Complete mesocolic excision and extended (D3) lymphadenectomy for colonic cancer: is it worth that extra effort? A review of the literature

Emmanuel, Andrew; Haji, Amyn

doi:10.1007/s00384-016-2502-0

Cited by 63 publications

(41 citation statements)

References 75 publications

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“…There is general consensus in the western world that the resection should be performed in the mesocolic (embryological) plane, but it is the importance of central ligation of the tumour feeding vessel that is still debated [18]. Concerns have also been raised about potentially increased morbidity from high ligation [16,19].…”

Section: Discussionmentioning

confidence: 99%

Radiological and pathological evaluation of the level of arterial division after colon cancer surgery

et al. 2017

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There are no conflicts of interest Word count:Text: 2992 Abstract: 250Colon-CT study -3 - Abstract:Aim: Complete mesocolic excision for colon cancer includes central division of the tumour feeding artery. The degree of central radicality is assessed by measuring the distance from the tumour to the artery ligation by the pathologist on the resected specimen. As the length of the artery is highly variable between individuals, this technique may not be the most accurate measure of radicality as it cannot assess the length of the artery left behind inside the patient. The aim was to visualize the length of the tumour feeding artery after surgery and compare the relationship to pathological measures.Method: The length of the arterial stump was measured from the origin to the ligation point on a CT-scan two days post-operatively. This was done by a specialized radiologist who was blinded to operative procedure.Results: 52 patients had the required CT images. The mean length of the residual arterial stump was 38 mm, which was significantly longer than the expected length of <10 mm (p<0.0001). On the right side, the mean length was 31 mm and independent of the relation to the superior mesenteric vein. On the left side, the mean length was 49 mm. There was no correlation between the residual arterial stump and the pathological measures of specimen radicality.Conclusions: The residual arterial stumps measured by post-operative CT were longer than expected even on the right side where a CME was attempted.. Caution should be taken when using pathological measures as an estimation of a central ligation.Colon-CT study -4 -What does this paper add to the literature? This is the first study that measures the length of the remaining arterial stump after colon cancer surgery in a prospective and consecutive cohort. Furthermore, the results are compared to the pathological measures of central radicality on the specimen resected and we found no correlation.

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Section: Discussionmentioning

confidence: 99%

Radiological and pathological evaluation of the level of arterial division after colon cancer surgery

et al. 2017

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“…The concept of CME introduced standardized colon cancer surgery with resection in the mesocolic plane and central ligation of the tumor feeding vessel [1]. In recent years, there has been significant debate about the clinical benefit of CME surgery and specifically mandatory division of the tumor feeding artery remains controversial [5,6].…”

Section: Discussionmentioning

confidence: 99%

Routine CT scan one year after surgery can be used to estimate the level of central ligation in colon cancer surgery

et al. 2019

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“…Colorectal cancer (CRC) is the third most common diagnosis and second deadliest malignancy for both sexes combined [1]. Many therapeutic strategies, such as surgery, chemotherapy, and radiotherapy, are used to treat CRC, and radiotherapy combined with chemotherapy is the standard of care in locally advanced rectal cancer in the setting of neoadjuvant treatment, but the outcome remains suboptimal for advanced cases.…”

Section: Introductionmentioning

confidence: 99%

Activation of PERK Contributes to Apoptosis and G2/M Arrest by Microtubule Disruptors in Human Colorectal Carcinoma Cells

Chien

Jargalsaikhan

et al. 2019

Cancers

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Microtubule-targeting agents (MTAs) are widely used in cancer chemotherapy, but the therapeutic responses significantly vary among different tumor types. Protein kinase RNA-like endoplasmic reticular (ER) kinase (PERK) is an ER stress kinase, and the role of PERK in the anticancer effects of MTAs is still undefined. In the present study, taxol (TAX) and nocodazole (NOC) significantly induced apoptosis with increased expression of phosphorylated PERK (pPERK; Tyr980) in four human colon cancer cell lines, including HCT-15, COLO205, HT-20, and LOVO cells. Induction of G2/M arrest by TAX and NOC with increases in phosphorylated Cdc25C and cyclin B1 protein were observed in human colon cancer cells. Application of the c-Jun N-terminal kinase (JNK) inhibitors SP600125 (SP) and JNK inhibitor V (JNKI) significantly reduced TAX- and NOC-induced apoptosis and G2/M arrest of human colon cancer cells. Interestingly, TAX- and NOC-induced pPERK (Tyr980) protein expression was inhibited by adding the JNK inhibitors, SP and JNKI, and application of the PERK inhibitor GSK2606414 (GSK) significantly reduced apoptosis and G2/M arrest by TAX and NOC, with decreased pPERK (Tyr980) and pJNK, phosphorylated Cdc25C, and Cyc B1 protein expressions in human colon cancer cells. Decreased viability by TAX and NOC was inhibited by knockdown of PERK using PERK siRNA in COLO205 and HCT-15 cells. Disruption of the mitochondrial membrane potential and an increase in B-cell lymphoma-2 (Bcl-2) protein phosphorylation (pBcl-2; Ser70) by TAX and NOC were prevented by adding the PERK inhibitor GSK and JNK inhibitor SP and JNKI. A cross-activation of JNK and PERK by TAX and NOC leading to anti-CRC actions including apoptosis and G2/M arrest was first demonstrated herein.

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Complete mesocolic excision and extended (D3) lymphadenectomy for colonic cancer: is it worth that extra effort? A review of the literature

Abstract: Although there is a reasonable anatomical and oncological basis for these techniques, there are no randomised controlled trials from which to draw confident conclusions and there is insufficient consistent high quality evidence to recommend widespread adoption of CME.

Cited by 63 publications

References 75 publications

Radiological and pathological evaluation of the level of arterial division after colon cancer surgery

Radiological and pathological evaluation of the level of arterial division after colon cancer surgery

Routine CT scan one year after surgery can be used to estimate the level of central ligation in colon cancer surgery

Activation of PERK Contributes to Apoptosis and G2/M Arrest by Microtubule Disruptors in Human Colorectal Carcinoma Cells

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