International Journal of Colorectal Disease最新文献

{"title":"The bidirectional association between hemorrhoidal disease and varicose veins: a nationwide population-based cohort study.","authors":"Meng-Lin Lee, Yi-Wei Kao, Yu-Ting Yang, Ming-Chih Chen, Ben-Chang Shia, Shih-Yu Huang, Pei-Shyuan Lee, Thay-Hsiung Chen, Yan-Jiun Huang, Wei-Che Chiu","doi":"10.1007/s00384-025-04889-8","DOIUrl":"https://doi.org/10.1007/s00384-025-04889-8","url":null,"abstract":"<p><strong>Purpose: </strong>Hemorrhoidal disease (HD) and varicose veins (VV) are both common diseases. The aim was to investigate the association between them.</p><p><strong>Methods: </strong>A nationwide cohort study was conducted using the Taiwan National Health Insurance Research Database (NHIRD) from 2005 to 2021, which included information of over 31 million beneficiaries. To assess the risk of developing VV among HD patients, records of 832,310 patients with HD diagnoses (the HD cohort) and those of propensity score-matched patients without HD diagnoses (the non-HD cohort) were identified and compared. Hazard ratios (HRs) and 95% confidence intervals (CIs) derived from the Cox proportional hazards model were used to estimate the association risks. Similarly, an opposite direction was approached using records of 112,027 patients with VV diagnoses (the VV cohort) to assess the risk of developing HD among VV patients.</p><p><strong>Results: </strong>HD was associated with an increased risk of VV (adjusted HR, 1.52; 95% CI: 1.47-1.57). Similarly, VV were associated with an increased risk of HD (adjusted HR, 1.50; 95% CI: 1.45-1.55). The associations between the two diseases were evident in both sexes and all age groups. Patients with comorbid HD and VV had higher incidences of mitral valve regurgitation (P < 0.001), hernia (P < 0.001), varicocele (P = 0.008), and mortality (P = 0.006).</p><p><strong>Conclusion: </strong>This study revealed a significant bidirectional association between HD and VV. It is recommended that physicians be mindful of either condition in patients already diagnosed with the other, as their coexistence could imply the potential for additional associated connective tissue diseases and adverse long-term outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"91"},"PeriodicalIF":2.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes for intracorporeal vs. extracorporeal anastomosis in laparoscopic right hemicolectomy for colonic cancer-a prospective cohort study (ICEA-study).","authors":"Emilie Schultz Hougaard, Benedicte Schelde-Olesen, Issam Al-Najami, Thomas Buchbjerg, Benjamin Schnack Brandt Rasmussen, Lasse Bugge, Thomas Kolbro, Sören Möller, Mark Bremholm Ellebæk","doi":"10.1007/s00384-025-04882-1","DOIUrl":"10.1007/s00384-025-04882-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare short-term outcomes and 1-year incisional hernia rates between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right hemicolectomy for management of right-sided colonic cancer. The primary outcome was the complication rate assessed by the comprehensive complication index (CCI). Secondary outcomes included time to bowel movement, length of hospital stay, 30-day readmission rate, early warning scores, and 1-year incisional hernia rate.</p><p><strong>Method: </strong>This was a single-center, prospective cohort study. Patients with right-sided colonic cancer eligible for laparoscopic surgery with primary anastomosis were consecutively included. Patients included in the first period underwent EA, while those in the second underwent IA. Clinical data were collected during the hospital admission up to 30 days postoperatively. Complications were evaluated by the CCI. A routine 1-year CT-scan was used to assess hernias.</p><p><strong>Results: </strong>One hundred three patients (51 in the EA and 52 in the IA groups) were included. Demographics were similar between the two groups. No significant difference in the CCI-score was found (EA: 17.9 (23.9) vs. IA: 15.0 (17.4), p = 0.85). The mean length of hospital stay was significantly shorter in the IA group (EA 6.6 days, IA 3.9 days, p = 0.02). The groups had no significant differences regarding other outcomes, including hernia rates (p = 0.12).</p><p><strong>Conclusion: </strong>Laparoscopic right hemicolectomy with IA significantly reduced the length of hospital stay without increasing complication rates compared to EA.</p><p><strong>Trial registration: </strong>The study is registered at ClinicalTrials.gov (NCT05039762).</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"90"},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholangioscope-assisted ERAT for the diagnoses and treatment of ulcerative colitis with appendiceal orifice inflammation: a case report and a literature review.","authors":"Pan Gong, Xujia Wu, Rengyun Xiang, Yang Yu, Xia Peng, Xuefeng Li","doi":"10.1007/s00384-025-04884-z","DOIUrl":"10.1007/s00384-025-04884-z","url":null,"abstract":"<p><strong>Purpose: </strong>Ulcerative colitis (UC) is a chronic, nonspecific inflammatory bowel disease primarily affecting the colorectal mucosa. The disease is characterized by a relapsing-remitting course and is currently incurable. Its pathogenesis is multifactorial, involving genetic predisposition, environmental triggers, immune dysregulation, and alterations in gut microbiota. The appendix plays a role in modulating intestinal immunity and maintaining microbial homeostasis. Left-sided colitis with appendiceal orifice inflammation (AOI) or periappendiceal erythematous patch (PARP) is a common endoscopic finding in UC. However, whether AOI in UC patients requires intervention remains debated.</p><p><strong>Methods: </strong>Here, we report a rare case of a UC with AOI.</p><p><strong>Results: </strong>By means of cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT), copious purulent secretions were discovered and flushed out of the appendiceal cavity, resulting in clinical remission and endoscopic mucosal healing of UC.</p><p><strong>Conclusion: </strong>Our case indicates that there may be some correlation between the appendix and the pathogenesis of ulcerative colitis. For refractory left-sided UC patients with AOI, ERAT-based management of appendiceal lumen inflammation may benefit patients.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"89"},"PeriodicalIF":2.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obsidian®ASG in anastomotic healing after rectal cancer resection-OBANORES: a prospective clinical feasibility study.","authors":"Thomas Nikolas Valsamidis, Anders Tøttrup, Ken Ljungmann, Tue Højslev Avlund, Sanne Harsløf, Charlotte Buchard, Lene Hjerrild Iversen","doi":"10.1007/s00384-025-04881-2","DOIUrl":"10.1007/s00384-025-04881-2","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leakage following rectal cancer resection is a serious complication. Despite efforts to prevent it, the risk remains high. Obsidian®ASG, an AUTOLOGOUS fibrin matrix with thrombocytes derived from the patient's blood, shows promise but has not been thoroughly tested in rectal anastomosis. The aim of this study was to assess the feasibility of using Obsidian®ASG as a supplement in rectal anastomosis creation during minimally invasive rectal cancer resection.</p><p><strong>Methods: </strong>This prospective IDEAL stage 2a development cohort study included 50 patients undergoing rectal cancer resection with anastomosis using minimally invasive surgery at Aarhus University Hospital, Denmark. Obsidian®ASG application was assessed using a predefined rating scale: \"Complete\" (applied in all three prescribed steps), \"Almost complete\" (applied in at least the first or second step), and \"Incomplete\" (all others). Feasibility required \"Complete\" or \"Almost complete\" application in at least 90% of patients.</p><p><strong>Results: </strong>Obsidian®ASG application was \"Complete\" in 15 cases (30%) and \"Almost complete\" in 35 cases (70%), meeting feasibility criteria in all patients. No \"Incomplete\" applications occurred. Difficulties in achieving \"Complete\" application included anatomical constraints, material depletion, machine error, and time constraints.</p><p><strong>Conclusion: </strong>Obsidian®ASG was successfully applied in all patients undergoing minimally invasive rectal cancer surgery. These findings suggest its feasibility, but further large-scale, multi-center randomized trials are needed to fully assess its potential benefits for patient outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"87"},"PeriodicalIF":2.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between colonic diverticulosis and colorectal polyps in a retrospective cohort study.","authors":"Saygın Altıner, Yunushan Furkan Aydoğdu, Koray Kosmaz, Abdullah Durhan, Abdullah Senlikci, Marlen Suleyman, Can Ersak, Mevlüt Recep Pekcici","doi":"10.1007/s00384-025-04866-1","DOIUrl":"10.1007/s00384-025-04866-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between colonic diverticulosis, colorectal polyps, and colorectal cancer.</p><p><strong>Material and methods: </strong>A total of 648 patients (275 females, 373 males) who underwent complete colonoscopy between January 2016 and June 2020 were retrospectively analyzed. The presence and localization of diverticula, polyps, and cancer were recorded, and the association between diverticular disease and the formation of polyps and cancer was evaluated.</p><p><strong>Results: </strong>Diverticula were identified in 53 patients (8.2%), while 595 patients (91.8%) had no diverticula. Polyps were detected in 148 patients (22.8%), and no polyps were found in 500 patients (77.2%). Adenocarcinoma was diagnosed in 67 patients (10.3%), with no malignancy observed in 581 patients (89.7%). The mean age of patients with polyps was 59.5 years, compared to 53.3 years in those without polyps (p < 0.001). Multivariate logistic regression analysis revealed that diverticulum status did not significantly influence the risk of polyp formation, whereas advanced age was identified as a significant risk factor (p < 0.001).</p><p><strong>Conclusion: </strong>Advanced age is a significant risk factor for colorectal polyp formation, whereas diverticulosis is not an independent risk factor. These findings highlight the importance of age-based screening strategies for colorectal neoplasia.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"88"},"PeriodicalIF":2.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and long-term outcomes of minimally invasive vs. open pelvic exenteration in rectal tumours: a focused meta-analysis.","authors":"Yu-Jen Hsu, Zhen-Hao Yu, Bor-Kang Jong, Jeng-Fu You, Yen-Lin Yu, Chun-Kai Liao, Cheng-Chou Lai, Yih-Jong Chern","doi":"10.1007/s00384-025-04876-z","DOIUrl":"10.1007/s00384-025-04876-z","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic exenteration (PE) is a complex surgical procedure used to treat patients with recurrent or locally advanced rectal cancer (LARC) as a final recourse. Thus, minimally invasive surgery (MIS) has emerged as an alternative to the traditional open PE as it may reduce surgical trauma and improve recovery. This meta-analysis compared the clinical outcomes between MIS and open PE in patients with LARC.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA and AMSTAR guidelines. Six retrospective studies comprising 368 patients (179 MIS patients; 189 open patients) were included. Data on operative parameters along with short-term and long-term outcomes, including the 3-year overall (OS) and disease-free survival (DFS), were extracted. Risk ratios (RRs) and odds ratios (ORs) were calculated for binary outcomes, while standardised mean differences (SMDs) were calculated for continuous outcomes. All measures were reported with 95% confidence intervals (CIs) using random-effects models.</p><p><strong>Results: </strong>MIS was associated with significantly reduced blood loss (standardised mean difference (SMD), - 1.57; 95% CI, - 2.27 to - 0.88; p < 0.00001), shorter hospital stays (SMD, - 6.46; 95% CI, - 12.21 to - 0.71; p = 0.03), and quicker diet resumption (SMD: - 0.79; 95% CI, - 1.36 to - 0.21; p = 0.008) than open PE. MIS was associated with a borderline reduction in total complications (OR, 0.45; 95% CI, 0.20-1.00; p = 0.05) and lower rates of abdominal wound complications (OR, 0.22; 95% CI, 0.11 to 0.45; p < 0.0001). No significant differences were observed in R0 resection rates, major complications, or mortality. For long-term outcomes, MIS demonstrated significantly improved 3-year OS (RR, 1.19; 95% CI, 1.01 to 1.41; p = 0.04), whereas 3-year DFS showed no significant difference (RR, 1.02; 95% CI, 0.79 to 1.41; p = 0.87).</p><p><strong>Conclusion: </strong>MIS offers significant short-term advantages over open PE, including reduced blood loss, faster recovery, and fewer complications while demonstrating improved 3-year OS. These findings support MIS PE as a safe, effective, and viable option for patients with recurrent or LARC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"86"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Adherence to multi‑target stool DNA testing for colorectal cancer screening in the United States.","authors":"Quang A Le, Mallik Greene, Shrey Gohil, A Burak Ozbay, Michael Dore, A Mark Fendrick, Paul Limburg","doi":"10.1007/s00384-025-04880-3","DOIUrl":"10.1007/s00384-025-04880-3","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"85"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experience with sacral neuromodulation for faecal incontinence - a multi-centre, longitudinal cohort study.","authors":"Matthew P Irwin, Yang Yu, Catherine E Turner, Kevin C Ooi, Matthew J Morgan","doi":"10.1007/s00384-025-04870-5","DOIUrl":"10.1007/s00384-025-04870-5","url":null,"abstract":"<p><strong>Purpose: </strong>Sacral neuromodulation (SNM) is an established treatment for faecal incontinence. This study analyses patient experience with SNM beyond quality of life and incontinence scores to better understand patient expectations and improve patient selection.</p><p><strong>Methods: </strong>Patients receiving SNM for faecal incontinence at three Australian sites from 2013 to 2023 were subject to cohort analysis. St. Mark's Incontinence Score (SMIS) and Rapid Assessment of Faecal Incontinence Score (RAFIS) assessed incontinence and quality of life. Thematic analysis of structured interviews qualitatively assessed patient experience.</p><p><strong>Results: </strong>Seventy-one patients aged 52-86 years (M = 69) experienced SNM and 56 agreed to interview at median 6-year post-procedure. Forty-five (63%) proceeded to permanent SNM and progression was not influenced by age, sex, culture, insurance status or presence of anal sphincter defect. Thirty-nine (87%) retained their neuromodulator with battery life M = 6.5 years, 95% CI [5.2, 7.8]. Permanent SNM improved incontinence (P < 0.01) and quality of life (P < 0.01). Forty-eight (86%) patients desired 30-min education pre- and post-procedure. Thirty-seven (86%) desired follow-ups at 1 month, 12 months and at battery depletion. Twenty (36%) had initial reservations which resolved in all but one patient. Twenty-one (54%) remained dependent on others for neuromodulator customisation and this dependence increased with age (P = 0.02). Fifty (89%) recommend SNM to others, despite 8 (14%) regretting their personal experience.</p><p><strong>Conclusion: </strong>SNM continues to improve faecal incontinence and quality of life. Initial reservations usually resolve and most patients recommend it to others. While adequate patient education and follow-up is not onerous to achieve, most patients remain dependent for neuromodulator customisation.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"84"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the prognostic value of lateral mesorectum using preoperative high-resolution MRI in patients with rectal cancer.","authors":"Siyuan Jiang, Qiaoling Chen, Shuqin Zang, Haidi Lu, Shiyu Ma, Fangying Chen, Wei Zhang, Chengwei Shao, Fu Shen","doi":"10.1007/s00384-025-04871-4","DOIUrl":"10.1007/s00384-025-04871-4","url":null,"abstract":"<p><strong>Background: </strong>To explore the lateral mesorectum structures and develop a nomogram model for predicting the prognosis of rectal cancer (RC) patients using preoperative high-resolution magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Patients who underwent radical resection of RC in our hospital from January 2017 to December 2018 were retrospectively analyzed. Imaging data and postoperative 3-year prognosis data of patients were collected. The lateral mesorectum was observed, and related parameters were investigated: lateral interruption of the mesorectal fascia (LI-MRF), type of the middle rectal artery (MRA), and the maximum diameter of the MRA. The impact of lateral mesorectum parameters on prognosis was determined using Cox analysis and Kaplan-Meier (KM) survival curves. A nomogram combining lateral mesorectum parameters with clinical data was constructed and its predictive performance was validated.</p><p><strong>Results: </strong>A total of 260 patients were included in this study. In preoperative high-resolution MRI, LI-MRF and MRA were observed bilaterally in all patients. Multivariate Cox regression analysis showed that the maximum diameter of the right MRA (P = 0.001) and right LI-MRF (P = 0.016) were predictive factors for postoperative 3-year overall survival (OS). Additionally, gender (P = 0.015), mrT stage (P = 0.025), and the maximum diameter of the right MRA (P = 0.002) were predictive factors for postoperative 3-year disease-free survival (DFS). The concordance indexes (C-index) of the predictive nomogram were 0.737 for OS and 0.685 for DFS.</p><p><strong>Conclusion: </strong>Preoperative high-resolution MRI revealed that the lateral mesorectum and MRA were inherent. The right LI-MRF and the maximum diameter of the right MRA were risk factors for poor postoperative survival in RC patients.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"81"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study on the efficacy and safety of FOLFOXIRI therapy for locally advanced rectal cancer: The Kanagawa Yokohama Colorectal Cancer Study Group (KYCC)1802.","authors":"Hironao Okamoto, Nobuhiro Sugano, Maho Sato, Kenta Iguchi, Masahiro Asari, Keisuke Kazama, Masakatsu Numata, Teni Godai, Akio Higuchi, Hiroyuki Mushiake, Aya Saito, Manabu Shiozawa","doi":"10.1007/s00384-025-04873-2","DOIUrl":"10.1007/s00384-025-04873-2","url":null,"abstract":"<p><strong>Purpose: </strong>Although chemoradiotherapy is considered an efficacious treatment option for patients with locally advanced rectal cancer, the associated radiological toxicities and late anal dysfunction are concerning issues. Herein, we examined the efficacy and safety of folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan (FOLFOXIRI) as upfront therapy for marginally unresectable local rectal cancers without distant metastasis.</p><p><strong>Methods: </strong>This multicenter, prospective, observational study was designed by the Yokohama Colorectal Cancer Study Group. The primary endpoint was the conversion rate. Secondary endpoints were the R0 resection rate, response rate, pathological response rate, postoperative complication rate, relapse-free survival, local progression-free rate, and circumferential resection margin-negative rate.</p><p><strong>Results: </strong>Twenty patients were enrolled in this study. The study achieved its primary endpoint; the R0 resection rate was 80% (95% confidence interval, 56.3 to 94.3). Major grade ≥ 3 adverse effects included neutropenia in 7 (35%) patients, anemia in 3 (15%), fatigue in 2 (10%), enterocolitis in 2 (10%), febrile neutropenia in 1 (5%), leukopenia in 1 (5%), diarrhea in 1 (5%), fever in 1 (5%), and urinary tract infection in 1 (5%).</p><p><strong>Conclusion: </strong>FOLFOXIRI therapy was well tolerated and showed comparable efficacy results, providing potential R0 resection in patients with marginally unresectable locally advanced rectal cancer without distant metastasis.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry (UMIN000040275).</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"82"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}