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Background: Colorectal cancer is the third most common cancer in men and the second most common in women worldwide. Almost a third of the patients has or will develop liver metastases. Neoadjuvant chemotherapy (NAC) has recently become nearly systematic prior to surgery of colorectal livers metastases (CRLMs). The response to NAC is evaluated by radiological imaging according to morphological criteria. More recently, the response to NAC has been evaluated based on histological criteria of the resected specimen. The most often used score is the tumor regression grade (TRG), which considers the necrosis, fibrosis, and number of viable tumor cells., Aim: To analyze the predictive factors of the histological response, according to the TRG, on CRLM surgery performed after NAC., Methods: From January 2006 to December 2013, 150 patients who had underwent surgery for CRLMs after NAC were included. The patients were separated into two groups based on their histological response, according to Rubbia-Brandt TRG. Based on their TRG, each patient was either assigned to the responder (R) group (TRG 1, 2, and 3) or to the non-responder (NR) group (TRG 4 and 5). All of the histology slides were re-evaluated in a blind manner by the same specialized pathologist. Univariate and multivariate analyses were performed., Results: Seventy-four patients were classified as responders and 76 as non-responders. The postoperative mortality rate was 0.7%, with a complication rate of 38%. Multivariate analysis identified five predictive factors of histological response. Three were predictive of non-response: More than seven NAC sessions, the absence of a radiological response after NAC, and a repeat hepatectomy ( P < 0.005). Two were predictive of a good response: A rectal origin of the primary tumor and a liver-first strategy ( P < 0.005). The overall survival was 57% at 3 yr and 36% at 5 yr. The disease-free survival rates were 14% at 3 yr and 11% at 5 yr. The factors contributing to a poor prognosis for disease-free survival were: No histological response after NAC, largest metastasis > 3 cm, more than three preoperative metastases, R1 resection, and the use of a targeted therapy with NAC ( P < 0.005)., Conclusion: A non-radiological response and a number of NAC sessions > 7 are the two most pertinent predictive factors of non-histological response (TRG 4 or 5)., Competing Interests: Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.

Background: Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, with up to 25% of patients who will develop metastases. Pulmonary metastases (PMs) resection for CRC might improve long-term survival, but the selection criteria for patients who would benefit remain unclear. The aim of this study was to identify preoperative predictive factors in patients eligible for this surgical strategy., Materials and Methods: We retrospectively reviewed data of patients from five thoracic surgery departments who underwent PM resection for CRC with intent to cure between 2005 and 2010. Univariate and multivariate analyses were performed to identify predictive factors influencing long-term survival and recurrence after pulmonary resection., Results: Three hundred fifty-four patients were eligible. Forty-eight patients had pulmonary recurrence (13.5%). Thirty-day postoperative mortality was 0.3% (n = 1). Five- and 8-y overall survival (OS) were 64.3 ± 3.99% and 60.72 ± 4.5%, respectively. In univariate analysis, 5-y OS was significantly associated with an American Society of Anesthesiologists score of 1 (P = 0.02), a low number of PM (P = 0.001), and single wedge resection (P = 0.00001). In multivariate analysis, an American Society of Anesthesiologists score of 3 or higher (P = 0.05), two or more PMs (P = 0.034) and pneumonectomy (P = 0.021) were significant predictors of a poor outcome. In univariate analysis, 5-y cumulative recurrence was significantly associated with the absence of mediastinal lymph node dissection (P = 0.01)., Conclusions: Given its high 5-y OS with low postoperative morbidity, thus allowing repeat surgical management, resection of PM could be performed. Resection of PM could improve long-term survival., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: Intussusceptions in infants and children are a medical and surgical emergency. A seasonal pattern, with fall and winter predominance, is usually taught in medical schools, but in France the epidemiological characteristics of intussusceptions are not clearly described., Methods: We conducted a retrospective study concerning children with idiopathic ileocolic intussusceptions admitted and treated at our institution (Emergency Department and Pediatric Surgery Department, Toulouse University Hospital) between January 2002 and December 2011. The main purpose was to evaluate the seasonality of intussusceptions. We describe the sex ratio, age of occurrence, rate of recurrence, and rate of failed enema reduction., Results: A total of 306 idiopathic ileocolic intussusceptions (280 patients) were included over a 10-year period with an average of 31 cases per year [21-42]. No seasonal pattern of intussusceptions or fall/winter predominance was shown (P=0.6) in the cumulative number of monthly cases: 24% of the intussusceptions occurred during fall, 21% during winter, 29% during spring, and 27% during summer. There were two peaks: April (35 cases over 10 years) and June (34 cases). The mean age was 18.7 months [2.3-159.4]: 19.5 months [3-159.4] in boys and 14.8 months [2.3-77.5] for girls (P=0.02). Two peaks were shown: one between six and nine months, the other one between 18 and 21 months. Male children had a higher incidence than female children: the sex ratio was 2:1, with 65.4% boys and 34.6% girls (P=0.0003), with an increasing sex ratio for older children. The recurrence rate was 8.2% among all (26 recurrences): 10.1% in boys and 4.9% in girls (P=0.08). The rate of surgery after failed enema reduction was 7.5% (21/280 children). There was no case of recurrence after operation., Conclusion: These results were consistent with previous reports. We did not show any seasonal pattern of idiopathic ileocolic intussusceptions in our patients. A new survey of childhood intussusceptions would be relevant to confirm these results and would make it possible to modify academic teachings about seasonality in intussusceptions., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)