Advances in the treatment of metastatic colorectal carcinoma

BackgroundThe aim of the study was to compare the survival of patients receiving laparoscopic vs. open radical resection for stage II colon cancer.Patients and methodsTwo hundred and twenty patients with stage II colon cancer were enrolled from Beijing Chaoyang Hospital of Capital Medical University from January 2000 to December 2009, including 61 patients in the laparoscopic radical resection group and 159 patients in the open radical resection group. The survival data in both groups were compared using the log rank test based on Kaplan-Meier survival curves.ResultsThere was no statistically significant difference in the 3-year survival (88.5% vs. 80.5%; X2=1.98, P=0.159) and the 5-year survival (81.9% vs. 69.2%; X2=1.98, P=0.159) between both groups. However, statistically significant difference was found in median overall survival (mOS), which was 102.6 (95% CI: 76.8–122.7) months in the laparoscopic group and 90.0 (95% CI: 70.4–109.6) months in the open radical resection group (X2=4.183, P=0.041). mOS was 96 (95% CI: 68.6–111.4) months and 92.6 (95% CI: 56.8–107.2) months in those with and without postoperative chemotherapy, respectively (X2=6.389, P=0.011). For patients older than 75 years the mOS was 90.0 (95% CI: 25.3–105.0) months and 83.4 (95% CI: 13.1–96.9) months in the laparoscopic and open group, respectively. The difference between the both groups was statistically significant (X2=6.191, P=0.013).ConclusionsThe mOS of patients receiving laparoscopic radical resection was better than open radical resection for stage II colon cancer, especially for patients over 75 years old.

Section: Discussionmentioning

confidence: 93%

Comparison of survival of patients receiving laparoscopic and open radical resection for stage II colon cancer

Fan¹,

Chu²,

Wei³

et al. 2011

“…It is extremely important for discovering the extent of the disease and enabling the proper choice of the treatment. On that way we can influence on better surviving and quality of life of our patients 8,9. Regarding comfort, the CTC procedure is undoubtedly in advance compared to other two procedures.…”

Section: Discussionmentioning

confidence: 95%

CT colonography in detection of colorectal carcinoma

Sofić¹,

Beslić²,

Kocijančič³

et al. 2010

BackgroundDiagnostic methods used in screening and detecting colorectal carcinoma are digitorectal examination, faecal occult blood testing, sigmoidoscopy, DNA stool analysis, barium enema, colonoscopy, and as of recently CT colonography. The aim of this study was to establish diagnostic accuracy and comfort of CT colonography compared to colonoscopy and barium enema.Patients and methods.We included 231 patients in the prospective study. For all patients CT colonography and barium enema followed by colonoscopy were performed. After the procedures a comfort assessment was done in all patients. Diagnostic positive results were verified by the pato-histological examination. Sensitivity, specificity, positive predicative value (PPV) and negative predicative value (NPV) were calculated for each procedure.ResultsWith CT colonography, barium enema and colonoscopy 95 lesions were found, 56 (59%) of them were tumours and 39 (41%) were polyps. Among polyps pato-histology revealed 34 adenomas, 3 tubulovillous adenomas and 2 lipomas, among tumours there were 55 adenocarcinomas and 1 lymphoma. Results showed CT colonography sensitivity to polyps to be 89.7%, barium enema 48.7%, and colonoscopy 94.9%. Sensitivity to tumours of CT colonography and colonoscopy was 100% and of barium enema 94.6%. Specificities and PPV were 100% in all procedures. The comfort assessment showed CT colonography as the far most comfortable out of three procedures.

“…The sensitivity to chemotherapeutic drugs and local concentration are two crucial factors determining the fate of cancer cells (especially the tumour stem cells) and the subsequent pathological remission rate 15. Traditionally, the pre-operative chemotherapy is carried out through intravenous infusion.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of local targeted chemotherapy for triple-negative breast cancer

He¹,

Wang²,

Guan³

et al. 2011

BackgroundThe aim of the study was to evaluate the clinical efficacy of superselective intra-arterial targeted neo-adjuvant chemotherapy in the treatment of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor receptor 2 (HER2)-negative (triple-negative) breast cancer.Patients and methods.A total of 47 triple-negative breast cancer patients (29 at stage II, 13 at stage III and 5 at stage IV) were randomly assigned to two groups: targeted chemotherapy group (n=24) and control group (n=23). Patients in the targeted chemotherapy group received preoperative superselective intra-arterial chemotherapy with CEF regimen (C: cyclophosphamide [600 mg/m2]; E: epirubicin [90 mg/m2]; F: 5-fluorouracil [600 mg/m2]), and those in the control group received routine neoadjuvant chemotherapy with CEF. The duration of the treatment, changes in lesions and the prognosis were determined.ResultsThe average course of the treatment was 15 days in the targeted chemotherapy group which was significantly shorter than that in the control group (31 days) (P<0.01). The remission rate of lesions was 91.6% in the targeted chemotherapy group and 60.9% in the control group, respectively. Among these patients, 9 died within two years, including 2 (both at IV stage) in the targeted chemotherapy group and 7 (2 at stage II, 4 at stage III and 1 at stage IV) in the control group.ConclusionsAs an neoadjuvant therapy, the superselective intra-arterial chemotherapy is effective for triple-negative breast cancer, with advantages of the short treatment course and favourable remission rates as well as prognoses.