A phase II clinical trial demonstrates the feasibility of mass-based response testing (MRT) in tailoring intraperitoneal chemotherapy for patients with unresectable appendiceal or colorectal peritoneal metastases. MRT assessed tumor susceptibility to various HIPEC drug regimens, offering a personalized approach to treatment. The study aims to improve outcomes by personalizing regimens based on patient-specific sensitivities, thereby […]
Category: Intestine and Lower Gastrointestinal Tract
Tertiary lymphoid structures predict improved survival and treatment response in colorectal cancer
A newly established colorectal cancer-specific tertiary lymphoid structures (TLS) signature correlates with enhanced overall survival and treatment responses in patients. In the TCGA cohort, those with high TLS scores showed significantly longer survival (p=0.008) and greater complete or partial response rates (p=0.017). The study also identified a positive association between TLS scores and tumor mutation […]
Combined surgery and endoscopic therapy shows high success in Crohn’s strictures
A novel approach using combined surgery and endoscopic stricturotomy achieved a remarkable 100% immediate success rate in treating multi-segmental fibrotic strictures from Crohn’s disease. Among 21 patients, 85.7% experienced significant symptom relief, and 90.5% returned to a regular diet within eight weeks. With a median follow-up of 528 days, the one-year re-intervention rate stood at […]
Guidance aids decision-making for managing colorectal polyps
Guidelines developed by the BSG/ACPGBI assist clinicians in managing colorectal polyps for patients with a life expectancy of under 10 years. The guidance outlines 33 recommendations drawn from a consensus process involving 28 experts. It includes assessments of life expectancy, polyp characteristics, and risks of polypectomy versus conservative management. A comparative model has been established […]
EMR shows lower mortality and healthcare utilization than surgery
In a comparative study of colon adenomas and early-stage cancers, endoscopic mucosal resection (EMR) significantly outperformed traditional surgery. Among 568 EMR patients and 2,054 surgical patients, EMR was associated with a lower all-cause mortality rate (hazard ratio 0.31) and reduced healthcare utilization over an average follow-up of 4.5 years. These findings suggest EMR is a […]
Emergency resection increases complications and mortality in colon cancer
A recent analysis of 5,056 patients with right-sided colon cancer revealed that emergency resections lead to significantly higher mortality rates (9.4% vs 4.2%) and complication rates (41.7% vs 33.0%) compared to elective resections. While anastomotic leakage rates remained statistically similar, the findings suggest that emergency procedures are riskier, highlighting the potential benefits of a bridge-to-surgery […]
C-reactive protein-to-albumin ratio predicts chemotherapy outcomes
A multicenter study has established that a high C-reactive protein-to-albumin ratio (≥0.234) correlates with increased risk of three-year disease progression and decreased five-year survival in patients undergoing neoadjuvant chemotherapy for colorectal liver metastases. The developed clinical prediction model, incorporating the ratio, clinical risk score, and tumor differentiation, demonstrated strong predictive capabilities for progression-free and overall […]
Higher surgical caseloads lower recurrence rates in pilonidal sinus disease
Analysis of 1,074 studies involving 130,599 patients revealed that higher annual surgical volumes significantly decrease recurrence rates for pilonidal sinus disease. Specifically, patients treated in centers performing 30 or more surgeries annually showed improved outcomes, with 5-year recurrence rates dropping to 12.5%. However, midline closure surgeries did not benefit from increased caseloads, maintaining high recurrence […]
Predictive factors identified for positive circumferential resection margins
The incidence of positive circumferential resection margin (CRM) after robot-assisted total mesorectal excision (R-TME) was found to be 6.0% in a study of 1,390 patients. Significant predictors include CT4 tumors, involvement of the mesorectal fascia on MRI, and non-sphincter-saving surgeries. A predictive model demonstrated over 70% accuracy, estimating a 26% risk when all factors were […]
Lymph node metastasis worsens survival in colorectal cancer with liver metastasis
Lymph node metastasis (LNM) significantly impacts cancer-specific survival (CSS) in colorectal cancer patients with liver metastasis (CRLM), as demonstrated in an analysis of 11,266 patients. Those with LNM exhibited poorer CSS compared to those without LNM, and this trend remained consistent across different cohorts. Incorporating N staging into the AJCC TNM system, particularly for M1a […]