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Cancer Risk of Peutz-Jeghers Syndrome and Treatment Experience: A Chinese Medical Center. 癌症的标致-杰格斯综合征风险和治疗经验：中国医学中心。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-05-03 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767704
Zuxin Xu, Guoli Gu
{"title":"Cancer Risk of Peutz-Jeghers Syndrome and Treatment Experience: A Chinese Medical Center.","authors":"Zuxin Xu, Guoli Gu","doi":"10.1055/s-0043-1767704","DOIUrl":"10.1055/s-0043-1767704","url":null,"abstract":"<p><p>Peutz-Jeghers syndrome (PJS), also known as hereditary mucocutaneous pigmented gastrointestinal polyposis, is a clinically rare autosomal dominant genetic disease, which falls into the category of hereditary colorectal cancer. There are ∼7,000 new cases of PJS in China every year, and 170,000 PJS patients may survive for a long time in society. PJS polyps are characterized by an early age of onset, difficult diagnosis and treatment, and easy recurrence. With repeated growth, polyps can lead to serious complications such as intestinal obstruction, intussusception, gastrointestinal bleeding, and cancerization, which cause serious clinical problems. Due to repeated hospitalization and endoscopic follow-up, PJS patients and their families suffer from great physical and mental pain and economic burden. With the in-depth understanding of PJS and the development and popularization of endoscopic techniques in the past decade, an integrated treatment modality based on endoscopy plus surgery has gradually become the preferred treatment in most hospitals, which greatly improves the quality of life of PJS patients. However, there is still a lack of effective drug prevention and cure means. In this paper, the current clinical treatment means for PJS polyps were summarized by literature review combined with the treatment experience of our medical center, with a focus on their clinical diagnosis, treatment, and cancer risk.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"406-414"},"PeriodicalIF":1.4,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening and Management of Lynch Syndrome: The Chinese Experience. 林奇综合征的筛查和治疗：中国经验。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-05-03 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767706
Jiehai Yu, Pei-Rong Ding, Wu Jiang
{"title":"Screening and Management of Lynch Syndrome: The Chinese Experience.","authors":"Jiehai Yu, Pei-Rong Ding, Wu Jiang","doi":"10.1055/s-0043-1767706","DOIUrl":"10.1055/s-0043-1767706","url":null,"abstract":"<p><p>Lynch syndrome (LS), caused by germline mutations in the mismatch repair genes, is the most common hereditary colorectal cancer. While LS is also associated with various cancers, early detection of the proband is meaningful for tumor prevention, treatment, and familial management. It has been a dramatic shift on the screening approaches for LS. As the rapid development of the molecular biological methods, a comprehensive understanding of the LS screening strategies will help to improve the clinical care for this systematic disease. The current screening strategies have been well validated but mainly by evidence derived from western population, lacking consideration of the ethnic heterogeneity, which hampers the universality and clinical application in China. Hence, this review will focus on the Chinese experience in LS screening, aiming to help better understand the ethnic diversity and further optimize the screening strategies.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"369-377"},"PeriodicalIF":1.4,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of Molecular Profiling in Colorectal Cancer Surgery. 分子图谱在癌症结直肠癌手术中的应用。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-17 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767702
Pei-Rong Ding
{"title":"Application of Molecular Profiling in Colorectal Cancer Surgery.","authors":"Pei-Rong Ding","doi":"10.1055/s-0043-1767702","DOIUrl":"10.1055/s-0043-1767702","url":null,"abstract":"","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"367-368"},"PeriodicalIF":1.4,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on Familial Adenomatous Polyposis-Associated Desmoid Tumors. 家族性腺瘤性息肉病相关筛状肿瘤的最新进展。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-17 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767709
Wanjun Yang, Pei-Rong Ding
{"title":"Update on Familial Adenomatous Polyposis-Associated Desmoid Tumors.","authors":"Wanjun Yang, Pei-Rong Ding","doi":"10.1055/s-0043-1767709","DOIUrl":"10.1055/s-0043-1767709","url":null,"abstract":"<p><p>Desmoid tumors (DT) represent the second high risk of tumor in familial adenomatous polyposis (FAP) patients. Although FAP-associated DTs (FAP-DT) are caused by germline mutations in the adenomatous polyposis coli (APC) gene, extracolonic manifestations, sex, family history, genotype, and the ileal pouch anal anastomosis procedure are all linked to the development of DTs in FAP patients. Multidisciplinary management has replaced aggressive surgery as the preferred treatment of DTs. There is growing evidence to support the use of active surveillance strategy as first-line treatment for FAP-DT patients. Radiotherapy for intra-abdominal desmoids is now rarely used because of severe late toxicity. Pharmacotherapy, however, represents a promising future with the improvement of traditional cytotoxic drugs and the investigation of targeted drugs. Although nonsurgery treatment has been used widely nowadays, surgery remains the mainstay when symptomatic or life-threatening DTs are present. Further research will be needed for more optimal clinical practice.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"400-405"},"PeriodicalIF":1.4,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update on Surgical Management of FAP. FAP外科管理的最新进展。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-17 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767707
Tianqi Zhang, Ye Xu
{"title":"Update on Surgical Management of FAP.","authors":"Tianqi Zhang, Ye Xu","doi":"10.1055/s-0043-1767707","DOIUrl":"10.1055/s-0043-1767707","url":null,"abstract":"<p><p>Familial adenomatous polyposis (FAP) is an autosomal dominant disease caused by pathogenic germline adenomatous polyposis coli mutation, and characterized with multiple adenomas in the colon and the rectum. Various genetic variants have been confirmed to be associated with corresponding FAP phenotypes, which play important roles in the diagnosis and surgical treatment of FAP. Generally, proctocolectomy is recommended for FAP patients at the age of 20s. Exceptionally, for patients with attenuated FAP, high-risk of desmoid, chemoprevention therapy, or other circumstances, surgery can be postponed. With the wide application of minimal invasive surgery in colorectal cancer, laparoscopic, robotic surgery, and natural orifice specimen extraction are proved to be feasible for FAP patients, but high-level evidences are needed to confirm their safety and advantages. In the times of precise medicine, the surgical management of FAP should vary with individuals based on genotype, phenotype, and clinical practice. Therefore, in addition to innovation in surgical procedures, investigation in links between genetic features and phenotypes will be helpful to optimize the surgical management of FAP in the future.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"385-390"},"PeriodicalIF":1.4,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Quality Dilemma. 质量困境
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-16 eCollection Date: 2023-07-01 DOI: 10.1055/s-0043-57232
Scott R Steele
{"title":"The Quality Dilemma.","authors":"Scott R Steele","doi":"10.1055/s-0043-57232","DOIUrl":"10.1055/s-0043-57232","url":null,"abstract":"","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 4","pages":"285-286"},"PeriodicalIF":1.4,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10202535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9871483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Molecular Status on Cytoreductive Surgery for Peritoneal Metastases from Colorectal Cancer. 分子状态对癌症腹膜转移细胞减灭术的影响。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-16 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767705
Yun Zhong, Keli Yang, Xiusen Qin, Rui Luo, Hui Wang
{"title":"Impact of Molecular Status on Cytoreductive Surgery for Peritoneal Metastases from Colorectal Cancer.","authors":"Yun Zhong, Keli Yang, Xiusen Qin, Rui Luo, Hui Wang","doi":"10.1055/s-0043-1767705","DOIUrl":"10.1055/s-0043-1767705","url":null,"abstract":"<p><p>Colorectal cancer peritoneal metastases (CRC-PM) are present in 5 to 15% of instances of CRC, and the overall survival (OS) of patients with CRC-PM is much lower than that of patients with other isolated metastatic locations. In recent years, the introduction of cytoreductive surgery (CRS) in conjunction with hyperthermic intraperitoneal chemotherapy has resulted in a significant improvement in CRC-PM patients' OS. Despite this, a significant proportion of CRS patients continue to suffer complications of grades III to V or even die during the perioperative period. Early diagnosis, optimization of patient selection criteria, and refining of individualized combination therapy are necessary for these patients. In this review, we evaluate studies examining the relationship between molecular status and CRS in CRC-PM. Our objective is to gain a comprehensive understanding of how the altered molecular status of CRC-PM impacts CRS, which could increase the likelihood of tailored therapy in the future.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"415-422"},"PeriodicalIF":1.4,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Organ Preservation in MSS Rectal Cancer. MSS直肠癌症的器官保存。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-16 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767710
Yuye Gao, Aiwen Wu
{"title":"Organ Preservation in MSS Rectal Cancer.","authors":"Yuye Gao, Aiwen Wu","doi":"10.1055/s-0043-1767710","DOIUrl":"10.1055/s-0043-1767710","url":null,"abstract":"<p><p>Rectal cancer is a heterogeneous disease with complex genetic and molecular subtypes. Emerging progress of neoadjuvant therapy has led to increased pathological and clinical complete response (cCR) rates for microsatellite stable (MSS) rectal cancer, which responds poorly to immune checkpoint inhibitor alone. As a result, organ preservation of MSS rectal cancer as an alternative to radical surgery has gradually become a feasible option. For patients with cCR or near-cCR after neoadjuvant treatment, organ preservation can be implemented safely with less morbidity. Patient selection can be done either before the neoadjuvant treatment for higher probability or after with careful assessment for a favorable outcome. Those patients who achieved a good clinical response are managed with nonoperative management, organ preservation surgery, or radiation therapy alone followed by strict surveillance. The oncological outcomes of patients with careful selection and organ preservation seem to be noninferior compared with those of radical surgery, with lower postoperative morbidity. However, more studies should be done to seek better regression of tumor and maximize the possibility of organ preservation in MSS rectal cancer.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"430-440"},"PeriodicalIF":1.4,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases. 分子状态对结直肠癌癌症肝转移灶切除的影响。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-09 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767700
Yan-Yan Wang, Ze-Chang Xin, Kun Wang
{"title":"Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases.","authors":"Yan-Yan Wang, Ze-Chang Xin, Kun Wang","doi":"10.1055/s-0043-1767700","DOIUrl":"10.1055/s-0043-1767700","url":null,"abstract":"<p><p>Although surgical resection could provide better survival for patients with colorectal cancer liver metastases (CRLM), the recurrence rate after resection of CRLM remains high. The progress of genome sequencing technologies has greatly improved the molecular understanding of colorectal cancer. In the era of genomics and targeted therapy, genetic mutation analysis is of great significance to guide systemic treatment and identify patients who can benefit from resection of CRLM. RAS and BRAF mutations and microsatellite instability/deficient deoxyribonucleic acid (DNA) mismatch repair status have been incorporated into current clinical practice. Other promising molecular biomarkers such as coexisting gene mutations and circulating tumor DNA are under active investigation. This study aimed to review the prognostic significance of molecular biomarkers in patients with CRLM undergoing metastasectomy based on the current evidence.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"423-429"},"PeriodicalIF":1.4,"publicationDate":"2023-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Progress of Colorectal Polyposis Syndrome in Chinese Population. 中国人群结直肠息肉综合征研究进展。
IF 1.4 4区 医学
Clinics in Colon and Rectal Surgery Pub Date : 2023-04-09 eCollection Date: 2023-11-01 DOI: 10.1055/s-0043-1767708
Zhijun Yuan, Mengyuan Yang, Ying Yuan
{"title":"The Progress of Colorectal Polyposis Syndrome in Chinese Population.","authors":"Zhijun Yuan, Mengyuan Yang, Ying Yuan","doi":"10.1055/s-0043-1767708","DOIUrl":"10.1055/s-0043-1767708","url":null,"abstract":"<p><p>The pathogenesis, clinical phenotype, treatment strategy, and family management of hereditary tumor syndromes are different from those of sporadic tumors. Nearly a quarter of patients with colorectal cancer show significant familial aggregation and genetic predisposition, and 5 to 10% are associated with definite genetic factors. According to the clinical phenotype, it can be divided into nonpolyposis syndrome and polyposis syndrome. Among the polyposis syndrome patients with definite clinical symptoms, there are still some patients with unknown etiology (especially attenuated familial adenomatous polyposis), which is a difficult problem in clinical diagnosis and treatment. Therefore, for this rare disease, it is urgent to carry out multicenter studies, complete the gene variation spectrum, explore new pathogenic factors, and accumulate clinical experience. This article mainly introduces the research progress and related work of colorectal polyposis syndrome in China.</p>","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 6","pages":"391-399"},"PeriodicalIF":1.4,"publicationDate":"2023-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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