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Purpose: Colon cancer (CC) remains a leading cause of cancer-related mortality worldwide, for which colectomy represents the standard of care. Yet, the impact of delayed resection on survival outcomes remains controversial. We assessed the association between time to surgery and 10-year survival in a national cohort of CC patients. Methods: This retrospective cohort study identified all adults who underwent colectomy for Stage I–III CC in the 2004–2020 National Cancer Database. Those who required neoadjuvant therapy or emergent resection < 7 days from diagnosis were excluded. Patients were classified into Early (< 25 days) and Delayed (≥ 25 days) cohorts after an adjusted analysis of the relationship between time to surgery and 10-year survival. Survival at 1-, 5-, and 10-years was assessed via Kaplan–Meier analyses and Cox proportional hazard modeling, adjusting for age, sex, race, income quartile, insurance coverage, Charlson–Deyo comorbidity index, disease stage, location of tumor, receipt of adjuvant chemotherapy, as well as hospital type, location, and case volume. Results: Of 165,991 patients, 84,665 (51%) were classified as Early and 81,326 (49%) Delayed. Following risk adjustment, Delayed resection was associated with similar 1-year [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.97–1.04, P = 0.72], but inferior 5- (HR 1.24, CI 1.22–1.26; P < 0.001) and 10-year survival (HR 1.22, CI 1.20–1.23; P < 0.001). Black race [adjusted odds ratio (AOR) 1.36, CI 1.31–1.41; P < 0.001], Medicaid insurance coverage (AOR 1.34, CI 1.26–1.42; P < 0.001), and care at high-volume hospitals (AOR 1.12, 95%CI 1.08–1.17; P < 0.001) were linked with greater likelihood of Delayed resection. Conclusions: Patients with CC who underwent resection ≥ 25 days following diagnosis demonstrated similar 1-year, but inferior 5- and 10-year survival, compared to those who underwent surgery within 25 days. Socioeconomic factors, including race and Medicaid insurance, were linked with greater odds of delayed resection. Efforts to balance appropriate preoperative evaluation with expedited resection are needed to optimize patient outcomes. [ABSTRACT FROM AUTHOR]

Objective • Oxaliplatin is a first-line chemotherapy drug for the treatment of colorectal cancer, but its induced oxaliplatininduced peripheral neurotoxicity (OIPN) affect the chemotherapy process and quality of life of tumor patients. OIPN is a serious and potentially permanent side effect of cancer treatment. Currently, no unified standard has been established for preventing and treating OIPN in Western medicine. Therefore, it is very important to seek effective prevention and treatment measures. Many clinical trials have reported that Huangqi Guizhi Wuwu decoction can effectively prevent OIPN, but substantial evidence base to support this treatment is lacking. We collected existing literature and evaluated the clinical efficacy and safety of Huangqi Guizhi Wuwu decoction for OIPN by performing a meta-analysis. Methods • We systematically searched China National Knowledge Internet (CNKI), VIP, Wan Fang Database, Pubmed, EMBASE, and Cochrane Library from inception through to Oct 2022 to identify only randomized controlled trials examining the prevention of OIPN using Huangqi Guizhi Wuwu decoction. This search was supplemented by manual retrieval, including dissertations and conference papers. All data were analyzed using RevMan 5.3 software. Results • A total of 18 papers involving 564 patients in the treatment group and 523 patients in the control group were included. A total of 17 articles reported the overall incidence of peripheral neurotoxicity (I² = 0%), and the overall incidence of peripheral neurotoxicity in the treatment group was 0.27 times higher than in the control group (95% CI: 0.20-0.36). A total of 16 articles reported the incidence of level III–IV severe peripheral neurotoxicity (I2 = 0%), which was 0.16 times higher in the treatment group than in the control group (95% CI: 0.09-0.32). In the Huangqi Guizhi Wuwu VS no-interference subgroup, it showed that the incidence of severe peripheral neurotoxicity in the treat group was significantly lower than in the control group (OR:0.13, 95% CI:0.06-0.28). But in the Huangqi Guizhi Wuwu VS west medicine therapy subgroup, no significant difference between Huangqi Quizhi Wuwu and conventional Western medicine was observed for the prevention and treatment of severe OIPN (OR:0.37, 95% CI:0.09-1.53). A total of 2 articles were reported median nerve conduction velocity (I² = 51.2%); and no significant difference was found between the treatment and control groups (SMD: 1.43; 95% CI: 0.80-2.08); 4 studies showed Huangqi Guizhi Wuwu decoction did not increase the incidence of chemotherapyrelated adverse reactions and was safe. Conclusions • Our current findings support the application of Huangqi Guizhi Wuwu decoction for the clinical prevention and treatment of patients with OIPN. However, high-quality RCT research is still needed to further exploration. The potential impact of Huangqi Guizhi Wuwu decoction on the quality of life or treatment compliance of cancer patients needs further research. [ABSTRACT FROM AUTHOR]

Objective • This study aims to investigate the potential of mustard oil-induced reduction in acetylcholine expression as a means to delay the progression of colon cancer within the internal environment. Methods • The study design in this research involved both in vitro cellular experiments and in vivo animal experiments to employ mustard oil to modulate acetylcholine expression levels and evaluate its impact on colon cancer. Cellular experiments involved the introduction of six concentrations of acetylcholine (10-2, 10-3, 10-4, 10-5, 10-6, and 10-7 mol/L) into colon cancer cell cultures to monitor cell proliferation. Animal experiments encompassed the subcutaneous CT26 colon cancer cells implantation into 28 Balb/c mice, divided into experimental and control groups. After tumor establishment, both groups were fed standard diets for two weeks. Serum acetylcholine concentrations were measured from eye blood samples. Additionally, Balb/c mice were inoculated with CT26- derived colon cancer cells and further categorized into experimental and control groups. A total of 14 mice comprised each group, with experimental mice fed mustard oil and control mice fed soybean oil. Post two weeks, serum acetylcholine expression in both groups was assessed. After sacrifice, subcutaneous tumors were excised, and tumor dimensions were measured using a Vernier scale. Results • Acetylcholine concentration augmentation in the culture medium corresponded to gradual cell proliferation escalation, peaking at 10-5 mol/L, exhibiting statistical significance. Comparative analysis revealed significantly elevated relative acetylcholine expression levels in Balb/c mice with tumor-bearing colon cancers compared to normal Balb/c mice. Experimental group mice exhibited substantially lower serum acetylcholine concentrations than control group mice. Mustard oil administration effectively curtailed acetylcholine expression in normal Balb/c mice, consequently retarding tumor growth. These findings underscore mustard oil’s potential to diminish serum acetylcholine expression, thereby delaying colon cancer progression. Conclusions • This study suggests that mustard oil’s modulation of acetylcholine expression within the internal environment holds the potential for impeding colon cancer growth. [ABSTRACT FROM AUTHOR]

Purpose: A notable advantage of laparoscopic colorectal surgery is that only a small incision at the extraction site is necessary, which is considered to be cosmetically beneficial. Meanwhile, the optimal extraction site for the resected specimen in laparoscopic colectomy is controversial in terms of cosmetic benefit. This randomized controlled trial compares midline and off-midline extraction sites in laparoscopic colectomy in patients with colon cancer, with consideration of cosmetic benefits as the primary endpoint. Methods: Included were patients that underwent elective laparoscopic colectomy at WMUH between October 2014 and February 2017. Patients were randomly assigned to either midline incision group or off-midline incision group. Prospectively collected data included cosmetic results (patients and observer assessment scale) and complications including incidence of incisional hernia, SSI, and pain. This trial was registered with UMIN Clinical Trials (UMIN000028943). Results: Finally, 98 patients with colorectal cancer were analyzed. No significant differences were found between the two groups in patient and observer assessment scales of cosmetic results (midline 8 ± 1.1 vs off-midline 11 ± 5.9 p = 0.16, midline 13.5 ± 6.6 vs off-midline 15 ± 11 p = 0.58, respectively) or in postoperative pain. However, incisional hernia occurred in four cases in the midline group (8%), which was significantly higher than that in the off-midline group (no cases, 0%). Conclusion: There was no significant difference in terms of cosmetic benefit, the primary endpoint, between the two groups. In this study, only the extraction site location was compared; future studies will examine differences depending on the incisional direction, including the incidence of incisional hernia. [ABSTRACT FROM AUTHOR]

Background: In this observational study, patient-reported outcomes and short-term clinical outcome parameters in patients with colorectal cancer were studied 12 months after the start of treatment. Outcomes were also compared across German Certified Colorectal Cancer Centers. Methods: Data were collected from 4239 patients with colorectal cancer who had undergone elective tumor resection in one of 102 colorectal cancer centers and had responded to a quality-of-life questionnaire before treatment (EORTC QLQ-C30 and -CR29). 3142 (74.1%) of these patients completed a post-treatment questionnaire 12 months later. Correlation analyses were calculated and case-mix adjusted comparisons across centers were made for selected patient-reported outcomes, anastomotic insufficiency, and 30-day mortality. Results: At 12 months, mild improvements were seen in mean quality-of-life scores (66 vs. 62 points), constipation (16 vs. 19), and abdominal pain (15 vs. 17). Worsening was seen in physical function (75 vs. 82) and pain (22 vs. 19). Better patient-reported outcomes at 12 months were associated with better scores before treatment. Better results in at least three of the five scores were associated with male sex, higher educational level, higher age, and private health insurance. Major worsening of fecal incontinence was seen among patients with rectal cancer without a stoma. The largest differences across centers were found with respect to physical function. Anastomotic insufficiency was found in 4.3% of colon cancer patients and 8.2% of rectal cancer patients. 1.9% of patients died within 30 days after their resection. Conclusion: Clinicians can use these findings to identify patients at higher risk for poorer patient-reported outcomes. The differences among cancer centers that were found imply that measures for quality improvement would be desirable. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Faculty of Pharmacy of Ankara University / Ankara Üniversitesi Eczacilik Fakültesi Dergisi is the property of Ankara University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Colorectal cancer screening can reduce the incidence and mortality through early detection. First-degree relatives (FDRs) of patients with colorectal cancer are at high risk for colorectal cancer and therefore require colonoscopy. However, despite the high risk, screening adherence among FDRs remains low and the barriers to undergoing screening among FDRs in China are not clear. We explored the reasons why FDRs refused screening.Methods: In this qualitative study, 28 semistructured, in-depth interviews were conducted face-to-face. Participants were recruited at two hospitals (an urban tertiary hospital and a community health center) in Guangzhou, South China. We used qualitative content analysis to analyze transcripts based on audio recordings and identify major themes and subthemes.Results: Three major themes emerged related to FDRs' low screening participation. First, the emotional distance between FDRs and medicine was pulled away by uncomfortable feelings approaching hospitals and misunderstanding of cancer. Second, they confirmed their health state and minimized cancer risk if they had no signs in routine health examination, no symptoms and maintained a healthy, happy life. Third, they considered screening far from their daily life from the perspective of spatial distance and priority. Therefore, screening was not necessary in their view.Conclusions: Healthcare professionals should narrow psychological distance between people and screening when promoting screening technology. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Istanbul Kanuni Sultan Süleyman / İstanbul Kanuni Sultan Süleyman Tıp Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Carcinoembryonic antigen (CEA) is the only blood based protein biomarker at present, used for preoperative screening of advanced colorectal cancer (CRC) patients to determine the appropriate curative treatments and post-surveillance screening for tumour recurrence. Current diagnostics for CRC detection have several limitations and development of a highly sensitive, specific and rapid diagnostic device is required. The majority of such devices developed to date are antibody-based and suffer from shortcomings including multimeric binding, cost and difficulties in mass production. To circumvent antibody-derived limitations, the present study focused on the development of Affimer proteins as a novel alternative binding reagent for CEA detection. Here, we describe the selection, from a phage display library, of Affimers specific to CEA protein. Characterization of three anti-CEA Affimers reveal that these bind specifically and selectively to protein epitopes of CEA from cell culture lysate and on fixed cells. Kinetic binding analysis by SPR show that the Affimers bind to CEA with high affinity and within the nM range. Therefore, they have substantial potential for used as novel affinity reagents in diagnostic imaging, targeted CRC therapy, affinity purification and biosensor applications. [ABSTRACT FROM AUTHOR]

Generally, the postoperative examination of lymph nodes (LNs) is based on a microscopic examination of one hematoxylin and eosin (HE)‐stained slide; however, an examination of only one part of the LN might lead to incorrect staging of the tumor due to tissue allocation bias. Although multilevel sectioning and the use of immunohistochemistry (IHC) have improved the detection of micrometastases in LNs, this approach is laborious, time‐consuming, and costly. A novel molecular technique for the detection of LN metastases of tumors, called one‐step nucleic acid amplification (OSNA), is a rapid and semi‐quantitative examination quantifying the number of cytokeratin 19 (CK‐19) mRNA copies derived from a tumor. OSNA is already in clinical use for the diagnosis of LN metastasis in breast cancer patients; however, the use of OSNA is under investigation with promising results for colorectal cancer (CRC). The present review assessed recent studies on OSNA vs a histopathological examination and its implications for CRC staging and treatment. A total of 16 studies of OSNA in CRC yielded by a PubMed search were reviewed. Among them, seven studies evaluating the diagnostic performance revealed that OSNA had a high specificity (96.8%), high concordance rate (96.0%), and negative predictive value (98.6%) in a pooled assessment. In addition, four studies examining the utility of OSNA in sentinel LNs (SLNs) and two studies focusing on upstaging in pathologically node‐negative CRC patients were also reviewed. Multicenter prospective studies with a large cohort of CRC patients are warranted to reveal the benefits of OSNA in the future. [ABSTRACT FROM AUTHOR]

Now we are facing to aging society. We aimed to determine the long-term outcomes receiving adjuvant chemotherapy among elderly patients with stage III colorectal cancer. Elderly patients (≧65 years, n=91) diagnosed as stage III colorectal cancer and received adjuvant chemotherapy were retrieved from the database and classified into two groups according to whether the patient received monotherapy (n=65) or doublet therapy(n=26). Recurrence-free survival and overall survival were compared between the groups. To balance the essential variables, we conducted propensity score matching. After one-to-one propensity score matching, each group consisted of 22 patients. No significant difference was detected by comprehensive geriatric assessment 7. Overall survival was significantly longer in the monotherapy group. Adverse events occurred more frequently in the doublet therapy group. Monotherapy may improve the long-term outcome of elderly patients while the adverse events were less frequent. [ABSTRACT FROM AUTHOR]

Copyright of KONTAKT - Journal of Nursing & Social Sciences related to Health & Illness is the property of University of South Bohemia in Ceske Budejovice, Faculty of Health & Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Folates, including folic acid, may play a dual role in colorectal cancer development. Folate is suggested to be protective in early carcinogenesis but could accelerate growth of premalignant lesions or micrometastases. Whether circulating concentrations of folate and folic acid, measured around time of diagnosis, are associated with recurrence and survival in colorectal cancer patients is largely unknown. Methods Circulating concentrations of folate, folic acid, and folate catabolites p-aminobenzoylglutamate and p-acetamidobenzoylglutamate were measured by liquid chromatography-tandem mass spectrometry at diagnosis in 2024 stage I-III colorectal cancer patients from European and US patient cohort studies. Multivariable-adjusted Cox proportional hazard models were used to assess associations between folate, folic acid, and folate catabolites concentrations with recurrence, overall survival, and disease-free survival. Results No statistically significant associations were observed between folate, p-aminobenzoylglutamate, and p-acetamidobenzoylglutamate concentrations and recurrence, overall survival, and disease-free survival, with hazard ratios ranging from 0.92 to 1.16. The detection of folic acid in the circulation (yes or no) was not associated with any outcome. However, among patients with detectable folic acid concentrations (n = 296), a higher risk of recurrence was observed for each twofold increase in folic acid (hazard ratio = 1.31, 95% confidence interval = 1.02 to 1.58). No statistically significant associations were found between folic acid concentrations and overall and disease-free survival. Conclusions Circulating folate and folate catabolite concentrations at colorectal cancer diagnosis were not associated with recurrence and survival. However, caution is warranted for high blood concentrations of folic acid because they may increase the risk of colorectal cancer recurrence. [ABSTRACT FROM AUTHOR]

Background Smoking has been associated with worse colorectal cancer patient survival and may potentially suppress the immune response in the tumor microenvironment. We hypothesized that the prognostic association of smoking behavior at colorectal cancer diagnosis might differ by lymphocytic reaction patterns in cancer tissue. Methods Using 1474 colon and rectal cancer patients within 2 large prospective cohort studies (Nurses' Health Study and Health Professionals Follow-up Study), we characterized 4 patterns of histopathologic lymphocytic reaction, including tumor-infiltrating lymphocytes (TILs), intratumoral periglandular reaction, peritumoral lymphocytic reaction, and Crohn's-like lymphoid reaction. Using covariate data of 4420 incident colorectal cancer patients in total, an inverse probability weighted multivariable Cox proportional hazards regression model was conducted to adjust for selection bias due to tissue availability and potential confounders, including tumor differentiation, disease stage, microsatellite instability status, CpG island methylator phenotype, long interspersed nucleotide element-1 methylation, and KRAS , BRAF , and PIK3CA mutations. Results The prognostic association of smoking status at diagnosis differed by TIL status. Compared with never smokers, the multivariable-adjusted colorectal cancer–specific mortality hazard ratio for current smokers was 1.50 (95% confidence interval = 1.10 to 2.06) in tumors with negative or low TIL and 0.43 (95% confidence interval = 0.16 to 1.12) in tumors with intermediate or high TIL (2-sided P interaction =.009). No statistically significant interactions were observed in the other patterns of lymphocytic reaction. Conclusions The association of smoking status at diagnosis with colorectal cancer mortality may be stronger for carcinomas with negative or low TIL, suggesting a potential interplay of smoking and lymphocytic reaction in the colorectal cancer microenvironment. [ABSTRACT FROM AUTHOR]

Genetic polymorphisms in drug metabolizing enzymes and drug transporters may affect irinotecan toxicity. Although genetic polymorphisms have been shown to influence the irinotecan toxicity, data are limited in Thai population. Thus, the aim of this study was to assess the allele and genotype frequencies and the relationship between CYP3A4/5, DPYD, UGT1A1, ABCB1, and ABCC2 genetic variations and irinotecan-induced toxicity in Thai colorectal cancer patients. One hundred and thirty-two patients were genotyped, and the effect of genetic variations on irinotecan-induced toxicity was assessed in 66 patients who received irinotecan-based chemotherapy. Allele frequencies of ABCB1 c.1236C > T, ABCB1 c.3435C > T, ABCC2 c.3972C > T, ABCG2 c.421C > A, CYP3A4*1B, CYP3A4*18, CYP3A5*3, DPYD*5, UGT1A1*28, and UGT1A1*6 were 0.67, 0.43, 0.23, 0.27, 0.01, 0.02, 0.64, 0.19, 0.16, and 0.09, respectively. DPYD*2A and DPYD c.1774C > T variants were not detected in our study population. The ABCC2 c.3972C > T was significantly associated with grade 1–4 neutropenia (P < 0.012) at the first cycle. Patients carrying both UGT1A1*28 and *6 were significantly associated with severe neutropenia at the first (P < 0.001) and second (P = 0.017) cycles. In addition, patients carrying UG1A1*28 and *6 had significantly lower absolute neutrophil count (ANC) nadir at first (P < 0.001) and second (P = 0.001) cycles. This finding suggests that UGT1A1*28, *6, and ABCC2 c.3972C > T might be an important predictor for irinotecan-induced severe neutropenia. [ABSTRACT FROM AUTHOR]

Copyright of BJS Open is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of BJS Open is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of BJS Open is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Colorectal cancer (CRC) is one of the most common malignancies of the digestive system worldwide with the incidence has being increased significantly over the past three decades. CRC could present as sporadic (70%), more than half (55%) of all CRCs are attributable to lifestyle factors, including an unhealthy diet. Some studies refer higher circulating vitamin D ( 25(OH)D )was related to a statistically significant, substantially lower colorectal cancer risk, and other studies proposed the total calcium intake was inversely associated with the risk of developing colorectal cancer and other studies showed high total oxidant status ( TOS) are involved in the occurrence and development of malignant tumors. This study aims to investigate the change in the levels of calcium, vitamin D and total oxidant status levels in colorectal Patients. The results showed significance increased in total oxidant status in colorectal cancer patients but not for benign tumor and healthy peoples. Calcium levels were within the ideal limits for all groups and had not relationship with colorectal cancer. While vitamin D levels were below the normal level for all groups and Vitamin D levels was lower in the colorectal cancer group. Found inverse relationship between vitamin D levels and total oxidant status. [ABSTRACT FROM AUTHOR]

Aim: To compare long- and short-term outcomes of laparoscopic surgery with those of open surgery for patients with colorectal cancer and body mass index over 25 kg/m². Patients and Methods: This multicentre, retrospective study analysed clinical records and identified 178 patients with body mass index over 25 kg/m² who underwent surgery for colon and rectosigmoid cancer between 2000 and 2016. After applying propensity score matching, 96 patients were finally included. The primary outcome was the 3-year recurrence-free survival rate, and the secondary outcomes were short-term results during and after surgery. Results: The 3-year recurrence-free survival rates were similar for the laparoscopic and open surgery groups. The laparoscopic surgery group had longer operative times but less blood loss and shorter periods of hospital stay. There were no differences in incidence of postoperative complications. Conclusion: Laparoscopic and open surgeries had similar longterm outcomes for obese patients. Laparoscopic surgery is an effective option for this population. [ABSTRACT FROM AUTHOR]

Dysbiosis, defined as an imbalance in the gut microbiota caused by too few beneficial bacteria and an overgrowth of bad bacteria, yeast, and/or parasites, is now being associated with several diseases, including the development of colorectal carcinoma (CRC). In this study, the potential association of Clostridioides difficile (formerly Clostridium difficile) with CRC was investigated. Plasma samples obtained from preoperative histologically confirmed CRC patients (n=39) and their age- and sex-matched clinically healthy controls (n=39) were analyzed for antibodies to toxin B of C. difficile (anti-tcdB) by enzyme-linked immunosorbent assay (ELISA). A significantly greater number (p=0.012) of CRC cases (n=26/39, 66.7%) had anti-tcdB IgG levels above the cutoff value compared with controls (n=12/39, 30.8%). Eight cases (8/39, 20.5%) and none of the controls registered anti-tcdB IgA levels above the cutoff value (p=0.0039). Anti-tcdB IgG and IgA levels were not shown to be significantly associated with tumor grade or tumor stage. Anti-tcdB IgG showed 66.7% sensitivity and 69.2% specificity. For anti-tcdB IgA, sensitivity and specificity were 20.5% and 100%, respectively. The positive predictive values for anti-tcdB IgA and IgG were 100% and 68.4%, respectively. The anti-tcdB IgA and IgG negative predictive values were 55.7% and 67.5%, respectively. The results suggest the potential association of C. difficile with CRC and anti-tcdB levels, particularly the IgA level. Hence, anti-tcdB antibodies can be candidate serologic markers for CRC. [ABSTRACT FROM AUTHOR]

With the increasing number of elderly patients, the risk of diseases such as colorectal cancer (CRC) has increased. The objective of this prospective study was to explore the effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications among elderly patients who recently underwent colorectal surgery. Patients aged over 65 years who underwent surgery for CRC at the First Affiliated Hospital of Wenzhou Medical University were considered for this study. The demographical and clinical characteristics of these patients, as well as postoperative complications, were prospectively analyzed. The patients were divided into two groups depending on the diagnosis of sarcopenia, and the clinical variables corresponding to the two groups were compared. Further, the risk factors associated with postoperative complications were evaluated using univariate analysis and multivariate logistic regression analysis. A total of 360 patients fulfilled the inclusion criteria. Incidences of postoperative complications in the sarcopenia and non-sarcopenia groups were at 38.3% and 27.3%, respectively. In addition, sarcopenia (p=0.029) and hypoalbuminemia (p=0.010) were identified as independent risk factors, while laparoscopic surgery (p=0.023) was identified as a protective factor for postoperative complications. However, laparoscopic surgery was a protective factor for postoperative complications in the colon group only (p=0.001). Sarcopenia and hypoalbuminemia are independent risk factors that influence the probability of developing complications following CRC surgery. Laparoscopic surgery is a protective factor for postoperative complications of CRC patients, particularly colon cancer patients. [ABSTRACT FROM AUTHOR]

Aim: With population aging, the number of frail patients with colorectal cancer has increased. The Clinical Frailty Scale (CFS) is a validated tool for assessing frailty, and higher scores indicate worse clinical outcomes following cardiovascular procedures. This retrospective study aimed to examine preoperative frailty in relation to recurrence and mortality following curative resection of colorectal cancer. Methods: We retrospectively analyzed data for 729 consecutive patients undergoing curative resection of stage I–stage III colon and rectal adenocarcinoma between January 2009 and December 2016. Frailty was assessed using the CFS: 1 (very fit) to 9 (terminally ill), and frailty was defined as CFS ≥ 4. Recurrence‐free survival (RFS) and overall survival (OS) were compared between frail and nonfrail patients. Cox proportional hazards model was used to calculate hazard ratios (HRs), controlling for potential confounders. Results: CFS score was negatively correlated with the Barthel index of activities of daily living (Spearman's ρ = −0.83). Of the 729 patients, 253 (35%) were frail. In multivariable analyses adjusting for potential confounders including age and disease stage, frailty was independently associated with shorter RFS (multivariable HR: 1.70, 95% confidence interval: 1.25‐2.31, P <.001) and OS (multivariable HR: 2.04, 95% confidence interval: 1.40‐2.99, P <.001). There were no significant interactions of frailty with age and disease stage regarding RFS and OS (Pinteraction >.72). Conclusion: Preoperative frailty was independently associated with shorter RFS and OS following resection of nonmetastatic colorectal cancer, regardless of age and disease stage. Further trials are needed to establish treatment strategies for frail patients with colorectal cancer. [ABSTRACT FROM AUTHOR]

Background and Aim: Epidemiological studies of colorectal cancer (CRC) in South Africa (SA) have been poorly characterized. Black and white SA population groups have demonstrated distinct CRC clinical presentations, suggesting that black SA patients follow a different carcinogenic pathway than their white counterparts. Thus, the aim of this study was to identify unique demographic and histopathological features associated with black SA patients to facilitate earlier diagnosis and to improve disease management. Methods: This preliminary descriptive epidemiological study included 665 retrospective CRC cases diagnosed between the period 2011 and 2015 at the Charlotte Maxeke Johannesburg Academic Hospital. Demographic and histopathological features in black versus other race groups (ORG) were compared, and Student's t‐test, Chi‐square, and Fischer's exact tests were used for statistical analysis. Results: Statistical analysis demonstrated that patients with left‐sided tumors of invasive adenocarcinoma were predominantly black and male. These patients were considerably younger when compared to ORG (median 56 vs 62 years, respectively), P < 0.0001. However, no significant propensity for other histological features was illustrated. Polyps were mostly tubular adenomas (51%) and tubulovillous adenomas (TVAs) (44%). TVAs were mostly high‐grade lesions (P < 0.0001) and associated with left‐sided CRC (P = 0.0325). Conclusion: These findings verify that black SA CRC patients have an earlier disease onset in comparison to ORG; however, no increased tendency for tumor site, precursor lesion, stage of disease, or gender was evident. Thus, a deeper molecular characterization of CRC is required to understand the underlying causes associated with earlier disease onset in black SA CRC patients. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Colorectal cancer (CRC) is prevalent in the developed world. Favourable survival rates highlight the need to better understand CRC survivors' experiences of long-term impacts of treatment, which can in turn inform decision making. This systematic review aimed to identify and synthesise CRC survivors' experiences of long-term impacts on health-related quality of life. Methods: We searched Medline, Embase and PsychINFO from inception to January 2019. Qualitative studies describing CRC survivors' experiences at least 1-year post-treatment were included. Study eligibility, quality assessment (COREQ guidelines), and data synthesis was performed independently by two reviewers and discussed with the study team. Results: Of 1363 papers retrieved, 20 reporting 15 studies met eligibility. Thematic synthesis produced 12 themes: symptoms, physical, social, psychological and sexual functioning, impact on relationships, informal care needs provided by family/friend, supportive care needs provided by healthcare professional, health care experiences, health behaviour, financial toxicity and occupational experiences. Stoma problems (e.g. leakage, skin irritation) were common in ostomates. Survivors with no/reversed stoma experienced unexpected, long-term altered and unpredictable bowel functioning. Survivors often regulated timing, amount and foods consumed to manage bowel functioning. Less common symptoms included fatigue, impaired sleep and anal pain. Stoma problems and altered bowel functioning impaired survivors' physical, social, sexual and psychological functioning. Cognitive functioning and heredity issues were not reported in any paper. Conclusion: CRC survivors experience ongoing symptoms and functioning impairments more than 1-year post-treatment completion. Many survivors find their own ways to manage symptoms rather than seek professional help. Follow-up care for CRC survivors should integrate screening for long-term effects and provide targeted supportive care. [ABSTRACT FROM AUTHOR]

The second most commonly diagnosed cancer is colorectal cancer (CRC) is in female. The levels of progranulin, obestatin and liver enzymes including ALT, AST and ALP were measured in forty five sera in female patients suffering from CRC before chemotherapy initiation treatment as G1, G2 after first chemotherapy cycle and G3 after second chemotherapy cycle compared with thirty female as a healthy control G4. Results showed a high significant increased in progranulin concentration and a high significant decrease in obestatin in G2 than other groups. The correlation between progranulin and ALP was a significant negative (-ve) relation while obestatin with AST gave a significant positive (+ve) correlation in G. The results also showed non significant negative (-ve) and positive (+ve) between progranulin, obestatin with ALP, AST and ALT in other groups. [ABSTRACT FROM AUTHOR]

This research include (100) samples which grouped as following: control group (35) sample (blood and benign), patients group including (30) blood samples and (35) FFPE samples (tissue imbed in paraffin). The age of study samples were ranged from 30-89 years old men and women). These samples were grouped in six aging groups that each 10 years in one group. results indicate that the age risk of disease incidence is begin in 50 years old and increased between 60-69 years old for both sexes. The MAD1L1 gene was detected by PCR-sequencing in order to investigate if there any genetic defect within this gene. The alignment results of the 209 bp samples revealed the presence of novel SNP g.301217T>G that distributed variably in the analyzed samples in comparison with the referring reference DNA sequences. The results showed that the allele G is responsible for the appearance of disease and its progression in patientsby reaching to metastasis stage and have gene expression by tumor molecular phenotype, with significant value in tissue samples. [ABSTRACT FROM AUTHOR]

Complexity of cascading interrelations between molecular cell components at different levels from genome to metabolome ordains a massive difficulty in comprehending biological happenings. However, considering these complications in the systematic modelings will result in realistic and reliable outputs. The multilayer networks approach is a relatively innovative concept that could be applied for multiple omics datasets as an integrative methodology to overcome heterogeneity difficulties. Herein, we employed the multilayer framework to rehabilitate colon adenocarcinoma network by observing co-expression correlations, regulatory relations, and physical binding interactions. Hub nodes in this three-layer network were selected using a heterogeneous random walk with random jump procedure. We exploited local composite modules around the hub nodes having high overlay with cancer-specific pathways, and investigated their genes showing a different expressional pattern in the tumor progression. These genes were examined for survival effects on the patient's lifespan, and those with significant impacts were selected as potential candidate biomarkers. Results suggest that identified genes indicate noteworthy importance in the carcinogenesis of the colon. [ABSTRACT FROM AUTHOR]

Whole brain radiotherapy (WBRT) is a mainstay of the treatment for brain metastases (BM). We evaluated prognostic factors in colorectal cancer (CRC) patients undergoing WBRT for BM. The medical records of 106 CRC patients undergoing WBRT for BM between 2000 and 2014 at three institutions were reviewed. Patient and tumor factors were analyzed to identify the prognostic factors for overall survival (OS) calculated from the date of BM diagnosis to the date of death or last follow-up. Surgical resection of BM was performed in six patients. The dose of WBRT was 30 Gy, and boost radiotherapy or stereotactic radiosurgery (8–23 Gy) was given to 15 patients. Systemic therapy for BM was administered in one patient before WBRT and 26 patients after WBRT. The median follow-up time was 3.9 months (range, 0.4–114.1 months). The median OS time was 3.9 months, and the 1-year OS rate was 18.2%. Older age (>65 years), multiple BM (≥3), elevated level of carcinoembryonic antigen (CEA, >5 ng/ml) at BM diagnosis, and extracranial metastases were adverse prognostic factors for OS. Patient with 0–1 factor showed better OS (at 1 year, 76.9%) than patients with 2 factors (16.7%) or 3–4 factors (4.2%; p < 0.001). In conclusion, we evaluated age, the number of BM, CEA level, and extracranial metastases as the prognostic factors for OS in CRC patients undergoing WBRT. Our result might be useful to develop prognostic models predicting survival for patients whom WBRT is intended for. [ABSTRACT FROM AUTHOR]

The article focus on Colonoscopy, which is being performed routinely for colorectal cancer (CRC) screening. Topics include the primary goals of colonoscopy screening and post-polypectomy surveillance are to reduce CRC incidence andmortality; risk for incident and fatal CRC among individuals with baseline SSP is uncertain; and CRC incidence and mortality are decreasing secondary to improvements in risk factor exposures, screening, treatment to surveillance among patients with polyps.

The article focuses on early screening of first degree relatives (FDRs) of patients with colorectal cancer (CRC). Topics include the increasing incidence of early-onset CRC, it is imperative to increase awareness of advanced colorectal polyps (ACPs) among gastroenterologists; all patients is essential to identifying those with underlying hereditary cancer syndromes, including Lynch syndrome; and Improved strategies to communicate risk for colorectal neoplasia among probands and FDRs.

Objective: Since colorectal cancers (CRC) are tumors with heterogeneous biological behavior, prediction of their prognosis remains challenging. Caudal-related homeobox gene 2 (CDX2), which has important roles in the development and maintenance of intestines, is thought to have tumor suppressing effect on CRCs. The aim of this study was to investigate the prognostic significance of decreased-CDX2 expression. Method: This retrospective study included 224 patients diagnosed with CRC between 2009 and 2014. Paraffinized blocks of these patients were stained with CDX2 immunohistochemically and evaluated semiquantitatively. Results: Only 35 (15.6%) of 224 patients had low-CDX2 expression. Decrease in CDX2 expression was closely associated with classical prognostic parameters such as histopathologic type, histologic grade, lymph node metastasis, distant metastasis, and TNM stage. Patients with decreased-CDX2 expression had more lymph node metastasis (p=0.013) and advanced TNM stage (p=0.004) than those without decreased-expression. The mean survival was 53.0±0.89 months. Cox regression analysis showed that decreased-CDX2 expression was significantly related with overall survival (Univariate analysis; hazard ratio: 0.09, 95% confidence interval: 0.05-0.16; p<0.001; Multivariate analysis; hazard ratio: 0.24, 95% confidence interval: 0.13-0.48; p<0.001) and disease-free survival (Univariate analysis; hazard ratio: 0.80, 95% confidence interval: 0.05-0.13; p<0.001; Multivariate analysis; hazard ratio: 0.15, 95% confidence interval: 0.08-0.25; p<0.001). Conclusion: Decreased CDX2 expression is significantly related with worse biological features and can be used as an independent prognostic biomarker in patients with CRCs. [ABSTRACT FROM AUTHOR]

Objective: Enhanced recovery after surgery (ERAS) provides a multimodal approach to postsurgical recovery, seeking to reduce a patient's stress response and promoting recovery. This study aimed to determine the suitability of ERAS protocols for elderly patients above 75 years of age. Methods: This is a retrospective analysis of all patients who had undergone major colorectal resections under ERAS protocols in Khoo Teck Puat Hospital, Singapore and Faculty of Medicine Siriraj Hospital, Thailand between 2013 and 2014. Data collected included patient characteristics and outcomes, including length of hospitalization, and time to first flatus and mobilization. Results: Of the 196 patients studied, 38 were above 75 years of age. Elderly patients were more likely to have more comorbidities, a higher ASA score and a higher POSSUM predicted mortality. They also had an increased risk of developing Clavien 2 complications (OR 2.41, 95% CI 1.10-5.29). Compared to their younger counterparts, elderly patients did not have a delay in first flatus or mobilization. However, they tended to stay longer (7.89 vs. 5.16 days, p<0.001). On multivariate analysis, ASA score of 3 and above was an independent risk factor for a length of stay over 1 week while age was not. Conclusion: This study has shown that elderly patients achieve comparable functional recovery under an enhanced recovery approach. Enhanced recovery after surgery can be adopted regardless of a patient's age. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate prognostic impacts of the number of lymph nodes (LNs) examined and LN ratio on cancer-specific mortality after surgery in patients with right-sided colon cancer (RCC) or left-sided colon cancer (LCC) using the Surveillance, Epidemiology, and End Results database. Number of LNs examined and LN ratio were treated as categorical and/or continuous. Competing risks proportional hazards regressions adjusted by propensity score were performed. All included patients had stage I, II, or III disease, and 45.1% of them had RCC. RCC and LCC patients with high level of LNs examined had better prognosis after segmental resection or hemicolectomy. RCC and LCC patients with higher LN ratio had worse prognosis regardless of surgery. Survival benefit of having high level of LNs examined was observed in RCC patients with stage I, II, or III disease, but only in LCC patients with stage II disease. Both higher LN ratio and high level of LN were negative prognostic factors for cancer-specific mortality in stage III patients regardless of tumor sidedness. In conclusion, RCC patients in various conditions had worse or comparable prognosis compared to their LCC counterparts, which reflected the severity of LN metastasis. [ABSTRACT FROM AUTHOR]

Insulin-like growth factor 1 (IGF1) is implicated in normal cell growth. It has been reported that IGF1 has a mitogenic and anti-apoptotic effect on colorectal cancer cells. However, results of studies on the association between cytosine-adenine (CA) repeat polymorphism in IGF1 gene promoter and colorectal cancer (CRC) risk are inconsistent. We aimed to evaluate the association between CA repeat polymorphism and CRC risk, as well as the relationship with the clinicopathological characteristics of CRC and circulating IGF1 level in a native Chinese population. There were 734 participants who were native Chinese in this case-control study, including 367 CRC cases and 367 age- and sex-matched controls. CA repeat polymorphism was genotyped by PCR and fragment analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were evaluated by unconditional logistic regression analysis. Circulating level of IGF1 in cases was significantly higher than that in controls (p=0.002), particularly in males. Less than 38 CA repeats were associated with decreased CRC risk after adjusting for age and sex (37 versus 38 CA repeats: OR=0.45; 95% CI=0.26-0.78), especially in males. (CA)18/19 genotype showed approximately half reduced CRC risk comparing to (CA)19/19 genotype (OR=0.46; 95% CI=0.25-0.85). There was a significant association between the sum of CA repeats and degree of differentiation of CRC (p=0.044). We observed a trend that circulating level of IGF1 in individuals with CA =38 repeats was lower than that in individuals with CA >38 repeats with a borderline statistical significance in overall and males. In conclusion, our findings support the possible role of CA repeat polymorphism in CRC risk. [ABSTRACT FROM AUTHOR]

Background: Parvimonas micra is a gram-positive anaerobe and a part of the normal commensal flora of the gastrointestinal tract. Factors predisposing to anaerobic bacteremia include malignant neoplasms, periodontal disease, immune deficiencies, chronic renal insufficiency, decubitus ulcers and perforated abdominal viscus. Cases of Parvimonas bacteremia in a patient with esophageal carcinoma and in a patient following ERCP procedure have been reported but to our best knowledge no case has been reported yet in which a patient had colonic carcinoma. Case presentation: We present a rare case of a 94-year-old male who presented with chief complaint of fever and constipation. Complete blood count revealed normal white blood cell count anemia. Urinalysis came out to be unremarkable for any evidence of infection. Two blood cultures grew Parvimonas micra and Gamella morbillorum and patient was later switched to ampicillin-sulbactam as per blood culture susceptibility results. Echocardiogram came negative for any evidence of infective endocarditis. CT abdomen/pelvis showed soft tissue mass in the ascending colon just superior to the ileocecal valve (fig.1, 2). Colonoscopy showed non-obstructing eccentric mass (fig. 3). Biopsy of the mass revealed moderately differentiated adenocarcinoma. Because of lack of distant metastasis, surgical resection of the mass as definitive curative treatment was done. Conclusion: Immune deficiency is a risk factor for anaerobic bacteremia. Apart from immediately starting the patient on antibiotics, a thorough search for malignancy may be considered when a patient presents with anaerobic bacteremia, especially, when the source of infection is not known. Identifying malignancy in earliest stages may improve treatment outcome. [ABSTRACT FROM AUTHOR]

Background: To determine the expression of cancer stem cell marker Leucine-rich repeatcontaining G-protein coupled receptor 5 (Lgr5) in colorectal carcinoma samples compared to normal adjacent tissue and any possible association with clinicopathological findings. Methods: This study was performed on forty samples of cancerous colorectal tissues (case group) and their adjacent normal mucosa (control group) in Imam Khomeini Hospital (Sari, Mazandaran, Iran). Expression of Lgr5 in tissue sections was done by immunohistochemistry. Statistical analysis was carried out using SPSS software. Results: Forty colorectal cancer patients including 21 males (57.8±11.6 years) and 19 females (58.4±12.77 years) were enrolled. Lgr5 was overexpressed in tumoral samples than normal adjacent tissues (77.5% vs 27.5%, p<0.001). Also, no association was found between primary tumor, regional lymph nodes, invasion, histological type, grade, distant metastasis and IHC results. Patients with low Lgr5 expression had a better survival rate than patients with high expression but this was not statistically significant (p=0.121). Conclusion: The higher immunoreactivity of Lgr5 in colorectal cancer tissues may indicate its role as a cancer stem cell marker in tumor carcinogenesis and patient's survival however; Lgr5 is not associated with pathological prognostic variables. [ABSTRACT FROM AUTHOR]

It is possible that data are not always fitted with sufficient precision by the existing distributions; therefore this article presents a methodology that enables the use of families of asymmetric distributions as alternative probabilistic models for survival analysis, with censorship on the right, different from those usually studied (the Exponential, Gamma, Weibull, and Lognormal distributions). We use a more flexible parametric model in terms of density behavior, assuming that data can be fit by a distribution of stable distribution families considered unconventional in the analyses of survival data that are appropriate when extreme values occur, with small probabilities that should not be ignored. In the methodology, the determination of the analytical expression of the risk function h(t) of the Lévy distribution is included, as it is not usually reported in the literature. A simulation was conducted to evaluate the performance of the candidate distribution when modeling survival times, including the estimation of parameters via the maximum likelihood method, survival function Ŝ (t) and Kaplan-Meier estimator. The obtained estimates did not exhibit significant changes for different sample sizes and censorship fractions in the sample. To illustrate the usefulness of the proposed methodology, an application with real data, regarding the survival times of patients with colon cancer, was considered. [ABSTRACT FROM AUTHOR]

Early detection of metastatic colorectal cancer, at initial diagnosis or during routine surveillance, can improve survival outcomes. Current routine investigations, including CEA and CT, have limited sensitivity and specificity. Recent studies of colorectal cancer cohorts under post surgery surveillance indicate circulating tumor DNA (ctDNA) evidence of recurrence can occur many months before clinical detection. Another possible role for ctDNA is in the further assessment of indeterminate findings on standard CEA or CT investigations. To further explore this potential, we undertook a prospective study. Further investigation, including FDG‐PET imaging, was at clinician discretion, blinded to ctDNA analysis. Forty‐nine patients were enrolled. Analyzed here are the 45 patients with an evaluable blood sample of whom 6 had an isolated elevated CEA, 30 had indeterminate CT findings, and 9 had both. FDG‐PET scans were performed in 30 patients. Fourteen of 45 patients (31%) had detectable ctDNA. At completion of the planned 2 year follow‐up, recurrence has occurred in 21 (47%) patients. Detectable ctDNA at study entry was associated with inferior relapse free survival (HR 4.85, p < 0.0001). Where FDG‐PET scan was normal/equivocal (n = 15, 50%) 1 of 1 with detectable ctDNA versus 3 of 14 with undetectable ctDNA ultimately had recurrence confirmed. In summary, for colorectal cancer patients with indeterminate findings on routine investigations, ctDNA detection increases the probability that the findings indicate metastatic disease, including in a nonpredefined subset that also underwent FDG‐PET imaging. Further studies of the value of ctDNA analysis during patient surveillance are warranted. What's new? Colorectal cancer (CRC) patients undergoing routine surveillance frequently present with findings considered indeterminate for recurrence following standard workup with computed tomography scanning and carcinoembryonic antigen testing. Here, circulating tumor DNA (ctDNA) was examined as a potential tool for further assessment of indeterminate CRC cases. Of 45 patients included in the analysis, 14 had detectable ctDNA at study entry. With a minimum 2 years follow‐up, positive ctDNA analysis was significantly associated with inferior relapse‐free survival. The findings identify ctDNA as a predictor of CRC recurrence and highlight its potential as an adjunct or routine test in CRC surveillance. [ABSTRACT FROM AUTHOR]

The IL‐17 receptor (IL‐17R) has a perplexing role in cancer, which may be explained by its yin‐yang signaling pathways. Recently, the critical role of IL‐17R in maintaining basal levels of A20—a key negative regulator of NF‐κB and JNK‐c‐Jun pathways has been demonstrated in cancer cell lines. Cross‐cancer analyses of somatic copy number alterations in IL‐17RA, IL‐17RC and A20 genes reveal that IL‐17RA‐deletion is common in colorectal cancer (CRC) patients, representing 24, 26, 37 and 49% of stage I, II, III and IV of patients, respectively, and mutually exclusive with patients displaying microsatellite instability. Importantly, patients with IL‐17R‐deletion or concurrent deletions of A20 show significantly reduced overall survival. Analysis of multiple published microarray studies confirms that IL‐17RA expression is significantly reduced in CRC samples compared to normal counterparts, and its level is closely associated with A20 expression. Analyses of RNAseq data indicate that tumors with IL‐17R‐deletion express strong molecular markers of tumor invasion, growth and metastasis. Notably, approximately 20 genes responsible for protein synthesis and mitochondrial metabolism are inversely correlated with both IL‐17RA and A20. Immunohistochemistry staining in human colorectal tissue arrays further reveals that high‐grade tumors have significantly reduced IL‐17RA staining compared to low‐grade tumors. Thus, collective evidence strongly supports a previously unrecognized CRC‐promoting mechanism triggered by IL‐17RA‐deletion and highlights its utility as a prognostic marker in CRC. What's new? Interleukin‐17 signaling plays an important, complex role in inflammation and colorectal cancer. Here, the authors show that high grade tumors have far less IL‐17 receptor than low grade tumors. They also found that IL‐17R levels correlate closely with the ubiquitin‐editing enzyme A20, which helps keep a lid on inflammation by regulating NF‐kB. Patients with reduced IL‐17R had worse overall survival, and tumors carrying deletions in IL‐17R had significant changes in the NF‐kB and MAPK signalling pathways. Together, these data suggest that IL‐17R deletions could be useful as a prognostic marker for CRC patients. [ABSTRACT FROM AUTHOR]

The Focal adhesion kinase (FAK) is a ubiquitous cytoplasmic tyrosine‐kinase promoting tumor progression and metastasis processes by acting in cancer cells and their tumor microenvironment partners. FAK overexpression in primary colon tumors and their metastasis is associated to poor colorectal cancer (CRC) patients' outcome. Eight FAK mRNA alternative splice variants have been described and contribute to additional level of FAK activity regulation, some of them corresponding to overactivated FAK isoforms. To date, FAK mRNA alternative splice variants expression and implication in CRC processes remain unknown. Here, using different human CRC cells lines displaying differential invasive capacities in an in vivo murine model recapitulating the different steps of CRC development from primary tumors to liver and lung metastasis, we identified three out of the eight mRNA variants (namely FAK0, FAK28 and FAK6) differentially expressed along the CRC process and the tumor sites. Our results highlight an association between FAK0 and FAK6 expressions and the metastatic potential of the most aggressive cell lines HT29 and HCT116, suggesting that FAK0 and FAK6 could represent aggressiveness markers in CRC. Our findings also suggest a more specific role for FAK28 in the interactions between the tumors cells and their microenvironment. In conclusion, targeting FAK0, the common form of FAK, might not be a good strategy based on the numerous roles of this kinase in physiological processes. In contrast, FAK6 or FAK28 splice variants, or their corresponding protein isoforms, may putatively represent future therapeutic target candidates in the development of CRC primary tumors and metastasis. What's new? Overexpression of the focal adhesion kinase (FAK) is associated with poor outcome in patients with colorectal cancer but the role of the eight splice variants of FAK remains unknown. Here the authors correlated FAK splice variant expression in colorectal tumor cell lines with invasiveness in mouse models. FAK0 and FAK6 splice variant expression was associated with higher aggressiveness and metastatic potential, underscoring that distinct FAK splice variants may represent new targets in the development of drugs against colorectal cancer and associated metastasis. [ABSTRACT FROM AUTHOR]

Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 stage III colon cancer patients who completed a dietary questionnaire at enrollment. Multivariable hazard ratios and 95% confidence intervals (CIs) were calculated for the association between MO3PUFA and disease‐free survival (DFS) and overall survival according to KRAS and BRAFV600E mutations and DNA mismatch repair (MMR) status. Higher MO3PUFA intake was associated with improved 3‐year DFS for KRAS wild‐type tumors (77% vs. 73%; HR: 0.84; 95% CI: 0.67–1.05) but not KRAS‐mutant tumors (64% vs. 70%; HR: 1.30; 95% CI: 0.97–1.73; Pinteraction = 0.02). Similar heterogeneity was found by MMR (Pinteraction = 0.14): higher MO3PUFA was associated with better 3‐year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). No heterogeneity was found by BRAFV600E mutation. Similar findings were obtained for overall survival. In conclusion, we found a suggestive beneficial association between higher MO3PUFA intake and improved survival among stage III colon cancer patients with wild‐type KRAS and deficient MMR. Given the relatively small number of cases with tumor molecular assessments, further studies, preferably through pooled analyses of multiples cohorts, are needed to validate our findings. What's new? Consumption of fish oil or related products containing marine omega‐3 polyunsaturated fatty acid (MO3PUFA) has long been associated with health benefits but effects on cancer survival remain unclear. Here the authors find tentative evidence that MO3PUFA supplementation in patients with stage III colon cancer is associated with better survival, but the benefit was restricted to tumors lacking mutations in the KRAS proto‐oncogene and arising from the microsatellite instability pathway, a finding with possible implications for improving patient care. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is one of the most common cancers in Latin America and the Caribbean, with the highest rates reported for Uruguay, Brazil and Argentina. We provide a global snapshot of the CRC patterns, how screening is performed, and compared/contrasted to the genetic profile of Lynch syndrome (LS) in the region. From the literature, we find that only nine (20%) of the Latin America and the Caribbean countries have developed guidelines for early detection of CRC, and also with a low adherence. We describe a genetic profile of LS, including a total of 2,685 suspected families, where confirmed LS ranged from 8% in Uruguay and Argentina to 60% in Peru. Among confirmed LS, path_MLH1 variants were most commonly identified in Peru (82%), Mexico (80%), Chile (60%), and path_MSH2/EPCAM variants were most frequently identified in Colombia (80%) and Argentina (47%). Path_MSH6 and path_PMS2 variants were less common, but they showed important presence in Brazil (15%) and Chile (10%), respectively. Important differences exist at identifying LS families in Latin American countries, where the spectrum of path_MLH1 and path_MSH2 variants are those most frequently identified. Our findings have an impact on the evaluation of the patients and their relatives at risk for LS, derived from the gene affected. Although the awareness of hereditary cancer and genetic testing has improved in the last decade, it is remains deficient, with 39%–80% of the families not being identified for LS among those who actually met both the clinical criteria for LS and showed MMR deficiency. [ABSTRACT FROM AUTHOR]

KISS1 and KISS1R, a novel pair of metastasis suppressors, are likely to be associated with the prognosis of colorectal cancer (CRC). Here, a meta‐analysis was performed to study the role of KISS1 and KISS1R in CRC. Heterogeneity, stability and publication bias were all estimated. Six publications describing a total of 559 CRC patients were included in the present study. Low KISS1 expression predicted 70% higher risk of poor prognosis for general patients (HR, 1.71; 95% CI, 1.28–2.29) and 99% higher risk for East Asian patients (HR, 1.99; 95% CI, 1.46–2.72). Limited evidence indicated that decreased KISS1R expression might predict poor outcome (HR, 2.96; 95% CI, 1.51–5.82). Neither heterogeneity nor publication bias was identified. The current analyses suggest that low KISS1 expression predicts poor overall survival among East Asian patients with CRC. Evidence on other races and KISS1R are still insufficient, and additional studies are required to clarify the risk of CRC associated with KISS1R by race. [ABSTRACT FROM AUTHOR]

Aim: Deep vein thrombosis (DVT) is a major complication of cancer. The postoperative prevalence of DVT in colorectal cancer (CRC) surgery is high, but the preoperative prevalence and the risk factors have not been clarified in detail. The objective of this retrospective study was to investigate the preoperative prevalence and risk factors of DVT in patients admitted to hospital for CRC surgery. Methods: From January 2013 to March 2017, 1006 patients admitted for CRC surgery were deemed eligible for this retrospective study. Diagnosis of preoperative DVT was confirmed by compression ultrasonography. Prevalence of silent DVT in lower limbs in patients before CRC surgery was assessed, and the risk factors for preoperative DVT were investigated regarding the correlation of DVT with the patient's background. Results: Preoperative DVT and asymptomatic pulmonary thromboembolism were diagnosed in 136 (13.5%) and in 10 (1.0%) of 1006 patients overall, respectively. Multivariate analysis showed that increased age (≥75 years), female gender, and an elevated d‐dimer level (>1.0 μg/mL) were independent risk factors for preoperative DVT in this study. Notably, the prevalence of preoperative DVT exceeded 50% in patients with all three predictors. Conclusions: A high prevalence (13.5%) of preoperative DVT was found in patients admitted to the hospital for CRC surgery. The present results suggest that instrumental screening should be encouraged, at least in subgroups at a higher risk of preoperative DVT. [ABSTRACT FROM AUTHOR]

Background: Data on 25-OH VD concentrations and the associated factors in colorectal cancer (CRC) patients are scarce and need to be investigated. Methods: A total of 200 CRC patients participated in this cross-sectional study conducted in Pakistan. Socio-demographic and other health data were collected in a pretested questionnaire. Serum measurements of Vitamin D (1, 25(OH)2 D3) levels and hormones were performed. Association of age, sex, primary site, effects of hormone therapy and stage of disease and selected reproductive health indicators on vitamin D status were primarily scrutinized by univariate analysis. Results: Mean age of the population was 55.3 years (±15.6; Range: 20–90 years). Estradiol concentration was considerably elevated in young females compared to young male patients (p < 0.001). The concentrations of FSH, LH testosterone and estradiol were significantly lower in post-menopausal female CRC patients as compared to their male counterparts of old age (p , for all trends < 0.05). Both LH and FSH showed significant gender difference but only in older patients. Level of estrogen was markedly decreased in older post-menopausal CRC patients compared to premenopausal CRC patients, which might be associated with CRC progression. In the group of women, who "ever used hormone therapy" had differences of statistical significance (p , for all trends < 0.05) in their mean serum 25-OH VD concentrations, while in the group of women who "never used hormone therapy" had non-significant differences in their mean serum 25-OH VD concentrations (p , for all trends > 0.05). High 25-OH VD concentrations were observed in women who had their menarche at the age of 15 years or more. Nulliparous women had the highest mean 25-OH VD concentrations as compared to unparious or multiparious women. In addition, women having their menopause at 40–44 years of age had the highest 25-OH VD concentrations, although the difference was not significant (p = 0.08). Women who "never used any oral contraceptive" had higher 25-OH VD concentrations as compared to those "whoever used oral contraceptives." Conclusion: Our findings suggest that vitamin D has a positive effect on the development of CRC through the mediation of hormones. Other health and reproductive traits that affect hormone levels may have an indirect effect on the development of CRC. Further potential studies that directly evaluate levels of circulating hormones and hormone therapy in women in association to 25-OH VD concentrations, as well as their possible role in colorectal cancer risk, would be vastly edifying. [ABSTRACT FROM AUTHOR]

Purpose: A phase II trial was conducted to investigate the benefit of oxaliplatin-based adjuvant chemotherapy in Japanese stage III colon cancer patients. Methods: Eligible patients were scheduled to receive 12 cycles of mFOLFOX6 or 8 cycles of CAPOX in adjuvant settings. The primary endpoint was the 3-year disease-free survival (DFS). Cox proportional hazards regression was performed to identify risk factors for a worse DFS. Results: A total of 130 patients, including 73 patients receiving mFOLFOX6 and 57 patients receiving CAPOX, were enrolled from 16 institutions between April 2010 and April 2014. The 3-year DFS was 82.2%, exceeding the expected primary endpoint of 81.7%. The 3-year DFS tended to be higher in patients receiving mFOLOFOX6 than in those receiving CAPOX (mFOLFOX6, 86.3%; CAPOX, 76.9%; P = 0.06). The 3-year DFS rates did not differ markedly based on the risk stratification (T1/T2/T3 N1 vs. T4 or N2) indicated by the IDEA COLLABORATION study (P = 0.22). In the multivariate analysis, stage IIIC (P = 0.046) and early discontinuation (P < 0.01) were identified as independent significant risk factors for a worse DFS. Conclusion: Our findings represent the first positive results in a Japanese phase II trial of adjuvant chemotherapy with mFOLFOX6/CAPOX. Early discontinuation within 2 months was an independent risk factor for a shorter DFS. [ABSTRACT FROM AUTHOR]