Clinical colorectal cancer最新文献

Impact of Neoadjuvant Immunotherapy in Localized Rectal Cancer. A Systematic Review. 新辅助免疫治疗对局部直肠癌的影响。系统评价。

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-26 DOI: 10.1016/j.clcc.2025.08.005

Florian Salihu, Claudia Corro, Frédéric Ris, Guillaume Meurette, André Durham, Vassilis Genoud, Aurélie Bornand, Jeremy Meyer, Thibaud Koessler

{"title":"Impact of Neoadjuvant Immunotherapy in Localized Rectal Cancer. A Systematic Review.","authors":"Florian Salihu, Claudia Corro, Frédéric Ris, Guillaume Meurette, André Durham, Vassilis Genoud, Aurélie Bornand, Jeremy Meyer, Thibaud Koessler","doi":"10.1016/j.clcc.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.005","url":null,"abstract":"Current treatments for locally advanced rectal cancer (LARC) include preoperative radiotherapy, chemotherapy and chemoradiotherapy followed by total mesorectal excision (TME), which can severely impact quality of life. Recently, anti-PD1 immunotherapy in microsatellite instability high (MSI-H) LARC has shown 100% clinical complete responses, allowing patients to avoid surgery with minimal toxicity. This review assesses the safety, toxicity, pathological impact, and long-term benefits of incorporating immunotherapy into the neoadjuvant treatment of microsatellite stable (MSS) and MSI-H LARC. This systematic review, conducted following PRISMA guidelines, investigates neoadjuvant immunotherapy in LARC. Data on study characteristics, treatment protocols, and outcomes were extracted. Quality assessment was conducted by using the Methodological Index for nonrandomized studies (MINORS) and the RoB2 tool. Patients were categorized into MSI-H, MSS, and unknown microsatellite status cohorts. We found twelve published studies including 547 patients. In the MSS cohort, postneoadjuvant surgery rates ranged from 57.6% to 100%, with a watch-and-wait approach adopted in up to 27.1% of cases. For MSI-H patients, surgery and watch-and-wait rates varied widely (0%-100%), reflecting heterogeneity in management. R0 resection rates were high across cohorts (70%-100% MSS, 80%-100% MSI-H). Pathological complete response (pCR) rates were 25% to 50% in MSS and 50% to 60% in MSI-H cohorts. Grade 3-4 adverse events ranged from 3.9% to 45.2% (MSS), 0% to 60% (MSI-H), with immune-related events generally below 10%. The role of immunotherapy in MSS rectal cancer remains unclear; phase III trials and translational research are needed urgently for guidance.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adjuvant Anti-Inflammatory Therapy in Postoperative Colorectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 结直肠癌术后辅助抗炎治疗：随机对照试验的系统回顾和荟萃分析。

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-21 DOI: 10.1016/j.clcc.2025.08.003

Gabriel Lenz, Rafael Alvim Pereira, Gabriel Valagni, Tiago Biachi de Castria

{"title":"Adjuvant Anti-Inflammatory Therapy in Postoperative Colorectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Gabriel Lenz, Rafael Alvim Pereira, Gabriel Valagni, Tiago Biachi de Castria","doi":"10.1016/j.clcc.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.003","url":null,"abstract":"Colorectal cancer (CRC) recurrence remains a major challenge in postsurgery. Chronic inflammation driven by cyclooxygenase (COX-2) and prostaglandin pathways promotes tumor recurrence, encouraging interest in nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin (acetylsalicylic acid, ASA) and COX-2 inhibitors. While observational studies suggest a benefit in reducing recurrence, randomized controlled trial (RCT) evidence is controversial. This meta-analysis evaluates the efficacy and safety of adjuvant NSAIDs in nonmetastatic resected CRC. We systematically searched PubMed, Scopus, and Cochrane Central for RCTs comparing anti-inflammatory agents to placebo in postoperative CRC patients. Primary outcomes included overall survival (OS) and disease-free survival (DFS); secondary outcomes were time to recurrence (TTR), recurrence rate, and adverse events. Subgroup analyses focused on aspirin use and the presence of PI3K pathway mutations were performed. Five RCTs (7246 patients) were included. Anti-inflammatory therapy improved DFS (HR = 0.85; 95% CI: 0.76-0.96; P = .008) and TTR (HR = 0.61; 95% CI: 0.44-0.84; P = .003) but not OS (HR = 0.90; P = .07) or recurrence rates (RR = 0.90; P = .06). Aspirin demonstrated superior DFS benefit (HR = 0.70; P = .03) and patients with PI3K mutations had markedly reduced recurrence risk (HR = 0.56; P < .0001). Serious cardiac events, gastrointestinal bleeding, and infections showed no significant differences. Adjuvant anti-inflammatory therapy improves DFS and delays recurrence in postoperative CRC, with pronounced benefit in PIK3CA mutant tumors. These findings support biomarker-driven strategies and highlight the need for ongoing trials to validate long-term efficacy and safety.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dietary Diabetes Risk Reduction Score (DDRRS) and the Risk of Colorectal Cancer and Adenoma: A Case-Control Study. 饮食糖尿病风险降低评分（DDRRS）与结直肠癌和腺瘤的风险：一项病例对照研究

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-20 DOI: 10.1016/j.clcc.2025.08.006

Niayesh Naghshi, Milad Mohammadzadeh, Fatemeh Babaee Kiadehi, Alireza Bahrami, Fatemeh Abdi, Mohammad Gholizadeh, Ehsan Hejazi

{"title":"Dietary Diabetes Risk Reduction Score (DDRRS) and the Risk of Colorectal Cancer and Adenoma: A Case-Control Study.","authors":"Niayesh Naghshi, Milad Mohammadzadeh, Fatemeh Babaee Kiadehi, Alireza Bahrami, Fatemeh Abdi, Mohammad Gholizadeh, Ehsan Hejazi","doi":"10.1016/j.clcc.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.006","url":null,"abstract":"Background: Given the role of insulin resistance in several cancers, we hypothesized that the risk of colorectal cancer and colorectal adenoma may be lessened by following a diet that improves insulin resistance. Therefore, we conducted the current study to examine the association between dietary diabetes risk reduction and the odds of colorectal cancer and colorectal adenoma.Method: This hospital-based case-control study was conducted on 129 newly diagnosed colorectal cancer patients, 130 newly diagnosed colorectal adenoma cases, and 240 healthy age- and sex-matched hospitalized controls. We used a valid and reliable 148-item food frequency questionnaire (FFQ) to collect the dietary intake of subjects. Multivariate logistic regression was used to estimate the association between DDRRS and the odds of colorectal cancer and adenoma.Results: After adjusting for confounding variables, individuals in the highest tertile of the DDRRS were 0.13 and 0.22 times less likely to have colorectal cancer (OR = 0.13, 95% CI: 0.06-0.25) and adenoma (OR = 0.22, 95% CI: 0.12-0.41) respectively.Conclusion: Current results demonstrated that a high DDRRS was associated with a lower risk of colorectal cancer and adenoma.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age as a Modifier of the Effects of Sarcopenia on Survival Among Colon Cancer Patients Receiving Chemotherapy. 年龄是结肠癌化疗患者骨骼肌减少症对生存影响的调节因素。

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-20 DOI: 10.1016/j.clcc.2025.08.002

Wen-Li Lin, Li-Min Wu, Wen-Tsung Huang, Yu-Pao Chen

{"title":"Age as a Modifier of the Effects of Sarcopenia on Survival Among Colon Cancer Patients Receiving Chemotherapy.","authors":"Wen-Li Lin, Li-Min Wu, Wen-Tsung Huang, Yu-Pao Chen","doi":"10.1016/j.clcc.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.002","url":null,"abstract":"Background: Sarcopenia is common among older adults and is associated with poor prognosis in several malignancies. This study evaluated whether sarcopenia serves as a survival risk factor among patients with colon cancer treated with chemotherapy, alongside the effects of age and visceral adiposity (VA).Patients and methods: We retrospectively recruited 133 patients diagnosed with resectable colon cancer who received chemotherapy between January 2014 and December 2017 at a teaching hospital. Computed tomography images were analyzed to assess body composition, and Kaplan-Meier survival curves and Cox proportional hazards regression models were used to assess survival.Results: Patients receiving chemotherapy who were diagnosed with sarcopenia were associated with worse 5-year overall survival (OS: 87.3% vs. 65.4%) and longer hospital stay (19.1 vs. 15 days) compared with patients without sarcopenia. VA was not associated with OS or the length of hospital stay. There was a significant association between sarcopenia and OS, with a hazard ratio (HR) of 2.77 (95% confidence interval [CI]:1.42-5.38). The association remained after adjustment for other independent risk factors, including age > 70 years (adjusted HR: 1.98, 95% CI: 0.99-3.95) and alcohol consumption (adjusted HR: 8.96, 95% CI: 1.22-65.77). In age-stratified analyses, sarcopenia was an independent risk factor for worse OS (adjusted HR: 7.85, 95% CI: 1.05-58.91) among patients > 70 years but not among patients ≤ 70 years (adjusted HR: 2.01, 95% CI: 0.75-5.93).Conclusion: Sarcopenia is associated with improved OS, particularly in patients aged ≥ 70 years who underwent chemotherapy after resection of colorectal cancer.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization of the Tumor Immune Microenvironment in HER2-Positive Colorectal Cancer: Association With Prognostic and Therapeutic Implications. her2阳性结直肠癌肿瘤免疫微环境的特征：与预后和治疗意义的关联

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-20 DOI: 10.1016/j.clcc.2025.08.004

Wen-Wen Huang, Yan-Jun Cheng, Sha-Sha Yuan, Yu Liu, Fu-Rong Liu

{"title":"Characterization of the Tumor Immune Microenvironment in HER2-Positive Colorectal Cancer: Association With Prognostic and Therapeutic Implications.","authors":"Wen-Wen Huang, Yan-Jun Cheng, Sha-Sha Yuan, Yu Liu, Fu-Rong Liu","doi":"10.1016/j.clcc.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.004","url":null,"abstract":"Background: The human epidermal growth factor receptor 2 (HER2) status has been proposed as a biomarker to identify colorectal cancer (CRC) patients suitable for anti-HER2 treatment. However, response varies from HER2-negative CRC, influenced by factors such as the tumors immune microenvironment (TIME) in HER2-positive CRC patients. We aimed to characterize the TIME of HER2-positive CRC by assessing the associations of inflammatory cells and prognosis.Methods: TIME was characterized through immunostaining for CD3, CD4, CD8, CD20, CD68, Forkhead box protein P3 (Foxp3), and programmed death-ligand 1 (PD-L1) cell densities in 36 HER2-positive and 72 HER2-negative CRC patients. HER2 positivity was evaluated by the HERACLES criteria. PD-L1 expression was evaluated by the tumor proportion score (TPS) and combined proportion score (CPS).Results: In our study, the densities of CD3, CD4, CD8, CD20, CD68, Foxp3 cells and PD-L1 expression showed no statistic differences in HER2-positive CRC patients compared to HER2-negative patients. There was a greater proportion of Foxp3+ cells (≥ 10%) among patients with HER2-positive CRC (P = .023). Although the PD-L1 CPS was correlated with sex (P = .012), inflammatory cells and the PD-L1 TPS were not correlated with clinicopathological parameters. Additionally, CRC patients with PD-L1 CPSs ≥ 1 had significantly better event-free survival (EFS) than patients with PD-L1 CPSs < 1 (P = .029). For patients with HER2-positive CRC, higher CD68 indicated better EFS (P = .047).Conclusions: This study characterized a preliminary immune microenvironment profile and indicated CD68 increased correlation with EFS for HER2-positive CRC patients. These immune microenvironment profiles and prognostic implications could serve as potential biomarkers for stratifying patients with HER-2 positive for clinical trials.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of distal resection margin on survival after tumour-specific mesorectal excision for rectal cancer: retrospective cohort study. 远端切除缘对肿瘤特异性直肠癌肠系膜切除术后生存率的影响：回顾性队列研究。

IF 3.2

Clinical colorectal cancer Pub Date : 2025-08-20 DOI: 10.1016/j.clcc.2025.08.001

Fabio Carbone, Roberto Santalucia, Simona Borin, Davide Ciardiello, Luca Bottiglieri, Stefano de Pascale, Emilio Bertani, Uberto Fumagalli Romario

{"title":"Impact of distal resection margin on survival after tumour-specific mesorectal excision for rectal cancer: retrospective cohort study.","authors":"Fabio Carbone, Roberto Santalucia, Simona Borin, Davide Ciardiello, Luca Bottiglieri, Stefano de Pascale, Emilio Bertani, Uberto Fumagalli Romario","doi":"10.1016/j.clcc.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.clcc.2025.08.001","url":null,"abstract":"Background: The safe oncological distal resection margin (DRM) after anterior resection (AR) with tumour-specific mesorectal excision (TSME) for rectal cancer is still debated. This study aims to clarify the impact of DRM on survival outcomes.Methods: Patients who underwent an intention-to-treat AR-TSME for a non-metastatic rectal adenocarcinoma within 15 cm from the anal verge from September 2018 to February 2024 were included. Those with locally advanced rectal cancer underwent neoadjuvant treatment. Patients were divided into 3 groups according to the DRM: < 1 cm, 1 to 4.9 cm, and ≥ 5 cm, and compared for overall survival (OS) and disease-free survival (DFS).Results: A total of 268 patients were included: 29 with DRM < 1 cm (11%), 208 with DRM 1 to 4.9 cm (78%), and 31 with DRM ≥ 5 cm (11%). Median follow-up was 27 months. Three-year OS was 93%, 97%, and 100% in the respective groups (P = .36); DFS was 85%, 76%, and 75% (P = .51). Multivariable analysis did not identify DRM as an independent risk factor for OS or DFS. Circumferential resection margin (CRM) involvement (HR 4.68, 95%CI 1.78-12.31) and R1 resections (HR 5.66, 95%CI 2.31-13.87) were significantly associated with disease recurrence. Subgroup analysis showed no significant impact of DRM on the survival of patients undergoing neoadjuvant therapy.Conclusions: Short DRM does not compromise oncological outcomes, provided that complete (R0) resection is achieved. These findings support a more individualised surgical approach, with emphasis on CRM status over arbitrary DRM thresholds.","PeriodicalId":93939,"journal":{"name":"Clinical colorectal cancer","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0