Removal Of Colorectal Cancer Research Articles

Colorectal microbiota after removal of colorectal cancer.

The colonic microbiome has been implicated in the pathogenesis of colorectal cancer (CRC) and intestinal microbiome alterations are not confined to the tumour. Since data on whether the microbiome normalises or remains altered after resection of CRC are conflicting, we studied the colonic microbiota of patients after resection of CRC. We profiled the microbiota using 16S rRNA gene amplicon sequencing in colonic biopsies from patients after resection of CRC (n = 63) in comparison with controls (n = 52), subjects with newly diagnosed CRC (n = 93) and polyps (i = 28). The colonic microbiota after surgical resection remained significantly different from that of controls in 65% of patients. Genus-level profiling and beta-diversity confirmed two distinct groups of patients after resection of CRC: one with an abnormal microbiota similar to that of patients with newly diagnosed CRC and another similar to non-CRC controls. Consumption levels of several dietary ingredients and cardiovascular drugs co-varied with differences in microbiota composition suggesting lifestyle factors may modulate differential microbiome trajectories after surgical resection. This study supports investigation of the colonic microbiota as a marker of risk for development of CRC.

Early detection and follow-up of colorectal neoplasia based on faecal volatile organic compounds.

Early detection and removal of colorectal cancer (CRC) and advanced adenomas (AAs) decreases the incidence of and mortality from the disease. We aimed to evaluate the potential of faecal volatile organic compounds (VOCs) for detection and follow-up of colorectal adenoma using advanced electronic nose technology. This was a prospective multi-centre case-control cohort including two district hospitals and one tertiary referral hospital. Patients undergoing colonoscopy were instructed to collect a faecal sample prior to bowel cleansing and were included in the study when CRC, AAs, large adenomas (LAs; 0.5-1.0cm), small adenomas (SAs; 0.1-0.5cm) or no endoscopic abnormalities (controls) were observed. Patients undergoing polypectomy and controls were asked for a second sample after 3months. Faecal VOCs were measured with gas chromatography-ion mobility spectrometry. Random forest, support vector machine, Gaussian process and neural net classification were used to evaluate accuracy. In total, 14 patients with CRC, 64 with AAs, 69 with LAs, 127 with SAs and 227 controls were included. A second sample was collected from 32 polypectomy patients and 32 controls. Faecal VOCs discriminated CRC and adenomas from control [AUC (95% CI): CRC vs control 0.96 (0.89-1); AA vs control 0.96 (0.93-1); LA vs control 0.96 (0.92-0.99); SA vs control 0.96 (0.94-0.99)]. There were no significant differences between CRC and adenoma groups. Patients with adenomas and controls were discriminated prior to polypectomy, whereas 3months after polypectomy VOC profiles were similar [T0 adenoma vs control 0.98 (0.95-1); T1 adenoma vs control 0.55 (0.40-0.69)]. Faecal VOC profiles may be useful for early detection of CRC and adenomas and the timing of polyp surveillance as polypectomy led to a normalization of the VOC profile.

Simultaneous laparoscopic liver resection: a single-center experience

Background: About 15 to 25% of colorectal cancer patients have synchronous liver metastasis at diagnosis. In the recent years, the strategy of simultaneous removal of colorectal cancer and liver metastases has been preferred. Development of minimally invasive technologies in abdominal and hepatopancreatobiliary surgery allows for active advance to fully laparoscopic approach to these types of interventions.Aim: Comparative analysis of simultaneous and isolated laparoscopic liver resections performed in the Department of Surgery, Russian Research Center of Roentgenoradiology (Moscow).Materials and methods: We have analyzed intra- and postoperative results of 29 laparoscopic procedures for metastatic liver disease. Group 1 included 14 patients who had undergone simultaneous laparoscopic primary tumor resection and laparoscopic liver resection for metastatic disease. Group 2 included 15 patients who had undergone isolated laparoscopic liver resection for metastatic lesions.Results: Mean (± SD) blood loss in the simultaneous and isolated procedures groups was 469 ± 176 and 408 ± 124 mL, respectively (p = 0.2), whereas the duration of surgeries was 296 ± 107 and 204 ± 82 min, respectively (p = 0.01). Conversion rate in the isolated resection group was higher (26% vs. 14%). This difference is to be explained by the learning curve in laparoscopic liver surgery. All liver resections in both groups were carried out in R0 mode. No deaths and significant complications were seen in any of the groups.Conclusion: The study demonstrated feasibility and safety of simultaneous, fully laparoscopic liver resections, including those for difficult localization of primary tumors and metastatic lesions.

The Possibilities of Magnetic Resonance Imaging in the Differential Diagnosis of Recurrent Rectal Cancer and Postoperative Scars

The purpose: to develop differential diagnostic criteria of recurrence and scarring by using various MRI techniques.Materials and methods. MRI of the pelvis was performed in 139 patients at different times after removal of colorectal cancer. Recurrence was diagnosed in 48 (34.5%) patients. The shape, size, structure, signal characteristics and the intensity of the accumulation of contrast agent in zones of recurrence and scarring were analyzed. The patients were divided into three groups with different types of postoperative MRI pattern of pelvic: patients without scarring in the pelvis, patients with a homogeneous scarring, patients with inhomogeneous scarring. The present study was compared with MRI data performed in the early stages after surgery.Results. The recurrences with typical MR characteristics were so easy to identify and did not require differential diagnosis. The patients with recurrence occurred in severe scar process in the pelvis needed for differential diagnosis. The detection of recurrence and monitoring of patients without scarring in the pelvis was not difficult. The greatest difficulties arose during the initial examination of patients with inhomogeneous scarring. The difficulties in the differential diagnosis occurred at small sizes of recurrence up to 15 mm, making it impossible to assess their structure and signal characteristics; in the event of relapse in presacral areas of scarring, the presence of areas of hemorrhage in the tumor structure.Conclusions. The presence of severe scar process in the pelvis was the main reason for difficulties in detection and differential diagnosis of recurrence of rectal cancer.

Synchronous polyps predict metachronous colorectal lesions after curative resection of colorectal cancer

Background: The principal aim of endoscopic follow-up programs after curative resection of colorectal cancer (CRC) is to improve survival and identify local recurrence and metachronous CRC. The aim of our study was to identify the possible predictors of metachronous colorectal lesions.Methods: The records of 348 consecutive patients with CRC and who completed at least 1 year of endoscopic follow-up after surgery were analyzed. In this group, 336 patients underwent surgery for primitive CRC and 12 for metachronous cancer. Patients’ characteristics, operative details, and endoscopical follow-up findings were retrieved. Multivariate survival analyses were used to identify patient categories at risk of metachronous colonic lesions.Results: 128 patients presented a metachronous lesion: 118 adenomas and 10 adenocarcinomas. At multivariate analysis, active smoke (HR = 1.84, p = 0.03), neoadjuvant therapy (HR = 0.24, p = 0.01), and presence of synchronous polyps (HR = 1.55, p = 0.04) resulted independent predictors of metachronous adenoma after CRC removal while neoadjuvant therapy (HR = 0.25, p = 0.02), active smoke (HR = 1.54, p = 0.04), and presence of synchronous polyps (HR = 1.86, p = 0.02) resulted independent predictors of metachronous lesions after CRC removal.Conclusions: This study demonstrated a high rate of metachronous lesions in the early follow-up after curative CRC resection. The negative effects of synchronous polyps should be carefully evaluated when planning patients’ follow-up.

Identification of microRNA-135b in Stool as a Potential Noninvasive Biomarker for Colorectal Cancer and Adenoma

Detecting microRNA (miRNA) in stool is a novel approach for colorectal cancer (CRC) screening. This study aimed to identify stool-based miRNA as noninvasive biomarkers for detection of CRC and adenoma. A miRNA expression array covering 667 human miRNAs was performed on five pairs of CRC and two pairs of advanced adenoma tissues. The most upregulated miRNAs were validated in 40 pairs of CRC tissues, 16 pairs of advanced adenoma tissues, and 424 stool samples, including 104 CRCs, 169 adenomas, 42 inflammatory bowel diseases (IBD), and 109 healthy controls. miRNA levels were followed-up after removal of lesions. In an array analysis, miR-31 and miR-135b were the most upregulated miRNAs in CRC and advanced adenoma as compared with their adjacent normal tissues (>13-fold increase). In stool samples, level of miR-135b was significantly higher in subjects with CRC (P < 0.0001) or adenomas (P < 0.0001), but not in patients with IBD compared with controls. miR-135b showed a significant increasing trend across the adenoma to cancer sequence (P < 0.0001). Levels of miR-31 were not significantly different among groups. The sensitivity of stool mR-135b was 78% for CRC, 73% for advanced adenoma, and 65% for any adenoma, respectively, with a specificity of 68%. No significant difference in the miR-135b level was found between proximal and distal colorectal lesions. Stool miR-135b dropped significantly upon removal of CRC or advanced adenoma (P < 0.0001). Stool-based miR-135b can be used as a noninvasive biomarker for the detection of CRC and advanced adenoma. Clin Cancer Res; 20(11); 2994-3002. ©2014 AACR.

Changes of macrophage function in patients undergoing surgery for colorectal cancer

Objective To evaluate the efficacy of surgical treatment for colorectal cancer in terms of immunocyte function. Methods The number and percentage of peripheral monocytes were detected before and after surgery; the expression levels of CD14 and SR-A ( surface markers of macrophage ) were determined using immunohistochemistry; macrophage migration inhibition factor ( MIF ) mRNA were tested by real-time PCR; and cytokines TNF-a, IL-8, and IL-18 were detected through ELISA before and 8 weeks after surgery.Results As compared with the baselines, the expression levels of CD14 and SR-A increased significantly ( P = 0.026 and P= 0.031 ), expression of MIF mRNA downregulated ( P= 0.000 ), the number and percentage of monocytes elevated ( P= 0.006 and P= 0.004 ), and the concentrations of TNF-α, IL-8 and IL-18 markedly declined 8 weeks after surgery ( P= 0.000, P= 0.016, and P= 0.004 ). Conclusions Surgical removal of colorectal cancer can enhance the activity of intestinal macrophages and the number of peripheral monocytes,leading to the improvement of immunity against the malignancy. Key words: Colorectal cancer; Immunology; Macrophage; Cytokines; Macrophage migration inhibitory factor

Improvement in cutaneous delayed hypersensitivity following removal of colorectal cancer: [formula omitted], Tuz-Chi Hsu, Pi Chen-Huang, Shu-Lin Tsai, Shu-Ching Lin Nutrition Support Service, Mackay Memorial Hospital, Taipei, Taiwan

Improvement in cutaneous delayed hypersensitivity following removal of colorectal cancer: [formula omitted], Tuz-Chi Hsu, Pi Chen-Huang, Shu-Lin Tsai, Shu-Ching Lin Nutrition Support Service, Mackay Memorial Hospital, Taipei, Taiwan