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.

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

PTH-261 Laparoscopic surgery for locally advanced sigmoid colon cancer: short and long-term clinical outcomes

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A526.1-A526
Author(s):  
T Yamanashi ◽  
T Sato ◽  
A Tsutsui ◽  
H Miura ◽  
N Ogura ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Sigmoid Colon ◽  
Clinical Outcomes ◽  
Locally Advanced ◽  
Sigmoid Colon Cancer ◽  
Short And Long Term

scholarly journals Neoadjuvant Chemoradiotherapy in Patients With Unresectable Locally Advanced Sigmoid Colon Cancer: Clinical Feasibility and Outcome

2021 ◽  
Author(s):  
Shao-Qing Niu ◽  
Rong-Zhen Li ◽  
Yan Yuan ◽  
Wei-Hao Xie ◽  
Qiao-Xuan Wang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Sigmoid Colon ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Sigmoid Colon Cancer ◽  
Cumulative Probability ◽  
R0 Resection ◽  
Dismal Prognosis

Abstract Background: Patients with locally advanced sigmoid colon cancer (LASCC) have limited treatment options and a dismal prognosis with poor quality of life. This prospective study aimed to further evaluate the feasibility and efficacy of neoadjuvant chemoradiotherapy (NACRT) followed by surgery as treatment for select patients with unresectable LASCC.Methods: We studied patients with unresectable LASCC who received NACRT between November 2010 and April 2019. The NACRT regimen consisted of intensity modulated radiotherapy (IMRT) of 50 Gy to the gross tumor and positive lymphoma nodes and 45 Gy to the clinical target volume. Capecitabine‑based chemotherapy was administered every 3 weeks. Surgery was scheduled 6–8 weeks after radiotherapy.Results: Seventy‑two patients were enrolled in this study. Patients had a regular follow-up (median, 41.1 months; range, 8.3–116.5 months). Seventy‑one patients completed NACRT, and sixty-five completed surgery. Resection with microscopically negative margins (R0 resection) was achieved in 64 patients (88.9%). Pathologic complete response was observed in 15 patients (23.1%), and multivisceral resection was necessary in 38 patients (58.3%). The cumulative probability of 3-year overall survival and disease‑free survival were 75.8% and 70.7%, respectively.Conclusion: For patients with unresectable LASCC, neoadjuvant chemoradiotherapy is feasible, surgery can be performed safely and may result in increased survival and organ preservation rates.

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.

scholarly journals Neoadjuvant chemoradiotherapy in patients with unresectable locally advanced sigmoid colon cancer: clinical feasibility and outcome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shao-Qing Niu ◽  
Rong-Zhen Li ◽  
Yan Yuan ◽  
Wei-Hao Xie ◽  
Qiao-Xuan Wang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Sigmoid Colon ◽  
Treatment Options ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Sigmoid Colon Cancer ◽  
Cumulative Probability ◽  
R0 Resection ◽  
Dismal Prognosis

Abstract Background Patients with locally advanced sigmoid colon cancer (LASCC) have limited treatment options and a dismal prognosis with poor quality of life. This retrospective study aimed to further evaluate the feasibility and efficacy of neoadjuvant chemoradiotherapy (NACRT) followed by surgery as treatment for select patients with unresectable LASCC. Methods We studied patients with unresectable LASCC who received NACRT between November 2010 and April 2019. The NACRT regimen consisted of intensity modulated radiotherapy (IMRT) of 50 Gy to the gross tumor and positive lymphoma node and 45 Gy to the clinical target volume. Capecitabine‑based chemotherapy was administered every 2 (mFOLFOX6) or 3 weeks (CAPEOX). Surgery was scheduled 6–8 weeks after radiotherapy. Results Seventy‑two patients were enrolled in this study. Patients had a regular follow-up (median, 41.1 months; range, 8.3–116.5 months). Seventy‑one patients completed NACRT, and sixty-five completed surgery. Resection with microscopically negative margins (R0 resection) was achieved in 64 patients (88.9%). Pathologic complete response was observed in 15 patients (23.1%), and multivisceral resection was necessary in 38 patients (58.3%). The cumulative probability of 3-year overall survival (OS) and progression-free survival (PFS) were 75.8 and 70.7%, respectively. Conclusions For patients with unresectable LASCC, neoadjuvant chemoradiotherapy is feasible, surgery can be performed safely and may result in increased survival and organ preservation rates.

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.

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