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Colon Cancer Metastasis to the Right Testis: Case Report and Review of Literature. Case Rep Urol 2022; 2022:2649259. [PMID: 36035642 PMCID: PMC9411008 DOI: 10.1155/2022/2649259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction A metastatic testicular tumor is uncommon. We report here a case of testicular metastasis associated with recurrent colorectal cancer. Case Presentation. A 75-year-old male was presented with right scrotum pain one year after undergoing a right hemicolectomy combined with resection of the small intestine and omentum for ascending colon cancer (pT4N0M0). Magnetic resonance imaging of the pelvis showed a 7.3 × 5.4 × 4.5 cm mass consisting of a cystic solid tumor. A right inguinal orchiectomy was performed and right testicular pain improved after surgery. Pathology results showed that the tumor was a metastatic adenocarcinoma. The patient subsequently died two months later due to progression of the colon cancer. Conclusion Although colorectal cancer metastasis to the testis is very uncommon, it should be kept in mind in clinical situations, especially for older males with a testicular mass or discomfort.
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Li X, Zhou Y, Wen P, Yuan Y, Xiao Z, Shi H, Zhou H. Tumor suppressor LHX6 upregulation contributes to the inhibitory effect of miR-346 knockdown on colorectal cancer cell growth. ENVIRONMENTAL TOXICOLOGY 2022; 37:435-445. [PMID: 34773443 DOI: 10.1002/tox.23410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 10/04/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Colorectal cancer (CRC) is one of the prevalent types of human malignancies and ranks as the second leading cause of cancer-associated death worldwide. Dysregulated miRNAs have been promulgated as oncogenes or tumor-suppressive genes participating in the initiation and progression of CRC. A recent study reported that miR-346 was highly expressed in CRC patients. However, the biological role and underlying mechanism of miR-346 in CRC remain elusive. qRT-PCR and western blot assays were employed to detect miR-346 and LIM homeobox domain 6 (LHX6) expression in CRC cells. Cell proliferation was evaluated by CCK-8 and BrdU assays. Apoptosis was evaluated by TUNEL assay. The interaction between miR-346 and LHX6 was assessed by luciferase reporter assay. Results showed that miR-346 expression was increased and LHX6 expression was reduced in CRC cells. miR-346 knockdown and LHX6 overexpression inhibited proliferation and promoted apoptosis of CRC cells. Additionally, we found that miR-346 negatively regulated LHX6 expression in CRC cells by directly targeting LHX6. LHX6 knockdown partially attenuated anti-miR-346-induced proliferation reduction and apoptosis promotion in CRC cells. Furthermore, miR-346 knockdown inhibited the protein kinase B (Akt)/mechanistic target of rapamycin (mTOR) pathway in CRC cells by targeting LHX6. The present study indicated that miR-346 knockdown repressed cell growth in CRC cells by upregulating LHX6, and this was associated with inactivation of the Akt/mTOR pathway.
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Affiliation(s)
- Xianzhe Li
- Department of General Surgery, Nanshi Hospital, Nanyang, China
| | - Yeqi Zhou
- Department of Radiotherapy, The Second People's Hospital of Huai'an, Huai'an Hospital Affiliated to Xuzhou Medical University, Huai'an, China
| | - Penghao Wen
- Department of Medical Oncology, Nanshi Hospital, Nanyang, China
| | - Yan Yuan
- Department of Radiotherapy, Nanshi Hospital, Nanyang, China
| | - Zhenghong Xiao
- Department of Medical Oncology, Nanshi Hospital, Nanyang, China
| | - Hengwei Shi
- Department of General Surgery, Nanshi Hospital, Nanyang, China
| | - Hailang Zhou
- Department of Gastroenterology, Lianshui County People's Hospital Affiliated to Kangda College of Nanjing Medical University, Huai'an, China
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3
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Cassar N, Geoghegan J, Hoti E. Shifting concepts in the management of colorectal liver metastases. Surgeon 2022; 20:363-372. [PMID: 34998701 DOI: 10.1016/j.surge.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/21/2021] [Accepted: 12/14/2021] [Indexed: 02/07/2023]
Abstract
Management of patients with colorectal liver metastases has evolved considerably due to a better understanding of the biology of the disease with concurrent improvements in surgical techniques, oncological strategies and radiological interventions. This review article examines the factors that have contributed to this radical change. Management will be discussed in relation to chemotherapy, surgery and interventional radiology. The addition of chemotherapy and biological agents has greatly extended the reach and scope of surgery. Parenchymal sparing resections, repeat resections, two stage hepatectomy and Associating Liver Partition and Portal Vein ligation are all available to the hepatobiliary surgeon who deals with colorectal liver metastases. Interventional radiology techniques like liver venous deprivation may also replace established surgical practice. Whilst traditionally it was thought that only a few liver metastases could be treated effectively, nowadays tumour number is no longer a limiting factor provided enough functioning liver can be spared and the patient can tolerate the operation.
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Affiliation(s)
- Noel Cassar
- Department of Hepatobiliary Surgery and Liver Transplantation, St Vincent's University Hospital, Elm Park, Dublin 4 D04 T6F4, Ireland.
| | - Justin Geoghegan
- Department of Hepatobiliary Surgery and Liver Transplantation, St Vincent's University Hospital, Elm Park, Dublin 4 D04 T6F4, Ireland
| | - Emir Hoti
- Department of Hepatobiliary Surgery and Liver Transplantation, St Vincent's University Hospital, Elm Park, Dublin 4 D04 T6F4, Ireland
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4
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Wen XD, Xiao L. Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of colorectal cancer liver metastases. World J Gastrointest Surg 2021; 13:814-821. [PMID: 34512905 PMCID: PMC8394386 DOI: 10.4240/wjgs.v13.i8.814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/24/2021] [Accepted: 07/13/2021] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is a common malignancy of the digestive system. Colorectal liver cancer metastasis (CRLM) occurs in approximately 50% of the patients and is the main cause of CRC mortality. Surgical resection is currently the most effective treatment for CRLM. However, given that the remnant liver volume after resection should be adequate, only a few patients are suitable for radical resection. Since Dr. Hans Schlitt first performed the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for CRLM in 2012, ALPPS has received considerable attention and has continually evolved in recent years. This review explains the technical origin of the ALPPS procedure for CRLM and evaluates its efficacy, pointing to its favorable postoperative outcomes. We also discuss the patient screening strategies and optimization of ALPPS to ensure long-term survival of patients with CRLM in whom surgery cannot be performed. Finally, further directions in both basic and clinical research regarding ALPPS have been proposed. Although ALPPS surgery is a difficult and high-risk technique, it is still worth exploration by experienced surgeons.
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Affiliation(s)
- Xu-Dong Wen
- Department of Gastroenterology and Hepatology, Chengdu First People’s Hospital, Chengdu 610016, Sichuan Province, China
| | - Le Xiao
- General Surgery Center, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
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5
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Jin Y, Zhan X, Zhang B, Chen Y, Liu C, Yu L. Polydatin Exerts an Antitumor Effect Through Regulating the miR-382/PD-L1 Axis in Colorectal Cancer. Cancer Biother Radiopharm 2020; 35:83-91. [PMID: 31755739 DOI: 10.1089/cbr.2019.2999] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Ye Jin
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Xiaobo Zhan
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Bin Zhang
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Yun Chen
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Changfeng Liu
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Lingli Yu
- Department of Anesthesiology, The Children's Hospital Zhejiang University School of Medicine, Hangzhou, China
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6
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Hasselgren K, Isaksson B, Ardnor B, Lindell G, Rizell M, Strömberg C, Loftås P, Björnsson B, Sandström P. Liver resection is beneficial for patients with colorectal liver metastases and extrahepatic disease. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:109. [PMID: 32175402 DOI: 10.21037/atm.2019.12.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Liver metastases are the most common cause of death for patients with colorectal cancer and affect up to half of the patients. Liver resection is an established method that can potentially be curative. For patients with extrahepatic disease (EHD), the role of liver surgery is less established. Methods This is a retrospective study based on data from the national quality registry SweLiv. Data were obtained between 2009 and 2015. SweLiv is a validated registry and has been in use since 2009, with coverage above 95%. Patients with liver metastases and EHD were analyzed and cross-checked against the national death cause registry for survival analysis. Results During the study period, 2,174 patients underwent surgery for colorectal liver metastases (CRLM), and 277 patients with EHD were treated with resection or ablation. The estimated median survival time for the entire cohort from liver resection/ablation was 40 months (95% CI, 32-47). The survival time for patients treated with liver resection was 45 months compared to 26 months for patients treated with ablation (95% CI 38-53, 18-33, P=0.001). A subgroup analysis of resected patients revealed that the group with pulmonary metastases had a significantly longer estimated median survival (50 months; 95% CI, 39-60) than the group with lymph node metastases (32 months; 95% CI, 7-58) or peritoneal carcinomatosis (28 months; 95% CI, 14-41) (P=0.022 and 0.012, respectively). Other negative prognostic factors were major liver resection and nonradical liver resection. Conclusions For patients with liver metastases and limited EHD, liver resection results in prolonged survival compared to what can be expected from chemotherapy alone.
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Affiliation(s)
- Kristina Hasselgren
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Bengt Isaksson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Bjarne Ardnor
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Gert Lindell
- Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden
| | - Magnus Rizell
- Transplant Institute, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Strömberg
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Per Loftås
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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7
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Expression analysis and implication of Rab1A in gastrointestinal relevant tumor. Sci Rep 2019; 9:13384. [PMID: 31527621 PMCID: PMC6746845 DOI: 10.1038/s41598-019-49786-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 08/31/2019] [Indexed: 12/20/2022] Open
Abstract
Gastrointestinal cancers have become increasingly prevalent worldwide. Previous studies have reported an oncogenic function of Rab1A in colorectal cancer and hepatocellular carcinomas via the mTOR pathway. However, the exact role of Rab1A in gastrointestinal cancers remains elusive. We detected significantly higher expression of Rab1A in the gastrointestinal tumor tissues compared to that in other cancer types following an in silico analysis of TGCA and GTEX databases. Furthermore, Rab1A was overexpressed in the gastrointestinal tumor tissues compared to the para-tumor tissues. Although Rab1A expression levels were not associated with the tumor-lymph node-metastasis (TNM) stage, Rab1A overexpression in the tumor tissues of a gastric cancer (GC) cohort was strongly correlated with poor prognosis in the patients. In addition, Rab1A knockdown significantly inhibited the in vitro proliferation and migration abilities of GC cells, as well as the growth of GC xenografts in vivo. Furthermore, a positive correlation was observed between Rab1A expression levels and that of different upstream/downstream mTOR targets. Taken together, Rab1A regulates the PI3K-AKT-mTORC1 pathway through the mTORC1 complex consisting of mTORC1, Rheb and Rab1A, and is a promising therapeutic target in GC.
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8
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In Vitro and In Silico Mechanistic Insights into miR-21-5p-Mediated Topoisomerase Drug Resistance in Human Colorectal Cancer Cells. Biomolecules 2019; 9:biom9090467. [PMID: 31505885 PMCID: PMC6769444 DOI: 10.3390/biom9090467] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/06/2019] [Accepted: 09/07/2019] [Indexed: 12/27/2022] Open
Abstract
Although chemotherapy for treating colorectal cancer has had some success, drug resistance and metastasis remain the major causes of death for colorectal cancer patients. MicroRNA-21-5p (hereafter denoted as miR-21) is one of the most abundant miRNAs in human colorectal cancer. A Kaplan-Meier survival analysis found a negative prognostic correlation of miR-21 and metastasis-free survival in colorectal cancer patients (The Cancer Genome Atlas Colon Adenocarcinoma/TCGA-COAD cohort). To explore the role of miR-21 overexpression in drug resistance, a stable miR-21-overexpressing clone in a human DLD-1 colorectal cancer cell line was established. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) cell viability assay found that miR-21 overexpression induced drug resistance to topoisomerase inhibitors (SN-38, doxorubicin, and etoposide/VP-16). Mechanistically, we showed that miR-21 overexpression reduced VP-16-induced apoptosis and concomitantly enhanced pro-survival autophagic flux without the alteration of topoisomerase expression and activity. Bioinformatics analyses suggested that miR-21 overexpression induced genetic reprogramming that mimicked the gene signature of topoisomerase inhibitors and downregulated genes related to the proteasome pathway. Taken together, our results provide a novel insight into the role of miR-21 in the development of drug resistance in colorectal cancer.
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9
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Duan X, Hong J, Wang F, Wei K, Wang P, Hou F, Zhang M, Liu D, Yuan D, Liu S. The influence of ACYP2 polymorphisms on gastrointestinal cancer susceptibility in the Chinese Han population. Mol Genet Genomic Med 2019; 7:e00700. [PMID: 31070019 PMCID: PMC6625334 DOI: 10.1002/mgg3.700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/29/2019] [Accepted: 04/07/2019] [Indexed: 12/11/2022] Open
Abstract
Background Gastrointestinal cancer (GI cancer) is a type of cancer that has a high death rate. It has been reported that ACYP2 gene was associated with the development of gastric cancer and colorectal cancer, but it is not clear that the relationship between ACYP2 gene and GI cancer in Chinese Han population. This study aimed to investigate the association between polymorphisms of ACYP2 and GI cancer in the Chinese Han population. Methods We used Agena MassARRAY to determine the genotypes of 1,160 GI cancer patients and 495 healthy controls. The correlation between ACYP2 variants and GI cancer risk was examined by logistic regression analysis. Results We identified that rs6713088 (OR = 1.17, 95% CI: 1.00–1.36, p = 0.047), rs843711 (OR = 1.17, 95 CI: 1.01–1.36, p = 0.035), and rs11896604 (OR = 1.20, 95% CI: 1.00–1.45, p = 0.048) were correlated with an increased risk of GI cancer under allele model. Rs11125529 under the recessive model (OR = 2.05, 95% CI: 1.00–4.23, p = 0.038), rs843711 in recessive model (OR = 1.37, 95% CI: 1.04–1.82, p = 0.026), and rs11896604 under log‐additive model (OR = 1.23, 95% CI: 1.01–1.51, p = 0.042) were associated with an increased risk of GI cancer. Conclusion Our study suggested that polymorphisms of ACYP2 gene might be associated with susceptibility to GI cancer.
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Affiliation(s)
- Xianglong Duan
- The Second Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China.,Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Jiajing Hong
- College of Acupuncture and Massage, Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Fuchun Wang
- Institute of Acupuncture and Massage, Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Kun Wei
- Medical College, Yan'an University, Yan'an, China
| | - Pengyuan Wang
- Clinical Medical College, Xi'an Medical University, Xi'an, China
| | - Feng Hou
- Clinical Medical College, Xi'an Medical University, Xi'an, China
| | - Min Zhang
- Medical College, Yan'an University, Yan'an, China
| | - Dengfeng Liu
- Clinical Medical College, Xi'an Medical University, Xi'an, China
| | - Dongya Yuan
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang, China
| | - Sida Liu
- The Second Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an, China
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10
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Wan J, Yang J, Qiao C, Sun X, Di A, Zhang L, Wang D, Zhao G. MicroRNA-362 Inhibits Cell Proliferation and Invasion by Directly Targeting SIX1 in Colorectal Cancer. Yonsei Med J 2019; 60:414-422. [PMID: 31016902 PMCID: PMC6479121 DOI: 10.3349/ymj.2019.60.5.414] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Colorectal cancer (CRC) is the third most common cancer in China and poses high morbidity and mortality. In recent years, increasing evidence has indicated that microRNAs played important functions in the occurrence and development of tumors. The purpose of this study was to identify the biological mechanisms of miR-362 in CRC. MATERIALS AND METHODS Quantitative real-time PCR was carried out to assess the expression of miR-362 and SIX1. The Kaplan-Meier method was employed to evaluate the 5-year overall survival of CRC patients. The proliferative and invasive abilities of CRC cells were assessed by MTT and transwell assays. RESULTS miR-362 was significantly decreased in CRC tissues and cell lines, compared to the normal tissues and normal cells. A significant connection was confirmed between the overall survival of 53 CRC patients and low expression of miR-362. Downregulation of miR-362 inhibited the proliferation and invasion through binding to the 3'-UTR of SIX1 mRNA in CRC. Additionally, we discovered that SIX1 was a direct target gene of miR-362 and that the expression of miR-362 had a negative connection with SIX1 expression in CRC. SIX1 could reverse partial functions in the proliferation and invasion in CRC cells. CONCLUSION miR-362 may be a prognostic marker in CRC and suppress CRC cell proliferation and invasion in part through targeting the 3'-UTR of SIX1 mRNA. The newly identified miR-362/SIX1 axis provides insight into the progression of CRC.
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Affiliation(s)
- Jin'e Wan
- Department of Hyperbaric Oxygen, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jian Yang
- Department of Oncology, Zouping Centre Hospital, Binzhou, China
| | - Cuixia Qiao
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaomei Sun
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Aiting Di
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lize Zhang
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dandan Wang
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Gang Zhao
- Department of Anorectal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
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11
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Yao Y, Wang X, Jiang L, Shao X, Zhu X, He S. Prognostic and clinicopathological value of FoxM1 expression in colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13899. [PMID: 30593202 PMCID: PMC6314739 DOI: 10.1097/md.0000000000013899] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The study aims to assess the relationship between FoxM1 expression and clinicopathological parameters and prognosis of patients diagnosed with colorectal cancer (CRC) by summarizing the studies included. METHODS PubMed, EMBASE, The Cochrane Library and other sources were searched for relative studies. Odds ratio (OR) and confidence interval (CI) were used to assess association between FoxM1 expression and clinical parameters and prognosis of CRC patients. RESULTS Eight studies were included in the final analysis, with 1149 CRC patients. The outcome revealed that expression of FoxM1 was associated with lymph node metastasis (OR = 0.33, 95%CI = 0.19-0.62, P < .001), distant metastasis (OR = 0.35, 95%CI = 0.24-0.46, P < .001) and tumor node metastasis (TNM) stage (OR = 0.45, 95%CI = 0.29-0.72, P < .001). Meanwhile, reduced FoxM1 expression indicated higher 5-year survival rate (OR = 0.38, 95%CI = 0.18-0.78, P = .01). Expression of FoxM1 was also increased obviously in CRC tissues (OR = 13.04, 95%CI = 4.07-41.71, P < .001). CONCLUSION This pooled analysis indicated that FoxM1 expression related to lymph node metastasis, distant metastasis, TNM stage and poor prognosis of the CRC patients.
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Affiliation(s)
- Yizhou Yao
- Department of General Surgery, The First Affiliated Hospital of Soochow University
| | - Xuchao Wang
- Department of General Surgery, The First Affiliated Hospital of Soochow University
| | - Linhua Jiang
- Department of General Surgery, The First Affiliated Hospital of Soochow University
| | - Xinyu Shao
- Department of Gastroenterology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Xinguo Zhu
- Department of General Surgery, The First Affiliated Hospital of Soochow University
| | - Songbing He
- Department of General Surgery, The First Affiliated Hospital of Soochow University
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12
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Moris D, Tsilimigras DI, Machairas N, Merath K, Cerullo M, Hasemaki N, Prodromidou A, Cloyd JM, Pawlik TM. Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review. J Surg Oncol 2018; 119:30-39. [DOI: 10.1002/jso.25313] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/12/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Dimitrios Moris
- Department of SurgeryWexner Medical Center, The Ohio State UniversityColumbus Ohio
- Division of Surgical OncologyJames Cancer Hospital and Solove Research Institute, The Ohio State UniversityColumbus Ohio
- Department of SurgeryDuke University Medical CenterDurham North Carolina
| | - Diamantis I. Tsilimigras
- Department of SurgeryWexner Medical Center, The Ohio State UniversityColumbus Ohio
- Division of Surgical OncologyJames Cancer Hospital and Solove Research Institute, The Ohio State UniversityColumbus Ohio
| | - Nikolaos Machairas
- Third Department of Surgery, National and Kapodistrian University of Athens Medical SchoolAthens Greece
| | - Katiuscha Merath
- Department of SurgeryWexner Medical Center, The Ohio State UniversityColumbus Ohio
- Division of Surgical OncologyJames Cancer Hospital and Solove Research Institute, The Ohio State UniversityColumbus Ohio
| | - Marcelo Cerullo
- Department of SurgeryDuke University Medical CenterDurham North Carolina
| | - Natasha Hasemaki
- Third Department of Surgery, National and Kapodistrian University of Athens Medical SchoolAthens Greece
| | - Anastasia Prodromidou
- Third Department of Surgery, National and Kapodistrian University of Athens Medical SchoolAthens Greece
| | - Jordan M Cloyd
- Department of SurgeryWexner Medical Center, The Ohio State UniversityColumbus Ohio
- Division of Surgical OncologyJames Cancer Hospital and Solove Research Institute, The Ohio State UniversityColumbus Ohio
| | - Timothy M Pawlik
- Department of SurgeryWexner Medical Center, The Ohio State UniversityColumbus Ohio
- Division of Surgical OncologyJames Cancer Hospital and Solove Research Institute, The Ohio State UniversityColumbus Ohio
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13
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Hyun EJ, Hasan MN, Kang SH, Cho S, Lee YK. Oral siRNA delivery using dual transporting systems to efficiently treat colorectal liver metastasis. Int J Pharm 2018; 555:250-258. [PMID: 30399434 DOI: 10.1016/j.ijpharm.2018.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/31/2018] [Accepted: 11/03/2018] [Indexed: 01/29/2023]
Abstract
Oral siRNA delivery is an ideal way to translate siRNA therapeutic effects in the clinic due to its ability to be administered in convenient and multiple dosages. However, an effective oral delivery system requires overcoming both a hostile gastrointestinal (GI) environment and non-specific targeting. Here, an HTsRP-NC system is a new oral siRNA delivery system consisting of a siRNA/protamine (sRP) nano-complex protected by a multi-functional hyaluronic acid-taurocholic acid (HA-TCA) conjugate. The HTsRP-NC promotes cell penetration and enhances endosomal escape in cancer cells. Moreover, protection of the sRP by HA-TCA from the hostile GI environment helps the AKT siRNA complex to reach the liver through the utilization of a TCA-mediated enterohepatic bile acid recycling system. AKT siRNA was released by 90% in presence of hyaluronidase in the tumor cells which indicate the potential use of HTsRP-NCs for siRNA delivery to treat tumor. After HA receptor (CD44)-mediated cellular uptake of the HTsRP-NC by the liver cancer cells, functional expression of AKT siRNA leads to the suppression of metastatic liver cancer growth in a colorectal liver metastasis (CLM) murine model. Tumor nodules were reduced by more than 1 mm size compared to control group and tumor cells were suppressed by 50% after HTsRP-NCs treatment with AKT siRNA. Overall, oral administration of the HTsRP-NC supports its potential in therapeutic applications for the effective treatment of CLM.
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Affiliation(s)
- Eun-Ju Hyun
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 380-702, Republic of Korea
| | - Mohammad Nazmul Hasan
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 380-702, Republic of Korea
| | | | - Sungpil Cho
- 4D Biomaterials Center, Korea National University of Transportation, Jeungpyeong 27909, Republic of Korea.
| | - Yong-Kyu Lee
- Department of Chemical and Biological Engineering, Korea National University of Transportation, Chungju 380-702, Republic of Korea; KB BioMed Inc., Chungju 380-702, Republic of Korea; 4D Biomaterials Center, Korea National University of Transportation, Jeungpyeong 27909, Republic of Korea.
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14
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Comparative profiling between primary colorectal carcinomas and metastases identifies heterogeneity on drug resistance. Oncotarget 2018; 7:63937-63949. [PMID: 27613840 PMCID: PMC5325415 DOI: 10.18632/oncotarget.11570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/11/2016] [Indexed: 12/17/2022] Open
Abstract
Metastases cause recurrence and mortality for patients with colorectal carcinomas (CRC). In present study, we evaluated heterogeneity on drug resistance and its underlying mechanism between metastatic and primary CRC. Immunohistochemical results from clinical tissue microarray (TMA) suggested that the expression concordance rates of cancer stem cells (CSCs) and drug resistance relative proteins between lymph-node metastatic and primary CRC foci were low. The apoptotic and proliferation indexes in metastasis CRC specimens were decreased compared with primary. In vitro experimental results indicated that the migration and invasion abilities were upregulated in metastatic cells SW620 compared with primary cells SW480, the cellular efflux ability and WNT/β-catenin activity were also upregulated in SW620 cells. After 5-fluorouracil (5-Fu) treatment, the reduction in the proportion of cell apoptosis, CD133 and TERT expression levels in SW620 were lower than that in SW480 cells. Bioinformatics analysis in whole-genome transcriptional profiling results between metastatic and primary CRC cells suggested that differentially expressed genes were mainly centered on well-characterized signaling pathways including WNT/β-catenin, cell cycle and cell junction. Collectively, heterogeneity of drug resistant was present between metastatic and primary CRC specimens and cell lines, the abnormal activation of WNT/β-catenin signaling pathway could be a potential molecular leading to drug resistant ability enhancing in metastatic CRC cells.
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15
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Park PG, Jo SJ, Kim MJ, Kim HJ, Lee JH, Park CK, Kim H, Lee KY, Kim H, Park JH, Dong SM, Lee JM. Role of LOXL2 in the epithelial-mesenchymal transition and colorectal cancer metastasis. Oncotarget 2017; 8:80325-80335. [PMID: 29113306 PMCID: PMC5655201 DOI: 10.18632/oncotarget.18170] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/11/2017] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most dangerous types of malignant tumors, and cancer metastasis is a major factor in the failure of CRC therapy. Recently, LOXL2 (lysyl oxidase-like 2) has been shown to represent a regulator of epithelial-mesenchymal transition (EMT) in different cancer types. However, LOXL2 has not been reported to be involved in CRC metastasis. In this study, we demonstrated that LOXL2 expression is strongly correlated with the rate of CRC metastasis, it participates in the regulation of EMT-related molecule expression in CRC cells in vitro, and it is involved in migratory potential alterations. Additionally, tissue microarray analysis of CRC patients showed an increase in the probability of developing CRC distant metastasis and a decrease in the survival rate of patients with high LOXL2 expression. The results obtained in this study indicate that LOXL2 is involved in the development and progression of CRC metastasis, and therefore, its expression levels may represent a useful prognostic marker.
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Affiliation(s)
- Pil-Gu Park
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Ji Jo
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.,BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Jung Kim
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jeong Kim
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Hae Lee
- Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Cheol Keun Park
- Department of Pathology, Yonsei University, College of Medicine, Seoul, South Korea
| | - Hyunki Kim
- Department of Pathology, Yonsei University, College of Medicine, Seoul, South Korea
| | - Kang Young Lee
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hoguen Kim
- BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Pathology, Yonsei University, College of Medicine, Seoul, South Korea
| | - Jeon Han Park
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Myung Dong
- Research Institute, National Cancer Center, Goyang, Republic of Korea.,IMK Bio-Convergence R&D Center, International Vaccine Institute SNU Research Park, Seoul, Republic of Korea
| | - Jae Myun Lee
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.,BK21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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16
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Shiozawa K, Watanabe M, Ikehara T, Matsukiyo Y, Kogame M, Kikuchi Y, Otsuka Y, Kaneko H, Igarashi Y, Sumino Y. Comparison of contrast-enhanced ultrasonograpy with Gd-EOB-DTPA-enhanced MRI in the diagnosis of liver metastasis from colorectal cancer. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:138-144. [PMID: 27861987 PMCID: PMC5363388 DOI: 10.1002/jcu.22421] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 08/26/2016] [Accepted: 09/23/2016] [Indexed: 05/14/2023]
Abstract
PURPOSE To compare contrast-enhanced ultrasonography (CEUS) using Sonazoid with Gd-EOB-DTPA-enhanced MRI (EOB-MRI) in the diagnosis of liver metastases in patients with colorectal cancer. METHODS A total of 69 patients diagnosed with or suspected of having liver metastasis were enrolled. These hepatic lesions were diagnosed by histopathological examination after surgical resection or based on follow-up using various imaging modalities. The diagnostic accuracies of CEUS and EOB-MRI were compared. RESULTS One hundred thirty-three lesions were detected. Of these lesions, 109 were diagnosed as liver metastases. Of the 133 lesions, 90.2% were detected on CEUS, and 98.5% on EOB-MRI. One hundred nine lesions were diagnosed as liver metastasis. The areas under the receiver operating characteristic curve for diagnosis were 0.906 and 0.851 on CEUS and EOB-MRI, respectively (p = 0.41). Sensitivity, specificity, positive predictive value (PPV), negative predictive value, and overall accuracy were 90.8%, 84.5%, 97.1%, 67.1%, and 90.2%, respectively, for CEUS, and 95.4%, 70.8%, 93.7%, 77.3%, and 91%, respectively, for EOB-MRI. CONCLUSIONS CEUS has a higher specificity and PPV for the diagnosis of liver metastasis than EOB-MRI. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:138-144, 2017.
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Affiliation(s)
- Kazue Shiozawa
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Manabu Watanabe
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Takashi Ikehara
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Yasushi Matsukiyo
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Michio Kogame
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Yoshinori Kikuchi
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Yuichiro Otsuka
- Department of SurgeryToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Hironori Kaneko
- Department of SurgeryToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
| | - Yasukiyo Sumino
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineToho University Medical CenterOmori Hospital, 6‐11‐1, OmorinishiOta‐kuTokyo143‐8541Japan
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17
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Hasselgren K, Malagò M, Vyas S, Campos RR, Brusadin R, Linecker M, Petrowsky H, Clavien PA, Machado MA, Hernandez-Alejandro R, Wanis K, Valter L, Sandström P, Björnsson B. Neoadjuvant chemotherapy does not affect future liver remnant growth and outcomes of associating liver partition and portal vein ligation for staged hepatectomy. Surgery 2017; 161:1255-1265. [PMID: 28081953 DOI: 10.1016/j.surg.2016.11.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/09/2016] [Accepted: 11/30/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The only potentially curative treatment for patients with colorectal liver metastases is hepatectomy. Associating liver partition and portal vein ligation for staged hepatectomy has emerged as a method of treatment for patients with inadequate future liver remnant. One concern about associating liver partition and portal vein ligation for staged hepatectomy is that preoperative chemotherapy may negatively affect the volume increase of the future liver remnant and outcomes. METHODS This study from the International Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy Registry (NCT01924741) includes 442 patients with colorectal liver metastases registered from 2012-2016. Future liver remnant hypertrophy (absolute increase, percent increase, and kinetic growth rate) and clinical outcome were analyzed retrospectively in relation to type and amount of chemotherapy. The analyzed groups included patients with no chemotherapy, 1 regimen of chemotherapy, >1 regimen, and a group that received monoclonal antibodies in addition to chemotherapy. RESULTS Ninety percent of the patients received neoadjuvant oncologic therapy including 42% with 1 regimen of chemotherapy, 44% with monoclonal antibodies, and 4% with >1 regimen. Future liver remnant increased between 74-92% with the largest increase in the group with 1 regimen of chemotherapy. The increase in milliliters was between 241 mL (>1 regimen) and 306 mL (1 regimen). Kinetic growth rate was between 14-18% per week and was greatest for the group with 1 regimen of chemotherapy. No statistical significance was found between the groups with any of the measurements of future liver remnant hypertrophy. CONCLUSION Neoadjuvant chemotherapy, including monoclonal antibodies, does not negatively affect future liver remnant growth. Patients with colorectal liver metastases who might be potential candidates for associating liver partition and portal vein ligation for staged hepatectomy should be considered for neoadjuvant chemotherapy.
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Affiliation(s)
- Kristina Hasselgren
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Massimo Malagò
- Department of Hepatopancreaticobiliary Surgery and Liver Transplantation, Division of Surgical and Interventional Sciences, University College London, Royal Free Hospital, London, United Kingdom
| | - Soumil Vyas
- Department of Hepatopancreaticobiliary Surgery and Liver Transplantation, Division of Surgical and Interventional Sciences, University College London, Royal Free Hospital, London, United Kingdom
| | - Ricardo Robles Campos
- Department of General Surgery, Liver Transplant Unit, Virgen De La Arrixaca University Hospital, Murcia, Spain
| | - Roberto Brusadin
- Department of General Surgery, Liver Transplant Unit, Virgen De La Arrixaca University Hospital, Murcia, Spain
| | - Michael Linecker
- Department of Surgery and Transplantation, Swiss Hepatopancreaticobiliary and Transplant Center Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Henrik Petrowsky
- Department of Surgery and Transplantation, Swiss Hepatopancreaticobiliary and Transplant Center Zürich, University Hospital Zürich, Zürich, Switzerland
| | - Pierre Alain Clavien
- Department of Surgery and Transplantation, Swiss Hepatopancreaticobiliary and Transplant Center Zürich, University Hospital Zürich, Zürich, Switzerland
| | | | | | - Kerollos Wanis
- Department of Surgery, Western University, London, Ontario, Canada
| | - Lars Valter
- Research and Development Unit in Local Healthcare, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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18
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Hokuto D, Nomi T, Yamato I, Yasuda S, Obara S, Yoshikawa T, Kawaguchi C, Yamada T, Kanehiro H, Nakajima Y. The prognosis of liver resection for patients with four or more colorectal liver metastases has not improved in the era of modern chemotherapy. J Surg Oncol 2016; 114:959-965. [DOI: 10.1002/jso.24461] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/07/2016] [Indexed: 01/31/2023]
Affiliation(s)
- Daisuke Hokuto
- Department of Surgery; Nara Medical University; Nara Japan
| | - Takeo Nomi
- Department of Surgery; Nara Medical University; Nara Japan
| | - Ichiro Yamato
- Department of Surgery; Nara Medical University; Nara Japan
| | - Satoshi Yasuda
- Department of Surgery; Nara Medical University; Nara Japan
| | - Shinsaku Obara
- Department of Surgery; Nara Medical University; Nara Japan
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19
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Silberhumer GR, Paty PB, Denton B, Guillem J, Gonen M, Araujo RLC, Nash GM, Temple LK, Allen PJ, DeMatteo RP, Weiser MR, Wong WD, Jarnagin WR, D'Angelica MI, Fong Y. Long-term oncologic outcomes for simultaneous resection of synchronous metastatic liver and primary colorectal cancer. Surgery 2016; 160:67-73. [PMID: 27079362 DOI: 10.1016/j.surg.2016.02.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/05/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Twenty-five percent of patients with colorectal cancer present with simultaneous liver metastasis. Complete resection is the only potential curative treatment. Due to improvements in operative and perioperative management, simultaneous liver and colon resections are an accepted procedure at specialized centers for selected patients. Nevertheless, little is known about the long-term, oncologic results of simultaneous operative procedures compared with those of staged operations. METHODS Patients with colorectal cancer and simultaneous liver metastases presenting for complete resection at a tertiary cancer center were identified. Patients who received the primary colon resection at an outside institution were excluded from analysis. RESULTS Between 1984 and 2008, 429 patients underwent operative treatment for colorectal cancer with simultaneous liver metastasis. Of these, 320 (75%) had simultaneous resection and 109 had staged resection. There was no difference in the distribution of primary tumor locations between the 2 groups. Mean size of the hepatic metastases was significantly greater in the staged group (median 4 cm vs 2.5 cm; P < .01). Neither disease-free nor overall survival differed significantly between the 2 treatment strategies. The extent of the liver procedure (more than 3 segments) was identified as a risk factor for decreased disease-free and overall survival (both P < .01). CONCLUSION Simultaneous liver and colorectal resections for metastatic colorectal cancer are associated with similar long-term cancer outcome compared with staged procedures.
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Affiliation(s)
- Gerd R Silberhumer
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Surgery, Medical University Vienna, Vienna, Austria
| | - Philip B Paty
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brian Denton
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jose Guillem
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mithat Gonen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Raphael L C Araujo
- Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Garret M Nash
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Larissa K Temple
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Peter J Allen
- Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ronald P DeMatteo
- Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin R Weiser
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - W Douglas Wong
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - William R Jarnagin
- Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael I D'Angelica
- Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuman Fong
- Department of Surgery, City of Hope, Duarte, CA.
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20
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Oguro S, Imamura H, Yoshimoto J, Ishizaki Y, Kawasaki S. Liver metastases from gastric cancer represent systemic disease in comparison with those from colorectal cancer. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2016; 23:324-32. [PMID: 26946472 DOI: 10.1002/jhbp.343] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The aim of this retrospective study was to clarify the difference in behavior and outcome after initial hepatectomy between gastric cancer liver metastases (GCLM) and colorectal cancer liver metastases (CCLM). METHODS Data for patients undergoing curative hepatectomy for liver-only metastases from colorectal cancer (n = 193) and gastric cancer (n = 26) performed at single institution with the same criteria regarding the status of liver metastases were reviewed. Post-hepatectomy recurrence pattern, re-resection for recurrence, and three different endpoints were evaluated. RESULTS There was no significant difference between the GCLM and the CCLM in the incidence of recurrence (69% vs. 63%, P = 0.553) and recurrence-free survival (median, 15.2 months vs. 16.5 months, P = 0.230) following initial hepatectomy for liver metastases. However, the GCLM had a higher frequency of systemic unresectable recurrences than the CCLM. Time to surgical failure (median, 15.2 months vs. 39.7 months, P = 0.006) and overall survival (median, 20.1 months vs. 66.2 months, P < 0.001) were significantly shorter in the GCLM than in the CCLM. CONCLUSIONS GCLM shows more systemic and aggressive oncological behavior than CCLM after curative hepatectomy even when metastases are confined only to the liver at the time of initial hepatectomy.
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Affiliation(s)
- Seiji Oguro
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Hiroshi Imamura
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Jiro Yoshimoto
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yoichi Ishizaki
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Seiji Kawasaki
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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21
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Zhu P, Zhao N, Sheng D, Hou J, Hao C, Yang X, Zhu B, Zhang S, Han Z, Wei L, Zhang L. Inhibition of Growth and Metastasis of Colon Cancer by Delivering 5-Fluorouracil-loaded Pluronic P85 Copolymer Micelles. Sci Rep 2016; 6:20896. [PMID: 26864651 PMCID: PMC4750032 DOI: 10.1038/srep20896] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/12/2016] [Indexed: 12/21/2022] Open
Abstract
Hepatic metastasis is the leading cause of mortality of colon cancer, which is still lack of an effective therapy. A new delivery system, pluronic P85 block copolymers, conveying chemotherapeutic agent 5-fluorouracil (5-Fu) for inhibiting growth and metastasis of colon cancer was designed and developed. In this study, we demonstrated that 5-Fu produce strong pesticide effect at lower doses in the present of pluronic P85 compared with control groups. The migration and invasion of HCT116 cells and RKO cells were examined and the results showed that migration and invasion capacities of HCT116 cells and RKO cells were reduced by administering 5-Fu/P85 copolymer micelles in vitro and in vivo which indicating an effectively activity. Interestingly, the content of CD133 + CXCR4+ cells in HCT116 cancer cells and RKO cells treated by 5-Fu/P85 copolymer micelles was decreased. Importantly, the epithelial-mesenchymal transition (EMT) of CD133 + CXCR4+ cells, which was strongly associated with liver metastasis of colon cancer, was also suppressed by giving 5-Fu/P85 copolymer micelles. The results indicated that 5-Fu/P85 copolymer micelles could inhibit the growth and metastasis of colon cancer, which could be attributed to the decrease of the content of CD133 + CXCR4+ cells and suppression of EMT of CD133 + CXCR4+ cells.
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Affiliation(s)
- Pengxi Zhu
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Naping Zhao
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Dandan Sheng
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Jing Hou
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Chong Hao
- Tumor Immunology and Gene Therapy Center, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Xue Yang
- Tumor Immunology and Gene Therapy Center, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Bing Zhu
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Shanshan Zhang
- Tumor Immunology and Gene Therapy Center, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Zhipeng Han
- Tumor Immunology and Gene Therapy Center, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Lixin Wei
- Tumor Immunology and Gene Therapy Center, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai, 200433, China
| | - Li Zhang
- Department of Phamacy, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China
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22
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Zhang H, Zhong H, Li L, Ji W, Zhang X. Overexpressed transcription factor FOXM1 contributes to the progression of colorectal cancer. Mol Med Rep 2016; 13:2696-700. [PMID: 26861549 DOI: 10.3892/mmr.2016.4875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 11/30/2015] [Indexed: 11/06/2022] Open
Abstract
Forkhead box M1 (FOXM1) is a characteristic proliferation‑associated transcription factor, which is overexpressed in various types of human cancer. The aim of the present study was to determine the expression of FOXM1 in a large collection of colorectal cancer (CRC) samples. Between March 2012 and January 2014, 96 patients with histologically diagnosed CRC were recruited into the current study. Using immunohistochemistry, reverse transcription‑quantitative polymerase chain reaction and western blotting, mRNA and protein expression levels of FOXM1 in CRC tissue samples were determined. The function of FOXM1 in the CRC cells was evaluated by small interfering RNA‑mediated depletion of FOXM1, followed by analyses of cell proliferation and invasion. High levels of staining for FOXM1 were observed in significantly more CRC tissue samples: 85.42% (82/96) of CRC tissue samples compared with 18.75% (18/96) of adjacent normal mucosa tissue samples. Silencing FOXM1 inhibited the proliferation of LoVo cells, which express a relatively high level of FOXM1, and the invasion and migration of LoVo cells were also markedly suppressed. The data from the present study suggested that the pathogenesis of human CRC may be mediated by FOXM1, and that FOXM1 inhibition may provide a promising therapeutic strategy for CRC.
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Affiliation(s)
- Hongmei Zhang
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
| | - Hua Zhong
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
| | - Lei Li
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
| | - Wansheng Ji
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
| | - Xiaoqian Zhang
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, P.R. China
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23
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Wang B, Li Y, Tan F, Xiao Z. Increased expression of SOX4 is associated with colorectal cancer progression. Tumour Biol 2016; 37:9131-7. [PMID: 26768610 DOI: 10.1007/s13277-015-4756-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 12/29/2015] [Indexed: 11/29/2022] Open
Abstract
Sex-determining region Y-related high-mobility group box 4 (SOX4) has been proven to serve as a critical role in cancer progression. However, the pathological role of SOX4 in colorectal cancer (CRC) remains unknown. The aim of this study was to investigate the role of SOX4 in CRC. In this study, we investigated the expression of SOX4 in CRC tissues by immunohistochemistry, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and Western blot. We also evaluated the effect of SOX4 on cell proliferation and invasion by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and transwell assay. The SOX4 messenger RNA (mRNA) and protein expression were markedly higher in CRC tissues compared with adjacent normal mucosa tissues. Inhibition of SOX4 could suppress CRC cell proliferation, and invasion in vitro. Our findings indicate that targeting SOX4 might provide a new therapeutic modality for the treatment of CRC patients.
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Affiliation(s)
- Baochun Wang
- Department of General Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China.,Department of General Surgery, Hainan Province People's Hospital, Haikou, 570311, China
| | - Yixiong Li
- Department of General Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China.
| | - Fengbo Tan
- Department of General Surgery, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, China
| | - Zhanxiang Xiao
- Department of General Surgery, Hainan Province People's Hospital, Haikou, 570311, China
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24
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Arredondo J, Baixauli J, Rodríguez J, Beorlegui C, Arbea L, Zozaya G, Torre W, -Cienfuegos JA, Hernández-Lizoáin JL. Patterns and management of distant failure in locally advanced rectal cancer: a cohort study. Clin Transl Oncol 2015; 18:909-14. [PMID: 26666769 DOI: 10.1007/s12094-015-1462-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 11/23/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE To determine the long-term outcomes of locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiation (CRT) and surgery, and to analyze the management and survival once distant failure has developed. METHODS Data from LARC patients treated from 2000 to 2010 were retrospectively reviewed. CRT protocols were based on fluoropirimidines ± oxaliplatin. Follow-up consisted of physical examination, carcinoembryonic antigen levels, and chest-abdominal-pelvic CT scan. RESULTS The study included 228 patients with a mean age of 59 years. Forty-eight (21.1 %) patients had distant recurrence and 6 patients (2.6 %) had local recurrence. Median follow-up was 49 months. The 5- and 10-year actuarial disease free survival was 75.3 and 65.0 %, respectively. The 5- and 10-year actuarial overall survival (OS) was 89.6 and 71.2 %, respectively. Patients were classified as having liver (14 patients) or lung (27 patients) relapse according to the organ firstly metastasized. The variables significantly associated by univariate Cox analysis to survival were the achievement of an R0 metastases resection and the Köhne risk index, while the metastatic site showed a statistical trend. By multivariate Cox analysis, the only variable associated with survival was a R0 resection (HR = 16.3, p < 0.001). Median OS for patients undergoing a R0 resection was 73 months (95 % CI 67.8-78.2) compared to 25 months (95 % CI 5.47-44.5) in those non-operated patients (p < 0.001). CONCLUSIONS Combined treatment for LARC obtains a 5-year OS rounding 90 %. Follow-up based on thoracic-abdominal CT scan allows an early diagnosis of metastatic lesions. Surgical resection of metastases, regardless of their location, greatly increases the patient's survival rate.
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Affiliation(s)
- J Arredondo
- Department of General Surgery, Complejo Asistencial Universitario de León, c/Altos de Nava s/n, 24008, León, Spain.
| | - J Baixauli
- Department of General Surgery, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - J Rodríguez
- Department of Medical Oncology, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - C Beorlegui
- Department of Pathology, School of Medicine, Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - L Arbea
- Department of Radiation Oncology, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - G Zozaya
- Department of General Surgery, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - W Torre
- Department of Thoracic Surgery, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - J A -Cienfuegos
- Department of General Surgery, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
| | - J L Hernández-Lizoáin
- Department of General Surgery, Clínica Universidad de Navarra, Avenida Pío XII 36, 31008, Pamplona, Spain
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SphK1 promotes tumor cell migration and invasion in colorectal cancer. Tumour Biol 2015; 37:6831-6. [PMID: 26662312 DOI: 10.1007/s13277-015-4542-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/27/2015] [Indexed: 01/21/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common cancers worldwide. Sphingosine kinase 1 (SphK1), which phosphorylates sphingosine to sphingosine-1-phosphate (S1P), is overexpressed in various types of cancers and may act as an oncogene in tumorigenesis. However, little is known about the role of SphK1 in CRC patients. We studied the expression of SphK1 in 85 cases of CRC tissues by immunohistochemistry, qRT-PCR, and western blot. We also evaluated the effect of SphK1 on cell proliferation and invasion by MTT and transwell invasion assay. SphK1 is overexpressed in CRC tissues and cell lines, and upregulation of SphK1 correlated significantly with the following parameters: lymph node metastasis, liver metastasis, and advanced TNM stage. SphK1 knockdown results in inhibition of cancer cell proliferation. Inhibition of CRC cell migration and invasion is also evident through reversal of EMT by increases in E-cadherin expression and decreases in vimentin expression. In conclusion, SphK1 is associated with the proliferation and invasiveness of CRC cells and the SphK1 gene may contribute to a novel therapeutic approach against CRC.
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Hasselgren K, Sandström P, Björnsson B. Role of associating liver partition and portal vein ligation for staged hepatectomy in colorectal liver metastases: A review. World J Gastroenterol 2015; 21:4491-4498. [PMID: 25914457 PMCID: PMC4402295 DOI: 10.3748/wjg.v21.i15.4491] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/11/2015] [Accepted: 03/12/2015] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer is the third most common cancer in the Western world. Approximately half of patients will develop liver metastases, which is the most common cause of death. The only potentially curative treatment is surgical resection. However, many patients retain a to small future liver remnant (FLR) to allow for resection directly. There are therefore strategies to decrease the tumor with neoadjuvant chemotherapy and to increase the FLR. An accepted strategy to increase the FLR is portal vein occlusion (PVO). A concern with this strategy is that a large proportion of patients will never be operated because of progression during the interval between PVO and resection. ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) is a new procedure with a high resection rate. A concern with this approach is the rather high frequency of complications and high mortality, compared to PVO. In this review, it is shown that with ALPPS the resection rate was 97.1% for CRLM and the mortality rate for all diagnoses was 9.6%. The mortality rate was likely lower for patients with CRLM, but some data were lacking in the reports. Due to the novelty of ALPPS, the indications and technique are not yet established but there are arguments for ALPPS in the context of CRLM and a small FLR.
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van Dam RM, Lodewick TM, van den Broek MAJ, de Jong MC, Greve JW, Jansen RLH, Bemelmans MHA, Neumann UP, Olde Damink SWM, Dejong CHC. Outcomes of extended versus limited indications for patients undergoing a liver resection for colorectal cancer liver metastases. HPB (Oxford) 2014; 16:550-9. [PMID: 24246003 PMCID: PMC4048077 DOI: 10.1111/hpb.12181] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/16/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Currently, resection criteria for colorectal cancer liver metastases (CRCLM) are only limited by remnant liver function. Morbidity and survival after a partial hepatectomy with limited or extended indication criteria were compared. METHODS/DESIGN Between 1991 and 2010, patients undergoing a liver resection for CRCLM with limited (n = 169) or extended indication criteria (n = 129) were retrospectively identified in a prospectively collected single-centre database. Limited indication criteria were defined as less than three unilateral, not centrally located liver metastases in the absence of extra hepatic metastases. The extended criteria were only limited by predicted remnant liver volume and patients fitness. Data on co-morbidity, resection margin, short- and long-term morbidity, disease-free (DFS) and overall survival were compared. RESULTS Patients with limited indications had less major complications (19.5% vs. 33.1%, P < 0.01), longer overall survival of 68.8 months [confidence interval (CI) 46.5-91.1] vs. 41.4 months (CI 33.4-49.0, P ≤ 0.001) and longer median DFS of 22.0 months [confidence interval (CI) 15.8-28.2] vs 10.2 months (CI 8.4-11.9, P < 0.001) compared with the extended indication group. Cure rates, defined as 10-year DFS, were 35.5% and 15.8%, respectively. Fewer patients in the extended indication group underwent an R0 resection (92.9% vs. 77.5%, P < 0.001). Only 17% of all R1 resected patients had recurrences at the transection plane. CONCLUSION A partial hepatectomy for CRCLM with extended indications seems justified but is associated with higher complication rates, earlier recurrence and lower overall survival compared with limited indications. However, the median 5-year survival was substantial and a cure was achieved in 15.8% of patients.
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Affiliation(s)
- Ronald M van Dam
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Toine M Lodewick
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht UniversityMaastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH AachenAachen, Germany,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Maartje AJ van den Broek
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Mechteld C de Jong
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Jan Willem Greve
- Department of Surgery, Atrium Medical CenterHeerlen, The Netherlands
| | - Rob LH Jansen
- Department of Medical Oncology, Maastricht University Medical CentreMaastricht, The Netherlands
| | - Marc HA Bemelmans
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Ulf P Neumann
- Department of General, Visceral and Transplant Surgery, University Hospital RWTH AachenAachen, Germany,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Steven WM Olde Damink
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht UniversityMaastricht, The Netherlands,Department of HPB Surgery and Liver Transplantation, Royal Free Hospital- University College LondonLondon, UK,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
| | - Cornelis HC Dejong
- Department of Surgery, Maastricht University Medical CentreMaastricht, The Netherlands,Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht UniversityMaastricht, The Netherlands,Euregional Surgical HPB collaboration Aachen-MaastrichtGermany–The Netherlands
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Surgical resection of hepatic metastasis from gastric cancer: a review and new recommendation in the Japanese gastric cancer treatment guidelines. Gastric Cancer 2014; 17:206-12. [PMID: 24022130 DOI: 10.1007/s10120-013-0299-x] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/22/2013] [Indexed: 02/07/2023]
Abstract
Liver metastases from gastric cancer are rarely indicated for surgery because they are often diagnosed as multiple nodules occupying both lobes and coexist with extra hepatic disease. A literature search identified no clinical trials on hepatectomy for this disease; only retrospective studies of a relatively small number of cases collected over more than a decade, mostly from a single institution, were found. Five-year survival rates from these reports ranged from 0 % to 37 %, and long-term survivors were observed among carefully selected case series. The most commonly reported prognostic factor was the number of metastatic nodules, and patients with a solitary metastasis tended to have superior outcome. Patients diagnosed to have a small number of metastatic nodules by modern imaging tools could be indicated for surgery. Because both intrahepatic and extrahepatic recurrences are common,patients are likely to benefit from perioperative adjuvant chemotherapy, although it is not possible at this time to specify which regimen is the most appropriate
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Mizuguchi T, Kawamoto M, Meguro M, Okita K, Ota S, Ishii M, Ueki T, Nishidate T, Kimura Y, Furuhata T, Hirata K. Impact of aging on morbidity and mortality after liver resection: a systematic review and meta-analysis. Surg Today 2014; 45:259-70. [PMID: 24526292 DOI: 10.1007/s00595-014-0863-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 12/26/2013] [Indexed: 02/06/2023]
Abstract
Surgery involving elderly patients is becoming increasingly common due to the rapid aging of societies all over the world. The objective of this study was to elucidate the prognostic differences between elderly and young patients who undergo liver resection. A systematic review based on the PRISMA flow diagram was conducted. Ovid Medline and PubMed were used to search for relevant literature published between January 2000 and March 2013, and the modified MINORS score was used to assess the methodological quality. In cases of hepatocellular carcinoma and miscellaneous liver tumors, the morbidity and mortality rate did not differ significantly between the elderly and young patients. For patients with colorectal metastatic liver cancer, the mortality of the young patients was 2.7 times lower than that of elderly patients. Our review of high-quality retrospective studies was able to elucidate the clinical risks of age on the outcomes after liver surgery in specific patient populations.
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Affiliation(s)
- Toru Mizuguchi
- Department of Surgery I, Sapporo Medical University School of Medicine, Sapporo Medical University Hospital, Sapporo Medical University, S-1, W-16, Chuo-Ku, Sapporo, Hokkaido, 060-8543, Japan,
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Loss of chromosome 4 correlates with better long-term survival and lower relapse rate after R0-resection of colorectal liver metastases. J Cancer Res Clin Oncol 2013; 139:1861-7. [DOI: 10.1007/s00432-013-1505-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/27/2013] [Indexed: 01/17/2023]
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Hwang JE, Kim SH, Jin J, Hong JY, Kim MJ, Jung SH, Shim HJ, Bae WK, Hwang EC, Kim JW, Shin SS, Jeong O, Park YK, Cho SH, Chung IJ. Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer. Clin Exp Metastasis 2013; 31:25-32. [PMID: 23975154 PMCID: PMC3892106 DOI: 10.1007/s10585-013-9606-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 07/19/2013] [Indexed: 12/13/2022]
Abstract
This study evaluated the efficacy of percutaneous radiofrequency ablation (RFA) for the treatment of metachronous liver metastases of gastric cancer. We enrolled a total of 44 patients who underwent percutaneous RFA for the treatment of metachronous liver metastases after resection of a primary gastric adenocarcinoma from January 2002 to November 2011. The primary endpoint of this study was overall survival (OS) and recurrence-free survival (RFS) after RFA. Systemic chemotherapy was combined with RFA in 40 patients; the OS and RFS of the patients with liver-only metastasis who underwent RFA and chemotherapy were 20.9 months (95 % CI 18.4–23.4) and 9.8 months (95 % CI 9.2–10.5), respectively. On multivariate analysis, the factors independently, negatively associated with OS were extrahepatic metastatic lesions (HR 12.6, 95 % CI 3.7–42.9; p = 0.001), no chemotherapy (HR 43.3, 95 % CI 7.4–251.3; p = 0.001), and tumor number ≥2 (HR 2.6, 95 % CI 1.2–5.9; p = 0.015). The factors independently, negatively associated with RFS were extrahepatic metastatic lesions (HR 3.6, 95 % CI 1.6–7.8; p = 0.003) and bilobar intrahepatic distribution (HR 3.9, 95 % CI 1.5–9.9; p = 0.001). The efficacy of percutaneous RFA for metachronous liver metastases of gastric cancer is limited to patients with a single, unilobar metastasis without extrahepatic metastatic lesions. Combined systemic chemotherapy is very important for the prolongation of OS.
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Affiliation(s)
- Jun-Eul Hwang
- Department of Hematology and Oncology, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam, Kwangju, 519-763, Korea
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Treska V, Skalicky T, Sutnar A, Vaclav L, Fichtl J, Kinkorova J, Vachtova M, Narsanska A. Prognostic importance of some clinical and therapeutic factors for the effect of portal vein embolization in patients with primarily inoperable colorectal liver metastases. Arch Med Sci 2013; 9:47-54. [PMID: 23515176 PMCID: PMC3598138 DOI: 10.5114/aoms.2013.33348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 06/25/2011] [Accepted: 08/18/2011] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Portal vein embolization (PVE) may increase the resectability of liver metastases. However, the problem of PVE is insufficient growth of the liver or tumor progression in some patients. The aim of this study was to evaluate the significance of commonly available clinical factors for the result of PVE. MATERIAL AND METHODS Portal vein embolization was performed in 38 patients with colorectal liver metastases. Effects of age, gender, time between PVE and liver resection, oncological therapy after PVE, indocyanine green retention rate test, synchronous, metachronous and extrahepatic metastases, liver volume before and after PVE, increase of liver volume after PVE and the quality of liver parenchyma before PVE on the result of PVE were evaluated. RESULTS Liver resection was performed in 23 (62.2%) patients within 1.3 ±0.4 months after PVE. Tumor progression occurred in 9 (23.7%) patients and 6 (15.8%) patients had insufficient liver hypertrophy. Significant clinical factors of PVE failure were number of liver metastases (cut-off - 4; odds ratio - 4.7; p < 0.03), liver volume after PVE (cut-off 1000 cm(3); odds ratio - 5.1; p < 0.02), growth of liver volume after PVE (cut-off 150 cm(3); odds ratio - 18.7; p < 0.002), oncological therapy administered concomitantly with PVE (p < 0.003). CONCLUSIONS Negative clinical factors of resectability of colorectal cancer liver metastases after PVE included more than four liver metastases, liver volume after PVE < 1000 cm(3), growth of the contralateral lobe by less than 150 cm(3) and concurrent oncological therapy.
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Affiliation(s)
| | - Tomas Skalicky
- University Hospital, School of Medicine, Pilsen, Czech Republic
| | - Alan Sutnar
- University Hospital, School of Medicine, Pilsen, Czech Republic
| | - Liska Vaclav
- University Hospital, School of Medicine, Pilsen, Czech Republic
| | - Jakub Fichtl
- University Hospital, School of Medicine, Pilsen, Czech Republic
| | | | - Monika Vachtova
- University Hospital, School of Medicine, Pilsen, Czech Republic
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Jiang B, Mason J, Jewett A, Qian J, Ding Y, Cho WCS, Zhang X, Man YG. Cell budding from normal appearing epithelia: a predictor of colorectal cancer metastasis? Int J Biol Sci 2013; 9:119-33. [PMID: 23355797 PMCID: PMC3555151 DOI: 10.7150/ijbs.5441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 12/21/2012] [Indexed: 12/21/2022] Open
Abstract
Background: Colorectal carcinogenesis is believed to be a multi-stage process that originates with a localized adenoma, which linearly progresses to an intra-mucosal carcinoma, to an invasive lesion, and finally to metastatic cancer. This progression model is supported by tissue culture and animal model studies, but it is difficult to reconcile with several well-established observations, principally among these are that up to 25% of early stage (Stage I/II), node-negative colorectal cancer (CRC) develop distant metastasis, and that circulating CRC cells are undetectable in peripheral blood samples of up to 50% of patients with confirmed metastasis, but more than 30% of patients with no detectable metastasis exhibit such cells. The mechanism responsible for this diverse behavior is unknown, and there are no effective means to identify patients with pending, or who are at high risk for, developing metastatic CRC. Novel findings: Our previous studies of human breast and prostate cancer have shown that cancer invasion arises from the convergence of a tissue injury, the innate immune response to that injury, and the presence of tumor stem cells within tumor capsules at the site of the injury. Focal degeneration of a capsule due to age or disease attracts lymphocyte infiltration that degrades the degenerating capsules resulting in the formation of a focal disruption in the capsule, which selectively favors proliferating or “budding” of the underlying tumor stem cells. Our recent studies suggest that lymphocyte infiltration also triggers metastasis by disrupting the intercellular junctions and surface adhesion molecules within the proliferating cell buds causing their dissociation. Then, lymphocytes and tumor cells are conjoined through membrane fusion to form tumor-lymphocyte chimeras (TLCs) that allows the tumor stem cell to avail itself of the lymphocyte's natural ability to migrate and breach cell barriers in order to intravasate and to travel to distant organs. Our most recent studies of human CRC have detected nearly identical focal capsule disruptions, lymphocyte infiltration, budding cells, and the formation of TLCs. Our studies have further shown that age- and type-matched node-positive and -negative CRC have a significantly different morphological and immunohistochemical profile and that the majority of lymphatic ducts with disseminated cells are located within the mucosa adjacent to morphologically normal appearing epithelial structures that express a stem cell-related marker. New hypothesis: Based on these findings and the growth patterns of budding cells revealed by double immunohistochemistry, we further hypothesize that metastatic spread is an early event of carcinogenesis and that budding cells overlying focal capsule disruptions represent invasion- and metastasis-initiating cells that follow one of four pathways to progress: (1) to undergo extensive in situ proliferation leading to the formation of tumor nests that subsequently invade the submucosa, (2) to migrate with associated lymphocytes functioning as “seeds” to grow in new sites, (3) to migrate and intravasate into pre-existing vascular structures by forming TLCs, or (4) to intravasate into vascular structures that are generated by the budding cells themselves. We also propose that only node-positive cases harbor stem cells with the potential for multi-lineage differentiation and unique surface markers that permit intravasation.
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Affiliation(s)
- Bin Jiang
- National Medical Centre of Colorectal Disease, The Third Affiliated Hospital, Nanjing University of Chinese Medicine, Nanjing, China.
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Chu XY, Zhu ZM, Chen LB, Wang JH, Su QS, Yang JR, Lin Y, Xue LJ, Liu XB, Mo XB. FOXM1 expression correlates with tumor invasion and a poor prognosis of colorectal cancer. Acta Histochem 2012; 114:755-62. [PMID: 22326401 DOI: 10.1016/j.acthis.2012.01.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 12/25/2011] [Accepted: 01/04/2012] [Indexed: 01/01/2023]
Abstract
FOXM1, a member of the Forkhead Box (Fox) family of transcription factors, plays a critical role in tumor development and metastasis. The aim of this study was to elucidate its role in colorectal cancer (CRC), particularly prognosis and metastasis. Semi-quantitative RT-PCR and Western blot assays were used to measure the expression levels of FOXM1 mRNA and protein in 15 CRC and adjacent normal mucosa tissues. Immunohistochemical assay was performed to detect FOXM1 protein expression in 112 CRC tissues and further determine its clinicopathological and prognostic significance. RNA interference (RNAi) was used to knockdown endogenous FOXM1 expression in CRC cell lines and to analyze the effects of FOXM1 knockdown on migration and invasion of CRC cells. The relative expression levels of FOXM1 mRNA and protein were significantly higher in CRC tissues than in adjacent normal mucosa tissues (P<0.01). In addition, the immunostaining of FOXM1 protein was stronger in CRC tissues than in adjacent normal mucosa tissues. By statistical analysis, we showed that high FOXM1 expression was closely correlated with the presence of lymph node metastasis, incidence of liver metastasis, and advanced TNM stage. Moreover, the cumulative 5-year survival rate of CRC patients with high FOXM1 expression was lower than that of those with low FOXM1 expression (P=0.0047). Multivariate analysis showed that the status of FOXM1 expression was an independent prognostic factor for CRC patients (P=0.025). Furthermore, RNAi-mediated FOXM1 knockdown could significantly inhibit growth, migration and invasion of CRC cells. Our results showed that FOXM1 over-expression is a molecular marker predicting increased invasive/metastatic potential of CRC and a poorer prognosis.
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Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature. Gastric Cancer 2012; 15:131-6. [PMID: 21892617 DOI: 10.1007/s10120-011-0080-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 07/19/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although up to 9% of patients with gastric cancer develop liver metastases, liver resection is rarely performed because of co-existing non-curative factors. Furthermore, the benefit of liver resection is still controversially discussed. Our goal was to investigate the outcome of patients who underwent liver resection or radiofrequency ablation (RFA) for hepatic metastasized gastric cancer. METHODS Retrospectively collected data from a prospectively maintained database were analyzed from 15 patients who underwent liver resection or RFA for liver metastases from gastric cancer. RESULTS Overall 5-year survival and median survival were 27% and 48 months for resected/RFA patients. The peri-operative complication rate was low. One patient has been tumor-free for 90 months now. CONCLUSIONS Liver resection in patients with hepatic metastasized gastric cancer is beneficial and safe if an R0 situation can be achieved. RFA might be a useful alternative in those patients where surgery is not feasible.
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Gadoxetate disodium-enhanced magnetic resonance imaging versus contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography for the detection of colorectal liver metastases. Invest Radiol 2011; 46:548-55. [PMID: 21577131 DOI: 10.1097/rli.0b013e31821a2163] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE : To compare the diagnostic accuracy of gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) on a 3-T system and integrated contrast-enhanced F-fluorodeoxyglucose positron emission tomography/computed tomography (CE-PET/CT) for the detection of hepatic metastases from colorectal cancers. MATERIALS AND METHODS : The approval from the institutional review board was obtained, and the requirement for informed consent was waived. We retrospectively evaluated 135 metastases in 68 patients (37 men, 31 women; mean age: 68 years; age range: 37-82 years) who underwent both EOB-MRI and CE-PET/CT. A total of 103 metastases were confirmed during surgery and 32 were confirmed by imaging findings during follow-up. The images were independently reviewed by 2 observers. The diagnostic accuracies of EOB-MRI and CE-PET/CT were determined by calculating the areas under each reader-specific receiver operating characteristic curve (Az). Patient-based lesion sensitivity and specificity were compared using the McNemar test. RESULTS : The mean area under the Az on EOB-MRI versus CE-PET/CT was 0.94 versus 0.81 for all lesions (P < 0.001), 0.92 versus 0.60 for lesions ≤1 cm in size (P < 0.001), and 0.88 versus 0.96 for lesions >1 cm (P = 0.098), respectively. The sensitivity, specificity, positive predictive values, and negative predictive value on a patient basis were 100%, 71%, 97%, and 100% for EOB-MRI and 93%, 71%, 97%, and 57% for CE-PET/CT, respectively. CONCLUSIONS : EOB-MRI using a 3-T system is more accurate than CE-PET/CT, especially for the detection of small (≤1.0 cm) lesions. Patient-based analysis revealed that EOB-MRI has a higher sensitivity and negative predictive value than CE-PET/CT.
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Recent advances in colorectal cancer research: the microenvironment impact. CANCER MICROENVIRONMENT 2011; 4:127-31. [PMID: 21710272 DOI: 10.1007/s12307-011-0070-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Pan C, Wu P, Yu J, Li W, Huang Z, He N, Wang J, Zhao M. CT-guided radiofrequency ablation prolonged metastatic survival in patients with liver metastases from nasopharyngeal carcinoma. Int J Hyperthermia 2011; 27:549-54. [DOI: 10.3109/02656736.2011.593019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Xu J, Qin X, Wang J, Zhang S, Zhong Y, Ren L, Wei Y, Zeng S, Wan D, Zheng S. Chinese guidelines for the diagnosis and comprehensive treatment of hepatic metastasis of colorectal cancer. J Cancer Res Clin Oncol 2011; 137:1379-96. [PMID: 21796415 DOI: 10.1007/s00432-011-0999-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Accepted: 06/16/2011] [Indexed: 12/14/2022]
Affiliation(s)
- Jianmin Xu
- Zhongshan Hospital, Fudan University, Shanghai, China
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Nachabé R, Evers DJ, Hendriks BHW, Lucassen GW, van der Voort M, Wesseling J, Ruers TJM. Effect of bile absorption coefficients on the estimation of liver tissue optical properties and related implications in discriminating healthy and tumorous samples. BIOMEDICAL OPTICS EXPRESS 2011; 2:600-14. [PMID: 21412465 PMCID: PMC3047365 DOI: 10.1364/boe.2.000600] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 02/09/2011] [Accepted: 02/14/2011] [Indexed: 05/08/2023]
Abstract
We investigated differences between healthy tissue and metastatic tumor from ex vivo human partial liver resections using diffuse optical spectroscopy with a fiber optic probe. We extracted various physiological and morphological parameters from the spectra. During evaluation of the residual between the measurements and a fit model based on diffusion theory, we found that bile is an additional chromophore absorbing in the visible wavelength range that was missing in our model. Consistency of the residual with the absorption spectrum of bile was noticed. An accurate measurement of the absorption coefficient of bile from various human bile samples was performed and implemented into the fit model. Having the absorption coefficient of bile as a priori knowledge in the model showed a clear improvement in terms of reducing the fitting discrepancies. The addition of this chromophore yields significantly different estimates of the amount of blood. Furthermore, the estimated bile volume fraction and reduced scattering amplitude turned out to be two main relevant discriminators between normal and metastatic liver tissues.
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Affiliation(s)
- Rami Nachabé
- Department of Minimally Invasive Healthcare, Philips Research, 5656 AE Eindhoven, The Netherlands
| | - Daniel J. Evers
- Department of Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherland
| | - Benno H. W. Hendriks
- Department of Minimally Invasive Healthcare, Philips Research, 5656 AE Eindhoven, The Netherlands
| | - Gerald W. Lucassen
- Department of Minimally Invasive Healthcare, Philips Research, 5656 AE Eindhoven, The Netherlands
| | - Marjolein van der Voort
- Department of Minimally Invasive Healthcare, Philips Research, 5656 AE Eindhoven, The Netherlands
| | - Jelle Wesseling
- Department of Pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Theo J. M. Ruers
- Department of Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherland
- Technical University Twente, 7500 AE Twente, The Netherlands
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Metastasis of colorectal carcinoma to the testes: clinical presentation and possible pathways. Int J Clin Oncol 2010; 16:203-9. [PMID: 21069550 DOI: 10.1007/s10147-010-0140-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 10/05/2010] [Indexed: 11/25/2022]
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42
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Brown RE, Bower MR, Martin RCG. Hepatic resection for colorectal liver metastases. Surg Clin North Am 2010; 90:839-52. [PMID: 20637951 DOI: 10.1016/j.suc.2010.04.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Colorectal adenocarcinoma remains the third most common cause of cancer death in the United States, with an estimated 146,000 new cases and 50,000 deaths annually. Survival is stage dependent, and the presence of liver metastases is a primary determinant in patient survival. Approximately 25% of new cases will present with synchronous colorectal liver metastases (CLM), and up to one-half will develop CLM during the course of their disease. The importance of safe and effective therapies for CLM cannot be overstated. Safe and appropriately aggressive multimodality therapy for CLM can provide most patients with liver-dominant colorectal metastases with extended survival and an improved quality of life.
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Affiliation(s)
- Russell E Brown
- Division of Surgical Oncology, Department of Surgery, James Graham Brown Cancer, University of Louisville School of Medicine, 315 East Broadway, Louisville, KY 40202, USA
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