Diseases of the Colon & Rectum最新文献

{"title":"Being Remembered.","authors":"James M Church","doi":"10.1097/DCR.0000000000003560","DOIUrl":"10.1097/DCR.0000000000003560","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"128-130"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Final Results of the GRECCAR-6 Trial on Waiting Period Following Neoadjuvant Radiochemotherapy for Locally Advanced Rectal Cancer: 5 Years of Follow-up.","authors":"Maxime K Collard, Laurent Mineur, Célia Nekrouf, Quentin Denost, Philippe Rouanet, Cécile de Chaisemartin, Aude Merdrignac, Mehrdad Jafari, Eddy Cotte, Jérôme Desrame, Gilles Manceau, Stéphane Benoist, Etienne Buscail, Mehdi Karoui, Yves Panis, Guillaume Piessen, Alain Saudemont, Michel Prudhomme, Frédérique Peschaud, Anne Dubois, Jérôme Loriau, Jean-Jacques Tuech, Emilie Duchalais, Renato M Lupinacci, Nicolas Goasguen, Tabassome Simon, Yann Parc, Jérémie H Lefevre","doi":"10.1097/DCR.0000000000003477","DOIUrl":"10.1097/DCR.0000000000003477","url":null,"abstract":"<p><strong>Background: </strong>The potential oncological benefit of extending the waiting period between neoadjuvant radiochemotherapy and surgical resection for rectal cancer is debated.</p><p><strong>Objective: </strong>To evaluate the impact of prolonging this waiting period on the 5-year oncological prognosis and 2-year functional result of locally advanced rectal adenocarcinoma.</p><p><strong>Design: </strong>Phase III, multicenter, randomized, open-label, parallel-group, controlled trial.</p><p><strong>Settings: </strong>Patients were enrolled from 24 colorectal centers.</p><p><strong>Patients: </strong>Patients with nonmetastatic mid or lower cT3/T4Nx or cTxN+ rectal adenocarcinoma who had received radiochemotherapy (45-50 Gy radiation dose with fluorouracil or capecitabine).</p><p><strong>Intervention: </strong>Patients were randomly assigned to undergo total mesorectal excision either 7 weeks or 11 weeks after radiochemotherapy.</p><p><strong>Main outcomes measures: </strong>Overall survival and disease-free survival at 5-year follow-up and low anterior resection syndrome score assessed after 2 years of follow-up.</p><p><strong>Results: </strong>Among 265 patients enrolled, 133 were randomized in the 7-week group and 132 in the 11-week group. Twelve patients were excluded because they did not undergo resection. Among 253 patients analyzed, 5-year overall survival was not different between the 2 groups (81.6% in the 7-week group vs 82.6% in the 11-week group, p = 0.827), and neither was the 5-year disease-free survival (70.4% in the 7-week group vs 69.5% in the 11-week group, p = 0.856). No difference was observed between the 2 groups for distant recurrence (27.4% in the 7-week group vs 25.7% in the 11-week group, p = 0.777) or local recurrence (8.4% in the 7-week group vs 10.2% in the 11-week group, p = 0.543). The low anterior resection syndrome score was similar between the 7-week (25.0; interquartile range, 15.0-34.0) and 11-week groups (23.0; interquartile range, 14.2-32.0; p = 0.743).</p><p><strong>Limitations: </strong>The response rate to the low anterior resection syndrome questionnaire was only 52%.</p><p><strong>Conclusions: </strong>Extending the waiting period between radiochemotherapy and resection from 7 to 11 weeks does not change the 5-year oncological prognosis in rectal cancer or the 2-year low anterior resection occurrence. See Video Abstract.</p><p><strong>Resultados finales del ensayo greccar sobre el perodo de espera tras la radioquimioterapia neoadyuvante para el cncer de recto localmente avanzado aos de seguimiento: </strong>ANTECEDENTES:Se debate el posible beneficio oncológico de prolongar el periodo de espera entre la radioquimioterapia neoadyuvante y la resección quirúrgica del cáncer de recto.OBJETIVO:Evaluar el impacto de la prolongación de este periodo de espera sobre el pronóstico oncológico a 5 años y el resultado funcional a 2 años del adenocarcinoma rectal localmente avanzado.DISEÑO:Ensayo controlado d","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"199-208"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in Robotic-Assisted Compared to Laparoscopic-Assisted Colorectal Surgery in a Newly Established Colorectal Tertiary Center: Our Experience.","authors":"Ahmed Alkhamis, Diaa Soliman, Sulaiman Almazeedi","doi":"10.1097/DCR.0000000000003346","DOIUrl":"10.1097/DCR.0000000000003346","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"125-127"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Commentary on Rectourethral Fistula.","authors":"Judith C Hagedorn","doi":"10.1097/DCR.0000000000003602","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003602","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"142-143"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"February 2025 Translations.","authors":"","doi":"10.1097/DCR.0000000000003624","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003624","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e56-e98"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Technique: Colonic Sleeve Resection in Endometriosis.","authors":"Michelle Zhiyun Chen, Stephen Pillinger","doi":"10.1097/DCR.0000000000003578","DOIUrl":"10.1097/DCR.0000000000003578","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e49-e50"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic Therapy Is Associated With Improved Oncologic Outcomes in Crohn's Disease-Associated Colorectal Cancer.","authors":"Bhuwan Giri, Stefan D Holubar, David Liska, Olga Lavryk, Benjamin L Cohen, Michael A Valente, Scott R Steele, Leonardo C Duraes","doi":"10.1097/DCR.0000000000003550","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003550","url":null,"abstract":"<p><strong>Background: </strong>Patients with Crohn's disease face an elevated risk of colorectal cancer, in part due to underlying chronic inflammation. Biologic therapy is the mainstay of medical treatment; however, the impact of treatment on colorectal cancer-related outcomes remains unclear.</p><p><strong>Objective: </strong>To investigate the association between prior exposure to biologic treatment and colorectal cancer-related outcomes in patients with underlying Crohn's disease.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>High volume, tertiary colorectal surgery department.</p><p><strong>Patients: </strong>Adults (older than 18 years) diagnosed with Crohn's disease and colorectal cancer who underwent curative operation between 1998 and 2020.</p><p><strong>Interventions: </strong>Exposure to any biologic IBD medication before cancer diagnosis.</p><p><strong>Main outcome measures: </strong>Survival and recurrence outcomes.</p><p><strong>Results: </strong>A total of 56 patients were included with a median age of 52.5 years (interquartile range, 18.9 years) at the time of surgery; 19 patients (33.9%) were treated with biologics before surgery; 10 (52.6%) received infliximab, 2 (10.5%) received adalimumab, and 7 (36.8%) received multiple biologics. Rectal cancer (57% vs 43.2%, p = 0.02) and well-differentiated or moderately differentiated tumors (93% vs 50%, p = 0.005) were more common in the biologic exposure group. Exposure to biologics was associated with a higher 5-year disease-free survival rate (80% vs 45%, p = 0.048), whereas the 5-year overall survival (93% vs 57%, p = 0.19) and 5-year recurrence rates (7% vs 31%, p = 0.18) were numerically but not statistically significant.</p><p><strong>Limitations: </strong>Retrospective, single-center study.</p><p><strong>Conclusions: </strong>In patients with Crohn's disease and colorectal adenocarcinoma who underwent curative surgery, those previously exposed to biologic therapy were more likely to have well-differentiated or moderately differentiated tumors, which were more likely to be distal to the splenic flexure. Biologic exposure was associated with significantly higher 5-year disease-free survival. These findings suggest that treatment of inflammation in patients with Crohn's disease fundamentally alters carcinogenesis pathways. See Video Abstract.</p><p><strong>La terapia biolgica se asocia con mejores resultados oncolgicos en el cncer colorrectal asociado a la enfermedad de crohn: </strong>ANTECEDENTES:Los pacientes con enfermedad de Crohn enfrentan un riesgo elevado de cáncer colorrectal, en parte debido a la inflamación crónica subyacente. La terapia biológica es el pilar del tratamiento médico; sin embargo, el impacto del tratamiento en los resultados relacionados con el cáncer colorrectal sigue sin estar claro.OBJETIVO:Investigar la asociación entre la exposición previa al tratamiento biológico y los resultados relacionados con el cáncer","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"227-233"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anastomotic Leakage After Colorectal Cancer Surgery on Quality of Life: A Systematic Review.","authors":"Anke H C Gielen, Danique J I Heuvelings, Patricia Sylla, Yu-Ting van Loon, Jarno Melenhorst, Nicole D Bouvy, Merel L Kimman, Stephanie O Breukink","doi":"10.1097/DCR.0000000000003478","DOIUrl":"10.1097/DCR.0000000000003478","url":null,"abstract":"<p><strong>Background: </strong>Colorectal anastomotic leakage remains one of the most frequent and dreaded postoperative complications after colorectal resection. However, limited research has been conducted on the impact of this complication on the quality of life of patients who have undergone colorectal cancer surgery.</p><p><strong>Objective: </strong>The aim of this systematic review was to identify, appraise, and synthesize the available evidence regarding the quality of life in patients with anastomotic leakage after oncological colorectal resections to inform clinical decision-making.</p><p><strong>Data sources and study selection: </strong>PubMed, Embase, and the Cochrane Library were searched for studies reporting quality of life using validated questionnaires in patients with anastomotic leakage after oncological colorectal resections. The literature search was performed systematically and according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Outcomes: </strong>Outcomes from quality-of-life questionnaires of patients with and without anastomotic leakage were analyzed.</p><p><strong>Results: </strong>Thirteen articles reporting on 4618 individual patients were included, among which 527 patients developed anastomotic leakage. Quality of life was evaluated using 10 distinct questionnaires administered at various postoperative time points, ranging from 1 month to 14 years. Quality-of-life outcomes differed across studies and time points, but overall scores were most negatively affected by anastomotic leakage up to 12 months postoperatively.</p><p><strong>Limitations: </strong>There was a high heterogeneity between the included studies based on the questionnaires used and the time of assessment.</p><p><strong>Conclusions: </strong>The published evidence suggests that anastomotic leakage after oncologic colorectal resection is associated with impaired quality of life, especially within the first postoperative year. The impact of anastomotic leakage on quality of life warrants further evaluation and discussion with patients.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"154-170"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal Cancer Watch-and-Wait Management: Experience of 545 Patients From the US Rectal Cancer Research Group.","authors":"Samuel H Lai, Maria Widmar, John R T Monson, Fergal J Fleming, Arden M Morris, Jon D Vogel","doi":"10.1097/DCR.0000000000003586","DOIUrl":"10.1097/DCR.0000000000003586","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of a watch-and-wait management strategy after a complete clinical response to neoadjuvant therapy for rectal cancer is increasing. However, insights into implementation, treatments, and outcomes on a national level in the United States are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate and report on watch-and-wait management practices and outcomes in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Multicenter.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Patients with stage II or III rectal cancer who underwent intentional watch-and-wait management between January 2015 and August 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Patient and tumor characteristics, neoadjuvant treatment and response, local cancer regrowth and metastasis, salvage surgery, overall survival, and disease-specific survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 545 patients from 33 centers, follow-up was 21 months (range, 9-37). Total neoadjuvant therapy or other types of neoadjuvant therapy were used in 395 (72%) and 150 (28%) patients, respectively. The estimated 3-year local regrowth rate was 23.8% (95% CI, 19.1%-29.4%). Patients with local regrowth had higher distant metastases incidence (14.2% vs 3.5%, p &lt; 0.001). Salvage surgery was performed in 74 of 84 patients (88%) with local regrowth and included rectal resection in 66 patients (89%) and local excision in 8 (11%). Of 64 salvage resections with known pathology results, 58 (91%) were margin-negative. Overall, 3-year overall survival was 94.8% (95% CI, 90.5%-97.2%) and 3-year disease-specific survival was 96.2% (95% CI, 91.8%-98.2%). Patients with and without local regrowth exhibited 3-year overall survival of 83.6% (95% CI, 68.4%-91.9%) and 97.7% (95% CI, 93.3%-99.2%), respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Retrospective study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This multicenter study indicates that the watch-and-wait approach for locally advanced rectal cancer is feasible with acceptable outcomes across a variety of geographical regions and practice settings in the United States. Local regrowth and distant metastasis rates were within published norms and salvage surgery proved effective. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Manejo de espera y observacin del cncer rectal experiencia de pacientes del grupo de investigacin del cncer rectal de ee uu: &lt;/strong&gt;ANTECEDENTES:El uso de una estrategia de manejo de observación y espera después de una respuesta clínica completa a la terapia neoadyuvante para el cáncer de recto está aumentando. Sin embargo, los conocimientos sobre la implementación, los tratamientos y los resultados, a nivel nacional de los Estados Unidos, son limitados.OBJETIVO:Investigar e informar sobre las prácticas y los resultados del manejo de observación y espera en los EE. UU.DISEÑO:Estudio retrospectivo.ESCENARIO:Multicéntrico.PACIENTES:Pacientes con cáncer de recto en estadio II o III que s","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"180-189"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Announcements.","authors":"","doi":"10.1097/01.dcr.0001098252.25156.7b","DOIUrl":"https://doi.org/10.1097/01.dcr.0001098252.25156.7b","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e99"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}