Purpose: This study aims to optimize neoadjuvant radiotherapy target area for locally advanced rectal cancer (LARC) patients undergoing total neoadjuvant therapy (TNT) by examining local recurrence patterns.
Methods And Materials: We retrospectively analyzed the clinical data of rectal cancer patients who undergone local recurrence after surgery. Recurrence sites were categorized and compared with initial diagnosis imaging, focusing on visible and suspicious lesions.
Results: Of the 126 patients who met our criteria, 186 lesions were analyzed. Within these, 75.40% of cases (95/126) and 83.33% of lesions (155/186) were located within the pelvic cavity. Conversely, 3.97% of cases (5/126) and 3.33% of lesions (6/186) occurred outside the pelvic cavity. Additionally, 20.63% of cases (26/126) and 13.44% of lesions (25/186) were found in both regions. Recurrences were predominantly observed in mesenteric regions (MR) (40.86%, 76/186) and presacral regions (PR) (32.26%, 60/186). In addition, 86.51% of patients (109/126) had recurrent lesions in HRA and the suspected lesions areas. Further analysis showed that initial CEA levels and adjuvant therapy types were identified as independent predictors for recurrence in MR/PR and initially suspected lesions. 86.51% of patients had recurrent lesions in HRA and the suspected lesions areas.
Conclusion: The MR, PR, and areas of initial suspicious lesions are high-risk zones for post-surgical recurrence of LARC. Exploratory study of involved-field irradiation (IFI) can be carried out in the context of TNT in LARC.
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http://dx.doi.org/10.3389/fonc.2024.1459024 | DOI Listing |
Prostate
December 2024
Urology Unit, Department of Medical, Oral and Biotechnological Sciences, 'G. d'Annunzio University', Chieti, Italy.
Introduction: The introduction of multiparametric prostate magnetic resonance imaging (mpMRI) has revolutionized prostate cancer (PCa) diagnosis, enhancing the localization of clinically significant prostate cancer (csPCa) and guiding targeted biopsies. However, significant disparities in the execution, interpretation, and reporting of prostate MRI examinations across centers necessitate greater standardization and accuracy. This study compares the diagnostic efficacy of mpMRI from academic and nonacademic centers in detecting csPCa and identifies factors associated with csPCa detection.
View Article and Find Full Text PDFSurgery
December 2024
Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:
Background: Frail patients have poor outcomes after emergent colon surgery. While minimally invasive surgery has shown improved outcomes in the general patient population undergoing colectomy, the benefits in frail patients are unknown.
Methods: We identified frail patients who underwent urgent or emergent colon resections from 2017 to 2021 in the National Surgical Quality Improvement Program database.
Cell Mol Biol (Noisy-le-grand)
November 2024
División de Medicina Molecular, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México.
Connective tissue growth factor (CTGF) and Caspase 8 (CASP8) have been implicated in cancer development and progression. Variants such as CASP8 rs3834129 (-652 6N I/D) and CTGF rs6918698 (-945 C>G) have been associated with several cancers, although their association is still debated between populations. This study investigates the possible association between the CASP8 rs3834129 and CTGF rs6918698 variants with colorectal cancer (CRC) in Mexican patients.
View Article and Find Full Text PDFInt J Surg Case Rep
November 2024
Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco; Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco.
Introduction: Anorectal melanoma (AM) is a rare and aggressive type of cancer. Its symptoms often resemble those of common benign anal conditions, such as hemorrhoids, leading to frequent delays in diagnosis. Consequently, about one-third of patients have metastases at the time of their initial diagnosis.
View Article and Find Full Text PDFAm J Surg
December 2024
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Total Neoadjuvant Therapy (TNT) is a promising strategy for treating locally advanced rectal cancer (LARC) and has started to replace the traditional neoadjuvant chemoradiotherapy (CRT). This review combines findings from pivotal studies that helped TNT to integrate into clinical practice. It emphasizes the efficacy of TNT in improving the disease-free and metastasis-free survival, pathologic complete response and, according to recent studies, a potential improvement in overall survival when compared to standard CRT.
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