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Introduction Neuroendocrine tumors (NETs) of the rectum are rare, with an estimated incidence of 0.1% of all colorectal cancers. However, it is crucial to diagnose NET, particularly in patients with ulcerative colitis, who seem to have a higher risk of cancerization according to recent studies, given the aggressiveness and poor prognosis of these tumors. Presentation of case We report the case of a 54-year-old man who developed multiple rectal NETs (approximately 10), measuring 1–6 mm, only 2 years after a primary diagnosis of ulcerative colitis. Discussion In the literature, all reported cases of NETs present patients with a long history of several years of inflammatory bowel disease; however, very little literature exists on this subject. Herein, we discussed the outcomes and a literature review of the pathology, prognosis, and management of NETs. Conclusion Despite advances in research on rectal NETs, many aspects about the disease remain unclear, partly due to its rarity., Highlights • A 54-year-old man developed NETs 2 years after ulcerative colitis diagnosis. • We discussed the pathology, prognosis, and management of NETs. • Ulcerative colitis seems to predispose patients to NET development. • Many aspects about multiple NETs remain unclear.

Shaping is a crucial step to produce technical catalysts that remains as some sort of dark art for catalytic researchers in academia. This contribution discusses aspects concerning the fabrication of technical catalysts based on MnO2 powders aimed for the combustion of hazardous aromatic compounds; namely, benzene and styrene. Both laboratory and pilot plant scale catalytic tests were conducted over tablets and extrudates of the technical catalyst. Key physicochemical properties of these materials; namely, surface area, porosity, crystallinity, and mechanical resistance, were assessed and correlated to the catalytic behaviour. On the one hand, the paper describes the hurdles to be overcome when formulating and testing a technical catalyst whose characteristics must be a good compromise between its physicochemical properties and catalytic behaviour at the pilot plant scale. Furthermore, the importance of adopting adequate security and waste management protocols for testing technical catalysts is highlighted. On the other hand, the following conclusions were drawn from the analysis of results: (i) Between tableting and extrusion, only the latter was found to produce shaped bodies with suitable mechanical resistance for pilot plant scale tests. (ii) Calcination of the fabricated extrudates at temperatures from 500 °C leads to a crystallographic transformation of the MnO2 that had a positive impact on the intrinsic activity of the technical catalyst while favouring its mechanical resistance owing to densification at the expense of a decrease in surface area and enlargement of pore size distribution. (iii) Thanks to pilot plant testing of the catalysts, it was possible to identify a detailed reaction scheme for styrene combustion in which besides the occurrence of oxidation, reactions of hydrogenation, dehydrogenation, ring opening, and isomerization take place by a combination of both surface and free radical mechanisms.

SCOPUS: ar.j, info:eu-repo/semantics/published

International audience; Introduction: During the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating.Materials and methods: This French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020.Results: This study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19-95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12-42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died.Conclusion: The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.

La fistule anastomotique ainsi que les infections du site opératoire sont les causes principales de morbidité postopératoire après chirurgie colorectale avec une augmentation significative de la mortalité postopératoire. Essayer de prévenir leur apparition est, pour cette raison, la priorité de la préparation d’une chirurgie colorectale. Pour éviter leur survenue, la nécessité d’effectuer une préparation intestinale préopératoire et les différentes méthodes de réalisation de cette préparation, sont toujours débattues sans qu’il n’y ait de consensus international. Des études randomisées multicentriques qui comparent l’utilité d’une préparation mécanique du côlon associée ou non à l’administration d’antibiotiques oraux, viennent de débuter avec l’espoir que leurs résultats éclairciront au moins partiellement ce débat. Une nouvelle approche, pourrait consister à changer ou moduler en préopératoire le microbiote intestinal de telle fac¸on qu’il favorise la guérison anastomotique et la récupération postopératoire en général. [Bowel preparation prior to colorectal surgery] Anastomotic leak and surgical site infections are the most important causes of postoperative morbidity after colorectal surgery, with a significant increase in the post-surgical mortality. For this reason, the priority of the preparation for colorectal surgery is avoiding their occurrence. The question whether a bowel preparation prior to surgery is necessary and what methods to use are still highly debated, and no consensus has been reached so far. In the past years, this controversy was revived following several studies with diverging results. A set of multi-center randomized studies comparing the effects of a mechanical bowel preparation, associated or not with oral antibiotic have just started, and their results may help shed light, at least partly, on this ongoing debate. On the other side, a new approach, outside the usual prospects, would be to try to change or modulate the intestinal microbiota prior to surgery so that it can eventually contribute to anastomotic healing and post-surgery recovery in general.

PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients with stage III colon cancer (CC) and to analyze its association with the effect of chemotherapy on time to recurrence (TTR). METHODS An international study led by the Society for Immunotherapy of Cancer evaluated the predefined consensus Immunoscore in 763 patients with American Joint Committee on Cancer/Union for International Cancer Control TNM stage III CC from cohort 1 (Canada/United States) and cohort 2 (Europe/Asia). CD3+ and cytotoxic CD8+ T lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The primary end point was TTR. Secondary end points were overall survival (OS), disease-free survival (DFS), prognosis in microsatellite stable (MSS) status, and predictive value of efficacy of chemotherapy. RESULTS Patients with a high Immunoscore presented with the lowest risk of recurrence, in both cohorts. Recurrence-free rates at 3 years were 56.9% (95% CI, 50.3% to 64.4%), 65.9% (95% CI, 60.8% to 71.4%), and 76.4% (95% CI, 69.3% to 84.3%) in patients with low, intermediate, and high immunoscores, respectively (hazard ratio [HR; high v low], 0.48; 95% CI, 0.32 to 0.71; P = .0003). Patients with high Immunoscore showed significant association with prolonged TTR, OS, and DFS (all P < .001). In Cox multivariable analysis stratified by participating center, Immunoscore association with TTR was independent (HR [high v low], 0.41; 95% CI, 0.25 to 0.67; P = .0003) of patient’s sex, T stage, N stage, sidedness, and microsatellite instability status. Significant association of a high Immunoscore with prolonged TTR was also found among MSS patients (HR [high v low], 0.36; 95% CI, 0.21 to 0.62; P = .0003). Immunoscore had the strongest contribution χ2 proportion for influencing survival (TTR and OS). Chemotherapy was significantly associated with survival in the high-Immunoscore group for both low-risk (HR [chemotherapy v no chemotherapy], 0.42; 95% CI, 0.25 to 0.71; P = .0011) and high-risk (HR [chemotherapy v no chemotherapy], 0.5; 95% CI, 0.33 to 0.77; P = .0015) patients, in contrast to the low-Immunoscore group ( P > .12). CONCLUSION This study shows that a high Immunoscore significantly associated with prolonged survival in stage III CC. Our findings suggest that patients with a high Immunoscore will benefit the most from chemotherapy in terms of recurrence risk.

A 9-year-old boy presenting with recurrent rectal bleeding and prolapse refractory to therapy for constipation was referred for colonoscopy. Initial work-up (magnesium, thyroid function, food allergies, celiac disease, and stool cultures) was negative. Five large rectal polyps were evidenced just above dental line. Due to the location of the lesions, a combined endoscopic/surgical submucosal resection of the lesions was performed. [...]

Background The management of ulcerative colitis (UC) has been improved due to progresses in medical and surgical practices during the past twenty years. Yet the impact of new therapies on the evolution of the three colectomy’s indications in UC (severe acute colitis, refractory ulcerative colitis and (pre-)neoplastic complication) is still not well established. The aim of this study was to compare the evolution of the surgical indications within the last two decades. Methods This was an observational retrospective study carried out in two tertiary hospitals. All patients with UC who underwent total or segmental colectomy between 2001 and 2020 were included, without age restriction. Two periods were compared: 2001–2010 and 2011–2020. Endpoints were to compare the colectomy indications, patients’ characteristics, surgical procedures, and rates of postoperative complication between the two cohorts. Results Among the 286 patients included (57% were men; median age of 40 years; 60.5% of extensive and 35.7% of distal colitis), 87 (30.4%) underwent colectomy in 2001–2010 and 199 patients (69.6%) in 2011–2020. Patients’ characteristics were similar between the two periods, including duration of UC and the severity according to the global Mayo score. Colectomy rate for refractory UC significantly decreased over time (n=119) (50.6% vs. 37.7%; p=0.042), while it increased for acute severe colitis (n=116) (36.8% vs. 42.2%; p=0.390) and (pre-)neoplastic indication (n=51) (12.6% vs. 20.1%; p=0.130) (Figure 1). Regarding surgery, there was an increased use of laparoscopic colectomy (47.7% vs. 81.4%; p As expected, the mean number of past biotherapies was higher during the second period (1.2 versus 0.6; p Conclusion The rate of surgery for refractory colitis has significantly decreased while the rate of colectomy for cancer and acute severe colitis has risen during the last twenty years. In the same time, surgical technics have changed with more laparoscopic surgeries associated with a reduction of postoperative morbidity despite the larger use of biotherapies.

We examined how the immune microenvironment molds tumor evolution at different metastatic organs in a longitudinal dataset of colorectal cancer. Through multiplexed analyses, we showed that clonal evolution patterns during metastatic progression depend on the immune contexture at the metastatic site. Genetic evidence of neoantigen depletion was observed in the sites with high Immunoscore and spatial proximity between Ki67+ tumor cells and CD3+ cells. The immunoedited tumor clones were eliminated and did not recur, while progressing clones were immune privileged, despite the presence of tumor-infiltrating lymphocytes. Characterization of immune-privileged metastases revealed tumor-intrinsic and tumor-extrinsic mechanisms of escape. The lowest recurrence risk was associated with high Immunoscore, occurrence of immunoediting, and low tumor burden. We propose a parallel selection model of metastatic progression, where branched evolution could be traced back to immune-escaping clones. The findings could inform the understanding of cancer dissemination and the development of immunotherapeutics.