Prognostic value of carcinoembryonic antigen in colorectal adenocarcinoma: expanding hypotheses into clinical practice.

Purpose: This study seeks to resolve a fundamental question in oncology: Why do appendiceal and colorectal adenocarcinomas exhibit distinct liver metastasis rates? Building on our prior hypothesis published in the British Journal of Surgery, our institution has investigated potential DNA mutations within the carcinoembryonic antigen-related cell adhesion molecule (CEACAM5) gene's Pro-Glu-Leu-Pro-Lys (PELPK) motif to evaluate its role as a biomarker for liver metastasis risk.

Methods: Partnering with the Australian Genome Research Facility, the PELPK motif of CEACAM5 was analysed in colorectal and appendiceal adenocarcinomas to detect DNA mutations associated with liver metastasis. Additionally, our institution performed the COPPER trial to assess carcinoembryonic antigen (CEA) levels in portal versus peripheral blood in patients with appendiceal adenocarcinoma and a systematic review and meta-analysis of 136 studies on CEA's prognostic significance among patients with colorectal and appendiceal adenocarcinoma.

Mutations of the CEACAM5 Gene PELPK Motif in Patients With Appendiceal or Colorectal Adenocarcinoma.

Background/aim: The study examines whether DNA level mutations in the carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) gene Pro-Glu-Leu-Pro-Lys (PELPK) motif differ between patients with appendiceal or colorectal adenocarcinoma. Significant differences between these two groups in correlation with development of metachronous liver metastases could help in the development of targeted therapies and preventative treatment approaches.

Patients And Methods: This retrospective comparative trial analysed 18 patients, 9 with appendiceal adenocarcinoma and 9 with colorectal adenocarcinoma.

The 'Starburst' Sign: A Novel Description of PET Images in Carcinoma of Unknown Primary.

Background/aim: Carcinoma of unknown primary (CUP) poses a formidable diagnostic challenge, characterised by high mortality rates and an elusive primary tumour site. While Positron emission tomography (PET) scans are routinely employed in the initial evaluation of CUP patients, identifying the primary tumour remains an ongoing struggle. In light of this, the aim of this case report is to introduce a novel radiological description, termed the 'Starburst' sign, derived from distinctive PET scan appearances associated with CUP.

Comparison of Proportion of Elevated Carcinoembryonic Antigen Levels in Patients With Appendiceal and Colorectal Adenocarcinoma: A Systematic Review and Meta-analysis.

Background/aim: The proportion of patients with liver metastases in patients with appendiceal versus colorectal adenocarcinomas was 3.1 percent and 24 percent, respectively, in our peritonectomy centre. From our internal analyses, carcinoembryonic antigen (CEA) was potentially involved.

Development and validation of a multivariable prediction model in open abdomen patients for entero-atmospheric fistula.

Background: Laparostomy or Open Abdomen (OA) has matured into an effective strategy in the management of abdominal catastrophe. Single prognostic factors have been identified in a previous systematic review regarding entero-atmospheric fistula (EAF). Unfortunately, no prognostic multivariable model for EAF exist.

A case report of small bowel obstruction from previously undiagnosed lobular breast carcinoma: First in Australian literature.

Introduction: This case report is the first in the Australian literature of a patient, without prior diagnosis, presenting with a bowel obstruction secondary to lobular breast cancer. This highlights a relatively rare cause of bowel obstruction, but also the importance of breast self-examination as a compliment to the current BreastScreen Australia program.

Presentation Of Case: A 67-year-old female presented to the Emergency Department with a 48-h history of sharp, constant epigastric pain, vomiting and constipation.

Treatments and other prognostic factors in the management of the open abdomen: A systematic review.

Background: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prognostic factors in OA patients in regard to definitive fascial closure (DFC), mortality and intra-abdominal complications.

Dilemma of mucosal appendicitis: a clinico-pathological entity? A retrospective cohort study.

Background: The presence of mucosal inflammation within appendicectomy specimens is poorly described in the literature, and there is debate regarding the clinical significance of this histological finding. The aim of this study is to correlate clinical and radiological data with histologically confirmed acute mucosal appendicitis (MA).

Methods: A retrospective cohort study was performed to identify all patients who underwent appendicectomy over 5 years at Caboolture Hospital.

The impact of temporal artery biopsy on surgical practice.

Background: Giant cell arteritis (GCA) has the potential to cause irreversible blindness and stroke in affected patients [1-4]. Temporal artery biopsy (TAB) remains the gold standard test for GCA [6-8]. Recent literature suggests that TAB does not change management of patients with suspected GCA and that ultrasound scan (USS) may be sufficient enough alone to confirm the diagnosis [9-11,13].

A surgeon-led model to improve operating theatre change-over time and overall efficiency: A randomised controlled trial.

Background: The non-operative time during the process of patient change-over between operating theatre cases is a significant source of delay and overall theatre inefficiency. The aim of this study was to integrate and trial a working strategy to improve this change-over time.

Method: This was a single-blinded, randomised controlled intervention study comparing a surgeon-led, team-based model of strategies versus routine patient change-over.