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Xia W, Geng Y, Hu W. Peritoneal Metastasis: A Dilemma and Challenge in the Treatment of Metastatic Colorectal Cancer. Cancers (Basel) 2023; 15:5641. [PMID: 38067347 PMCID: PMC10705712 DOI: 10.3390/cancers15235641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 10/25/2024] Open
Abstract
Peritoneal metastasis (PM) is a common mode of distant metastasis in colorectal cancer (CRC) and has a poorer prognosis compared to other metastatic sites. The formation of PM foci depends on the synergistic effect of multiple molecules and the modulation of various components of the tumor microenvironment. The current treatment of CRC-PM is based on systemic chemotherapy. However, recent developments in local therapeutic modalities, such as cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC), have improved the survival of these patients. This article reviews the research progress on the mechanism, characteristics, diagnosis, and treatment strategies of CRC-PM, and discusses the current challenges, so as to deepen the understanding of CRC-PM among clinicians.
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Affiliation(s)
- Wei Xia
- Department of Oncology, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, China;
| | - Yiting Geng
- Department of Oncology, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, China;
| | - Wenwei Hu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou 213003, China;
- Jiangsu Engineering Research Center for Tumor Immunotherapy, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
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2
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Morton D, Seymour M, Magill L, Handley K, Glasbey J, Glimelius B, Palmer A, Seligmann J, Laurberg S, Murakami K, West N, Quirke P, Gray R. Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized Controlled Trial. J Clin Oncol 2023; 41:1541-1552. [PMID: 36657089 PMCID: PMC10022855 DOI: 10.1200/jco.22.00046] [Citation(s) in RCA: 193] [Impact Index Per Article: 96.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/15/2022] [Accepted: 10/20/2022] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Neoadjuvant chemotherapy (NAC) has potential advantages over standard postoperative chemotherapy for locally advanced colon cancer but requires formal evaluation. METHODS Patients with radiologically staged T3-4, N0-2, M0 colon cancer were randomly allocated (2:1) to 6 weeks oxaliplatin-fluoropyrimidine preoperatively plus 18 postoperatively (NAC group) or 24 weeks postoperatively (control group). Patients with RAS-wildtype tumors could also be randomly assigned 1:1 to receive panitumumab or not during NAC. The primary end point was residual disease or recurrence within 2 years. Secondary outcomes included surgical morbidity, histopathologic stage, regression grade, completeness of resection, and cause-specific mortality. Log-rank analyses were by intention-to-treat. RESULTS Of 699 patients allocated to NAC, 674 (96%) started and 606 (87%) completed NAC. In total, 686 of 699 (98.1%) NAC patients and 351 of 354 (99.2%) control patients underwent surgery. Thirty patients (4.3%) allocated to NAC developed obstructive symptoms requiring expedited surgery, but there were fewer serious postoperative complications with NAC than with control. NAC produced marked T and N downstaging and histologic tumor regression (all P < .001). Resection was more often histopathologically complete: 94% (648/686) versus 89% (311/351), P < .001. Fewer NAC than control patients had residual or recurrent disease within 2 years (16.9% [118/699] v 21.5% [76/354]; rate ratio, 0.72 [95% CI, 0.54 to 0.98]; P = .037). Tumor regression correlated strongly with freedom from recurrence. Panitumumab did not enhance the benefit from NAC. Little benefit from NAC was seen in mismatch repair-deficient tumors. CONCLUSION Six weeks of preoperative oxaliplatin-fluoropyrimidine chemotherapy for operable colon cancer can be delivered safely, without increasing perioperative morbidity. This chemotherapy regimen, when given preoperatively, produces marked histopathologic down-staging, fewer incomplete resections, and better 2-year disease control. Histologic regression after NAC is a strong predictor of lower postoperative recurrence risk so has potential use as a guide for postoperative therapy. Six weeks of NAC should be considered as a treatment option for locally advanced colon cancer.
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Affiliation(s)
- Dion Morton
- University Hospital Birmingham, Birmingham, United Kingdom
| | | | - Laura Magill
- University of Birmingham Clinical Trials Unit, Birmingham, United Kingdom
| | - Kelly Handley
- University of Birmingham Clinical Trials Unit, Birmingham, United Kingdom
| | - James Glasbey
- University Hospital Birmingham, Birmingham, United Kingdom
| | | | - Andy Palmer
- University of Birmingham Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Keigo Murakami
- Division of Pathology and Data Analytics, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Nick West
- Division of Pathology and Data Analytics, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Philip Quirke
- Division of Pathology and Data Analytics, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Richard Gray
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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3
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Mönch D, Koch J, Maaß A, Janssen N, Mürdter T, Renner P, Fallier-Becker P, Solaß W, Schwab M, Dahlke MH, Schlitt HJ, Leibold T. A human ex vivo coculture model to investigate peritoneal metastasis and innovative treatment options. Pleura Peritoneum 2021; 6:121-129. [PMID: 34676285 PMCID: PMC8482451 DOI: 10.1515/pp-2021-0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives Peritoneal metastasis (PM) is commonly observed in patients with colorectal cancer (CRC). The outcome of these patients is poor, with an average survival of only six months without therapy, which requires a better understanding of PM biology and new treatment strategies. Methods We established and characterized a human ex vivo peritoneal model to investigate the mechanisms of peritoneal seeding and possible treatment options. For this, CRC cell lines and patient-derived tumor organoids were cultured together with human peritoneum to investigate the invasion of malignant cells and the effects of local chemotherapy. Results Fresh human peritoneum was cultured for up to three weeks in a stainless steel ring system, allowing for survival of all peritoneal structures. Peritoneal cell survival was documented by light microscopy and immunohistochemical staining. Further, immunohistological characterization of the tissue revealed CD3-positive T-lymphocytes and vimentin-positive fibroblasts within the peritoneum. In addition, extracellular matrix components (collagens, matrix metalloproteinases) were localized within the tissue. Coculture with CRC cell lines and patient-derived CRC organoids revealed that cancer cells grew on the peritoneum and migrated into the tissue. Coculture with CRC cells confirmed that hyperthermal treatment at 41 °C for 90 min significantly enhanced the intracellular entry of doxorubicin. Moreover, treatment with mitomycin C under hyperthermic conditions significantly reduced the amount of cancer cells within the peritoneum. Conclusions This human ex vivo peritoneal model provides a stringent and clinically relevant platform for the investigation of PM and for further elucidation of possible treatment options.
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Affiliation(s)
- Dina Mönch
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Jana Koch
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Annika Maaß
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Nicole Janssen
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Thomas Mürdter
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,University of Tübingen, Tübingen, Germany
| | - Philipp Renner
- Department of General and Visceral Surgery, Robert-Bosch-Hospital, Stuttgart, Germany.,University Medical Center Regensburg, Regensburg, Germany
| | | | - Wiebke Solaß
- Institute of Pathology, University of Tübingen, Tübingen, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany.,Departments of Clinical Pharmacology, Pharmacy, and Biochemistry, University of Tübingen, Tübingen, Germany
| | - Marc-H Dahlke
- Department of General and Visceral Surgery, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Hans J Schlitt
- University Medical Center Regensburg, Regensburg, Germany
| | - Tobias Leibold
- Department of General and Visceral Surgery, Robert-Bosch-Hospital, Stuttgart, Germany
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Jung F, Guidolin K, Lee MHY, Lam-Tin-Cheung K, Zhao G, Doshi S, Chesney T, Englesakis M, Lukovic J, O’Kane G, Quereshy FA, Chadi SA. Interventions and Outcomes for Neoadjuvant Treatment of T4 Colon Cancer: A Scoping Review. Curr Oncol 2021; 28:2065-2078. [PMID: 34072615 PMCID: PMC8261638 DOI: 10.3390/curroncol28030191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 01/27/2023] Open
Abstract
While adjuvant treatment of colon cancers that penetrate the serosa (T4) have been well-established, neoadjuvant strategies have yet to be formally evaluated. Our objective was to perform a scoping review of eligibility criteria, treatment regimens, and primary outcomes for neoadjuvant approaches to T4 colon cancer. A librarian-led, systematic search of MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL up to 11 February 2020 was performed. Primary research evaluating neoadjuvant treatment in T4 colon cancer were included. Screening and data abstraction were performed in duplicate; analyses were descriptive or thematic. A total of twenty studies were included, most of which were single-arm, single-center, and retrospective. The primary objectives of the literature to date has been to evaluate treatment feasibility, tumor response, disease-free survival, and overall survival in healthy patients. Conventional XELOX and FOLFOX chemotherapy were the most commonly administered interventions. Rationale for selecting a specific regimen and for treatment eligibility criteria were poorly documented across studies. The current literature on neoadjuvant strategies for T4 colon cancer is overrepresented by single-center, retrospective studies that evaluate treatment feasibility and efficacy in healthy patients. Future studies should prioritize evaluating clear selection criteria and rationale for specific neoadjuvant strategies. Validation of outcomes in multi-center, randomized trials for XELOX and FOLFOX have the most to contribute to the growing evidence for this poorly managed disease.
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Affiliation(s)
- Flora Jung
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (F.J.); (M.H.-Y.L.); (G.Z.)
| | - Keegan Guidolin
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
| | - Michael Ho-Yan Lee
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (F.J.); (M.H.-Y.L.); (G.Z.)
| | - Kimberley Lam-Tin-Cheung
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
| | - Grace Zhao
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (F.J.); (M.H.-Y.L.); (G.Z.)
| | - Sachin Doshi
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
| | - Tyler Chesney
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
- Department of Surgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Marina Englesakis
- Library and Information Services, University Health Network, Toronto, ON M5G 2C4, Canada;
| | - Jelena Lukovic
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada;
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Grainne O’Kane
- Princess Margaret Cancer Centre, Division of Medical Oncology, Toronto, ON M5G 2C1, Canada
| | - Fayez A. Quereshy
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
- Princess Margaret Cancer Centre, Division of Surgical Oncology, University Health Network, Toronto, ON M5G 2C1, Canada
| | - Sami A. Chadi
- Department of Surgery, University of Toronto, Toronto, ON M5T1P5, Canada; (K.G.); (K.L.-T.-C.); (S.D.); (T.C.); (F.A.Q.)
- Princess Margaret Cancer Centre, Division of Surgical Oncology, University Health Network, Toronto, ON M5G 2C1, Canada
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Body A, Prenen H, Latham S, Lam M, Tipping-Smith S, Raghunath A, Segelov E. The Role of Neoadjuvant Chemotherapy in Locally Advanced Colon Cancer. Cancer Manag Res 2021; 13:2567-2579. [PMID: 33762848 PMCID: PMC7982559 DOI: 10.2147/cmar.s262870] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/14/2021] [Indexed: 12/15/2022] Open
Abstract
Neoadjuvant systemic therapy has many potential advantages over up-front surgery, including tumor downstaging, early treatment of micrometastatic disease, and providing an in vivo test of tumor biology. Due to these advantages, neoadjuvant therapy is becoming the standard of care for an increasing number of tumor types. Currently, colon cancer patients are still routinely treated with up-front surgery, and neoadjuvant systemic therapy is not yet standard. Limitations to widespread use of neoadjuvant therapy have included inaccurate radiological staging, concerns about tumor progression while undergoing preoperative treatment rendering a patient incurable, and a lack of randomized data demonstrating benefit. However, there is great interest in neoadjuvant chemotherapy, and a number of trials are under way. Early follow up of the first phase III trial of neoadjuvant chemotherapy for colon cancer demonstrated tumor downstaging and suggested an improvement in disease-free survival with neoadjuvant chemotherapy, and it is hoped that this will translate into longer-term overall survival benefit. Clinicians should closely watch this developing field, consider the option of neoadjuvant chemotherapy for colon cancer patients, and actively seek out opportunities for their patients to participate in ongoing clinical trials to further inform this field in future.
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Affiliation(s)
- Amy Body
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia.,School of Clinical Sciences, Monash University, Clayton, Melbourne, VIC, Australia
| | - Hans Prenen
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia.,Oncology Department, University Hospital Antwerp, Antwerp, Belgium
| | - Sarah Latham
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia
| | - Marissa Lam
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia
| | | | - Ajay Raghunath
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia
| | - Eva Segelov
- Medical Oncology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia.,School of Clinical Sciences, Monash University, Clayton, Melbourne, VIC, Australia
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Al Dybiat I, Mirshahi S, Belalou M, Abdelhamid D, Shah S, Ullah M, Soria J, Pocard M, Mirshahi M. Injured tissues favor cancer cell implantation via fibrin deposits on scar zones. Neoplasia 2020; 22:809-819. [PMID: 33152619 PMCID: PMC7644810 DOI: 10.1016/j.neo.2020.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/23/2022]
Abstract
AIM Evaluation of fibrin role on cancer cells implantation in injured tissues and studying the molecular mechanism of cancer cell interaction with the peritoneal damage. MATERIAL AND METHODS Mouse colon cancer (CT26) and human mesothelial cells (HMCs) were used. CT26 cells were implanted on injured peritoneal zones. Icodextrin was used as a lubricant. For in vitro studies, fibrin clots from human plasma were used. The cell-fibrin interaction was observed by optical, electronic, and confocal microscopies. Aprotinin was used as a plasmin inhibitor. Hemostasis impact quantified by (1) the fibrin degradation product D-Dimer and PAR expression in HMCs; (2) the expression of plasminogen activator (PA) and its inhibitor (PAI-1) in cancer cells by qPCR and in supernatants through ELISA after in vitro HMC incubation with 2U of thrombin for 24 h. RESULTS (i) Cancer cell lines were adhered and implanted into the wound area in vivo in both the incision and peeling zones of the peritoneum and on the fibrin network in vitro. (ii) Icodextrin significantly inhibited cancer nodule formation in the scar and the incision or peritoneal damaged zones after surgery. (iii) In in vitro studies, cancer cell interaction with the fibrin clot generated a lysed area, causing an increase in plasmin-dependent fibrinolysis measured by D-dimer levels in the supernatants that was inhibited by aprotinin. (iv) Aprotinin inhibited cell-fibrin interaction and invasion. (v) Thrombin upregulates PAI-1 and downregulates PA expression in HMC. CONCLUSION Injured tissues favor cancer cell implantation through generated fibrin. Fibrin-cancer cells adhesion can be inhibited by icodextrin.
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Key Words
- ct26, mouse colon cancer cell line
- hmcs, human mesothelial cells
- pa, plasminogen activator
- pai-1, plasminogen activator inhibitor
- par, protease-activated receptors
- qpcr, quantitative polymerase chain reaction
- elisa, enzyme-linked immunosorbent assay
- dmem, dulbecco's modified eagle medium
- atcc, american type culture collection
- pbs, phosphate-buffered saline
- pci, peritoneal cancer index
- sem, scanning electron microscope
- pfa, paraformaldehyde
- nets, neutrophil extracellular traps
- upa, urokinase plasminogen activator
- tpa, tissue plasminogen activator
- ctrl, control
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Affiliation(s)
- Iman Al Dybiat
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France.
| | | | - Meriem Belalou
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Djedjiga Abdelhamid
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Shahid Shah
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Matti Ullah
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France
| | - Jeannette Soria
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France.
| | - Marc Pocard
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France.
| | - Massoud Mirshahi
- CAP-Paris Tech, INSERM U1275, Université de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France.
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Nomura M, Takahashi H, Fujii M, Miyoshi N, Haraguchi N, Hata T, Matsuda C, Yamamoto H, Mizushima T, Mori M, Doki Y. Clinical significance of invasion distance relative to prognosis in pathological T3 colorectal cancer. Oncol Lett 2019; 18:5614-5620. [PMID: 31620203 DOI: 10.3892/ol.2019.10913] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 07/12/2019] [Indexed: 12/14/2022] Open
Abstract
The T3 subdivision has been reported to predict prognosis in rectal cancer. However, few studies describe a correlation between T3 subdivision and prognosis in colon cancer. The current study aimed validate the correlation between the invasion distance (ID) beyond the muscularis propria and prognosis in colorectal cancer. The present retrospective study included 148 consecutive patients with pathologically confirmed T3 colorectal cancer, who underwent resection between January 2008 and October 2012. T3 stage was subdivided based on ID: T3a, ID<1 mm; T3b, ID=1-5 mm; and T3c, ID>5 mm. Statistical analyses were performed to evaluate correlations between T3 subdivision groups (T3a + T3b versus T3c) and clinicopathological factors. Compared with the T3a + T3b group, the T3c group exhibited worse 3-year RFS (P=0.003) and 5-year CSS (P=0.006). Multivariate analysis demonstrated that 3-year RFS was significantly correlated with sex (P=0.03) and ID (P=0.02), and 5-year CSS was significantly correlated with lymphoid dissection number (P=0.02) and ID (P=0.03). A ROC curve was constructed using ID values and recurrence data, and the area under the curve was 0.63. These data revealed that ID beyond the muscularis propria was significantly associated with prognosis in T3 colorectal cancer.
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Affiliation(s)
- Masatoshi Nomura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Makoto Fujii
- Division of Health Sciences, Department of Molecular Biochemistry & Clinical Investigation, Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Norikatsu Miyoshi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Naotsugu Haraguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Taishi Hata
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Chu Matsuda
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan.,Division of Health Sciences, Department of Molecular Pathology, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
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8
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Liu F, Tong T, Huang D, Yuan W, Li D, Lin J, Cai S, Xu Y, Chen W, Sun Y, Zhuang J. CapeOX perioperative chemotherapy versus postoperative chemotherapy for locally advanced resectable colon cancer: protocol for a two-period randomised controlled phase III trial. BMJ Open 2019; 9:e017637. [PMID: 30700474 PMCID: PMC6352769 DOI: 10.1136/bmjopen-2017-017637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Adjuvant chemotherapy with the CapeOX regimen is now widely used for treating colorectal cancer. However, prior studies have demonstrated better efficacy of pre-operative/neoadjuvant chemotherapy without increase of safety risks. METHODS AND ANALYSIS This multicentre, open-label, parallel-group, randomised, controlled, phase III study aims to compare the efficacy and safety of perioperative CapeOX chemotherapy with the postoperative one for treating patients with locally advanced R0 resectable colon cancers in China. In total 1370 eligible patients will be randomised to: the test group, up to four cycles (every 3 weeks is a cycle, Q3W) of chemotherapy plus radical surgery plus up to four cycles of post-operative chemotherapy; or the control group, radical surgery first, then up to eight cycles of chemotherapy. In each cycle, oxaliplatin will be given at a dose of 130 mg/m2 through continuous IV infusion for 2 hours on the first day. From day 1 to day 14, capecitabine will be taken orally every morning and evening at a dose of 1000mg/m2/d. The primary outcome measure is the 3-year disease free survival. The objective response rate, R0 resection rate, overall survival, as well as the adverse events will also be measured as second endpoints. The study may include two periods. If results of period 1 are not favourable, period 2 will be initiated, recruiting genetically sensitive patients and repeating the same process with period 1. ETHICS AND DISSEMINATION Informed consent will be required from, and provided, by all subjects. The study protocol has been approved by the independent ethics committee of Shanghai Fudan University Cancer Centre. This study will clearly demonstrate the potential benefit of perioperative chemotherapy with the CapeOX regimen. Results will be shared among all the participating centres, and with policymakers and the academic community to promote the clinical management of colon cancer. TRIAL REGISTRATION NUMBER NCT03125980.
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Affiliation(s)
- Fangqi Liu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China
- Department Of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tong Tong
- Department Of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Radiology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Dan Huang
- Department Of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Centre, Shanghai, China
| | - Weitang Yuan
- Department of Anorectal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dechuan Li
- Department of Colorectal Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
| | - Jianjiang Lin
- Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China
- Department Of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ye Xu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Centre, Shanghai, China
- Department Of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenbin Chen
- Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Yueming Sun
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Zhuang
- Department of General Surgery, Zhengzhou University Cancer Hospital, Zhengzhou, China
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Cienfuegos JA, Baixauli J, Beorlegui C, Ortega PM, Granero L, Zozaya G, Hernández Lizoáin JL. The impact of major postoperative complications on long-term outcomes following curative resection of colon cancer. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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10
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Cytoreductive Surgery and HIPEC in the First-Line and Interval Time Points of Advanced Epithelial Ovarian Cancer. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2017. [DOI: 10.1007/s40944-017-0148-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Lemoine L, Sugarbaker P, Van der Speeten K. Pathophysiology of colorectal peritoneal carcinomatosis: Role of the peritoneum. World J Gastroenterol 2016; 22:7692-7707. [PMID: 27678351 PMCID: PMC5016368 DOI: 10.3748/wjg.v22.i34.7692] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/28/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer-related death worldwide. Besides the lymphatic and haematogenous routes of dissemination, CRC frequently gives rise to transcoelomic spread of tumor cells in the peritoneal cavity, which ultimately leads to peritoneal carcinomatosis (PC). PC is associated with a poor prognosis and bad quality of life for these patients in their terminal stages of disease. A loco-regional treatment modality for PC combining cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy has resulted in promising clinical results. However, this novel approach is associated with significant morbidity and mortality. A comprehensive understanding of the molecular events involved in peritoneal disease spread is paramount in avoiding unnecessary toxicity. The emergence of PC is the result of a molecular crosstalk between cancer cells and host elements, involving several well-defined steps, together known as the peritoneal metastatic cascade. Individual or clumps of tumor cells detach from the primary tumor, gain access to the peritoneal cavity and become susceptible to the regular peritoneal transport. They attach to the distant peritoneum, subsequently invade the subperitoneal space, where angiogenesis sustains proliferation and enables further metastatic growth. These molecular events are not isolated events but rather a continuous and interdependent process. In this manuscript, we review current data regarding the molecular mechanisms underlying the development of colorectal PC, with a special focus on the peritoneum and the role of the surgeon in peritoneal disease spread.
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Gremonprez F, Willaert W, Ceelen W. Animal models of colorectal peritoneal metastasis. Pleura Peritoneum 2016; 1:23-43. [PMID: 30911606 DOI: 10.1515/pp-2016-0006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 03/04/2016] [Indexed: 12/13/2022] Open
Abstract
Colorectal cancer remains an important cause of mortality worldwide. The presence of peritoneal carcinomatosis (PC) causes significant symptoms and is notoriously difficult to treat. Therefore, informative preclinical research into the mechanisms and possible novel treatment options of colorectal PC is essential in order to improve the prognostic outlook in these patients. Several syngeneic and xenograft animal models of colorectal PC were established, studying a wide range of experimental procedures and substances. Regrettably, more sophisticated models such as those giving rise to spontaneous PC or involving genetically engineered mice are lacking. Here, we provide an overview of all reported colorectal PC animal models and briefly discuss their use, strengths, and limitations.
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Affiliation(s)
- Félix Gremonprez
- Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium
| | - Wouter Willaert
- Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium
| | - Wim Ceelen
- Department of Gastrointestinal Surgery, Ghent University Hospital, 2K12 IC UZ Gent De Pintelaan 185, 9000 Ghent, Belgium
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Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, Le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer 2015; 15:511. [PMID: 26156156 PMCID: PMC4497499 DOI: 10.1186/s12885-015-1507-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 06/19/2015] [Indexed: 02/08/2023] Open
Abstract
Background In patients with high risk stage II and stage III colon cancer (CC), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 20 to 30 % of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for these CCs and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery. Methods/Design PRODIGE 22 - ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy and feasibility of two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4 + Cetuximab) in a peri-operative strategy in patients with bulky CCs. Patients with CC deemed as high risk T3, T4 and/or N2 on initial abdominopelvic CT scan are randomized to either colectomy and adjuvant chemotherapy (control arm), or 4 cycles of neoadjuvant chemotherapy with FOLFOX-4 (for RAS mutated patients). In RAS wild-type patients a third arm testing FOLFOX+ cetuximab has been added prior to colectomy. Patients in the neoadjuvant chemotherapy arms will receive postoperative treatment for 4 months (8 cycles) to complete their therapeutic schedule. The primary endpoint of the study is the histological Tumor Regression Grade (TRG) as defined by Ryan. The secondary endpoints are: treatment strategy safety (toxicity, primary tumor related complications under chemotherapy, peri-operative morbidity), disease-free and recurrence free survivals at 3 years, quality of life, carcinologic quality and completeness of the surgery, initial radiological staging and radiological response to neoadjuvant chemotherapy, and the correlation between histopathological and radiological response. Taking into account a 50 % prevalence of CC without RAS mutation, accrual of 165 patients is needed for this Phase II trial. Trial Registration NCT01675999 (ClinicalTrials.gov)
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Affiliation(s)
- Mehdi Karoui
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, University Institute of Cancerology (Paris VI), Pierre & Marie Curie University (Paris VI), 47-83 Boulevard de l'Hôpital, 75013, Paris, France. .,FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Anne Rullier
- Department of Pathology, Pellegrin University Hospital, Bordeaux, France.
| | - Alain Luciani
- Assistance Publique-Hôpitaux de Paris, Department of Radiology, Henri Mondor University Hospital, Paris XII university, Créteil, France.
| | - Franck Bonnetain
- Department of Medical Oncology and public health, Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France.
| | - Marie-Luce Auriault
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Antony Sarran
- Department of Radiology, Institut Paoli Calmettes, Marseille, France.
| | - Geneviève Monges
- Department of Pathology, Institut Paoli Calmettes, Marseille, France.
| | - Hervé Trillaud
- Department of Radiology, St André University Hospital, Bordeaux, France.
| | - Karine Le Malicot
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Karen Leroy
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Iradj Sobhani
- Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Henri Mondor University Hospital, Créteil, France.
| | - Armelle Bardier
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Pitié-Salpêtrière University Hospital, Paris, France.
| | - Marie Moreau
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Isabelle Brindel
- Assistance Publique-Hôpitaux de Paris, Département de la Recherche Clinique et du Développement (DRCD), Paris, France.
| | | | - Julien Taieb
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France. .,Assistance Publique-Hôpitaux de Paris, Department of Digestive Oncology, European Georges Pompidou - Paris Descartes University, Paris, France.
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Gao D, Li S. Stimuli-induced organ-specific injury enhancement of organotropic metastasis in a spatiotemporal regulation. Pathol Oncol Res 2013; 20:27-42. [PMID: 24357158 DOI: 10.1007/s12253-013-9734-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 12/05/2013] [Indexed: 12/11/2022]
Abstract
The relationship between inflammation and tumorigenesis has been established. Recently, inflammation is also reported to be a drive force for cancer metastasis. Further evidences show that various stimuli directly induced-injury in a specific organ can also promote metastasis in this organ, which include epidemiological reports, clinical series and experimental studies. Each type of cancer has preferential sites for metastasis, which is also due to inflammatory factors that are released by primary cancer to act on these sites and indirectly induce injuries on them. Host factors such as stress,fever can also influence distant metastasis in a specific site through stimulation of immune and inflammatory effects. The five aspects support an idea that specific-organ injury directly induced by various stimuli or indirectly induced by primary tumor or host factors activation of proinflammatory modulators can promote metastasis in this organ through a spatiotemporal regulation, which has important implications for personalized prediction, prevention and management of cancer metastasis.
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Affiliation(s)
- Dongwei Gao
- , 536 Hospital of PLA, 29# Xiadu street, Xining, 810007, Qinghai Province, People's Republic of China,
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Gao D, Li S. Biological resonance for cancer metastasis, a new hypothesis based on comparisons between primary cancers and metastases. CANCER MICROENVIRONMENT : OFFICIAL JOURNAL OF THE INTERNATIONAL CANCER MICROENVIRONMENT SOCIETY 2013; 6:213-30. [PMID: 24214411 PMCID: PMC3855372 DOI: 10.1007/s12307-013-0138-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 10/22/2013] [Indexed: 12/11/2022]
Abstract
Many hypotheses have been proposed to try to explain cancer metastasis. However, they seem to be contradictory and have some limitations. Comparisons of primary tumors and matched metastases provide new insight into metastasis. The results show high concordances and minor differences at multiple scales from organic level to molecular level. The concordances reflect the commonality between primary cancer and metastasis, and also mean that metastatic cancer cells derived from primary cancer are quite conservative in distant sites. The differences reflect variation that cancer cells must acquire new traits to adapt to foreign milieu during the course of evolving into a new tumor in second organs. These comparisons also provided new information on understanding mechanism of vascular metastasis, organ-specific metastasis, and tumor dormancy. The collective results suggest a new hypothesis, biological resonance (bio-resonance) model. The hypothesis has two aspects. One is that primary cancer and matched metastasis have a common progenitor. The other is that both ancestors of primary cancer cells and metastatic cancer cells are under similar microenvironments and receive similar or same signals. When their interactions reach a status similar to primary cancer, metastasis will occur. Compared with previous hypotheses, the bio-resonance hypothesis seems to be more applicable for cancer metastasis to explain how, when and where metastasis occurs. Thus, it has important implications for individual prediction, prevention and treatment of cancer metastasis.
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Affiliation(s)
- Dongwei Gao
- 536 Hospital of PLA, 29# Xiadu street, Xining, 810007, Qinghai Province, People's Republic of China,
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Colmont CS, Harding KG, Piguet V, Patel GK. Human skin cancer stem cells: a tale of mice and men. Exp Dermatol 2012; 21:576-80. [PMID: 22775992 DOI: 10.1111/j.1600-0625.2012.01533.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Carcinomas, cancers of epithelial tissues, are the commonest malignancies and cause the greatest cancer mortality worldwide. Among these, the incidence of keratinocyte-derived non-melanoma skin cancers (NMSC), by far the greatest, is increasing rapidly. Yet despite access to tumor tissue, acceptance of human NMSC as a model carcinoma has been hindered by the lack of a reliable xenograft model. Instead, we have relied on the murine two-step carcinogenesis protocol as a reproducible squamous cell carcinoma (SCC) model, but this differs from their human counterpart in cause, site, genetic basis and biological behaviour. By xeno-engraftment of primary human SCC, we were recently successful in demonstrating the presence of primary human SCC cancer stem cells or tumor-initiating cells. These findings once more align the study human SCC as the archetypal carcinoma model. In this review, we describe the evidence for the existence of tumor-initiating cells, with emphasis on skin cancer, limiting our discussions to primary human cancer studies where possible.
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Affiliation(s)
- Chantal S Colmont
- Department of Dermatology and Wound Healing, School of Medicine Cardiff University, Cardiff, UK
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Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol 2012; 13:1152-60. [PMID: 23017669 PMCID: PMC3488188 DOI: 10.1016/s1470-2045(12)70348-0] [Citation(s) in RCA: 342] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Preoperative (neoadjuvant) chemotherapy and radiotherapy are more effective than similar postoperative treatment for oesophageal, gastric, and rectal cancers, perhaps because of more effective micrometastasis eradication and reduced risk of incomplete excision and tumour cell shedding during surgery. The FOxTROT trial aims to investigate the feasibility, safety, and efficacy of preoperative chemotherapy for colon cancer. Methods In the pilot stage of this randomised controlled trial, 150 patients with radiologically staged locally advanced (T3 with ≥5 mm invasion beyond the muscularis propria or T4) tumours from 35 UK centres were randomly assigned (2:1) to preoperative (three cycles of OxMdG [oxaliplatin 85 mg/m2, l-folinic acid 175 mg, fluorouracil 400 mg/m2 bolus, then 2400 mg/m2 by 46 h infusion] repeated at 2-weekly intervals followed by surgery and a further nine cycles of OxMdG) or standard postoperative chemotherapy (12 cycles of OxMdG). Patients with KRAS wild-type tumours were randomly assigned (1:1) to receive panitumumab (6 mg/kg; every 2 weeks with the first 6 weeks of chemotherapy) or not. Treatment allocation was through a central randomisation service using a minimised randomisation procedure including age, radiological T and N stage, site of tumour, and presence of defunctioning colostomy as stratification variables. Primary outcome measures of the pilot phase were feasibility, safety, and tolerance of preoperative therapy, and accuracy of radiological staging. Analysis was by intention to treat. This trial is registered, number ISRCTN 87163246. Findings 96% (95 of 99) of patients started and 89% (85 of 95) completed preoperative chemotherapy with grade 3–4 gastrointestinal toxicity in 7% (seven of 94) of patients. All 99 tumours in the preoperative group were resected, with no significant differences in postoperative morbidity between the preoperative and control groups: 14% (14 of 99) versus 12% (six of 51) had complications prolonging hospital stay (p=0·81). 98% (50 of 51) of postoperative chemotherapy patients had T3 or more advanced tumours confirmed at post-resection pathology compared with 91% (90 of 99) of patients following preoperative chemotherapy (p=0·10). Preoperative therapy resulted in significant downstaging of TNM5 compared with the postoperative group (p=0·04), including two pathological complete responses, apical node involvement (1% [one of 98] vs 20% [ten of 50], p<0·0001), resection margin involvement (4% [four of 99] vs 20% [ten of 50], p=0·002), and blinded centrally scored tumour regression grading: 31% (29 of 94) vs 2% (one of 46) moderate or greater regression (p=0·0001). Interpretation Preoperative chemotherapy for radiologically staged, locally advanced operable primary colon cancer is feasible with acceptable toxicity and perioperative morbidity. Proceeding to the phase 3 trial, to establish whether the encouraging pathological responses seen with preoperative therapy translates into improved long-term oncological outcome, is appropriate. Funding Cancer Research UK.
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Patel GK, Yee CL, Yuspa SH, Vogel JC. A humanized stromal bed is required for engraftment of isolated human primary squamous cell carcinoma cells in immunocompromised mice. J Invest Dermatol 2011; 132:284-90. [PMID: 21975825 PMCID: PMC3253324 DOI: 10.1038/jid.2011.284] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Epithelial cancers are the most common malignancies and the greatest cause of cancer mortality worldwide. The incidence of keratinocyte-derived (non-melanoma) skin cancers (NMSCa) is increasing rapidly. Despite access to abundant tumor tissue and ease of observation, acceptance of NMSCa as model carcinomas has been hindered by the lack of a reliable xenograft model. Herein we describe conditions that allow routine xenoengraftment of primary human squamous cell carcinoma (SCCa) cells. Tumor development required creation of an appropriate stromal bed prior to xenografting tumor tissue onto the backs of athymic nude mice. We also demonstrate that the stromal bed must be “humanized” if primary human SCCa is to be propagated from cell suspensions. SCCa xenografts recapitulated the histological grade and phenotype of the original tumors with considerable fidelity, even after serial passage, irrespective of the histological grade of the primary human SCCa. To our knowledge this previously unreported model can be used for drug testing, as well as for studies that are relevant to the biology of primary human SCCa and other epithelial cancers.
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Affiliation(s)
- Girish K Patel
- Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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Currall VA, Dixon JH. Synovial metastasis: an unusual cause of pain after total knee arthroplasty. J Arthroplasty 2008; 23:631-6. [PMID: 18514889 DOI: 10.1016/j.arth.2007.04.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Revised: 01/22/2007] [Accepted: 04/18/2007] [Indexed: 02/01/2023] Open
Abstract
There is only 1 previous report of synovial metastasis to a joint that has been replaced. A 73-year-old man presented for investigation of continuing pain after a left total knee arthroplasty with normal plain radiographs. Synovial biopsy revealed metastatic adenocarcinoma of colorectal type. A barium enema and flexible sigmoidoscopy showed a suspicious lesion at the rectosigmoid junction. The knee is the most frequently affected joint, and the lung is the most common primary site for synovial metastasis. This phenomenon should be considered in the differential diagnosis of continuing pain and effusion postarthroplasty.
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Affiliation(s)
- Verity A Currall
- Department of Orthopaedics, Bristol Royal Infirmary, Bristol, United Kingdom
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Allendorf J. Oncologic Impact of Surgery in the Early Postoperative Period. SEMINARS IN COLON AND RECTAL SURGERY 2007. [DOI: 10.1053/j.scrs.2007.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Brokelman WJA, Holmdahl L, Bergström M, Falk P, Klinkenbijl JHG, Klinkonbijl JHG, Reijnen MMPJ, Reijnen MMPJ. Peritoneal transforming growth factor beta-1 expression during laparoscopic surgery: a clinical trial. Surg Endosc 2007; 21:1537-41. [PMID: 17332965 DOI: 10.1007/s00464-006-9164-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 09/27/2006] [Accepted: 10/01/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Transforming growth factor-beta 1 (TGF-beta1) is a growth factor involved in various biologic processes, including peritoneal wound healing and dissemination of malignancies. Laparoscopic surgery is evolving rapidly, and indications are increasing. The peritoneal TGF-beta1 expression during laparoscopic surgery is unknown. METHODS For this study, 50 patients scheduled for laparoscopic cholecystectomy were randomized into five groups, then surgically treated with various pressures, light intensities, and dissection devices. Peritoneal biopsies were taken at the beginning and end of surgery. Tissue concentrations of total and active TGF-beta1 were measured using enzyme-linked immunosorbent assay (ELISA) techniques. RESULTS There was no significant difference in either total or active TGF-beta1 concentration between peritoneal biopsies taken at the start of surgery and samples taken at the end of the procedure. Patients who underwent surgery with the ultrasonic scalpel had significant lower levels of both active (p < 0.005) and total (p < 0.01) TGF-beta1 at the end of surgery than patients treated with electrocautery. Patients who had surgery with a high light intensity had significantly lower levels of total TGF-beta1 levels (p < 0.005) with an unchanged active part than patients who had surgery with low light intensity. CONCLUSION The choice of dissection device and the light intensity used in laparoscopic surgery affect peritoneal TGF-beta1 concentrations, indicating that peritoneal biology can be affected by laparoscopic surgery. Because TGF-beta1 is involved in various biologic processes in the peritoneal cavity, this observation may have important clinical consequences.
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Affiliation(s)
- Walter J A Brokelman
- Department of Surgery, Alysis Zorggroep, Locatie Rijnstate Wagnerlaan, 55 6815 AD, Arnhem, The Netherlands.
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De Simone P, Carrai P, Morelli L, Coletti L, Petruccelli S, Filipponi F, Doria R, Menichetti F, Vannozzi R. Posttransplant hepatocellular carcinoma metastasis at a skull trauma site. Transplantation 2005; 80:1358-1359. [PMID: 16314812 DOI: 10.1097/01.tp.0000179155.90423.dc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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