No abstract

(AMCO) and are increasingly used either palliatively or as a bridge to surgery (BTS) in patients in whom a definitive surgical approach is unsuitable. We evaluated short-term outcomes of malignant colorectal obstructive patients treated with SEMS in our institution over a 3-year period. Methods A prospectively maintained database was reviewed to identify all patients who presented to our institution with AMCO between August 2010 and 2013 and who were treated with a SEMS either temporarily or permanently. Additional data was retrieved from chart and pathology reviews. A single colorectal surgeon inserted all stents under both endoscopic and fluoroscopic guidance. Data was analysed using SPSSv21 (SPSS Inc., Chicago, IL, USA) and presented as median (interquartile range). Continuous variables were assessed using analysis of variance. A p value <0.05 was considered statistically significant. Results Sixteen patients each had a single stent inserted during the study period, either palliatively (n = 11) or as a BTS (n = 5). Their median (IQR) age was 75 (21) years and 12 (75%) patients were males. Most tumours were located in the sigmoid colon (6/16, 37%). The technical and clinical success rates were both 87.5% (14/16) and there were no SEMS-related perforations. The two unsuccessful stenting cases both had metastatic disease and required emergency surgery while five patients with potentially curable disease proceeded to elective resections. There was no procedure-related mortality. There was no difference in the median length of stay (LOS) post SEMS insertion in the palliative group compared to the BTS group [4 (4) vs. 5 (3), p = 0.2]. However, the median (IQR) LOS post acute surgery was longer than elective surgery [45 (30) vs. 14 (8) days, p = 0.018]. All patients in the BTS group were stoma-free post-operatively, while both patients who had emergency surgery ended up with permanent stomas. Finally, the stent complication rate was 6.2% (1/16), secondary to migration in a patient who was stented palliatively. The latter patient did not undergo further attempted stenting as his obstructive symptoms had been alleviated. Conclusion AMCO poses significant challenges in management due to the frailty of the presenting patients and the high morbidity/mortality rates associated with emergency surgery. Although limited by a small sample size, our study shows that SEMS are a favourable alternative to emergency surgery for the management of AMCO. Further larger scale studies looking at long-term survival and oncological outcomes are awaited. Disclosure of Interest None Declared. Introduction Colorectal cancer (CRC) is the fourth most common cancer in the UK and was responsible for more than 15,000 deaths in 2011. PWE-018 HSPC1 INHIBITORS POTENTIATE THE EFFECT OF 5-FU IN PRIMARY COLORECTAL CANCER CELL MODEL1 Less than 50% of patients with Dukes stage C and D survive more than 5 years. Following treatment, cell metabolism rate and apoptosis were assessed using MTS and caspase-3 assay. Results In HT29, 17-DMAG was effective in i...

BackgroundFaecal immunochemical tests (FIT) for haemoglobin (Hb) are being used in the investigation of colorectal cancer. These tests use antibodies raised to the globin moiety of human Hb. Here, four automated quantitative FIT systems (HM-JACKarc, NS-Prime, OC-Sensor PLEDIA and SENTiFIT 270) are evaluated analytically to confirm whether the performance of the systems meet the manufacturers’ claims.MethodsAssessment of the analytical performance of the FIT systems was undertaken using Hb lysates, real patient samples and external quality assessment (EQA) samples. This analytical assessment focused on detection characteristics, imprecision, linearity, prozone effect, recovery and carryover.ResultsAll four methods demonstrated good analytical performance, with acceptable within- and between-run imprecision, good recovery of f-Hb and limited carryover of samples. They also all show good linearity across the range of concentrations tested. The results of EQA samples showed different variations from the target values (−52 to 45%), due to the absence of standardisation across the different methods.ConclusionsAll four systems are fit for purpose and have an analytical performance as documented by their manufacturers.

Background The faecal immunochemical test (FIT) detects the presence of haemoglobin (Hb) in faeces. It is used as a screening tool for colorectal cancer (CRC) and increasingly to triage patients presenting with symptoms of CRC. A number of quantitative point-of-care (POC) FIT systems marketed for professional use and intended for use in a clinical setting are available. Here we reviewed the POC FIT systems available; three (Eurolyser Cube, OC-Sensor iO and QuikRead go) were evaluated to assess their performance against manufacturers’ claims and suitability for use in a clinical setting. Methods The analytical evaluation of the POC FIT systems was undertaken using Hb lysates, patient samples and an external quality assessment sample. The evaluation focused on linearity, recovery, imprecision, prozone effect, Hb variant detection and suitability for use in a clinical setting. Results All three POC FIT systems performed to their manufacturer’s claims and demonstrated good analytical performance with acceptable linearity, recovery, within- and between-run imprecision. The QuikRead go and OC-Sensor iO were able to accurately detect samples with results above their measuring range. However, because of a prozone effect the Eurolyser Cube gave falsely low results when using high concentrations of Hb. The QuikRead go performed best in the usability assessment due to portability and timeliness of result. Conclusion Each system performed according to their manufacturers’ claims. The QuikRead go and OC-Sensor iO are suitable for use. The Eurolyser Cube is not recommended because of the risk of falsely low results.