancer were determined. Materials and Methods: This longitudinal, descriptive study involved 96 hospitalized patients with colorectal cancer, all recruited from a tertiary general hospital in Guangzhou, China. Patients completed questionnaires three times to assess the degree of fatigue, and measurement points were within one week of admission, at 2 to 3 days after surgery and 3 weeks after surgery. Results: Significant differences among the three measurement points (p<0.01) were observed. The scores of fatigue in the second survey were the highest, followed by the third and first surveys. Colon cancer patient scores were higher than those of rectal cancer patients with a significant difference (p<0.05). Colorectal patients experienced different degrees of fatigue at different periods during hospitalization. Conclusions: This study highlights the importance of interventions that are carefully tailored to patients based on the characteristics at different periods to alleviate fatigue.