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While the delay in adjuvant chemotherapy (AC) is known to impact colon cancer outcomes, its effect on rectal cancer is less clear. This study aims to evaluate the influence of AC timing on survival in stage II and III rectal cancer. This retrospective multicenter study enrolled 1,144 patients receiving chemotherapy following resection of stage II–III rectal cancers. The effect of delayed AC on survival was assessed using multivariable Cox models with restricted cubic splines and logistic regression. Compared to patients initiating AC within four weeks postsurgery, those initiating within 5–8 weeks had a similar survival (HR=0.85, 95 % CI=0.66–1.11), whereas those initiating within 8–12 weeks (HR=1.62, 95 % CI=1.05–2.51) or beyond 12 weeks (HR=2.07, 95 % CI=1.21–3.56) had a significantly inferior survival. A delayed time to chemotherapy (>8 weeks) was associated with worse survival in patients aged ≥60 years but not in younger patients (<60 years: HR=1.36; 95 % CI=0.75–2.46, p=0.312; ≥60 years: HR=2.37; 95 % CI=1.56–3.60, p<0.001). Additionally, our exploratory analysis suggested that FOLFOX and FOLFIRI were more effective when starting within 5–8 weeks post-surgery, while CAPEOX and a single agent showed a slight advantage when starting within four weeks. Our findings advocate for initiating AC within eight weeks post-surgery in stage II–III rectal cancer, especially in older patients. Delayed treatment is linked to significantly worse survival outcomes. [ABSTRACT FROM AUTHOR]

We evaluate the prognostic value of chemotherapy and other prognostic factors on overall survival among colon patients with deficient mismatch repair (dMMR), and determine the optimum time to start chemotherapy after surgery. Data of 306 colon cancer patients with dMMR who received radical surgery were collected from three Chinese centers between August 2012 and January 2018. Overall survival (OS) was assessed with the Kaplan–Meier method and log-rank. Cox regression analysis were used to assess influencing prognosis factors. The median follow-up time for all patients was 45.0 months (range, 1.0–100). There was a nonsignificant OS benefit from chemotherapy for patients with stage I and stage II disease, including high-risk stage II disease (log-rank p: 0.386, 0.779, 0.921), and a significant OS benefit for patients with stage III and stage IV disease for receiving post-operation chemotherapy (log-rank p = 0.002, 0.019). Stage III patients benefitted from chemotherapy regimens that contained oxaliplatin (log-rank p = 0.004), and Starting chemotherapy with oxaliplatin treatment earlier resulted in better outcomes (95% CI 0.013–0.857; p = 0.035). Chemotherapy regimens containing oxaliplatin can prolong the survival time of stage III and IV dMMR colon cancer patients. This beneficial manifestation was more pronounced after starting chemotherapy treatment early post operation. High risk stage II dMMR colon patients including T4N0M0 cannot benefit from chemotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Dietary advanced lipoxidation end products (ALEs), which are abundant in heat-processed foods, could induce lipid metabolism disorders. However, limited studies have examined the relationship between maternal ALEs diet and offspring health., Methods: To investigate the transgenerational effects of ALEs, a cross-generation mouse model was developed. The C57BL/6J mice were fed with dietary ALEs during preconception, pregnancy and lactation. Then, the changes of glycolipid metabolism and gut microbiota of the offspring mice were analyzed., Results: Maternal ALEs diet not only affected the metabolic homeostasis of dams, but also induced hepatic glycolipid accumulation, abnormal liver function, and disturbance of metabolism parameters in offspring. Furthermore, maternal ALEs diet significantly upregulated the expression of TLR4, TRIF and TNF-α proteins through the AMPK/mTOR/PPARα signaling pathway, leading to dysfunctional glycolipid metabolism in offspring. In addition, 16S rRNA analysis showed that maternal ALEs diet was capable of altered microbiota composition of offspring, and increased the Firmicutes/Bacteroidetes ratio., Discussion: This study has for the first time demonstrated the transgenerational effects of maternal ALEs diet on the glycolipid metabolism and gut microbiota in offspring mice, and may help to better understand the adverse effects of dietary ALEs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer XJ declared a past co-authorship with the author BZ to the handling editor., (Copyright © 2024 Pang, Zhang, Zhang, Chen, Han and Yang.)