The role of postoperative chemotherapy in patients who undergoing surgery following chemoradiotherapy of initially unresectable rectal cancer

Introduction. Preoperative chemoradiotherapy (preCRT) improves local control of rectal cancer and such is parti­cularly merited for treating locoregionally advanced tumors. Nevertheless, the role of postoperative chemotherapy (postCT) in such patients is currently disputed. Materials. Subjects were 75 patients with unresectable cT3–4 and/or N+ tumors who underwent radical surgery following preCRT between January 2003 and December 2012 at the Oncology Centre in Bydgoszcz. PostCT was subsequently used in 32 (43%) of these patients. Results. There were 20 abdominoperineal resections (APR), 50 anterior resections (AR) and 5 Hartmann’s procedures (HART) performed in the patient group, where respectively 30%, 46% and 60%, received systemic treatment. Based on postoperative histopathological assessment, disease staging was assigned as follows: stage III for 32 (43%), patient­s,stage II for 22 (29%) and stage I for 15 (20%). Pathologic complete pathological response (pCR) was seen in 6 cases (8%). In the postCT+ group, disease stage III was observed in 13 (41%) patients. A three-year survival was observed in 43 patients; 25 (58%) and 18 (56%) of patients respectively undergoing either postCT– or postCT+. A five-year survival was noted in 26 patients; 19 (44%) and 7 (22%) in both groups, respectively. Conclusion. Together with the most recent reports, our study demonstrates that postoperative chemotherapy has no significant effect on the outcomes of oncological treatment in those patients having undergone preoperative chemoradiotherapy for locoregionally advanced rectal cancer

Rola chemioterapii pooperacyjnej u chorych operowanych po radiochemioterapii z powodu nieresekcyjnego pierwotnie raka odbytnicy

   Wstęp. Radiochemioterapia przedoperacyjna (pre-CRT) daje możliwość kontroli miejscowej raka odbytnicy. Ten rodzaj terapii jest szczególnie uzasadniony w zaawansowanych lokoregionalnie nowotworach. Współcześnie rola chemioterapii pooperacyjnej (post-CT) u tych chorych jest dyskutowana. Materiał. Od stycznia 2003 do grudnia 2012 r. w Centrum Onkologii w Bydgoszczy zoperowano radykalnie 75 chorych z nieresekcyjnymi guzami cT3–4 i/lub N+ po pre-CRT. U 32 z nich zastosowano jednocześnie post-CT, co stanowiło 43%. Wyniki. Wykonano 20 zabiegów APR (amputacja brzuszno-kroczowa), 50 AR (przednia resekcja) i 5 HART (operacja Hartmana) w obu grupach, gdzie pacjenci, u których zastosowano leczenie systemowe po zabiegu, stanowili odpo­wiednio 30%, 46% i 60%. W oparciu o wynik histopatologii (pooperacyjny) u 32 (43%) pacjentów stwierdzono III st. zaawansowania choroby, u 22 (29%) osób II st. zaawansowania, zaś u 15 (20%) — I st. zaawansowania. Całkowitą odpowiedź patologiczną (pCR) odnotowano w 6 (8%) przypadkach. U chorych pre-CRT + post-CT III st. zaawanso­wania potwierdzono u 13 (41%) osób. 3-letnie przeżycia obserwowano u 43 pacjentów — odpowiednio u 25 (58%) chorych poddanych wyłącznie pre-CRT oraz u 18 (56%), u których zastosowano również post-CT. 5-letnie przeżycia zaobserwowano u 26 chorych: odpowiednio 19 (44%) oraz 7 (22%). Wniosek. Na podstawie analizy materiału oraz w świetle najnowszych doniesień chemioterapia pooperacyjna u pacjentów poddanych radiochemioterapii przedoperacyjnej z powodu zaawansowanego lokoregionalnie raka odbytnicy nie wpływa znacząco na wyniki leczenia onkologicznego

Shale Gas in Poland

An example of interpretation of the Silurian and Ordovician shale formations in the Baltic Basin in Poland regarding determination of potential sweet spots is presented. Short geological information shows the position of shale gas play. Description of the data—laboratory measurement outcomes (petrophysical and geochemical) and well logging—presents results available for analyses. Detailed elemental analyses and various statistical classifications show the differentiation between sweet spots and adjacent formations. Elastic property modelling based on the known theoretical models and results of comprehensive interpretation of well logs is a good tool to complete information, especially in old wells. Acoustic emission investigations show additional characteristic features of shale gas rock and reveal that acoustic emission and volumetric strain of a shale sample induced by the sorption processes are lower for shale than for coals

Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study

Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Methods: Patients with stage I-III rectal cancer were treated with curative intent. The necessity for radiotherapy and chemotherapy was determined before surgery and/or postoperative histopathological results. Results: Of 365 rectal cancer patients, 76 (20.8%) developed recurrent disease. In total, 27 (7.4%) patients presented with a local tumor recurrence (isolated in 40.7% of cases). Radiotherapy was performed in 296 (81.1%) patients. The most often used schema was 5 × 5 Gy followed by immediate surgery (n = 214, 58.6%). Local recurrence occurred less frequently in patients treated with 5 × 5 Gy radiotherapy followed by surgery (n = 9, 4%). Surgical procedures of relapses were performed in 12 patients, six of whom were operated with radical intent. Only two (7.4%) patients lived more than 5 years after local recurrence treatment. The incidence of local recurrence was associated with primary tumor distal location and worse prognosis. The median overall survival of patients after local recurrence treatment was 19 months. Conclusions: Individualized rectal cancer patient selection and systematic treatment algorithms should be used clinical practice to minimize likelihood of relapse. 5 × 5 Gy radiotherapy followed by immediate surgery allows good local control in resectable cT2N+/cT3N0 patients. Radical resection of isolated local recurrence offers the best chances of cure

Plasma protein changes reflect colorectal cancer development and associated inflammation

Abstract Introduction: Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of death worldwide. Efficient non-invasive blood-based biomarkers for CRC early detection and prognosis are urgently needed. Methods: To identify novel potential plasma biomarkers, we applied a proximity extension assay (PEA), an antibody-based proteomics strategy to quantify the abundance of plasma proteins in CRC development and cancer-associated inflammation from few μL of plasma sample. Results: Among the 690 quantified proteins, levels of 202 plasma proteins were significantly changed in CRC patients compared to age-and-sex-matched healthy subjects. We identified novel protein changes involved in Th17 activity, oncogenic pathways, and cancer-related inflammation with potential implications in the CRC diagnosis. Moreover, the interferon γ (IFNG), interleukin (IL) 32, and IL17C were identified as associated with the early stages of CRC, whereas lysophosphatidic acid phosphatase type 6 (ACP6), Fms-related tyrosine kinase 4 (FLT4), and MANSC domain-containing protein 1 (MANSC1) were correlated with the late-stages of CRC. Discussion: Further study to characterize the newly identified plasma protein changes from larger cohorts will facilitate the identification of potential novel diagnostic, prognostic biomarkers for CRC

Frequent genetic differences between matched primary and metastatic breast cancer provide an approach to identification of biomarkers for disease progression

Breast cancer is a major cause of morbidity and mortality in women and its metastatic spread is the principal reason behind the fatal outcome. Metastasis-related research of breast cancer is however underdeveloped when compared with the abundant literature on primary tumors. We applied an unexplored approach comparing at high resolution the genomic profiles of primary tumors and synchronous axillary lymph node metastases from 13 patients with breast cancer. Overall, primary tumors displayed 20% higher number of aberrations than metastases. In all but two patients, we detected in total 157 statistically significant differences between primary lesions and matched metastases. We further observed differences that can be linked to metastatic disease and there was also an overlapping pattern of changes between different patients. Many of the differences described here have been previously linked to poor patient survival, suggesting that this is a viable approach toward finding biomarkers for disease progression and definition of new targets useful for development of anticancer drugs. Frequent genetic differences between primary tumors and metastases in breast cancer also question, at least to some extent, the role of primary tumors as a surrogate subject of study for the systemic disease