The “addition” and “subtraction” of adjuvant chemotherapy for locally advanced colorectal cancer

Chen, Xinhua; Lin, Zhousheng; Yu, Jiang

doi:10.1097/cm9.0000000000000473

Cited by 3 publications

(6 citation statements)

References 29 publications

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“…[9] With the development of preoperative neoadjuvant radiotherapy and chemotherapy, the technology of laparoscopic surgery continues to improve, and with the evolution of surgical instruments, [10] the success rate of sphincter-sparing surgery (SSS) for ultralow rectal cancer has increased. [11] However, there are still some controversies regarding the distal resection margin (the distance between the cutting edge and the tumor edge). [12] An insufficient distal resection margin is one of the reasons for local recurrence.…”

Section: This Study Was Funded By the Guangxi Science And Technology ...mentioning

confidence: 99%

Determining the optimal distal resection margin in rectal cancer patients by imaging of large pathological sections: An experimental study

Lin,

Wei,

Lai

et al. 2024

Medicine

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Objective: To determine the distal resection margin in sphincter-sparing surgery in patients with low rectal cancer based on imaging of large pathological sections. Methods: Patients who underwent sphincter-sparing surgery for ultralow rectal cancer at Guangxi Medical University Cancer Hospital within the period from January 2016 to March 2022 were tracked and observed. The clinical and pathological data of the patients were collected and analyzed. The EVOS fluorescence automatic cell imaging system was used for imaging large pathological sections. Follow-up patient data were acquired mainly by sending the patients letters and contacting them via phone calls, and during outpatient visits. Results: A total of 46 patients (25 males, 21 females) aged 27 to 86 years participated in the present study. Regarding clinical staging, there were 9, 10, 16, and 10 cases with stages I, II, III, and IV low rectal cancer, respectively. The surgical time was 273.82 ± 111.51 minutes, the blood loss was 123.78 ± 150.91 mL, the postoperative exhaust time was 3.67 ± 1.85 days, and the postoperative discharge time was 10.36 ± 5.41 days. There were 8 patients with complications, including 3 cases of pulmonary infection, 2 cases of intestinal obstruction, one case of pleural effusion, and one case of stoma necrosis. The longest and shortest distal resection margins (distances between the cutting edges and the tumor edges) were 3 cm and 1 cm, respectively. The minimum length of the extension areas of the tumor lesions in the 46 images of large pathological sections was 0.1 mm, and the maximum length was 15 mm. Among the tumor lesions, 91.30% (42/46) had an extension area length of ≤5 mm, and 97.83% (45/46) had an extension area length of ≤10 mm. The length of the extension zone was not related to clinical pathological parameters (P > .05). Conclusion: In the vast majority of cases, the distal resection margin was at least 1 cm; thus, “No Evidence of Disease” could have been achieved. Additional high-powered randomized trials are needed to confirm the results of the present study.

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Section: This Study Was Funded By the Guangxi Science And Technology ...mentioning

confidence: 99%

Determining the optimal distal resection margin in rectal cancer patients by imaging of large pathological sections: An experimental study

Lin,

Wei,

Lai

et al. 2024

Medicine

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“…Neoadjuvant chemoradiotherapy (nCRT) has a key role in the treatment of locally advanced mid-low rectal cancer, and has demonstrated efficacy in improving the R0 resection rate, anal preservation rate, and local control rate of tumors. [ 48 ] In both national and international CRC guidelines, nCRT is the recommended treatment for patients with locally advanced low rectal cancer (IA). [ 32 – 34 ] The classic neoadjuvant treatment is pre-operative concurrent chemoradiotherapy, which is divided into a long course (50.4 Gy/25 f) [ 49 ] and a short course (5 Gy × 5).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Current status of surgical treatment of rectal cancer in China

Yang

Wang

Chen

et al. 2020

Chinese Medical Journal

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With the changing lifestyle and the acceleration of aging in the Chinese population, the incidence and mortality of colorectal cancer (CRC) have risen in the last decades. On the contrary, the incidence and mortality of CRC have continued to decline in the USA since the 1980s, which is mainly attributed to early screening and standardized diagnosis and treatment. Rectal cancer accounts for the largest proportion of CRC in China, and its treatment regimens are complex. At present, surgical treatment is still the most important treatment for rectal cancer. Since the first Chinese guideline for diagnosis and treatment of CRC was issued in 2010, the fourth version has been revised in 2020. These guidelines have greatly promoted the standardization and internationalization of CRC diagnosis and treatment in China. And with the development of comprehensive treatment methods such as neoadjuvant chemoradiotherapy, targeted therapy, and immunotherapy, the post-operative quality of life and prognosis of patients with rectal cancer have improved. We believe that the inflection point of the rising incidence and mortality of rectal cancer will appear in the near future in China. This article reviewed the current status and research progress on surgical therapy of rectal cancer in China.

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“…As one of the leading causes of cancer-related deaths worldwide, colorectal cancer (CRC) seriously threatens human health [1][2][3]. With the ageing process of the global population, the incidence of CRC is increasing yearly and accounts for one-tenth of cancer cases and deaths.…”

Section: Introductionmentioning

confidence: 99%

“…More effective adjuvant therapy to prevent the occurence of peritoneum dissemination is urgent. Intraperitoneal chemotherapy using mitomycin-C or oxaliplatin in an ambulant setting has been explored [3]. Many studies have suggested that (hyperthermic) intraperitoneal chemotherapy ([H]IPEC) might be effective in preventing the development of peritoneal metastases and point towards improved oncological outcomes [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Intraperitoneal chemotherapy using mitomycin-C or oxaliplatin in an ambulant setting has been explored [3]. Many studies have suggested that (hyperthermic) intraperitoneal chemotherapy ([H]IPEC) might be effective in preventing the development of peritoneal metastases and point towards improved oncological outcomes [3][4][5][6]. As for treatment-related morbidity, previous research has shown that adjuvant HIPEC is well tolerated for CRC [5,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colorectal cancer: A propensity score matched cohort study

Yang,

Sun,

Mou

et al. 2024

Preprint

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Background The benefit of the application of adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) to the prognosis of locally advanced colorectal cancer (CRC) patients is unclear. Methods In total, 3008 consecutive CRC patients who underwent resection at Nanfang Hospital from September 2013 to May 2018 were analyzed. After Propensity score matching (PSM), the HIPEC group (n = 188) and control group (n = 188) were compared by surgical outcomes, complications, and long-term survival. Uni- and multivariate analyses were conducted to confirm the role of HIPEC in the prognosis. Results After PSM, there were no statistically significant differences in all the baseline parameters between two groups. However, the operation time in the HIPEC group was longer. Regarding recovery courses, the HIPEC group takes more time. There was no significant difference between the two groups regarding intra-abdominal infection, ileus, intestinal fistula, anastomotic leakage, lymphatic leakage, pancreatic fistula, uroschesis, pulmonary infection, urinary infection, and cerebrovascular events. However, wound infection was more severe in the HIPEC group than in the control group. The 3-year overall survival (OS) and disease-free survival (DFS) rates, respectively, were 87.2% and 81.7% in the HIPEC group, and 80.5% and 75.2% in the control group. Multivariate analyses revealed that HIPEC, ASA score > II, laparoscopic approach and advanced tumor T and N stages were independent predictive factors for superior OS and DFS. Conclusions Adjuvant HIPEC with more reasonable regimens, cycles, and duration could independently improve the prognosis in patients with locally advanced CRC.

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The “addition” and “subtraction” of adjuvant chemotherapy for locally advanced colorectal cancer

Cited by 3 publications

References 29 publications

Determining the optimal distal resection margin in rectal cancer patients by imaging of large pathological sections: An experimental study

Determining the optimal distal resection margin in rectal cancer patients by imaging of large pathological sections: An experimental study

Current status of surgical treatment of rectal cancer in China

Adjuvant hyperthermic intraperitoneal chemotherapy in locally advanced colorectal cancer: A propensity score matched cohort study

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