The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Recent advancement in modern genomic tools for adaptation of Lablab purpureus L to biotic and abiotic stresses: present mechanisms and future adaptations

Not AvailableHyacinth bean is an important traditional plant with substantial medicinal value. Being imperative, it is still less explored crop on genomic and transcriptomic scale that has indexed it as an “orphan” crop for its genome revolution. Among different crop legumes such as pigeon pea, chickpea, cowpea, soybean and common bean, hyacinth bean also serves as a significant source of nutrition for both tropical and temperate regions and execute an imperative function in fixing biological nitrogen in agriculture. Nonetheless, the productivity of hyacinth bean is restrained due to environmental and biotic cues. Thus, understanding of the genomic functions and identification of probable genes/proteins for major agronomic traits through transcriptomic approaches has become imperative to improve stress tolerance in hyacinth bean. For understanding the plant stress tolerance mechanisms, the deployment of functional genomics approaches viz., proteomics and metabolomics have become imperious in breeding programs in developing countries. These approaches have been successfully used in other legume crops to create protein reference maps and their exploitation through comparative approaches can greatly enhance the research and understanding of hyacinth bean biological processes to changing environmental conditions. In this review, emerging epigenomics, proteomics, metabolomics and phenomics approaches and their achievements both in model/crop legumes are discussed. Additionally, the review also provides an overview of the applications of advanced proteomics, metabolomics and next-generation sequencing technologies in the discovery of candidate biomarkers for the development of agronomically refined hyacinth bean which may further ensure food and nutritional security under adverse climacteric conditions in developing countries.Not Availabl