[Total pelvic exenteration - strategy and extent of surgery].

Introduction: Pelvic exenteration is an essential part of complex treatment of advanced tumours of the small pelvis. The strategy of surgery is well known and consensual. However, the optimal extent of lymphadenectomy is still under discussion.

Durable Complete Response of Colorectal Cancer Metastasis after Biochemotherapy.

Background: Resection of the metastatic site is indicated but not always possible in patients with metastatic colorectal cancer (mCRC) who achieve a partial or complete response (CR) to induction systemic treatment. CR after systemic treatment alone is uncommon, and even patients with radiologic CR after induction chemotherapy harbour persistent macroscopic or microscopic residual disease in more than 80% of cases. Occasionally, some metastatic lesions disappear radiologically but others persist after induction systemic treatment.

Monitoring of Circulating Tumor Cells by a Combination of Immunomagnetic Enrichment and RT-PCR in Colorectal Cancer Patients Undergoing Surgery.

Background: The presence of circulating tumor cells (CTC) has been reported in patients with advanced colorectal cancer. Monitoring CTC (also known as a liquid-biopsy) has recently become the center of interest for low-invasive monitoring of cancer progression and predictive biomarkers testing. Along with high-cost technology and a complex methodology, a straightforward method based on magnetic beads enrichment followed by RT-PCR is set to allow for routine CTC analysis in colorectal cancer patients.

[Quality of life after extensive pelvic surgery].

Introduction: Multiorgan resections in the small pelvis are standard procedures in oncosurgery and some indications have no alternative. In advanced pelvic cancer, pelvic exenteration with en bloc resection of the involved organs and structures, including portions of the bony pelvis, is indicated. The 5-year survival rate is fairly good, around 50%, but little is known about the long-term quality of life.

[Total pelvic exenteration - strategy of the surgery].

Introduction: Total pelvic exenteration (TPE) has a key role in the complex treatment of advanced T4 tumours of the small pelvis, which cannot be radically removed by a less invasive procedure. The aim of this work is to summarize the strategy of TPE, perioperative care of the patients, complications of the intervention and their management.

Methods: Overview of the current literature and the authors experience, based on our own group of 37 patients after TPE performed during the period 1999-2012.

[Pelvic exenteration in the treatment of advanced tumours of the small pelvis].

Introduction: Pelvic exenteration is the essential part of complex treatment of advanced urologic, gynaecologic and colorectal tumours of the small pelvis. The aim of this work is to summarize the individual types of pelvic exenteration, their indications, contraindications and long-term results.

Methods: Overview of the current literature and retrospective analysis of our cohort of 37 patients operated on at the Department of Surgery of the First Faculty of Medicine, Charles University, and Thomayer Hospital during the period 1999-2012.

HOTAIR long non-coding RNA is a negative prognostic factor not only in primary tumors, but also in the blood of colorectal cancer patients.

Colorectal cancer (CRC) is one of the main causes of death of neoplasia. Demand for predictive and prognostic markers to reverse this trend is increasing. Long non-coding RNA HOTAIR (Homeobox Transcript Antisense Intergenic RNA) overexpression in tumors was previously associated with poor prognosis and higher mortality in different carcinomas.

Functional, genetic, and epigenetic aspects of base and nucleotide excision repair in colorectal carcinomas.

Purpose: DNA repair capacity (DRC) is a determinant not only of cancer development but also of individual response to therapy. Previously, altered base and nucleotide excision repair (BER and NER) have been described in lymphocytes of patients with sporadic colorectal cancer. We, for the first time, evaluate both excision repair capacities in human colon biopsies to study their participation in colorectal tumorigenesis.

Mutation-based detection and monitoring of cell-free tumor DNA in peripheral blood of cancer patients.

Prognosis of solid cancers is generally more favorable if the disease is treated early and efficiently. A key to long cancer survival is in radical surgical therapy directed at the primary tumor followed by early detection of possible progression, with swift application of subsequent therapeutic intervention reducing the risk of disease generalization. The conventional follow-up care is based on regular observation of tumor markers in combination with computed tomography/endoscopic ultrasound/magnetic resonance/positron emission tomography imaging to monitor potential tumor progression.

Utility of cell-free tumour DNA for post-surgical follow-up of colorectal cancer patients.

Background: While efficient surgical treatment is the key to prolonged survival of patients with colorectal cancer, post-surgical follow-up is important for the early detection of relapsing disease or of disease progression. Current dispensarization, typically based on imaging CT, PET, MR, is frequently supported by the observation of tumour markers (CEA, CA19-9). Due to their limited sensitivity and selectivity, better tools for monitoring of the disease are desirable.

Polymorphisms in miRNA-binding sites of nucleotide excision repair genes and colorectal cancer risk.

Reduced DNA repair capacity and DNA damage accumulation may lead to cancer development. Regulation of and coordination between genes involved in DNA repair pathways is fundamental for maintaining genome stability, and post-transcriptional gene regulation by microRNAs (miRNAs) may therefore be of particular relevance. In this context, the presence of single nucleotide polymorphisms (SNPs) within the 3'untranslated regions of target DNA repair genes could alter the binding with specific miRNAs, modulating gene expression and ultimately affecting cancer susceptibility.

Differences in nucleotide excision repair capacity between newly diagnosed colorectal cancer patients and healthy controls.

Alteration of DNA integrity is a potential cause of cancer and it is assumed that reduced DNA repair capacity and accumulation of DNA damage may represent intermediate markers in carcinogenesis. In this case-control study, DNA damage and nucleotide excision repair capacity (NER-DRC) were assessed in association with sporadic colorectal cancer (CRC). Both parameters were quantified by comet assay in blood cells of 70 untreated incident patients and 70 age-matched healthy controls.

DNA damage and nucleotide excision repair capacity in healthy individuals.

Interindividual differences in DNA repair capacity (DRC) represent an important source of variability in genome integrity and thus influence health risk. In the last decade, DRC measurement has attracted attention as a potential biomarker in cancer prediction. Aim of the present exploratory study was to characterize the variability in DNA damage and DRC on 100 healthy individuals and to identify biological, lifestyle, or genetic factors modulating these parameters.

Celiac axis stenosis and lethal liver ischemia after pancreaticoduodenectomy.

Celiac axis stenosis can lead to a fatal hepatic ischemia after pancreaticoduodenectomy unless a simultaneous revascularisation of the celiac circulation is performed. In the present study are reported three cases of celiac axis stenosis, all of which had histologically confirmed periampullary cancer. Case 1: a 50-year-old male with a history of myocardial infarction and liver steatosis; visceral arteriography prior to the surgery demonstrated a celiac axis stenosis.

[Treatment outcomes of colon cancer surgery combined with radical lymphadenectomy].

The authors analyzed a group of 1281 subjects with colorectal cancer operated and followed up in a single institution from I/1992 to VIII/2007. Colon carcinoma patients were assessed separately (C18). Patients with rectal and rectosigmoid tumors are not included in the presentation.

[Colorectal carcinoma as a cause of acute abdominal illness].

Colorectal carcinoma (KCR) is the commonest malignancy in male patients and the second commonest in female patients in the Czech Republic. During 1990-2006, 1162 patients with colorectal carcinomas were operated in the FTNsP (Faculty Thomayer Hospital) Surgical Clinic. 212 patients aged between 39 to 94 y.

Tumor markers in staging and prognosis of colorectal carcinoma.

The precise preoperative staging of colorectal cancer is fundamental for surgical strategy, incomplete staging means incomplete treatment and poor outcome. Large-scale clinical evaluations of predictive markers are currently in progress, including determination of their ability to predict response of patients to therapy for advanced disease and for adjuvant treatment. Lack of specificity and sensitivity preclude the use of all existing serum markers for the early detection of colorectal carcinoma.

[Surgical management of intrahepatic cholelithiasis--two case reviews].

Introduction: Intrahepatic lithiasis (IHL) has a low incidence rate in countries with high social-economical level, with mostly secondary ethiology. The commonest signs include: cholangoitis, obstruction icterus, liver absces and secondary biliary cirrhosis. Although a wide range of treatment methods is available, in some cases, surgical management is the only alternative.

Tumor markers in patients with relapse of colorectal carcinoma.

Aim: To evaluate CEA and CA19-9 in a long-term follow-up after radical surgery for colorectal cancer.

Patients And Methods: A total of 1,090 patients were operated on for colorectal cancer, 716 patients underwent R0 resection, 631 patients were under further surveillance, relapse was diagnosed in 122 patients (20%), 74 patients were indicated for reoperation The resectability of the relapse was 35%. An AxSYM instrument (Abbott) was used for analysis.

Multiorgan resections for advanced colorectal cancer.

Background: A retrospective review is presented of a single institution's experience with multivisceral resections for locally-advanced colorectal cancer.

Materials And Methods: Twenty-eight patients, who had undergone RO multiorgan resection, were identified from the database of a total of 1150 patients operated on for colorectal carcinoma in the years 1995-2005 at a single center. There were twelve total pelvic exenterations and 16 patients had undergone en bloc primary tumor resection with adherent organs, such as the spleen, diaphragm, pancreas, stomach, kidney, etc.

[Re-laparotomy for complications of urgent abdominal disorders].

Urgent abdominal disorders are a daily work routine at surgical departments. Therefore, all surgeons are familiar with the problematics, including all its pitfalls, e.g.

The role of FDG-PET/CT in the detection of recurrent colorectal cancer.

Purpose: The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation.

Mesohepatectomy for colorectal liver metastasis. Case report.

A 54-year-old woman was operated for obstructive ileus in 1996. Obstruction was caused by a tumor of the descending colon invading the abdominal wall. Urgent left colectomy with lymphadenectomy was performed.

Changes of thymidine kinase (TK) during adjuvant and palliative chemotherapy.

Unlabelled: Thymidine kinase is involved in nucleic acid synthesis and is, therefore, considered to be an important proliferation tumor marker. For this reason, we monitored this marker in the course of colorectal cancer chemotherapy.

Materials And Methods: We examined thymidine kinase (TK) levels in 30 patients with colorectal cancer who underwent adjuvant or palliative chemotherapy (CHT schemes).