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This review explored recent advancements in organ preservation strategies for early rectal cancer. Although total mesorectal excision (TME) remains the standard treatment, there is a growing interest in organ preservation approaches due to the potential decline in quality of life associated with TME. We discussed precise staging methods for early rectal cancer and proposed specific organ preservation protocols for cT1N0M0 and cT2N0M0 patients. Additionally, immunotherapy has shown significant potential for patients with deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H) status. This review summarized current research findings and provided guidance for clinicians on organ preservation options when treating early rectal cancer.

Objective To investigate the expression of B7S1 mRNA which is encoded by VTCN1 and protein levels in colorectal cancer(CRC) with the analysis of relation to clinicopathological characteristics, immune cell infiltration, and prognosis for the evaluation as a immunotherapeutic target in CRC. Methods Both Oncomine and TIMER databases were used to review the expression of VTCN1 in a variety of human solid tumors. The relationship between the expression of VTCN1 and the clinicopathological characteristics of CRC was analyzed using UALCAN and LinkedOmics databases. The expression of VTCN1 which is related with immune infiltration and clinical prognosis was evaluated using Human Protein Atlas database, Kaplan-Meier Plotter and TIMER database. A total of 24 patients with CRC in Ruijin Hospital (North) were collected and the expression of B7S1 protein in both CRC and normal intestinal tissues was detected by immunofluorescence staining. Results It was found in database that VTCN1 was expressed in many human solid tumors. VTCN1 was highly expressed in various subtypes of CRC when compared with that in normal intestinal tissues. The up-regulated VTCN1 was related to tumor stage, lymph node metastasis, distant metastasis, mismatch repair and overall survival rate. VTCN1 was also related to the immune cell infiltration. Immunofluorescence analysis showed that the protein of B7S1 was up-regulated in CRC when compared with that in normal intestinal tissues, and it was expressed in CD45- cells and CD45+ cells. Conclusions As co-inhibitory immune checkpoint molecule, B7S1 may be a potential prognostic factor and might become the target of immunotherapy for CRC.

Objective To compare perioperative index and postoperative urinary function following radical resection for middle and low rectal cancer between robotic and laparoscopic surgery. Methods Clinicopathological data of 313 patients with radical surgery for middle and low rectal cancer at our department from September 2015 to October 2018 were analyzed retrospectively. Propensity score matching analysis (1∶1, caliper value=0.01) between robotic surgery group and laparoscopic surgery group was performed based on gender, age, body mass index, American Society of Anesthesiology score, and tumor staging. Two surgical approaches were studied for safety in radical treatment of middle and low rectal cancer and the effect on urinary function, which was assessed using the International Prostate Symptom Score (IPSS) preope-ratively and 1, 3, and 6 months after surgery. Results The matched sample of 101 cases in two groups using propensity score was included. There was no statistical difference in the outcome of radical resection between two groups. However, significant differences were found in operative time, intraoperative blood loss, time to first flatus and postoperative hospital stay (P