Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO) RAPIDO collaborative investigators; Bahadoer

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Background:The most common complication after breast cancer surgery is seroma formation. It is a source of significant morbidity and discomfort. Many articles have been published describing risk factors and preventive measures. The aim of this paper is to provide a systematic review of studies and reports on risk factors and preventive measures. Surgery lies at the core of seroma formation; therefore focus will be placed on surgical ways of reducing seroma. Methods: A computer assisted medline search was carried out, followed by manual retrieval of relevant articles found in the reference listings of original articles. Results: 136 relevant articles were reviewed. Though the level of evidence remain varied several factors,type of dissection, tools with wich dissection is carried out, reduction of dead space, suction drainage, use of fibrin glue and octreotide usage, have been found to correlate with seroma formation and have been shown to significantly reduce seroma rates. Conclusion: Seroma formation after breast cancer surgery can not be avoided at present. There are however several methods to minimize seroma and associated morbidity. Future research should be directed toward the best ways of reducing seroma by combining proven methods.

BackgroundThere is an increasing demand for accurate biomarkers for early non-invasive colorectal cancer detection. We employed a genome-scale marker discovery method to identify and verify candidate DNA methylation biomarkers for blood-based detection of colorectal cancer.Methodology/Principal FindingsWe used DNA methylation data from 711 colorectal tumors, 53 matched adjacent-normal colonic tissue samples, 286 healthy blood samples and 4,201 tumor samples of 15 different cancer types. DNA methylation data were generated by the Illumina Infinium HumanMethylation27 and the HumanMethylation450 platforms, which determine the methylation status of 27,578 and 482,421 CpG sites respectively. We first performed a multistep marker selection to identify candidate markers with high methylation across all colorectal tumors while harboring low methylation in healthy samples and other cancer types. We then used pre-therapeutic plasma and serum samples from 107 colorectal cancer patients and 98 controls without colorectal cancer, confirmed by colonoscopy, to verify candidate markers. We selected two markers for further evaluation: methylated THBD (THBD-M) and methylated C9orf50 (C9orf50-M). When tested on clinical plasma and serum samples these markers outperformed carcinoembryonic antigen (CEA) serum measurement and resulted in a high sensitive and specific test performance for early colorectal cancer detection.Conclusions/SignificanceOur systematic marker discovery and verification study for blood-based DNA methylation markers resulted in two novel colorectal cancer biomarkers, THBD-M and C9orf50-M. THBD-M in particular showed promising performance in clinical samples, justifying its further optimization and clinical testing.

A rare case of abdominal trauma, a handlebar hernia, is described, as well as a review of the pertinent literature. A 7-year-old boy presented to our emergency room after sustaining blunt force to the abdomen; he fell on the handlebar of his bicycle. Immediately after the accident, a bulge was noticeable at the point of impact. Handlebar hernia is a diagnosis that is easily missed, which can lead to strangulation and incarceration of the bowel. With this case report, we hope to augment the knowledge on traumatic abdominal wall hernia, hopefully leading to early diagnosis and treatment.