Prognostic Value of the Modified Cachexia Index in Colorectal Cancer Patients Undergoing Curative Surgery.

Background/aim: The cachexia index (CXI) has been reported to be a useful indicator for predicting the prognosis of cancer patients. However, CXI calculation requires skeletal muscle index (SMI) measurements, which involves an analysis of computed tomography images using an imaging software program, which makes the calculation process highly complex and time-consuming. Recently, the modified cachexia index (mCXI), calculated using the urea-to-creatinine ratio (UCR) instead of SMI, has been reported to be a useful marker that is easier to calculate than CXI.

Impact of Changes in Psoas Muscle Index on Prognosis in Patients With Colorectal Liver Metastases.

Background/aim: Reduction in skeletal muscle mass during chemotherapy is associated with poor outcomes. This study investigated the impact of changes in the psoas muscle index (PMI) on the prognosis of patients with unresectable colorectal liver metastases (CRLM) undergoing chemotherapy, including subgroup analyses based on the initial treatment response assessment.

Patients And Methods: We evaluated 47 patients with unresectable CRLM who underwent systematic chemotherapy and assessed changes in PMI to determine their prognosis.

Renal impairment as a risk factor for chemotherapy induced neutropenia in the treatment of trifluridine/thymidine phosphorylase inhibitor plus bevacizumab.

Although the phase III SUNLIGHT trial has demonstrated the survival benefit of the addition of bevacizumab (Bmab) to trifluridine/thymidine phosphorylase inhibitor (FTD/TPI), neutropenia, which frequently occurs during FDT/TPI + Bmab therapy, is a concern for clinicians. As TPI is excreted by the kidneys, the risk of adverse events is likely to be high in patients with an impaired renal function. This study aimed to investigate the relationship between renal impairment and the incidence of chemotherapy-induced neutropenia during FTD/TPI + Bmab therapy using real-world data.

Prognostic Significance of Innovative Inflammation-nutrition Biomarker Score in Patients With Colorectal Cancer.

Background/aim: A new index, inflammation-nutrition biomarker score (INS), based on host factors, including lymphocyte to C-reactive protein ratio, C-reactive protein to albumin ratio, advanced lung cancer inflammation index, and nutritional risk index, correlated with post-operative survival time independent of the tumor, node, metastasis (TNM) stage, in a cohort of patients with various types of malignancies. Therefore, this study aimed to evaluate the prognostic value of INS in patients with colorectal cancer who underwent curative resection.

Patients And Methods: We retrospectively evaluated 476 consecutive patients who underwent curative surgery for stage I-III colorectal cancer.

Physical pressure resistance of gastrointestinal anastomotic site via plate of polyglycolic acid promoting fibrosis.

Anastomotic-leakage incidence has been reported to be reduced on using polyglycolic acid (PGA) sheets as reinforcing materials; however, there is insufficient evidence regarding the reinforcement mechanism. Therefore, we investigated effects of PGA sheets on gastrointestinal anastomoses in rats. In the first approach, five rats underwent laparotomy; the PGA sheet was pasted onto the normal cecal wall.

Cachexia and efficiency of trifluridine/thymidine phosphorylase inhibitor + bevacizumab in metastatic colorectal cancer.

In later-line treatment of metastatic colorectal cancer (mCRC), there may be large differences in treatment efficacy depending on cancer cachexia. Recently, the cachexia index (CXI), which was calculated from the skeletal muscle mass index (SMI), serum albumin concentration, and neutrophil-to-lymphocyte ratio, was developed to evaluate cancer cachexia. We retrospectively examined the CXI of 80 patients who were treated with trifluridine/thymidine phosphorylase inhibitor (FTD/TPI) + bevacizumab (Bmab) therapy as a later-line treatment for mCRC, and assessed the impact of cancer cachexia on chemotherapeutic efficacy using CXI.

Successful resection of a rectal gastrointestinal stromal tumor using a transperineal approach: a case report.

Background: Rectal gastrointestinal stromal tumors (GISTs) complicate surgical approaches because of their anatomical position. We herein report a patient with rectal GIST on the anterior wall of the lower rectum, hat was successfully resected using a transperineal approach.

Case Presentation: This report describes a unique case of a 73-year-old man who was diagnosed with rectal GIST on the anterior wall of the lower rectum.

Utility of Assessing Early Tumor Shrinkage as an Efficacy Predictor in Patients with Non-Surgically Indicated or Recurrent Esophageal Cancer Treated with Nivolumab plus Ipilimumab.

Introduction: Nivolumab plus ipilimumab combination therapy has been administered as a first-line treatment in Japan since 2022 for patients with unresectable progressive or recurrent esophageal cancer. The efficacy and safety of this immune checkpoint inhibitor (ICI) doublet therapy are now being evaluated, and it is necessary to identify populations that benefit from this treatment at an early phase after initiation. For patients not showing early benefit, changing as soon as possible to other therapeutic strategies could improve their survival outcomes.

The Efficacy of Chemical Bowel Preparation Against Incisional Surgical Site Infection in Colorectal Cancer Surgery: A Propensity Score Matching Study.

Background/aim: In colorectal cancer surgery, the risk of surgical site infection (SSI) is relatively high. The development of SSI is related to longer and costlier hospitalization and reduced quality of life; therefore, perioperative prevention of SSI is important. Chemical bowel preparation (CBP) combined with mechanical bowel preparation (MBP) may be more effective in preventing surgical site infection (SSI) compared to MBP alone.

Impact of Circular Stapler Size on the Risk of Anastomotic Complications in Patients With Left-sided Colorectal Cancer: A Propensity Score-matched Study.

Background/aim: The present study examined the impact of circular stapler size on anastomotic complications, including leakage and stricture in patients undergoing double-stapling technique (DST) anastomosis for left-sided colon or rectal cancer.

Patients And Methods: A total of 403 patients were enrolled in this study, with circular stapler sizes  of 25, 28, and 29 mm.

Results: A small circular stapler (25 mm) was used in 170 cases (42.

Epithelial aPKC deficiency leads to stem cell loss preceding metaplasia in colorectal cancer initiation.

The early mechanisms of spontaneous tumor initiation that precede malignancy are largely unknown. We show that reduced aPKC levels correlate with stem cell loss and the induction of revival and metaplastic programs in serrated- and conventional-initiated premalignant lesions, which is perpetuated in colorectal cancers (CRCs). Acute inactivation of PKCλ/ι in vivo and in mouse organoids is sufficient to stimulate JNK in non-transformed intestinal epithelial cells (IECs), which promotes cell death and the rapid loss of the intestinal stem cells (ISCs), including those that are LGR5.

Prognostic significance of connective tissue growth factor expression in stromal cells in patients with diffuse‑type gastric cancer.

Connective tissue growth factor (CTGF) is a target gene of the Hippo signaling pathway. Its differential role in the histological types of gastric cancer (GC) remains unknown; therefore, the present study aimed to confirm the clinical significance of CTGF expression in cancer and stromal cells in patients with GC depending on the histological type. The present study enrolled 589 patients with GC.

An 8-mm port site hernia after robotic-assisted ileocecal resection: a case report.

Background: Robotic-assisted surgery is steadily becoming more prominent. The majority of reports regarding port site hernias (PSHs) have involved laparoscopic procedures. Currently, it is common to suture the fascia at port sites that are 10 mm or larger; however, the closure of 5-mm port sites is not considered mandatory.

An Improvement of Exertional Dyspnea by the Reintroduction of Anti-EGFR Antibody in Patients with Metastatic Rectal Cancer Who Developed Cancerous Lymphangiopathy: A Case Report.

Introduction: Reexposure to anti-EGFR antibodies, such as a reintroduction or rechallenge with anti-EGFR antibodies, has attracted much attention in the field of metastatic colorectal cancer. A reintroduction of anti-EGFR antibodies often shows good therapeutic outcomes, as most patients eligible for such reintroduction discontinued treatment due to adverse events despite a good treatment response during front-line treatment. We herein report a case demonstrating an improvement in exertional dyspnea after the reintroduction of anti-EGFR antibody in a patient with metastatic rectal cancer who developed cancerous lymphangiopathy.

Effects of an artificial pancreas on postoperative inflammation in patients with esophageal cancer.

Purposes: Subtotal esophagectomy for esophageal cancer (EC) is associated with high morbidity rates. Tight glycemic control using an artificial pancreas (AP) is one of the promising strategies to reduce postoperative inflammation and morbidities. However, the effects of tight glycemic control using AP in patients with EC are yet to be fully elucidated.

Optimal extent of lymph node dissection for high-risk gastric cancer stratified by a national clinical database risk calculator.

Background: For patients with gastric cancer, a well-balanced treatment that considers both oncological aspects and surgical risk is demanded. This study aimed to explore the optimal extent of lymph node dissection (LND) for patients with gastric cancer according to surgical risk, stratified by the risk calculator system produced by the Japan National Clinical Database (NCD).

Patients And Methods: We retrospectively evaluated 187 patients who underwent radical gastrectomy for gastric cancer.

Stromal area differences with epithelial-mesenchymal transition gene changes in conjunctival and orbital mucosa-associated lymphoid tissue lymphoma.

Purpose: To examine the molecular biological differences between conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma and orbital MALT lymphoma in ocular adnexa lymphoma.

Methods: Observational case series. A total of 129 consecutive, randomized cases of ocular adnexa MALT lymphoma diagnosed histopathologically between 2008 and 2020.

[A Case of Advanced Recurrent Rectal Cancer Successfully Treated by Rechallenge Therapy with an Anti-Epidermal Growth Factor Receptor(EGFR)Drug].

The patient was a 75-year-old man who had undergone potentially curative surgery for Stage Ⅲb rectal cancer followed by resection of liver metastases. Two years after the resection of liver metastases, lung and remnant liver metastases were found. He received chemotherapy for unresectable metastatic tumors.

[A Case of Late Recurrence of Anal Canal Carcinoma after Surgery, Discovered following the Diagnosis of a Subcutaneous Tumor in the Perineal Region].

We present an 82-year-old male patient who underwent laparoscopic abdominal perineal rectal amputation and D3 lymph node dissection, including left inguinal lymph node dissection for anal canal carcinoma. Left inguinal lymph node metastasis was positive, and pT1bN2aM0, pStage Ⅲa was the final pathological diagnosis. He underwent 8 courses of capecitabine plus oxaliplatin therapy as adjuvant chemotherapy.

[A Case of Robot-Assisted Abdominoperineal Resection Alongside En Bloc Prostatectomy and Vesico-Urethral Anastomosis for Local Recurrence].

A 66-year-old man presenting with cStage Ⅲc rectal cancer underwent laparoscopic low anterior resection(D3 lymph node dissection and R0 resection)following neoadjuvant chemoradiotherapy(capecitabine, 45 Gy/25 Fr)and received adjuvant chemotherapy(CAPOX). A year after surgery, abdominal contrast-enhanced computed tomography revealed recurrence near the rectal anastomosis with prostate invasion. The patient underwent robot-assisted abdominoperineal resection alongside en bloc prostatectomy and vesico-urethral anastomosis after 12 courses of neoadjuvant chemotherapy(FOLFIRI and panitumumab).

Two families with gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS): case reports and literature review.

Background: Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), a hereditary gastric polyposis syndrome that presents with fundic gastric polyposis, is associated with an increased risk of gastric adenocarcinoma. The four patterns of point mutation in the () promoter 1B region have been identified as the cause of GAPPS. GAPPS was first reported in 2012, and only 33 families with GAPPS have been reported worldwide to date.