Laparoscopic approach for T4 colon cancer can be associated with poor prognosis in right-sided T4b tumours

CD4 and FOXP3 as predictive markers for the recurrence of T3/T4a stage II colorectal cancer: applying a novel discrete Bayes decision rule

Background

We recently reported the relapse-free survival (RFS) significance of the combination of CD4⁺ and forkhead box P3⁺ (FOXP3) T-cell densities identified by immunohistochemistry in patients with stage I, II, and III colorectal cancer (CRC) who underwent curative resections. This study was designed to determine the optimal combination of markers that predict recurrence in patients with T factors of T3/T4a stage II CRC by applying a novel Bayes decision rule.

Methods

Using 137 cancer tissue specimens from T3/T4a stage II patients, 12 clinicopathologic and immune factors were analysed as predictive candidates for recurrence.

Results

Our study showed that the combination of low CD4⁺ and low FOXP3⁺ T-cell densities resulted in extremely poor RFS.

Conclusions

Adjuvant chemotherapy may be considered for patients with a combination of low CD4⁺ and low FOXP3⁺ T-cell densities. The discovery of this new prognostic indicator is important for the appropriate management of patients undergoing curative resection for T3/T4a stage II CRC.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12885-022-10181-7.

Comparison of laparoscopic and open colectomy for splenic flexure colon cancer: a systematic review and meta-analysis

PURPOSE

This study examined the short- and long-term outcomes of laparoscopic and open splenic flexure colon cancer (SFCC) surgery.

METHOD

Systematic literature searches were performed in PubMed and Ovid to compare laparoscopic and open colectomy for SFCC. The last search was conducted on November 7, 2021. Surgical and survival outcomes were collected and analyzed. This meta-analysis was performed using Review Manager Software (v 5.3).

RESULTS

This study included seven publications with 2397 patients published between 2011 and 2021. A significant difference in operative time was seen in the laparoscopic group (P = 0.01, WMD = 50.13, 95%CI [10.32, 89.94], I² = 97%); loss of blood estimated (P < 0.001, WMD =  -101.88, 95%CI [-161.65, -42.11], I² = 82%) and the incidence of overall complications (P < 0.001, OR = 0.53, 95%CI [0.38, 0.75], I² = 0%) of laparoscopic procedure were greatly decreased. There were similar results as compared in the two groups in terms of lymph node harvesting (P = 0.71, WMD = 0.49, 95%CI [-2.13, 3.12], I² = 93%) and the distance of proximal (P = 0.50, WMD =  -1.09, 95%CI [-4.26, 2.08], I² = 96%) or distal (P = 0.18, WMD = 2.44, 95%CI [-1.13, 6.01], I² = 97%) resection margin. In addition, no significant differences were observed on overall/disease-free survival over 3/5 years between the two procedures. An analysis of subgroups that used propensity matching scores produced similar results.

CONCLUSION

The laparoscopic procedure is clinically safe and feasible for SFCC. It shows the advantages in decreasing intraoperative blood loss and overall complications, and the long-term survival outcomes would not be affected. Randomized clinical trials with a larger sample size are warranted in the future for further investigation.