scholarly journals Efficacy of Neoadjuvant Chemotherapy with Capecitabine plus Oxaliplatin in the Treatment of Locally Advanced Sigmoid Colon Cancer Invading the Urinary Bladder: A Report of Three Cases

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Tsutomu Takenami ◽  
Shingo Tsujinaka ◽  
Jun Takahashi ◽  
Sawako Tamaki ◽  
Ryo Maemoto ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Urinary Bladder ◽  
Histological Examination ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Final Diagnosis ◽  
Partial Resection ◽  
Sigmoid Colon Cancer ◽  
Sigmoid Colectomy

Introduction. We herein present three cases of locally advanced colon cancer (LACC) invading the urinary bladder, in whom combined neoadjuvant chemotherapy with surgical intervention was effective in disease control and preserving urinary function. Case Presentation. Before neoadjuvant chemotherapy, all three cases underwent loop transverse colostomy for symptomatic colonic obstruction. Case 1: after 6 courses of capecitabine plus oxaliplatin (CAPOX), we performed sigmoid colectomy and partial resection of the bladder. The histological examination revealed pathological complete response (pCR). The final diagnosis was ypStage 0 (ypT0ypN0M0). Case 2: after 13 courses of CAPOX plus bevacizumab, we performed Hartmann’s operation with partial resection of the bladder. The histological examination revealed pCR. The final diagnosis was ypStage 0 (ypT0ypN0M0). Case 3: after 6 courses of chemotherapy with CAPOX plus bevacizumab, we performed sigmoid colectomy and partial resection of the bladder. The pathological response was grade 1a according to the Japanese Classification of Colorectal Carcinoma. The final diagnosis was ypStage IIC (ypT4bypN0M0). All three cases underwent capecitabine-based adjuvant chemotherapy after radical surgery and patients are alive without recurrence. Conclusion. Neoadjuvant chemotherapy with CAPOX with or without bevacizumab followed by radical surgery could be an effective treatment option for LACC invading the urinary bladder.

Radical surgery for locally advanced recurrent sigmoid colon cancer

2018 ◽  
pp. 108
Author(s):  
A. V. Zavaruev ◽  
A. A. Mazurenko ◽  
E. Yu. Bregadze ◽  
S. V. Shumsky ◽  
I. A. Achkasov ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Sigmoid Colon ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Sigmoid Colon Cancer

scholarly journals Local staging of sigmoid colon cancer using MRI

2017 ◽  
Vol 6 (7) ◽  
pp. 205846011772095 ◽  
Author(s):  
Claus Dam ◽  
Jan Lindebjerg ◽  
Anders Jakobsen ◽  
Lars Henrik Jensen ◽  
Hans Rahr ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Sigmoid Colon ◽  
Locally Advanced ◽  
Observer Agreement ◽  
Sigmoid Colon Cancer ◽  
Radiological Staging ◽  
Adc Values ◽  
N Stage ◽  
Advanced Tumors

Background An accurate radiological staging of colon cancer is crucial to select patients who may benefit from neoadjuvant chemotherapy. Purpose To evaluate the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) in identifying locally advanced sigmoid colon cancer, poor prognostic factors, and the inter-observer variation of the tumor apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI). Material and Methods Using 1.5 T MRI with high resolution T2-weighted (T2W) imaging, DWI, and no contrast enhancement, 35 patients with sigmoid colon cancer were assessed. T-stage, N-stage, extramural vascular invasion (EMVI), and ADC values of the tumors were assessed and blindly compared by two observers using postoperative histopathological examination as the gold standard. Early tumors were defined as T1 to T3ab, and advanced tumors as T3cd or T4. Results The accuracy of the two radiologists in staging early versus advanced tumors, N-stage, and identification of EMVI was 94%/89%, 60%/66%, and 77%/60% with an inter-observer agreement of к = 0.86 (95% confidence interval [CI] = 0.67–1.00), к = 0.64 (95% CI = 0.39–0.90), and к = 0.52 (95% CI = 0.23–0.80). All the measured mean ADC values were below 1.0 × 10−3 mm2/s with an intra-class correlation coefficient in T3cd–T4 tumors of 0.85. Conclusion Preoperative MRI can identify locally advanced sigmoid colon cancer and has potential as the imaging of choice to select patients for neoadjuvant chemotherapy. Initial experience with ADC measurement was achieved with an excellent inter-observer agreement in advanced tumors.

scholarly journals Complete Resection without Any Ostomies by Laparoscopic Extended Surgery for Locally Advanced T4 Sigmoid Colon Cancer Invading the Urinary Bladder and Ureter

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Ogura ◽  
Tsukasa Aritake ◽  
Satoru Kawai ◽  
Shigeki Yamamoto ◽  
Kenji Takagi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Urinary Bladder ◽  
Sigmoid Colon ◽  
Locally Advanced ◽  
Complete Resection ◽  
Sigmoid Colon Cancer ◽  
Extended Surgery ◽  
Laparoscopic Techniques

The feasibility and safety of laparoscopic surgery for locally advanced colorectal cancer remain controversial due to the high rate of incomplete resection and conversion to open surgery. Especially for T4 colorectal cancer, laparoscopic techniques are still demanding mainly because of the difficulty in distinguishing between inflammation and tumor involvement, which often lead surgeons to do overtreatment in surgery. We believe laparoscopic magnified and multidirectional approach might be useful for pathologically complete resection and minimizing an unnecessary extended surgery for these cases. A 49-year-old man was diagnosed with locally advanced T4 sigmoid colon cancer invading the urinary bladder and ureter. We performed laparoscopic anterior resection with en bloc resection of the urinary bladder and the left ureter. Total operative time was 462 min, and the estimated blood loss was 50 ml. This patient was discharged on the 28th day after surgery without any ostomies and urinary functional disorders. The magnified view by laparoscopic techniques from multiple directions would enable surgeons to set surgical landmarks for another approach, which is the key for safe and feasible laparoscopic surgery in patients with locally advanced T4 colorectal cancer.

Neoadjuvant chemotherapy followed by radical surgery in locally advanced vulvar carcinoma: a single-institution experience

2021 ◽  
pp. 030089162110276
Author(s):  
Adorni Marco ◽  
Bazzurini Luca ◽  
Lissoni Andrea Alberto ◽  
Vecchione Francesca ◽  
Negri Serena ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Vulvar Cancer ◽  
Elderly Women ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Complete Response ◽  
Tumor Burden ◽  
Clinical Response Rate

Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rathin Gosavi ◽  
Clemente Chia ◽  
Michael Michael ◽  
Alexander G. Heriot ◽  
Satish K. Warrier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Colon Cancer

Radical Surgery After Neoadjuvant Chemotherapy for Locally Advanced Neuroendocrine Cancer of the Cervix

2021 ◽  
Vol 41 (9) ◽  
pp. 4431-4438
Author(s):  
GIUSEPPE CARUSO ◽  
INNOCENZA PALAIA ◽  
VIOLANTE DI DONATO ◽  
ANGELINA PERNAZZA ◽  
ROBERTA GALLO ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Neuroendocrine Cancer ◽  
Cancer Of The Cervix

scholarly journals Neoadjuvant Chemotherapy for Locally Advanced T4 Colon Cancer: A Nationwide Propensity-Score Matched Cohort Analysis

2019 ◽  
Vol 37 (4) ◽  
pp. 292-301 ◽  
Author(s):  
Jan-Marie de Gooyer ◽  
Marlies G. Verstegen ◽  
Jorine ’t Lam-Boer ◽  
Sandra A. Radema ◽  
Rob H.A. Verhoeven ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Cohort Analysis ◽  
Locally Advanced ◽  
Group Versus ◽  
Control Group ◽  
Complication Rates ◽  
Term Survival ◽  
T4 Colon Cancer

Introduction: Neoadjuvant chemotherapy (CT) for locally advanced colon cancer (LACC) could potentially lead to tumor shrinkage, eradication of micrometastases, and prevention of tumor cell shedding during surgery. This retrospective study investigates the surgical and oncological outcomes of preoperative CT for LACC. Methods: Using the Netherlands Cancer Registry, data of patients with stage II or III colon cancer, diagnosed between 2008 and 2016 was collected. A propensity score matching (PSM; 1:2) was performed and compared patients with clinical tumor (cT) 4 colon cancer who were treated with neoadjuvant CT to patients with cT4 colon cancer treated with adjuvant CT (Fig. 1). Results: A total of 192 patients treated with neoadjuvant CT were compared to 1,954 patients that received adjuvant CT. After PSM, 149 patients in the neoadjuvant group were compared to 298 patients in the control group. No significant differences were found in baseline characteristics after PSM. After neoadjuvant CT, a significant response was observed in 13 (9%) patients with 5 (4%) patients showing a complete response. Complete resection margins (R0) were achieved in 77% in the neoadjuvant group versus 86% in the adjuvant treated group (p = 0.037). Significantly less tumor positive lymph nodes were found in the neoadjuvant group (median 0 vs. 2, p < 0.001). Major complication rates and 5-year overall survival did not differ between both groups (67–65%, p = 0.87). Conclusion: Neoadjuvant CT seems safe and feasible with similar long-term survival compared to patients who are treated with adjuvant CT.

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