Publications by authors named "Guole Lin"

Purpose: To evaluate the predictive value of MRI-determined variables for pathological complete response (pCR) in locally advanced rectal cancer (LARC) patients following neoadjuvant chemoradiotherapy (NCRT).

Methods: Clinical data were collected from patients who received NCRT between January 2019 and 2022. Patients with rectal adenocarcinoma, cT3-4N0, or TanyN1-2 were included.

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Background: The traditional neoadjuvant chemoradiotherapy (nCRT) combined with total mesorectal excision has been widely accepted as the standard treatment for patients with locally advanced rectal cancer (LARC). New strategies such as total neoadjuvant therapy (TNT) and neoadjuvant immunotherapy have shown great promise in certain patient populations. Currently, there is an urgent need to stratify patients before treatment to adopt the appropriate neoadjuvant strategies.

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Background: Neoadjuvant chemoradiotherapy (nCRT) is the standard for locally advanced rectal cancer (LARC). However, distant metastasis remains the primary cause of treatment failure. Early identification of high-risk individuals for personalized treatment may offer a solution.

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Radiotherapy displays unique antitumor synergism with immune checkpoint inhibitors, which is indicated by high pathological complete response (pCR) rates from single-arm trials of locally advanced rectal cancer (LARC). Here we test the efficacy and safety of the radiation-immune checkpoint inhibitor combination in patients with LARC in a phase 2, randomized trial conducted in eight major colorectal cancer centers in Beijing. In total, 186 eligible all-comer (proficient mismatch repair and deficient mismatch repair) participants were enrolled.

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Background: Total mesorectal excision is the standard surgery for locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT), but it may lead to high complication rates and poor quality of life. This study evaluates whether transanal endoscopic microsurgery (TEM), as a partial resection procedure, can enhance quality of life for clinical complete response (cCR) or near-cCR patients without compromising survival.

Methods: Between May 2017 to September 2021, 80 patients with T3-4N0M0 or TanyN+M0 mid-low rectal cancer achieving cCR or near-cCR post-nCRT were prospectively included at 6 Chinese centers.

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Article Synopsis
  • A study was conducted to evaluate the effects of different levels of inferior mesenteric artery (IMA) ligation during surgery for locally advanced rectal cancer (LARC) following neoadjuvant chemoradiotherapy (nCRT).
  • Results from 337 patients showed that while more lymph nodes were retrieved in the low ligation (LL) group, quality of life decreased similarly for both high ligation (HL) and LL groups, without significant differences in operation time or blood loss.
  • The conclusion suggests that the chosen ligation level does not affect complications or long-term outcomes, and decisions should consider factors like metastatic risk, vascular anatomy, and surgeon expertise.
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The pan-immune-inflammation value reflects the systemic inflammatory response, and tumor-infiltrating lymphocytes indicate a local immune response in rectal cancer. However, the association between systemic inflammatory response, as indicated by the pan-immune-inflammation value, and local immune responses in rectal cancer remains unclear. This study analyzed 915 treatment-naïve rectal cancer patients from the Peking Union Medical College Hospital and PLA General Hospital (PLAGH) cohorts who underwent radical surgery to investigate the relationship between the pan-immune-inflammation value and immune responses.

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Background: Conformal proctectomy with sphincter preservation (CPSP) is designed to preserve the rectal wall as much as possible in very low rectal cancer patients. Evaluations of anal function and quality of life outcomes are lacking.

Methods: This study included male patients with very low (≤ 5 cm from the anal verge) rectal adenocarcinoma between January 1, 2020, and January 1, 2022.

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Article Synopsis
  • Research shows significant differences between left-sided colon cancers (LCC) and right-sided colon cancers (RCC), particularly regarding the immune marker pan-immune-inflammation value (PIV) and its prognostic implications.
  • A study with 1510 colon cancer patients found that while PIV levels were generally higher in RCC, after matching for other factors, there was no difference in PIV between the two groups.
  • PIV is a useful predictor for disease-free survival (DFS) in LCC patients, where high PIV levels indicate worse DFS, but it does not show the same predictive ability in RCC patients.
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Background: Chemoresistance is the primary contributor to distant metastasis in the context of neoadjuvant chemoradiotherapy (nCRT) for rectal cancer. However, the underlying mechanisms remain elusive.

Aim: To detect the differential expression profiles of plasma exosomal microRNAs (miRNAs) in poor and good responders and explore the potential mechanisms of chemoresistance.

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Mechanical anastomosis in rectal cancer surgery offers several advantages but is plagued by complications like leaks and strictures. Variations in surgeons' experiences affect outcomes, but powered circular anastomosis has emerged as a promising solution, ensuring uniform staple formation, and reducing manual manipulation. This multicenter, randomized, parallel-controlled study in China compared IntoCare's powered circular staplers (ICS) with manual circular staplers (MCS) in 382 patients (195 ICS, 187 MCS).

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Background: Owing to the lack of evidence-based medical studies with large sample sizes, the surgical approach for the radical resection of rectal neuroendocrine tumors remains controversial.

Methods: We retrospectively collected the medical records of patients with rectal neuroendocrine tumors who underwent radical resection at 17 large tertiary care hospitals in China between January 1, 2010, and April 30, 2022. All patients were divided into laparoscopic and open surgery groups.

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Article Synopsis
  • * Researchers analyzed data from 1408 patients and identified key prognostic factors such as tumor grade, size, and nutritional index, forming the basis for the GATIS score.
  • * The GATIS score demonstrated better predictive accuracy for patient outcomes compared to traditional methods like TNM staging and WHO grading, indicating it could significantly enhance prognosis evaluation for R-NENs.
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Background: Intestinal flora disorder (IFD) poses a significant challenge after laparoscopic colonic surgery, and no standard criteria exists for its diagnosis and treatment.

Aim: To analyze the clinical features and risk factors of IFD.

Methods: Patients with colon cancer receiving laparoscopic surgery were included using propensity-score-matching (PSM) methods.

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Background: There is concern regarding the possibility of postoperative complications for laparoscopic right colectomy.

Objective: To evaluate the risk factors for postoperative complications for patients undergoing laparoscopic right colectomy.

Design: This was an observational study.

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Article Synopsis
  • Limited studies exist on the optimal treatment for rectal neuroendocrine tumors (R-NETs) measuring 1-2 cm, with this research exploring long-term outcomes and quality of life for affected patients.
  • The study analyzed data from 272 patients, comparing outcomes between those undergoing local excision (LE) and radical resection (RR), finding no significant differences in survival but better quality of life and fewer complications with LE.
  • The findings suggest that LE is preferable for patients without lymph node metastasis, while RR may be necessary for those with specific high-risk features like higher tumor location or elevated neutrophil-to-lymphocyte ratio.
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Background: Doctors are at high risk of developing hemorrhoidal disease (HD), but it is unclear whether doctors are aware of this risk. The OASIS (dOctors AS patIentS) study was performed to examine the prevalence, awareness, diagnosis, and treatment of HD among doctors in big cities in China.

Methods: An online survey consisting of a structured questionnaire was carried out among doctors in grade-A tertiary hospitals in 29 provinces across China from August to October 2020.

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Article Synopsis
  • A study was conducted to compare the effectiveness of local excision versus radical resection for treating grade 2 rectal neuroendocrine tumors, as there is limited research on the subject.
  • A total of 144 patients from 17 medical centers in China were analyzed, revealing no significant differences in cancer survival for tumors ≤1.5 cm, but a notable difference in relapse-free survival for tumors >1.5 cm, favoring radical resection.
  • Limitations of the study include its retrospective nature and relatively short follow-up period, which may impact the reliability of the findings.
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Article Synopsis
  • * A total of 103 patients participated, with the RMD group experiencing lower blood loss, shorter surgery times, and shorter hospital stays, as well as a higher rate of complete mesorectal excision (98.1%).
  • * One year post-surgery, RMD showed improved functional outcomes in urogenital and defecation functions, while the disease-free survival rates were similar in both groups, indicating RMD's safety and effectiveness.
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Article Synopsis
  • - The study aimed to find out if locally advanced rectal cancer (LARC) cases with a negative MRI-predicted mesorectal fascia (MRF) could skip preoperative radiation therapy (CRT) and go straight to surgery instead.
  • - It involved a randomized clinical trial with 275 patients, comparing outcomes between those who had primary surgery (intervention group) and those who received preoperative CRT followed by surgery (control group).
  • - After analyzing 3-year disease-free survival rates, results showed that the intervention group had a rate of 81.82% compared to 85.37% in the control group, leading to the trial's early termination due to more local recurrences in the intervention group.
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Anal adenocarcinoma combined with perianal Paget's disease (PPD) involving the vulva is rare, and there is no established standard treatment. We present the case of a 69-year-old woman with symptoms of intermittent hematochezia and perianal discomfort for 7 months. Upon examination, we discovered a plaque-like hard mass on the right posterior wall of the anal canal, which extended to encompass the anus and dentate line.

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Background: Frostbite is becoming increasingly common in urban environments, and severe cases can lead to tissue loss. The treatment goal is to preserve tissue and function; the sooner appropriate treatment is administered, the more tissue can be saved. However, not every patient with deep frostbite seeks medical care promptly.

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Background: The prognostic nutritional index (PNI), alkaline phosphatase (ALP), and lymph node ratio (LNR) are reportedly related to prognosis. The aim of this study was to elucidate the clinical importance of the LNR and hematological parameters in patients with high grade rectal neuroendocrine neoplasms (HG-RNENs) who were undergoing radical resection.

Methods: We reviewed the medical records of patients with HG-RNENs from 17 large-scale medical centers in China (January 1, 2010-April 30, 2022).

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Background: We aimed to analyze the benefit of adjuvant chemotherapy in high-risk stage II colon cancer patients and the impact of high-risk factors on the prognostic effect of adjuvant chemotherapy.

Methods: This study is a multi-center, retrospective study, A total of 931 patients with stage II colon cancer who underwent curative surgery in 8 tertiary hospitals in China between 2016 and 2017 were enrolled in the study. Cox proportional hazard model was used to assess the risk factors of disease-free survival (DFS) and overall survival (OS) and to test the multiplicative interaction of pathological factors and adjuvant chemotherapy (ACT).

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