Neoadjuvant chemoradiation improves oncologic outcomes in low and mid clinical T3N0 rectal cancers.

Background: Controversial data exists in the current literature in regard to the use of neoadjuvant chemoradiation (nCRT) in patients with clinical T3N0 (cT3N0) rectal cancers, specifically based on location and relation to peritoneal reflection. We aimed to analyze the impact of nCRT on oncologic outcomes among cT3N0 rectal cancers, depending on the tumor height from anal verge (AV).

Methods: A retrospective analysis of patients with cT3N0 rectal cancers was included from a query of a prospectively maintained rectal cancer database from 1980 to 2016.

Allergic sensitization and clinical outcomes in urban children with asthma, 2013-2016.

Background: The aim of this study was to examine if food and/or aeroallergen sensitization was associated with worse asthma, pulmonary function tests (PFT), and laboratory markers.

Methods: At our institution, 386 children with asthma were divided into allergic and nonallergic groups based on allergen-specific immunoglobulin E (IgE) testing classes 1-6 versus 0. Asthma severity and/or control, IgE level, eosinophil counts and/or percentages, forced vital capacity (FVC), forced expiratory volume in the first second of expiration (FEV1), and FEV1/FVC, were compared by using bivariate, regression, and subgroup analyses for children who were highly allergic (≥4 allergens).

Recurrence and survival rates of inflammatory bowel disease-associated colorectal cancer following postoperative chemotherapy: a comparative study.

Background And Aim: Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC). Studies have shown tumorigenetic and histomorphological differences between IBD-associated CRC and non-IBD CRC, suggesting differences in tumor behavior and response to treatment. We aimed to compare tumor recurrence and survival rates following postoperative chemotherapy in CRC patients with and without IBD.

Dual expression of MYC and BCL2 proteins predicts worse outcomes in diffuse large B-cell lymphoma.

Recent studies suggested that MYC and BCL2 protein co-expression is an independent indicator of poor prognosis in diffuse large B-cell lymphoma. However, the immunohistochemistry protocols for dual-expression staining and the scoring cut-offs vary by study. Sixty-nine cases of diffuse large B-cell lymphoma were evaluated for MYC and BCL2 protein expression using various cut-offs that have been recommended in prior studies.

Crohn's disease-like reaction predicts favorable prognosis in colitis-associated colorectal cancer.

Background: Idiopathic inflammatory bowel disease is associated with an increased risk of developing colorectal cancer. Colitis-associated colorectal cancer (CAC) has unique histomorphology features; however, whether histomorphology is predictive of survival in CAC, independent of overall clinical tumor stage, remains unknown. The aim of this study is to determine if clinicodemographics and tumor histomorphologic features are prognostic in patients with CAC.

Intraoperative colonoscopy does not worsen the outcomes of laparoscopic colorectal surgery: a case-matched study.

Background: Intraoperative colonoscopy is sometimes needed as an adjunct to colorectal surgery. When it is performed with laparoscopic surgery, there is the potential for prolonged bowel distension, obstructed surgical exposure, and increased morbidity. This study aimed to evaluate the overall safety and outcomes of laparoscopic colorectal procedures in which intraoperative colonoscopy was performed.

Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients.

Background: Ileal pouch anal anastomosis (IPAA) is the treatment of choice for chronic, medically refractory mucosal ulcerative colitis, indeterminate colitis, familial adenomatous polyposis (FAP), and a select group of patients with Crohn's disease.

Aim: : We report outcomes, complications, and quality of life (QOL) in a cohort of 3707 patients treated at our institution from January 1984 to March 2010.

Methods: Data were collected from a prospectively maintained database and chart review of 3707 consecutive primary IPAA cases.

Key factors associated with postoperative complications in patients undergoing colorectal surgery.

Background: Surgical outcomes are determined by complex interactions among a variety of factors including patient characteristics, diagnosis, and type of procedure.

Objective: The aim of this study was to prioritize the effect and relative importance of the surgeon (in terms of identity of a surgeon and surgeon volume), patient characteristics, and the intraoperative details on complications of colorectal surgery including readmission, reoperation, sepsis, anastomotic leak, small-bowel obstruction, surgical site infection, abscess, need for transfusion, and portal and deep vein thrombosis.

Design: This study uses a novel classification methodology to measure the influence of various risk factors on postoperative complications in a large outcomes database.

Prognostic modeling of preoperative risk factors of pouch failure.

Background: The prospect of pouch failure needs to be considered when evaluating the management strategy for patients who may be candidates for an ileo anal pouch. An ability to predict the likelihood and timing of failure preoperatively may influence surgical decision making.

Objective: The aim of this study was to define a preoperative prognostic model for ileoanal pouch failure.

BRAF mutations in colorectal cancer are associated with distinct clinical characteristics and worse prognosis.

Background: Colorectal cancer is a heterogeneous disease with multiple underlying genetic mutations causing different clinical phenotypes. Mutation in the BRAF oncogene is a key step in malignant transformation within the methylator pathway to colorectal cancer. However, there is a paucity of information about BRAF mutant colorectal tumors.

Presence of concomitant inflammatory bowel disease is associated with an increased risk of postcholecystectomy complications.

Background: Surgery in patients with inflammatory bowel disease (IBD) is often associated with complications. The aim of our study was to evaluate whether concomitant IBD was associated with an increased risk of postcholecystectomy complications.

Methods: The study group consisted of 82 consecutive IBD patients who underwent cholecystectomy from January 2001 to October 2010.

A novel data-driven prognostic model for staging of colorectal cancer.

Background: The aim of this study was to develop a novel prognostic model that captures complex interplay among clinical and histologic factors to predict survival of patients with colorectal cancer after a radical potentially curative resection.

Study Design: Survival data of 2,505 colon cancer and 2,430 rectal cancer patients undergoing radical colorectal resection between 1969 and 2007 were analyzed by random forest technology. The effect of TNM and non-TNM factors such as histologic grade, lymph node ratio (number positive/number resected), type of operation, neoadjuvant and adjuvant treatment, American Society of Anesthesiologists (ASA) class, and age in staging and prognosis were evaluated.

Prevalence and clinical implications of positive serum anti-microsomal antibodies in symptomatic patients with ileal pouches.

Background And Aim: Autoimmune disorders (AID) have been shown to be associated with chronic antibiotic-refractory pouchitis (CARP). The role of anti-microsomal antibodies in ileal pouch disorders has not been investigated. The aims of the study were to investigate the prevalence of positive anti-microsomal antibody in symptomatic patients with ileal pouches and to investigate its clinical implications.

Classification of large microarray datasets using fast random forest construction.

Random forest is an ensemble classification algorithm. It performs well when most predictive variables are noisy and can be used when the number of variables is much larger than the number of observations. The use of bootstrap samples and restricted subsets of attributes makes it more powerful than simple ensembles of trees.

Risk of colorectal adenoma and carcinoma after colectomy for colorectal cancer in patients meeting Amsterdam criteria.

Objective: To report the risk of metachronous colorectal neoplasia after colectomy for cancer in Hereditary Nonpolyposis Colorectal Cancer (HNPCC) syndrome.

Summary Background Data: Patients meeting Amsterdam criteria for diagnosis of HNPCC have a lifetime colorectal cancer risk approaching 80%, and a metachronous cancer rate of approximately 25%. Therefore, when colon cancer is diagnosed, total rather than segmental colectomy is advocated.

Polishing the crystal ball: knowing genotype improves ability to predict desmoid disease in patients with familial adenomatous polyposis.

Introduction: Desmoid disease occurs in one third of patients with familial adenomatous polyposis. Patients may be protected by changing surgical strategy. We designed a formula to predict desmoid risk and tested the value of adding genotype to the formula.

Genetic and epigenetic classifications define clinical phenotypes and determine patient outcomes in colorectal cancer.

Background: A molecular classification of colorectal cancer has been proposed based on microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and mutations in the KRAS and BRAF oncogenes. This study examined the prevalence of these molecular classes, and differences in clinical presentation and outcome.

Methods: Demographics, tumour characteristics and survival were recorded for 391 subjects with colorectal cancer.

Divergent oncogenic changes influence survival differences between colon and rectal adenocarcinomas.

Purpose: Colorectal cancers develop through various mechanisms such as chromosomal instability, DNA mismatch repair deficiency (microsatellite instability), and epigenetic DNA promoter methylation (CpG island methylator phenotype). This study evaluated the disparity in neoplastic changes between colon and rectal cancers.

Methods: A clinic-based colorectal frozen tumor bank at a single institution was queried for colon and rectal adenocarcinomas.

Development of a clinically feasible molecular assay to predict recurrence of stage II colon cancer.

The 5-year survival rate for patients with Stage II colon cancer is approximately 75%. However, there is no clinical test available to identify the 25% of patients at high risk of recurrence. We have previously identified a 23-gene signature that predicts individual risk for recurrence.

Adenoma detection rate: the real indicator of quality in colonoscopy.

Purpose: Completion rate is the most commonly used index of quality in colonoscopy, and yet a complete examination is not necessarily a good examination. The ability to detect and treat adenomas is an important component of endoscopic skill, because many colonoscopies are performed for this express purpose. Adenoma detection rate is rarely reported, although it seems to depend on the time taken for withdrawal.

Clinical outcomes and cost analysis of a "fast track" postoperative care pathway for ileal pouch-anal anastomosis: a case control study.

Purpose: Traditional length of hospital stay after ileal pouch-anal anastomosis is 8 to 15 days. Fast track rehabilitation programs reduce stay, but there are concerns that readmission and complication rates may be increased. This study evaluated a fast track pathway after ileoanal pouch surgery.

Surgical outcome in patients with primary sclerosing cholangitis undergoing ileal pouch-anal anastomosis: a case-control study.

Background: The outcome of restorative proctocolectomy in the setting of chronic ulcerative colitis complicated by primary sclerosing cholangitis (PSC) is not clear. The purpose of this study was to determine the surgical outcome, risk of dysplasia/cancer, morbidity/mortality, long-term results, and functional and quality of life results in patients with inflammatory bowel disease (IBD) and PSC who underwent restorative proctocolectomy with ileal pouch-anal anastomosis and compare them in a case-matched study.

Methods: Patients with PSC-associated IBD undergoing restorative proctocolectomy between 1983 and 2002 were included in the study.

Risk factors associated with ileal pouch-related fistula following restorative proctocolectomy.

Introduction: Pouch-related fistula occurs in 5-10 per cent of patients after restorative proctocolectomy. The present study identified risk factors associated with the development of such fistulas.

Methods: Data on preoperative and postoperative risk factors were recorded from 1965 patients who underwent restorative proctocolectomy in a single tertiary centre between 1983 and 2001.

Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery.

Objective: To identify risk factors associated with ileal pouch failure and to develop a multifactorial model for quantifying the risk of failure in individual patients. SUMMARY BACKGROUND DATA Ileal pouch anal anastomosis (IPAA) has become the treatment choice for most patients with ulcerative colitis and familial adenomatous polyposis who require surgery. At present, there are no published studies that investigate collectively the interrelation of factors related to ileal pouch failure, nor are there any predictive indices for risk stratification of patients undergoing IPAA surgery.