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Colorectal Cancer: Current Concept and Emerging Treatments
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Colorectal Cancer: Current Concept and Emerging Treatments

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 4627

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 Issues, Collections and Topics in MDPI journals

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

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Keywords

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

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Published Papers (3 papers)

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Research

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11 pages, 888 KiB  
Article
Is an Electronic Nose Able to Predict Clinical Response following Neoadjuvant Treatment of Rectal Cancer? A Prospective Pilot Study
by Ivonne J. H. Schoenaker, Alexander Pennings, Henderik L. van Westreenen, Evelyn J. Finnema, Richard M. Brohet, Julia Hanevelt, Wouter H. de Vos Tot Nederveen Cappel and Jarno Melenhorst
J. Clin. Med. 2024, 13(19), 5889; https://doi.org/10.3390/jcm13195889 - 2 Oct 2024
Cited by 1 | Viewed by 1034
Abstract
Introduction: A watch-and-wait strategy for patients with rectal cancer who achieve a clinical complete response after neoadjuvant (chemo) radiotherapy is a valuable alternative to rectal resection. In this pilot study, we explored the use of an electronic nose to predict response to [...] Read more.
Introduction: A watch-and-wait strategy for patients with rectal cancer who achieve a clinical complete response after neoadjuvant (chemo) radiotherapy is a valuable alternative to rectal resection. In this pilot study, we explored the use of an electronic nose to predict response to neoadjuvant therapy by analyzing breath-derived volatile organic compounds. Materials and Methods: A pilot study was performed between 2020 and 2022 on patients diagnosed with intermediate- or high-risk rectal cancer who were scheduled for neoadjuvant therapy. Breath samples were collected before and after (chemo) radiotherapy. A machine-learning model was developed to predict clinical response using curatively treated rectal cancer patients as controls. Results: For developing the machine-learning model, a total of 99 patients were included: 45 patients with rectal cancer and 54 controls. In the training set, the model successfully discriminated between patients with and without rectal cancer, with a sensitivity and specificity of 0.80 and 0.65, respectively, and an accuracy of 0.72. In the test set, the model predicted partial or (near) complete response with a sensitivity and specificity of 0.64 and 0.47, respectively, and an accuracy of 0.58. The AUC of the ROC curve was 0.63. Conclusions: The prediction model developed in this pilot study lacks the ability to accurately differentiate between partial and (near) complete responders with an electronic nose. Machine-learning studies demand a substantial number of patients and operate in a rapidly evolving field. Therefore, the prevalence of disease and duration of a study are crucial considerations for future research. Full article
(This article belongs to the Special Issue Colorectal Cancer: Current Concept and Emerging Treatments)
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9 pages, 3148 KiB  
Article
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 4 | Viewed by 1414
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 [...] Read more.
(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  
Review
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
Cited by 3 | Viewed by 1635
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 [...] Read more.
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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