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Background: Colorectal cancer (CRC) who is initially diagnosed with single or multiple synchronous distant metastases has an incidence of about 20% of all CRC patients. There is a controversy regarding the role of resection of the primary tumors in those patients. The aim of this study was to explore the prognostic roles and survival advantages of surgical excision of the primary colonic tumor in patients with CRC who are primarily diagnosed with distant metastases. Patients and Methods: We included forty patients who were diagnosed initially with stage IV CRC. We have divided the included patients into two categories the first one included 20 patients that underwent surgical excision of the primary cancer followed by administration of chemotherapy and the remaining 20 patients were initially given chemotherapy without excision of the cancer. We followed patients for 24 months to detect progression, response to chemotherapy, recurrence free survival and overall survival rates. Results: There is statistically significant difference between patients underwent different initial management techniques regarding N stage of the tumor (p = 0.039), response to chemotherapy (p = 0.048), occurrence of relapse (p = 0.022), disease free survival (DFS) (p = 0.027) or overall survival (OS) rates (p = 0.001) (DFS and OS were significantly higher among patients who received initial surgical management. Primary surgical removal of the tumor improved OS rate by 8 months (p = 0.001). Conclusion: Surgical removal of the primary malignancy in mCRC patients before chemotherapy How to cite this paper:

Background: Obesity is a major risk factor for endometrial carcinoma, and we aim to assess markers of carcinogenesis including PTEN and Ki-67 and hormone receptors profile including ER, PR and AR before and after bariatric surgery to find out its effects in reducing endometrial carcinoma risk in morbid obese females. Patients and methods: The study included 80 females with morbid obesity (BMI > 40 Kg/m 2) who underwent bariatric surgery. All were sampled by Pipelle biopsy at baseline and 12 months after operation and examined histopathologically and immunohistochemically for Ki-67, PTEN, ER, PR and AR. Results: Sixty two out of 80 (62/80) females showed no pathological abnormalities; 4 had polyps; 7 had simple endometrial hyperplasia; 4 had atypical endometrial hyperplasia and 3 had endometrial carcinoma. In total, 34 females underwent gastric bypass operation (42.5%) and 46 underwent a sleeve gastrectomy operation (57.5%). There was a statistically significant difference between baseline weight and BMI before and after surgery (p < 0.001). Of the 7 women with simple hyperplasia, resolution occurred in 5 within 7 months of surgery. Three of 4 females with atypical hyperplasia (AH) showed resolution after 9 months. Mean Ki-67 score was lower at 12

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