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The relations between individual foods and nutrients to colorectal tumours are conflicting. Few studies have taken into account the interdependence between individual components of diet and their possible interactions. The aim of the study was to examine the associations between dietary patterns and the risk of colorectal adenoma recurrence in the European fibre-calcium intervention trial. Among the 640 patients with confirmed adenomas at the index colonoscopy, 592 had an initial dietary assessment using a diet history questionnaire. The present analysis was restricted to 277 men and 165 women without history of adenoma prior to the index colonoscopy and who completed the study. The main end point was the 3-year recurrence of adenomas. Principal component analysis was used to identify dietary patterns from 50 food groups. Ninety-two patients presented new colorectal adenomas at the 3-year colonoscopy (65 men and 27 women). In men, three meaningful dietary patterns emerged from analysis, explaining 21.3% of variability. They were called 'Mediterranean', 'Sweets and snacks' and 'High fat and proteins' patterns. None of them were significantly related to the overall recurrence of colorectal adenomas either in univariate or multivariate analyses. Among women, the 'Mediterranean', the 'Western' and the 'Snacks' patterns explained 21.9% of variability. The 'Mediterranean' pattern characterized by a high consumption of olive oil, vegetables, fruit, fish and lean meat significantly reduced adenoma recurrence [second tertile: adjusted odds ratio (OR)=0.50, 95% confidence interval (CI)=0.18-1.42; third tertile: adjusted OR=0.30, 95% CI=0.09-0.98; P for linear trend=0.04]. The 'Western' and 'Snacks' patterns were not associated with recurrence among women. In conclusion, this study suggests that the Mediterranean dietary pattern may reduce the recurrence of colorectal adenomas, at least in women. These exploratory results need to be confirmed by larger studies.

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Objectives:To determine predictive factors of detectable prostate-specific antigen (PSA) in patients submitted to radical prostatectomy (RP) and to define the prognostic role of this event. Methods: A total of 318 patients who underwent RP between 2002 and 2007 were selected from our prospective database. Selection criteria were: no neo-adjuvant therapy; surgical specimens analyzed and reviewed according to a standardized protocol by two pathologists; clinical stage T1,T2 or T3 N0; pathological stage T2-3/N0-1. Results: Median age was 65. 22 years. All patients had a PSA greater than 20 ng/mL (6.9%). Fifty-six patients had poorly differentiated prostate cancer at biopsy (17.6%) and 77 after pathological examination. Cancer stage was cT2/3 in 128 (40.2%) patients, pT3 in 79 (24.8%) patients and pN1 in 20 patients (6.2%). Surgical margins were positive in 89 cases (28%). Thirty-three of the 318 patients had detectable PSA (10.3%) after RP. Multivariate analysis confirmed PSA (odds ratio 3.07; P = 0.0008), pT3a/b stage (odds ratio 2.72; P = 0.0466) and nodal metastasis (odds ratio 5.68; P = 0.0060) as independent predictors of detectable PSA after RP. Detectable PSA had a great impact on prognosis. Twenty-four of these 33 patients experienced a PSA progression and needed a second treatment. In a multivariate model, detectable PSA functioned as an independent predictor of PSA progression (hazard ratio 4.54; P = 0.0000). Conclusions: In our experience, a detectable PSA after RP can be predicted by preoperative PSA, pathological stage and nodal status. Moreover, it represents a significant risk factor of PSA progression. The strong imbalance towards risk factors of systemic disease supports the use of hormonal therapy in case of progression.

Transrectal ultrasound (TRUS) was performed preoperatively in 35 patients with rectal carcinoma and the results were compared to histologic findings. In the same group, postoperative studies were performed in 22 patients; in women, transvaginal ultrasound (TVUS) was added to the transrectal study. According to Duke's classification modified by Astler-Coller, in relation to the "T" parameter, TRUS correctly staged 33 of 35 neoplasms (accuracy, 94.3%); one was overstaged and one was understaged. In detection of lymph node involvement, accuracy was 74% (sensitivity 69%, specificity 73.9%). Recurrent local tumors, histologically confirmed, developed in two of 22 postoperative patients who had undergone curative anterior resection. This study demonstrates that TRUS is an accurate method in preoperative staging of rectal carcinoma. In the prospective study, the role of follow-up TRUS and TVUS in detection of local recurrences is evaluated.