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Background and Objectives: Definitive chemoradiotherapy (CRT) is considered curative intent treatment for locally advanced esophageal squamous cell carcinoma. Data concerning the usefulness of definitive CRT in patients with esophageal adenocarcinoma (ADC) are lacking. The aim of the study was to compare the results of definitive CRT versus surgery in patients with an ADC., Methods: All consecutive patients with a non-metastatic ADC treated between 1994 and 2008 were retrospectively assessed. Patients were divided into two groups: surgery group (±pre-operative treatment) versus definitive CRT group., Results: In surgery and definitive CRT groups, 67 and 79 patients were evaluated, respectively. A complete resection was achieved in 92.5% of patients in surgery group and a clinical complete response was observed in 49.4% of patients in definitive CRT group. Overall survival was 36.2 ± 2.0 months in surgery group versus 16.5 ± 0.8 months in definitive CRT group (P = 0.02). The predictive factors of survival were age (P < 0.01), stage (P = 0.04), WHO performance status (P < 0.01), initial weight loss (P < 0.01), and the treatment group (P < 0.01)., Conclusions: The results of the study do not support definitive CRT as an alternative to surgery in esophageal ADC treatment. Definitive CRT should be reserved for patients with a major operative risk., (Copyright © 2011 Wiley Periodicals, Inc.)

Perforation of rectal cancer usually occurs intraperitoneally. Extraperitoneal perforation is rare and usually presents as perineal sepsis, leading to diagnosis and urgent surgical management plus antibiotic therapy. We report the case of a patient presenting with a perforated rectal carcinoma which presented as necrotizing fasciitis of the right thigh., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Colorectal cancer is usually revealed by modifications of bowel habit and/or signs of haemorrhage. Hepatic and lung metastases are the common sites of metastatic involvement of this cancer. Brain metastasis are rare, especially when they are isolated. We report the case of a 37-year-old patient presenting with isolated brain metastasis revealing a rectal cancer. The patient was initially treated by surgical excision of the symptomatic brain metastasis, followed several days later by anterior resection of the rectum and whole-brain radiotherapy. This unusual strategy, due to the lack of preoperative diagnosis, did not improve the poor prognosis of brain metastasis.

In 4 to 5% of cases, the cancer of large bowel is presented with a perforation in situ. The mortality rate in these conditions is high, and it is evaluated in the literature between 40 to 50% of cases. The authors present their experience with 7 consecutive patients, operated for this complication. In all cases, the tumour is excised: in 6 patients, terminal colostomy is realised while one patient only had a direct resection anastomosis. No per-operative mortality, was noted, and in four patients retauration of intestinal tract is realised, within 3 to 6 months latter. In our experience, the perforated tumour does not appear as a factor of immediate gravity.