Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Manifestations in the esophagus in the scleroderma model induced by type V collagen in rabbits

Introdução: a esclerose sistêmica progressiva acomete diversas vísceras, das quais o esôfago é uma das mais freqüentemente lesadas. No entanto, o mecanismo de autoimunidade nesta enfermidade é ainda desconhecido. Objetivo: avaliar morfologicamente esôfagos de animais após imunização com colágeno tipo V, correlacionando-os com as alterações observadas em humanos. Materiais e métodos: foram analisados esôfagos de coelhos do modelode esclerodermia induzido por colágeno V. As amostras foram analisadas morfologicamente pelas técnicas de H&E, Tricrômico de Masson, Picro Sirius e Imunofluorescência. Resultados: observou-se aumento progressivo das fibras colágenas, caracterizado por alterações no epitélio, submucosa, camada muscular e adventícia. A análise da imunofluorescência revelou a existência de remodelamento dos diferentes tipos de colágeno da matriz. Discussão: o estudo de espécimes esofágicos em humanos é difícil. Na maioria das vezes só é possível analisá-lo em fases avançadas da doença. No modelo estudado acreditamos que as alterações observadas estão relacionadas a um processo inicial da doença e que o estudo de animais sacrificados após um tempo maior irá revelar uma fase mais avançada da doença.Backgrounds: Sclerosis systemic that usually affects the esophagus. However its patologic mechanism is still unknown. Objective: Evaluate the manifestation of the esophagus in a experimental model of scleroderma induced by type V collagen in rabbits. Matherial and Methods: 39 rabbits submited to the model immunization were morfologicaly analised. Results: A progressive deposit of collagen fibers was observed in H&E and Tricomico of Masson. Which was confirmed by the imunofluorescence. Conclusion: We concluded that the characteristics observeds are similar to what happens in the esophagus of human, but in an earlier period

Microsatellite instability in young patients with rectal cancer: molecular findings and treatment response

No abstract available

La défense sociale et la nouvelle pénologie comme outils d'analyse de la conception du libéré conditionnel dans la législation belge (1888-2006)

Importance The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes