• CEACAM6
• FOXA1
• circDIAPH1
• circRNAs
• colorectal cancer (CRC)
• liver metastasis

• Humans
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/metabolism
• Liver Neoplasms/secondary
• Liver Neoplasms/genetics
• Liver Neoplasms/metabolism
• RNA, Circular/genetics
• Animals
• Mice
• Gene Expression Regulation, Neoplastic
• Cell Proliferation/genetics
• Cell Adhesion Molecules/genetics
• Cell Adhesion Molecules/metabolism
• Cell Line, Tumor
• GPI-Linked Proteins/genetics
• GPI-Linked Proteins/metabolism
• Biomarkers, Tumor/genetics
• Mice, Nude
• Apoptosis
• Male
• Female
• Mice, Inbred BALB C
• Xenograft Model Antitumor Assays
• Antigens, CD

• This wok was supported by Youth Foundation of Changhai Hospital Affiliated to Naval Medical University (No. 2020QNB06).

• colon cancer liver metastasis
• transarterial chemoembolization
• transarterial radioembolization

• minimally invasive surgery
• neoadjuvant chemotherapy
• personalized treatment strategies
• staged resection
• synchronous colorectal liver metastases (scrlm)

• bispecific antibodies
• efficacy
• immunotherapy
• multiple myeloma
• safety

• Humans
• Multiple Myeloma/therapy
• Antibodies, Bispecific/adverse effects
• B-Cell Maturation Antigen
• Prospective Studies
• Neurotoxicity Syndromes
• Neutropenia

• Imaging examination
• Multidisciplinary team
• Oncological outcome
• Synchronous colorectal liver metastases
• Treatment strategy

• Colorectal cancer
• Hepatic resection
• Liver metastasis
• Prognosis

• Humans
• China
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/therapy
• Liver Neoplasms/diagnosis
• Liver Neoplasms/secondary
• Liver Neoplasms/therapy
• Prognosis
• United States

• No. SZSM201911012 Sanming Project of Medicine

• anastomotic leak
• metastatic colon cancer
• neoadjuvant therapy
• simultaneous resection
• synchronous liver metastasis

• Liver-first
• Rectal adenocarcinoma
• Rectal preservation
• Synchronous liver metastases

• Humans
• Retrospective Studies
• Liver
• Rectal Neoplasms/surgery
• Hepatectomy
• Morbidity

• Aged
• Colectomy/adverse effects
• Colorectal Neoplasms/pathology
• Female
• Hepatectomy/adverse effects
• Humans
• Liver Neoplasms/secondary
• Liver Neoplasms/surgery
• Male
• Middle Aged
• Proto-Oncogene Proteins p21(ras)

• Rab35
• TRX2
• exosome
• migration
• mitochondria
• protein–protein interaction

• colorectal liver metastasis
• elderly
• propensity score matching
• simultaneous resection

Colorectal cancer is the third most common cancer in France and by the time of the diagnosis, 15–25% of patients will suffer from synchronous liver metastases. Surgery associated to neoadjuvant treatment can cure these patients, but few studies focus only on rectal cancer. This study was meant to compare the outcomes of patients who underwent a simultaneous resection to those who underwent a staged resection (rectum first or liver first) in the University Hospital of Tours, France.

We assessed retrospectively a prospective maintained data base about the clinical, pathological and survival outcomes of patients who underwent a simultaneous or a staged resection in our center between 2010 and 2018. A propensity score matching was used, considering the initial characteristics of our groups.

There were 70 patients (55/15 males, female respectively) with median age 60 (54–68) years. After matching 48 (69%) of them underwent a staged approach and 22 (31%) a simultaneous approach were compared. After PSM, there were 22 patients in each group. No differences were found in terms of morbidity (p = 0.210), overall survival (p = 0.517) and disease-free survival (p = 0.691) at 3 years after matching. There were significantly less recurrences in the simultaneous group (50% vs 81.8%, p = 0.026).

Simultaneous resection of the rectal primary cancer and synchronous liver metastases is safe and feasible with no difference in terms of survival.

The online version contains supplementary material available at 10.1186/s12876-022-02250-9.

• Rectal cancer
• Simultaneous resection
• Staged resection
• Synchronous liver metastasis

• colorectal cancer CRC
• consensus recommendations
• management in a lower-middle income country
• metastatic CRC

• Sanofi (Biopharmaceutical company) and Servier Laboratories (pharmaceutical company)

• colorectal liver metastases
• robotic surgery
• systematic review

• gastrointestinal stromal tumours
• laparoscopic surgery
• laparoscopy
• minimally invasive surgery
• recurrence
• survival

• Colorectal cancer
• Consensus
• Minimally invasive surgery
• Synchronous colorectal liver metastases

• Colorectal Neoplasms/surgery
• Consensus
• Hepatectomy
• Humans
• Italy
• Liver Neoplasms/surgery

To provide expert guidance to clinicians and policymakers in resource-constrained settings on the management of patients with late-stage colorectal cancer.

ASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines, conducted a modified ADAPTE process, and used a formal consensus process with additional experts for two rounds of formal ratings.

Existing sets of guidelines from four guideline developers were identified and reviewed; adapted recommendations from five guidelines form the evidence base and provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% on all recommendations.

Common elements of symptom management include addressing clinically acute situations. Diagnosis should involve the primary tumor and, in some cases, endoscopy, and staging should involve digital rectal exam and/or imaging, depending on resources available. Most patients receive treatment with chemotherapy, where chemotherapy is available. If, after a period of chemotherapy, patients become candidates for surgical resection with curative intent of both primary tumor and liver or lung metastatic lesions on the basis of evaluation in multidisciplinary tumor boards, the guidelines recommend patients undergo surgery in centers of expertise if possible. On-treatment surveillance includes a combination of taking medical history, performing physical examinations, blood work, and imaging; specifics, including frequency, depend on resource-based setting.

Additional information is available at www.asco.org/resource-stratified-guidelines.

Spinster homologue 2 (SPNS2), a transporter of S1P (sphingosine-1-phosphate), has been reported to mediate immune response, vascular development, and pathologic processes of diseases such as cancer via S1P signaling pathways. However, its biological functions and expression profile in colorectal cancer (CRC) is elusive. In this study, we disclosed that SPNS2 expression, which was regulated by copy number variation and DNA methylation of its promoter, was dramatically upregulated in colon adenoma and CRC compared to normal tissues. However, its expression was lower in CRC than in colon adenoma, and low expression of SPN2 correlated with advanced T/M/N stage and poor prognosis in CRC. Ectopic expression of SPNS2 inhibited cell proliferation, migration, epithelial–mesenchymal transition (EMT), invasion, and metastasis in CRC cell lines, while silencing SPNS2 had the opposite effects. Meanwhile, measuring the intracellular and extracellular level of S1P after overexpression of SPNS2 pinpointed a S1P-independent model of SPNS2. Mechanically, SPNS2 led to PTEN upregulation and inactivation of Akt. Moreover, AKT inhibitor (MK2206) abrogated SPNS2 knockdown-induced promoting effects on the migration and invasion, while AKT activator (SC79) reversed the repression of migration and invasion by SPNS2 overexpression in CRC cells, confirming the pivotal role of AKT for SPNS2’s function. Collectively, our study demonstrated the suppressor role of SPNS2 during CRC metastasis, providing new insights into the pathology and molecular mechanisms of CRC progression.

• PTEN/AKT
• SPNS2
• colorectal cancer (CRC)
• epithelial–mesenchymal transition
• invasion
• metastasis

• primary tumor resection
• surgical treatment
• survival analysis
• synchronous colorectal liver metastases

• cancer metabolism
• gastrointestinal cancer

• Adenocarcinoma/genetics
• Adenocarcinoma/metabolism
• Adenocarcinoma/secondary
• Aged
• Animals
• Caco-2 Cells
• Cell Movement
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/metabolism
• Colorectal Neoplasms/pathology
• DNA (Cytosine-5-)-Methyltransferases/genetics
• DNA (Cytosine-5-)-Methyltransferases/metabolism
• DNA Methylation
• DNA-Binding Proteins/genetics
• DNA-Binding Proteins/metabolism
• Enhancer of Zeste Homolog 2 Protein/genetics
• Enhancer of Zeste Homolog 2 Protein/metabolism
• Epithelial-Mesenchymal Transition
• Female
• Gene Expression Regulation, Neoplastic
• Gene Silencing
• HCT116 Cells
• HT29 Cells
• Humans
• Liver Neoplasms/genetics
• Liver Neoplasms/metabolism
• Liver Neoplasms/secondary
• Male
• Mice, Inbred BALB C
• Mice, Nude
• Middle Aged
• Neoplasm Invasiveness
• Promoter Regions, Genetic
• RNA, Long Noncoding/genetics
• RNA, Long Noncoding/metabolism
• Tumor Suppressor Proteins/genetics
• Tumor Suppressor Proteins/metabolism
• Mice

The paper aims to assess the association between Hepatitis B Virus infection and colorectal liver metastasis by conducting a meta-analysis. The relevant studies were searched until 24 July 2020, Studies that assessed the correlation between HBV infection and CRLM were recruited. A random effects model was applied to calculate the odds ratio (OR) with 95% confidence interval (CI). All data analyses were performed by STATA 12.0 software. Ten studies involving 17529 participants were included in the study. The results shown that there was obvious association between HBV infection and CRLM (OR: 0.51, 95% CI: 0.28–0.91). The study type and case–control rate may be the main causes of heterogeneity. In addition, HBV infection had no association with extrahepatic metastasis or prognosis of patients with CRLM. Sensitivity analyses confirmed that the results were stable, and Egg’s test indicated that there was no publication bias. Patients with HBV infection have the reduced risk of CRLM.

• Hepatitis B Virus
• colorectal liver metastasis
• meta-analysis

Liver metastasis is the most common form of distant metastasis in colorectal cancer and is a key factor for prognosis in patients with colorectal cancer. Surgery may be the only way to cure colorectal liver metastases. This paper mainly summarizes the latest progress in surgical treatment of colorectal liver metastases, including how to increase resection rate of liver metastases with neoadjuvant therapy or staged hepatectomy, the effect of surgical margin on the prognosis of patients, the timing of surgery in patients with synchronous colorectal liver metastasis, the impact of laparoscopic hepatectomy of liver metastases, the application of liver transplantation in patients with colorectal liver metastases, etc, with an aim to help develop an optimal treatment for patients with colorectal liver metastases through combination of surgical innovations with individualized treatment, thereby improving patients' disease-free survival and overall survival.

• Colorectal liver metastasis
• Surgery
• Prognosis

This study is aimed at investigating predictive and prognostic factors of synchronous colorectal lung-limited metastasis (SCLLM) based on The Surveillance, Epidemiology, and End Results (SEER) database.

A multivariate logistic regression model was constructed to identify independent predictors of SCLLM. A multivariate Cox proportional hazards regression model was used to distinguish independent prognostic factors.

This study enrolled 168,007 colorectal cancer (CRC) patients without metastatic diseases and 1,298 cases with SCLLM. Eight features, involving race, tumor location, pathological grade, histological type, T stage, N stage, and tumor size as well as CEA, could be used as the independent predictors. As the nomogram shown, the T4 stage contributed the most to SCLLM, followed by the N2 stage, elevated CEA, and rectal cancer. A multivariate regression analysis discriminated 9 independent prognostic factors, including age, race, marital status, pathological grade, T stage, colectomy/proctectomy, chemotherapy, CEA, and TD. The prognostic nomogram illustrated that nonresection/NOS played as the poorest prognostic factor, followed by nonchemotherapy, ≥75-year old and T4 stage. The cumulative survival curves revealed the influence of each prognostic factor on survival after controlling the other variables.

This study identified independent predictors and prognostic factors for SCLLM based on a large database of the United States. The predictors and prognostic factors can provide supporting evidence for the prevention and treatment of SCLLM.

• Colorectal surgery
• Intraoperative ultrasonography
• Liver surgery
• Mini-invasive surgery
• Parenchymal-sparing liver resection
• Simultaneous resection
• Synchronous colorectal liver metastases

• Colorectal Neoplasms/surgery
• Hepatectomy
• Humans
• Laparoscopy
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/surgery

Colorectal cancer (CRC) is the third and second most common type of cancer diagnosed in males and females, respectively, and is the fourth leading cause of cancer-associated mortality worldwide. Liver metastasis is the primary cause of mortality in patients with CRC, and therefore requires therapeutic focus. Regulatory T cells (Tregs) and hepatic stellate cells (HSCs) are potentially involved in regulating the immune response during liver metastasis. The aim of the present study was to evaluate the influence of CD4⁺ forkhead box p3 (Foxp3)⁺ Tregs and the HGF/c-Met signaling pathway in the liver metastasis of CRC. A model of the latter was established using Balb/c mice via splenic injection of human CRC cells (CT-26 line). The mice were monitored for 3 weeks after being injected, and the spleens and livers were removed on day 22 for further analysis. Moreover, the single-cell suspensions were labeled with CD4 and Foxp3 antibodies, and were analyzed using flow cytometry. Expression levels of α-smooth muscle actin (SMA), hepatocyte growth factor (HGF) and hepatocyte growth factor receptor (c-Met) were analyzed using immunohistochemistry. Mice injected with CT-26 cells exhibited signs of illness and significant weight loss, compared with the control mice (P=0.013), and they also developed liver metastases, at an average of 20.5 tumors per mouse. Pathological evaluation using hematoxylin and eosin staining confirmed the tumors as liver metastases of CRC. The numbers of CD4⁺ T cells were significantly decreased in the spleen (P<0.001) and liver (P=0.003) of tumor-bearing mice, while the proportions of CD4⁺FOXP3⁺ Tregs increased significantly in the spleen (P<0.001) and liver (P=0.026) compared with that in the controls. Additionally, α-SMA, HGF and c-Met levels increased significantly during metastatic growth in the liver. In conclusion, CD4⁺FOXP3⁺ Treg levels increased and the HGF/c-Met pathway was upregulated during the liver metastasis of CRC in mice, indicating the presence of potential therapeutic targets.

• CD4+ T cells
• CD4+FOXP3+ Treg
• colorectal cancer
• hepatic stellate cells
• liver metastasis

• Colorectal cancer
• Liver metastasis
• Metachronous
• Neoadjuvant chemotherapy
• Survival
• Synchronous

• Colorectal liver metastases
• Liver resection
• Microwave ablation
• Radiofrequency ablation

• Ablation Techniques/methods
• Carcinoma/secondary
• Carcinoma/surgery
• Colorectal Neoplasms/pathology
• Cryosurgery/methods
• Disease Progression
• Disease-Free Survival
• Electroporation/methods
• Humans
• Liver Neoplasms/secondary
• Liver Neoplasms/surgery
• Radiofrequency Ablation/methods
• Survival Rate
• Treatment Outcome

• colorectal cancer
• liver resection
• synchronous colorectal liver metastasis

Pancreatic ductal adenocarcinoma (PDAC) has a bleak prognosis, especially for the majority of patients diagnosed with metastatic disease. The primary option for palliative treatment is chemotherapy, and responses beyond first-line treatment are rare and typically short. Here, we report a case of a 63-year-old woman with PDAC in the head of the pancreas who was initially successfully treated by pancreaticoduodenectomy followed by adjuvant chemotherapy with gemcitabine. However, disease recurrence with liver and para-aortic lymph node metastases was detected only two months after the completion of adjuvant chemotherapy. First-line palliative chemotherapy with gemcitabine-nab/paclitaxel was commenced. The results were discouraging, with disease progression (liver and lung metastases) detected at the first evaluation; the progression-free survival was just two months (64 days). Surprisingly, the response to second-line palliative chemotherapy with 5-fluorouracil-oxaliplatin was excellent; in combination with the ablation of a liver metastasis, this treatment regimen resulted in a complete radiological response and an 11-month treatment-free interval with a sustained good performance status.

• Colorectal cancer
• Colorectal liver metastases
• Population-based study
• Simultaneous resection
• Synchronous metastases

• Adult
• Aged
• Aged, 80 and over
• Colorectal Neoplasms/pathology
• Female
• Hepatectomy/adverse effects
• Hepatectomy/methods
• Humans
• Liver Neoplasms/secondary
• Liver Neoplasms/surgery
• Logistic Models
• Male
• Middle Aged
• Neoplasms, Multiple Primary/surgery
• Postoperative Complications/etiology
• Retrospective Studies

• Forecasting/methods
• Humans
• Models, Theoretical
• Neoplasm Metastasis/physiopathology
• Neoplasm Recurrence, Local/physiopathology
• Neoplasms/metabolism

• Colon cancer
• chemotherapy
• liver metastases
• rectal cancer
• survival

Colorectal cancer is a major health concern as a very common cancer and a leading cause of cancer-related mortality worldwide. The liver is a very common site of metastatic spread for colorectal cancers, and, while nearly half of the patients develop metastases during the course of their disease, synchronous liver metastases are detected in 15% to 25% of cases. There is no standardized treatment in this setting and no consensus exists on optimal sequencing of multimodality management for rectal cancer with synchronous liver metastases.

Herein, we review the use of pelvic radiation therapy (RT) as part of potentially curative or palliative management of rectal cancer with synchronous liver metastases.

There is accumulating evidence on the utility of pelvic RT for facilitating subsequent surgery, improving local tumor control, and achieving palliation of symptoms in patients with stage IV rectal cancer. Introduction of superior imaging capabilities and contemporary RT approaches such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) offer improved precision and toxicity profile of radiation delivery in the modern era.

Even in the setting of stage IV rectal cancer with synchronous liver metastases, there may be potential for extended survival and cure by aggressive management of primary tumor and metastases in selected patients. Despite lack of consensus on sequencing of treatment modalities, pelvic RT may serve as a critical component of multidisciplinary management. Resectability of primary rectal tumor and liver metastases, patient preferences, comorbidities, symptomatology, and logistical issues should be thoroughly considered in decision making for optimal management of patients.