Journal of Clinical Medicine

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Special Issue Editor

Dr. Philipp Horvath

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Guest Editor

Department of General, Visceral and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800 Feldkirch, Austria
Interests: peritoneal metastasis; rectal cancer; liver and pancreas surgery

Special Issue Information

Dear Colleagues,

This Special Issue focuses on current surgical concepts (robotic versus laparoscopic rectal cancer surgery) as well as by standing treatment and therapy options, such as total neoadjuvant therapy for high-risk rectal cancer (cT4,cN2, EMVI+, CRM+ and lateral pelvic nodes), the possibility of neoadjuvant immunotherapy for dMMR-colon cancer (NICHE-2- study), and finally, the management of a complete pathological response after neoadjuvant therapy, especially for patients unsuitable for sphincter-sparing surgery. Furthermore, evidence needs to be gathered regarding indications for adjuvant chemotherapy after neoadjuvant chemoradiotherapy with an ypN+-situation and Dworak-Stadium II and III.

Dr. Philipp Horvath
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

colorectal cancer
robotic
minimally invasive
total neoadjuvant therapy
neoadjuvant immunotherapy
watch and wait
adjuvant chemotherapy

Published Papers (2 papers)

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Research

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9 pages, 3148 KiB

Open AccessFeature PaperArticle

Possible Advantages of Minimal-Invasive Approaches in Rectal Cancer Surgery: A Nationwide Analysis

by Philipp Horvath, Christoph Steidle, Can Yurttas, Isabella Baur, Alfred Königsrainer and Ingmar Königsrainer

J. Clin. Med. 2023, 12(14), 4765; https://doi.org/10.3390/jcm12144765 - 19 Jul 2023

Cited by 1 | Viewed by 776

Abstract

(1) Background: Laparoscopic resection for colon and rectal cancer was introduced in the early 1990s; the aim of this analysis was to show possible advantages of minimal-invasive approaches in rectal cancer surgery. (2) Methods: From 2016 to 2020, all patients undergoing open, laparoscopic or robotic-assisted rectal cancer surgery in Germany were retrospectively analyzed regarding sex distribution, conversion rates and in-hospital mortality rates according to nationwide hospital billing data based on diagnosis-related groups (DRGs). (3) Results: In total, 68,112 patients were analyzed, and most commonly, low anterior rectal resections with primary anastomosis (n = 25,824) were performed with an increase of minimal-invasive procedures over the years (open: 51% to 27%; laparoscopic: 47% to 63% and robotic: 2% to 10%). In-hospital mortality rate was 2.95% (n = 2012). In total, 4.61%, 1.77%, 1.14% and 3.95% of patients with open, laparoscopic, robotic and converted-to-open surgery died during hospital stay, respectively (open vs. laparoscopic p < 0.0001; open vs. robotic p < 0.00001; laparoscopic vs. robotic p = 0.001). Conversion rates were significantly more favorable in the robotic compared to the laparoscopic group. (11.94% vs. 2.53%; p < 0.0001). (4) Conclusion: Minimal-invasive rectal cancer surgery might have some advantages in terms of a reduced in-hospital mortality, and an improved conversion rate for the robotic approach. Full article

(This article belongs to the Special Issue Colorectal Cancer: Current Concept and Emerging Treatments)

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Review

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11 pages, 625 KiB

Open AccessReview

The Antineoplastic Effect of Heparin on Colorectal Cancer: A Review of the Literature

by Emmanuel Giannas and Christos Kontovounisios

J. Clin. Med. 2023, 12(22), 7173; https://doi.org/10.3390/jcm12227173 - 19 Nov 2023

Viewed by 886

Abstract

Heparin and derivatives are commonly used for thrombophylaxis in surgical colorectal cancer (CRC) patients. Recent studies have suggested that, besides its protective effect on the incidence of venous thromboembolism, heparin has an anti-cancer effect. The aim of this review was to explore the literature and report the antineoplastic effect of heparin and derivatives on CRC. MEDLINE and EMBASE databases were searched for relevant articles. Nineteen studies were included (n = 19). Fifteen were lab studies conducted in vivo or in vitro on CRC cell lines and/or mice (n = 15). Four were in vivo clinical studies (n = 4). CRC tumor growth was reduced by 78% in one study, (p < 0.01), while tumorigenesis was suppressed in heparin-treated mice in seven studies. A high dose of low molecular weight heparin for extended duration significantly reduced post-operative VEGF, suggesting that such a regime may inhibit tumor angiogenesis and distant metastasis. A randomized trial demonstrated the antineoplastic effect of nadroparin as the 6 month survival in palliative patients increased. Another study has reported that disease-free survival of CRC patients was not affected by a similar tinzaparin regime. The anti-cancer properties of heparin and derivatives are promising, especially in lab studies. Further clinical trials are needed to investigate the anti-cancer benefit of heparin on CRC. Full article

(This article belongs to the Special Issue Colorectal Cancer: Current Concept and Emerging Treatments)

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