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The benefits of adjuvant chemotherapy (AC) in colon cancer after complete mesocolic excision (CME) have not been evaluated sufficiently. We reanalysed the ESCME trial data to investigate the survival benefits and establish AC stratified indications.The data of Stage II and III colon cancer patients who received CME in the ESCME trial were reanalysed. Patients were divided into AC and non-AC (NAC) groups. The primary outcomes measured were differences in 5-year cancer-specific survival and disease-free survival (DFS) between the groups.Of the 206 patients enrolled in the study, 125 patients (AC, 49; NAC, 76) had Stage II cancer and 111 (AC, 86; NAC, 25) had Stage III cancer. There were no significant differences in the adjusted 5-year cancer-specific survival and DFS between the AC and NAC groups. Poor differentiation (hazard ratio [HR] 2.947; 95% CI 1.218-7.131) and RAS mutation (HR 3.140; 95% CI 1.363-7.234) affected the 5-year DFS significantly in multivariate Cox regression analysis for Stage II and III cancer, respectively. In subgroup analysis, AC significantly improved 5-year DFS (HR 0.369; 95% CI 0.140-0.978) for Stage III cancer with lymphovascular/perineural invasion compared to NAC.The current indication and benefits of AC for colon cancer patients after CME should be re-evaluated. AC is more appropriate for Stage III cancer with lymphovascular/perineural invasion.

Aim The application of complete mesocolic excision (CME) in colon cancer is controversial. We performed a meta-analysis to compare the safety, quality and effect of CME with non-complete mesocolic excision (NCME) in patients with colon cancer. Method We searched PubMed, ScienceDirect, the Cochrane Library and Scopus to identify studies comparing CME with NCME in colon cancer. We focused on three study outcome areas: safety (operation time, blood loss, complications, mortality); quality (large bowel length, distance from the tumour to the high vascular tie, area of mesentery, total lymph nodes); and effect (long-term survival). Results A total of 8586 patients from 12 studies were included in the meta-analysis. CME was associated with greater intra-operative blood loss [weighted mean difference (WMD) 79.87, 95% CI: 65.88–93.86], more postoperative surgical complications (relative risk 1.23, 95% CI: 1.08–1.40), longer large bowel resection (WMD 47.06, 95% CI: 10.49–83.62), greater distance from the tumour to the high vascular tie (WMD 17.51, 95% CI: 15.16–19.87), larger area of mesentery (WMD 36.09, 95% CI: 18.06–54.13) and more lymph nodes (WMD 6.13, 95% CI: 1.97–10.28) than NCME. CME also had positive effects on 5-year survival [hazard ratio (HR) 0.33, 95% CI: 0.13–0.81], 3-year survival (HR 0.58, 95% CI: 0.39–0.86) and 3-year survival for Stage III disease (HR 0.69, 95% CI: 0.60–0.80) compared with NCME. Conclusion Limited evidence suggests that CME is a more effective strategy for improving specimen quality and survival but with a higher complication rate.

BACKGROUND AND AIM Increasing evidence has indicated that long noncoding ribonucleic acids (lncRNAs) play a major role in cancers. Although certain lncRNAs has been reported to play a role in gastric cancer (GC), specific lncRNAs involved in distant metastasis of GC remain unknown. METHODS Differentially expressed mRNAs and lncRNAs between stage IV and non-stage IV GC were obtained by microarray. Gene ontology and pathway analysis were used to study functions of differential mRNAs. Algorithms were used to predict potential gene targets of cis or trans-acting lncRNAs. Network analysis was performed to analyze each pair of gene-lncRNA, gene-gene, or lncRNA-lncRNA interactions. Expression of lncRNA special for distant metastasis of GC (SDMGC) and target gene TRIM16 were tested in GC tissues and cell lines. RNAi and overexpression were used to observe the biological functions of SDMGC and TRIM16 on GC cells. RESULTS 502 mRNAs and 440 lncRNAs were found to be differentially expressed. 74 gene ontology terms and 38 pathways were associated with the dysregulated transcripts. Fourteen core factors were determined by network analysis. Expression of SDMGC and TRIM16 was upregulated in the distant metastasis tissues, compared with primary GC tissues, which were positive correlation. Silencing of SDMGC or TRIM16 was demonstrated to decrease cell invasion and migration, while upregulated of SDMGC or TRIM16 could promote cell invasion and migration. However, little effect on proliferation, cell cycle, colony formation, and apoptosis was found. CONCLUSIONS SDMGC is obviously upregulated in stage IV GC and may represent a new marker and therapeutic target for GC treatment.

Background We have found that the expression of the novel focal adhesion protein kindlin-2 had a significant positive correlation with poor survival in gastric cancer. However, the mechanism by which kindlin-2 acts in gastric cancer warrants further evaluation. Methods Kindlin-2 mRNA expression in gastric cancer cell lines was measured by realtime RT-PCR under normal and hypoxic conditions. Cell proliferation, apoptosis, cell cycle, tumor adhesion, cell invasion ability, and phosphorylation of integrin β1 and β3 proteins were measured to assess the influence of kindlin-2 on the malignant behavior of gastric cancer cells. Results Kindlin-2 mRNA expression was highest in the distant metastasis gastric cancer cell line Hs-746T. Cell proliferation, adhesion with endothelium and collagen IV, invasion rate, and angiogenesis genes expression, as well as phosphorylation of integrin β1 and β3 in Hs-746T, were decreased significantly after kindlin-2 downregulation, but there was no change in apoptosis and cell cycle. Conclusions Kindlin-2 might promote the invasion of gastric cancer cells through enhancing proliferation and adhesion by the phosphorylation of integrin β1 and β3. J. Surg. Oncol. 2013; 108:106–112. © 2013 Wiley Periodicals, Inc.

Background: Although metabolic syndrome (MS) has received a lot of attention in recent years, the correlation between MS and colorectal carcinoma is still not very clear. This study aims at exploring the relationship between MS and colorectal carcinoma. Methods: Data was collected from 507 cases of colorectal carcinoma and 507 cases of healthy patients between January 2002 and March 2007 to establish the database. The patients with colorectal cancer were divided into two groups based on the presence of MS. Multivariate analysis of these data for the overall survival and recurrence was performed with the Cox proportional hazard model. Variables examined by multivariate analysis were sex , age, location, histotype, differentiation, tumour, node, metastasis (TNM) stage, the number of lymph nodes detected, etc. Results: The existence of MS in the colorectal carcinoma group was clearly more than that in the control group. The existence of two to four types of abnormal metabolic diseases was significantly more in the colorectal cancer group than in the control group. MS is one of the important elements that can independently influence the survival (odds ratio (OR) = 1.501, 95% confidence interval (CI) = 1.057–2.131) and have the highest risk with worse survival compared with other parameters. Conclusion: There is a close relationship between MS and colorectal carcinoma, and MS is a significantly independent element that influences the survival of the colorectal carcinoma. Decreasing the incidence of MS maybe play a role in improving therapeutic efficacy and prognosis of the cancer.