A Review of Controversies in the Management of Colorectal Cancers

Deo, S. V. S.; Kapali, Aravind S; Gupta, Mona; Shukla, Nootan Kumar

doi:10.1007/s12262-012-0586-5

Cited by 7 publications

(7 citation statements)

References 50 publications

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“…As distal resection margin length remains a crucial parameter in cases of rectal cancer due to challenges associated with sphincter preserving surgery, our study suggests molecular evaluation of distal margins along with histopathology for better prognostication of patients with CRC.…”

Section: Discussionmentioning

confidence: 89%

Augmented CD133 expression in distal margin correlates with poor prognosis in colorectal cancer

Pradhan

Padmanabhan

Prasad

et al. 2019

J Cellular Molecular Medi

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Pathological assessment of excised tumour and surgical margins in colorectal cancer (CRC) play crucial role in prognosis after surgery. Molecular assessment of margins could be more sensitive and informative than conventional histopathological analysis. Considering this view, we evaluated the distal surgical margins for expression of cancer stem cell (CSC) markers. Cellular and molecular assessment of normal, tumour and distal margin tissues were performed by flow cytometry, real‐time q‐PCR and immuno‐histochemical analysis for CRC patients after tumour excision. CRC patients were evaluated for expression of CSC markers in their normal, tumour and distal tissues. Flow cytometry assay revealed CD133 and CD44 enriched cells in distal margin and tumour compared to normal colorectal tissues, which was further confirmed by immunohistochemistry. Most importantly, immunohistochemistry also revealed the enrichment of CSC markers expression in pathologically negative distal margins. Patients with distal margin enriched for CD133 expression showed an increased recurrence rate and decreased disease‐free survival. This study proposes that although distal margin seems to be tumour free in conventional histopathological analysis, it could harbour cells enriched for CSC markers. Further CD133 could be a promising molecule to be used in molecular pathology for disease prognosis after surgery in CRC patients.

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Section: Discussionmentioning

confidence: 89%

Augmented CD133 expression in distal margin correlates with poor prognosis in colorectal cancer

Pradhan

Padmanabhan

Prasad

et al. 2019

J Cellular Molecular Medi

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“…Preoperative radiotherapy was performed to improve local control and the chance of performing a sphincter saving procedure [1,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…We also considered that neither a protective stoma (ileostomy or colostomy) was necessary, as suggested by some authors [9,13], because of the sub peritoneal location of the coloanal anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Intersphincteric Resection for Low Rectal Cancer – Case Report

Russu

Molnar

Copotoiu

et al. 2016

Acta Medica Marisiensis

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Introduction: Surgical treatment for low rectal cancer represents a challenge: to perform a radical resection and to preserve the sphincter's function. We report a case of intersphincteric resection in a combined multimodality treatment for low rectal cancer, with good oncologic and functional outcome. Case presentation: We report a case of a 73 years old woman admitted in April 2014 in surgery, for low rectal cancer. The diagnostic was established by colonoscopy and malignancy confirmed by biopsy. Complete imaging was done using computed tomography and magnetic resonance to establish the exact stage of the disease. The interdisciplinary individualized treatment began with radiotherapy (total dose of 50 Gy, administered in 25 fractions) followed by surgery after eight weeks. We performed intersphincteric rectal resection by a modified Schiessel technique. There were no postoperative complications and the oncologic and functional results were very good at one year follow up. Conclusions: Intersphincteric resection, in this selected case of low rectal cancer, represented an efficient surgical treatment, with good functional results and quality of life for the patient. A multidisciplinary team is an invaluable means of assessing and further managing the appropriate, tailored to the case, treatment in the aim of achieving best results.

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“…In our The high rate of postoperative anastomotic fistulas in patients with sphincter conservatory procedures can be associated, even if with no statistical significance (p = 0.6576), with a locally advanced stage of the disease (in 65.78% of cases were T3 tumors), of an altered biological status of the patient with cancerous disease and cannot be attributed to the technique of anastomosis [13]. As a possible option, that may reduce anastomotic leakage rate, can be taken into consideration the protective role of a temporary proximal diverting stoma [14,15].…”

Section: Discussionmentioning

confidence: 99%

Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives

Russu¹,

Copotoiu²,

Bud³

et al. 2015

Acta Medica Marisiensis

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Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results. Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared. Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made. Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.

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A Review of Controversies in the Management of Colorectal Cancers

Cited by 7 publications

References 50 publications

Augmented CD133 expression in distal margin correlates with poor prognosis in colorectal cancer

Augmented CD133 expression in distal margin correlates with poor prognosis in colorectal cancer

Intersphincteric Resection for Low Rectal Cancer – Case Report

Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives

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