• ASA
• PNI
• colorectal cancer
• nomogram
• postoperative complications

• Colorectal surgery
• EPIDEMIOLOGY
• Gastrointestinal tumours
• ONCOLOGY
• PATHOLOGY

• Humans
• Incidence
• Retrospective Studies
• Colorectal Neoplasms/epidemiology
• Cross-Sectional Studies
• Indonesia
• Colonic Neoplasms/pathology

Approximately 20 percent of patients with a tumour localized in the low rectum still encounter the possibility of requiring permanent stoma (PS), which can cause drastic changes in lifestyle and physical perceptions.

To determine the risk factors for PS and to develop a prediction model to predict the probability of PS in rectal cancer patients after sphincter-saving surgery.

A retrospective cohort of 421 rectal cancer patients who underwent radical surgery at Taipei Medical University Hospital between January 2012 and December 2020 was included in this study. Univariate and multivariate analyses were performed to identify the independent risk factors for PS. A nomogram was developed according to the independent risk factors obtained in the multivariate analysis. The performance of the nomogram was assessed using a receiver operating characteristic curve and a calibration curve.

The PS rate after sphincter-saving surgery was 15.1% (59/391) in our study after a median follow-up of 47.3 mo (range 7–114 mo). Multivariate logistic regression analysis demonstrated that local recurrence, perirectal abscess, anastomosis site stenosis, perineural invasion, tumor size and operative time were independent risk factors for PS. These identified risk factors were incorporated into the nomogram, and the concordance index of this model was 0.903 (95%CI: 0.851-0.955). According to the calibration curves, the nomogram represents a perfect prediction model.

Several risk factors for PS after sphincter-saving surgery were identified. Our nomogram exhibited perfect predictive ability and will improve a physician’s ability to communicate the benefits and risks of various treatment options in shared decision making.

• Nomogram
• Permanent stoma
• Risk factor
• Shared decision making
• Sphincter-saving operation
• Rectal cancer

• colonic cancer
• prognosis
• rectal cancer
• risk prediction
• tumor size

• colorectal cancer
• primary tumor location
• prognosis
• tumor size
• tumor length times width (tltw)
• tumor width

• Adenocarcinoma/pathology
• Carcinoma, Renal Cell/pathology
• Colonic Neoplasms/pathology
• Colorectal Neoplasms/pathology
• Humans
• Kidney Neoplasms/pathology
• Neoplasm Staging
• Rectal Neoplasms/pathology
• Retrospective Studies

• immune
• immune infiltrate
• mRNA signature
• prognosis
• rectum adenocarcinoma

Patients with middle-aged and elderly rectal cancer (MERC) usually have poor prognosis after surgery. This study aimed to develop a nomogram to achieve individualized prediction of overall survival (OS) in patients with MERC and to guide follow-up and subsequent diagnosis and treatment plans.

A total of 349 patients were randomly assigned to the training and validation cohorts in a 7:3 ratio. Multivariate Cox regression analysis was performed using the results of univariate Cox regression analysis to confirm independent prognostic factors of OS. Thereafter, the nomogram was built using the “rms” package. Subsequently, discriminative ability and calibration of the nomogram were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Integrated discrimination improvement (IDI), net reclassification improvement (NRI), and the area under the ROC curves (AUC) were compared between the nomogram and the tumor-node-metastasis (TNM) staging system (8th edition). Finally, we established a predictive model to assess the survival benefit of patients with MERC by calculating nomogram scores for each patient.

Six variables were identified as independent prognostic factors and included in the nomogram: smoking history, family history, hematochezia, tumor size, N stage, and M stage. Based on these factors, we successfully constructed a nomogram and evaluated its discriminative and predictive abilities using ROC curves, calibration curves, and DCA. ROC curves, IDI, and NRI showed that the nomogram had outstanding clinical utility compared with the TNM staging system (8th edition) for OS prediction. The predictive model successfully distinguished between high-, medium-, and low-risk MERC patients.

Our nomogram provided a more satisfactory survival prediction ability than the TNM staging system (8th edition) for MERC patients. In addition, the nomogram was able to accurately categorize patients into different risk groups after surgery.

• the 2020 Hebei Provincial Finance Department Grant for Outstanding Talents in Clinical Medicine

• Surveillance Epidemiology and End Results (SEER)
• colorectal cancer
• distant metastasis
• nomogram
• prognosis

• National Natural Science Foundation of China

• Nomogram
• Overall survival
• Rectal cancer
• Young patients

• COX
• FUSCC
• colorectal cancer
• prognostic factors
• survive over five years

• SEER
• distant metastases
• lymph node status
• rectal cancer
• tumor size

• Colonic Neoplasms
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/therapy
• Endoscopy
• Humans
• Neoplasm Staging
• Prognosis
• Retrospective Studies

To assess the feasibility and short-term outcomes of neoadjuvant chemoradiotherapy (CCRT) followed by transanal total mesorectal excision assisted by single-port laparoscopic surgery (TaTME-SPLS) for low-lying rectal adenocarcinoma.

A total of 23 patients with clinical stage II-III low-lying (from anal verge 0-8 cm) rectal adenocarcinoma who underwent neoadjuvant CCRT followed by TaTME-SPLS consecutively from December 2015 to December 2018, were enrolled into our study. Chi-squared testing and Student’s t testing were used to make parametric comparisons, and Fisher’s exact test or the Mann–Whitney U test were used to make nonparametric comparisons.

Conversion rate in patients who underwent neoadjuvant CCRT followed by TaTME-SPLS was only 4%. The mean operation time was 366 min and the inter-sphincter resection (ISR) was done for 14 patients (60%). The mean number of lymph nodes harvested was 15. There was no surgical mortality, but the 30-day morbidity rate was 21% (5 patients were Clavien-Dindo I-II). Pathological complete response was 21.74% with 100% organ preservation and 100% clear distal margin after neoadjuvant CCRT followed by TaTME-SPLS.

TaTME-SPLS would be highly successful in lymph node negative and low T stage of low-lying rectal cancer patients who had pathological complete remission or high percentage of partial remission after neoadjuvant CCRT.

• Neoadjuvant CCRT
• Rectal adenocarcinoma
• TaTME-SPLS

• KRAS
• colorectal carcinoma
• histology
• mutation
• prognosis

Colorectal cancer (CRC) is a major killer. Host immunity is important in tumorigenesis. Direct comparison among IL-36α, IL-36β and IL-36γ in the prognosis of CRC is unclear.

CRC tissue arrays were generated from colorectostomy samples with TNM stage, invasion depth and the demography of these patients (n = 185). Using immunohistochemistry/histopathology, IL-36α, IL-36β and IL-36γ were determined, in comparison to non-cancer tissues.

A significant association was observed between colonic IL-36α, IL-36β or IL-36γ and the presence of cancer (with all P < 0.0001). Using ROC curve analysis, specificity and sensitivity of IL-36α, IL-36β or IL-36γ were confirmed, with area under the curve (AUC) values of 0.68, 0.73 and 0.65, respectively. Significant differences in survival were observed between IL-36α^high and IL-36α^low (P = 0.003) or IL-36γ^high and IL-36γ^low (P = 0.03). Survival curves varied significantly when further stratification into sub-groups, on the basis of combined levels of expression of two isotypes of IL-36 was undertaken. A significant difference was observed when levels of IL-36α and IL-36β were combined (P = 0.01), or a combination of IL-36α plus IL-36γ (P = 0.002). The sub-groups with a combination of IL-36α^high plus IL-36β^high, or IL-36α^high plus IL-36γ^low exhibited the longest survival time among CRC patients. In contrast, the sub-groups of IL-36α^low plus IL-36β^high or IL-36α^low plus IL-36γ^high had the shortest overall survival. Using the log-rank test, IL-36α^high expression significantly improved survival in patients with an invasion depth of T4 (P < 0.0001), lymph node metastasis (P = 0.04), TNM III-IV (P = 0.03) or with a right-sided colon tumour (P = 0.02). Similarly, IL-36γ^low expression was significantly associated with improved survival in patients with no lymph node metastasis (P = 0.008), TNM I-II (P = 0.03) or with a left-sided colon tumour (P = 0.05). Multivariate analysis demonstrated that among IL-36α, IL-36β and IL-36γ, only IL-36α (HR, 0.37; 95% CI, 0.16–0.87; P = 0.02) was an independent factor in survival, using Cox proportional hazards regression analysis.

IL-36α or IL-36γ are reliable biomarkers in predicting the prognosis of CRC during the later or early stages of the disease, respectively. Combining IL-36α plus IL-36γ appears to more accurately predict the postoperative prognosis of CRC patients. Our data may be useful in the management of CRC.

• Colorectal cancer
• IL36
• Multivariate analysis
• Prognosis

• Colorectal cancer
• IL-38
• Potential target
• Prognosis

• chemoradiation therapy
• intersphincteric resection
• rectal cancer

• Abdomen/surgery
• Adenocarcinoma/mortality
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Adenocarcinoma/therapy
• Adult
• Aged
• Anal Canal/surgery
• Chemoradiotherapy, Adjuvant
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Laparoscopy/methods
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Staging
• Proctectomy/methods
• Prognosis
• Rectal Neoplasms/mortality
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Rectal Neoplasms/therapy
• Retrospective Studies
• Survival Analysis
• Treatment Outcome

• colorectal cancer
• primary tumor location
• prognosis
• propensity score matching
• tumor size

• colorectal cancer
• liver metastasis
• radiofrequency assay
• survival
• systemic chemotherapy
• ultrasound

• Rectal adenocarcinoma
• distant metastasis
• total mesorectal excision

Rectal hemorrhage should be evaluated within a wide spectrum ranging from benign diseases to a malignant process. Especially, the melanomas of rectum are detected at an advanced stage when diagnosed since the present symptoms of rectal melanomas are similar. The question of what will be the surgical approach with MR, CT, and PET-CT imaging methods performed after histopathological diagnosis still conserves its topicality. PET-CT is a good imaging method for determination of distant metastasis and lymphatic involvement. In the present case, a patient with early-stage rectal melanoma was treated with APR. No relapse/metastasis was detected during the 18-month follow-up. The aggressive course of the disease and its low response rates to medical treatments may cause the surgical approaches to be more extensive.

• PET-CT
• abdominoperineal resection
• anorectal melanoma