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Short- and long-term results of open vs laparoscopic multisegmental resection and anastomosis for synchronous colorectal cancer located in separate segments

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世界胃肠外科杂志:英文版(电子版) 2023年第9期15卷 1969-1977页

作者： Ji-Chuan Quan Xin-Jun Zhou Shi-Wen Mei Jun-Guang Liu Wen-Long Qiu Jin-Zhu Zhang Bo Li Yue-Gang Li Xi-Shan Wang Hu Chang Jian-Qiang Tang Department of colorectal Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of colorectal Anorectal Surgery Shengli Oilfield Central HospitalDongying 257000Shandong ProvinceChina Department of General Surgery Peking University First HospitalBeijing 100034China Department of Hospital Administration Office National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate *** To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate *** Patients with SCRC who underwent surgery between January 2010 and December 2021 at the cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively *** accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,***,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,*** prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with *** LMRA is safe and feasible for patients with SCRC located in separate *** to OMRA,the LMRA approach has more advantages related to short-term efficacy.

关键词： synchronous colorectal cancer Separate segments Laparoscopic surgery Multisegmental resection Short-term efficacy Prognosis

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Rare synchronous colorectal carcinoma with three pathological subtypes: A case report and review of the literature

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World Journal of Clinical Cases 2023年第35期11卷 8343-8349页

作者： Fang Li Bin Zhao Lei Zhang Guo-Qing Chen Li Zhu Xiao-Ling Feng Hui Yao Xue-Feng Tang Hua Yang Yong-Qiang Liu Department of General Surgery Chongqing General HospitalChongqing 401120China Department of Pathology Chongqing General HospitalChongqing 401147China

BACKGROUND synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single *** incidence is low and the number of pathological types of SCRC is usually no more than *** is very unusual that the pathological findings of a patient with SCRC show more than two different pathological ***,we report a rare case of SCRC with three pathological *** SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a *** displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ***,she underwent total colectomy,abdominoperineal resection for rectal cancer,and *** operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the *** is now recovering well and continues to be closely monitored during *** Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.

关键词： synchronous colorectal cancer Colon Rectum Adenocarcinoma Tumor location Different pathological subtypes Case report

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Multiple primary colorectal cancer: Individual or familial predisposition?

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World Journal of Gastrointestinal Oncology 2015年第12期7卷 434-444页

作者： José A Pajares José Perea Department of Gastreoenterology Gregorio Maranon University Hospital Department of Surgery 12 de Octubre University Hospital

colorectal carcinoma(CRC) is one of the most frequent cancers. Along the surface of the large bowel, several foci of CRC may appear simultaneously or over the time. The development of at least two different tumours has been defined as multiple primary CRC(MPCRC):When more than one tumour is diagnosed at the same time, it is known as synchronous CRC(SCRC), while when a second neoplasm is diagnosed some time after the resection and/or diagnosis of the first lesion, it is called metachronous CRC(MCRC). Multiple issues can promote the development of MPCRC, ranging from different personal factors, such as environmental exposure, to familial predisposition due to hereditary factors. However, most studies do not distinguish this dichotomy. High- and low-pentrance genetic variants are involved in MPCRC. An increased risk for MPCRC has been described in Lynch syndrome, familial adenomatous polyposis, and serrated polyposis. Non-syndromic familial CRCs should also be considered as risk factors for MPCRC. Environmental factors can promote damage to colon mucosae that enable the concurrence of MPCRC. Epigenetics are thought to play a major role in the carcinogenesis of sporadic MPCRC. The methylation state of the DNA depends on multiple environmental factors(e.g., smoking and eating foods cooked at high temperatures), and this can contribute to increasing the MPCRC rate. Certain clinical features may also suggest individual predisposition for MPCRC. Different etiopathogenic factors are suspected to be involved in SCRC and MCRC, and different familial vs individual factors may be implicated. MCRC seems to follow a familial pattern, whereas individual factors are more important in SCRC. Further studies must be carried out to know the molecular basis of risks for MPCRC in order to modify, if necessary, its clinical management, especially from a preventive point of view.

关键词： Multiple primary colorectal cancer synchronous colorectal cancer Metachronous colorectal cancer Chromosomal instability Microsatellite instability CpG island methylator phenotype

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