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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 (15 September 2022) | Viewed by 14208

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Prof. Dr. Victor Jilbert Verwaal

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Guest Editor

Institut for Regional Sundhedforskning, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
Interests: peritoneal metastases; HIPEC; intraperitoneal chemotherapy; advanced rectal cancer

Special Issue Information

Dear Colleagues,

The treatment of advanced colorectal cancers is still an emerging field. Modern treatment of advanced colorectal cancers includes the combination of the best of both surgical and medical oncology options. Over the last 20 years, the technical development of the different treatment fields has been huge. However, integrating the different treatments into one another to obtain the best result remains complex. This is even more true in the complex situation where there are different treatments for the same disease.

These multimodality treatments come with hope for the patients for a better survival but can also end in a large burden for both patient and healthcare providers. Thus, there is an urgent need for multimodality treatments for a robust scientific backbone.

In this Special Issue, the focus will be on the results of multimodality treatments for advanced colorectal cancer. Of particular will be papers comparing the outcome, complications, and quality of life of different treatments.

Prof. Dr. Victor Jilbert Verwaal
Guest Editor

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Keywords

Multimodality treatment
Advanced colorectal cancer
MDT
Combination therapy

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Published Papers (6 papers)

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Research

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9 pages, 1984 KiB

Open AccessArticle

Efficacy of Serotonin Type 3 Receptor Antagonist Ramosetron on Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D)-Like Symptoms in Patients with Quiescent Inflammatory Bowel Disease: A Randomized, Double-Blind, Placebo-Controlled Trial

by Toshihiko Tomita, Hirokazu Fukui, Daisuke Morishita, Sumire Mori, Tadayuki Oshima, Shinichiro Shinzaki and Hiroto Miwa

J. Clin. Med. 2022, 11(23), 6882; https://doi.org/10.3390/jcm11236882 - 22 Nov 2022

Cited by 2 | Viewed by 2389

Abstract

Patients with quiescent inflammatory bowel disease (IBD) frequently suffer diarrhea-predominant irritable bowel syndrome (IBS-D)-like symptoms, such as abdominal pain or stool irregularities. Here, we assessed the effect of ramosetron, a serotonin type 3 (5-HT₃) receptor antagonist, on IBS-D-like symptoms in patients with quiescent IBD. Seventy patients with quiescent IBD, who met the Rome III diagnostic criteria for IBS-D, were randomly assigned to receive either ramosetron (5 μg; n = 35) or a placebo (n = 35) orally once daily for 4 weeks. The primary endpoint was the responder rate for global assessment of relief from overall IBS-D-like symptoms. The responder rates for relief of abdominal pain/discomfort and improvement of bowel habits were also evaluated. The responder rate for relief from overall IBS-D-like symptoms at the final evaluation point was significantly higher in the ramosetron group (35.5%) than in the placebo group (11.4%) (p = 0.037). The responder rate for improvement of bowel habits was significantly higher in the ramosetron group (38.7%) than in the placebo group (14.3%) (p = 0.028). The reduction of stool frequency was significantly greater in the ramosetron group than in the placebo group (p = 0.044). Ramosetron is effective for relief of overall IBS-D-like symptoms in patients with quiescent IBD. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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8 pages, 1378 KiB

Open AccessArticle

Serum Leucine-Rich α2 Glycoprotein: A Biomarker for Predicting the Presence of Ulcerative Colitis but Not Ulcerative Proctitis

by Ichitaro Horiuchi, Akira Horiuchi and Takeji Umemura

J. Clin. Med. 2022, 11(21), 6366; https://doi.org/10.3390/jcm11216366 - 28 Oct 2022

Cited by 7 | Viewed by 1593

Abstract

The serum level of leucine-rich α2 glycoprotein (LRG) is a biomarker for active ulcerative colitis (UC). We examined the serum level of LRG as a biomarker for predicting the presence of UC. Patients with persistent diarrhea and/or bloody stool with no history of UC were consecutively enrolled at their initial visit. Serum LRG measurement and colonoscopy with histology were performed on the same day. We enrolled 103 patients (69 men; median age, 45 years) with suspected UC; 66 patients were diagnosed with active UC (proctitis, n = 10; left-sided colitis, n = 26; and pancolitis, n = 30) based on endoscopic and histological criteria. Although the median LRG value in patients with proctitis was similar to that of patients with normal colonoscopic findings (8.5 vs. 8.6 mg/mL, p = 0.24), the median LRG values were significantly elevated in patients with left-sided colitis and pancolitis compared with those of patients with normal colonoscopy (13.6 or 18.0 vs. 8.6 mg/mL, p < 0.0001). The LRG cut-off value of 10.8 μg/mL was derived from the ROC curve, showing 96% sensitivity and 97% specificity for active UC but not active proctitis. Using a cut-off value of 10.8 mg/mL serum, LRG could be a novel biomarker for predicting patients with active UC except for proctitis. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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12 pages, 5290 KiB

Open AccessArticle

A Surveillance Endoscopy Strategy Based on Local Recurrence Rates after Colorectal Endoscopic Submucosal Dissection

by Jin Hwa Park, Ji Young Yoon, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang and Jeong-Sik Byeon

J. Clin. Med. 2021, 10(19), 4591; https://doi.org/10.3390/jcm10194591 - 5 Oct 2021

Cited by 7 | Viewed by 2003

Abstract

Backgrounds: It is not clear when and how frequently surveillance endoscopy should be performed after colorectal endoscopic submucosal dissection (ESD). We aimed to suggest a surveillance endoscopy strategy by investigating the cumulative local recurrence rates and identifying risk factors for local recurrence after colorectal ESD. Methods: We reviewed the medical records of 770 patients who underwent colorectal ESD for 778 lesions at our institution from 2005 to 2016. We investigated the cumulative local recurrence rates and risk factors for local recurrence. Results: Local recurrence developed in 12 (1.5%) of 778 lesions during the follow-up period of 37.4 ± 31.7 months. The one-, three-, and five-year cumulative local recurrence rates were 0.4%, 1.7%, and 2.2%, respectively. The risk factors for local recurrence were piecemeal resection (odds ratio (OR) 3.948, 95% confidence interval (CI) 1.164–13.385; p = 0.028) and histological incomplete resection (OR 8.713, 95% CI 2.588–29.334; p < 0.001). Local recurrence tended to develop frequently after ESD of early cancers. Conclusions: Short-term surveillance endoscopy should be recommended after piecemeal ESD, histological incomplete resection, and ESD of early colorectal cancers. Surveillance endoscopy with longer intervals can be suggested after en bloc ESD with the histological complete resection of benign colorectal tumors. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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9 pages, 1434 KiB

Open AccessArticle

Usefulness of a Colonoscopy Cap with an External Grid for the Measurement of Small-Sized Colorectal Polyps: A Prospective Randomized Trial

by Seul-Ki Han, Hyunil Kim, Jin-woo Kim, Hyun-Soo Kim, Su-Young Kim and Hong-Jun Park

J. Clin. Med. 2021, 10(11), 2365; https://doi.org/10.3390/jcm10112365 - 27 May 2021

Cited by 6 | Viewed by 2279

Abstract

Accurate measurement of polyp size during colonoscopy is crucial. The usefulness of cap-assisted colonoscopy and external grid application on monitor (gCAP) was evaluated for polyp size measurement in this 3-year, single-center, single-blind, randomized trial. Using the endoscopic forceps width as reference, the discrepancy percent (DP), error rate (ER), and measurement time were compared between gCAP and visual estimation (VE) after randomization. ER was calculated within a 20% and 33% limit. From the 111 patients, 280 polyps were measured. The mean polyp sizes were 4.0 ± 1.7 mm and 4.2 ± 1.8 mm with gCAP and VE, respectively (p = 0.368). Compared with that by the forceps method, DP was significantly lower in the gCAP group than in the VE group. Moreover, ER was significantly lower in the gCAP group within its preset limit. The measurement time was 4 s longer in the gCAP group than in the VE group (8.2 ± 4.8 s vs. 4.2 ± 1.5 s; p < 0.001). However, the forceps method lasted 28 s longer than the others. On subgroup analysis by size, gCAP was more accurate for polyp size ≥ 5 mm. The gCAP method was more accurate for polyp size measurement than VE, especially for polyps ≥ 5 mm, and was more convenient than the forceps method. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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Review

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15 pages, 657 KiB

Open AccessReview

The Role of Selected Serpins in Gastrointestinal (GI) Malignancies

by Sara Pączek and Barbara Mroczko

J. Clin. Med. 2022, 11(20), 6225; https://doi.org/10.3390/jcm11206225 - 21 Oct 2022

Cited by 2 | Viewed by 2070

Abstract

Gastrointestinal (GI) cancers, which are a diverse group of malignant diseases, represent a major healthcare problem around the world. Due to the lack of specific symptoms in the early stages as well as insufficient diagnostic possibilities, these malignancies occupy the leading position in the causes of death worldwide. The currently available tests have too many limitations to be part of routine diagnostics. Therefore, new potential biomarkers that could be used as diagnostic and prognostic factors for these cancers are still being sought. Among the proteins that might fit this role are serpins, which are serine protease inhibitors. Although the serpins themselves have been known for many years, they have recently become the centre of attention for many authors, especially due to the fact that a number of proteins in this family are involved in many stages of neoplasia formation, from angiogenesis through tumour growth to progression. Therefore, the aim of this review is to present the current knowledge about the significance of serpins in GI malignancies, especially their involvement in the development and progression of oesophageal, gastric, pancreatic and colorectal cancers. This review summarises and confirms the important roles of selected serpins in the pathogenesis of various GI cancers and also points to their promising roles as therapeutic targets. However, due to the relatively nonspecific nature of serpins, future research should be carried out to elucidate the mechanisms involved in tumour pathogenesis in more detail. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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21 pages, 687 KiB

Open AccessReview

A Systematic Review of the Cyclooxygenase-2 (COX-2) Expression in Rectal Cancer Patients Treated with Preoperative Radiotherapy or Radiochemotherapy

by Monika Berbecka, Alicja Forma, Jacek Baj, Marzena Furtak-Niczyporuk, Ryszard Maciejewski and Robert Sitarz

J. Clin. Med. 2021, 10(19), 4443; https://doi.org/10.3390/jcm10194443 - 27 Sep 2021

Cited by 7 | Viewed by 2865

Abstract

The main objective of this systematic review is to investigate the expression level of the cyclooxygenase-2 (COX-2) in rectal cancer treated with either preoperative radiotherapy or radiochemotherapy. In addition, we have summarized the effects of preoperative treatment of rectal cancer with regards to the expression levels of COX-2. A systematic literature review was performed in The Cochrane Library, PubMed, Web of Science, and Scopus databases on 1 January 2021 with the usage of the following search string—(cyclooxygenase-2) OR (COX-2) AND (rectal cancer) AND (preoperative radiochemotherapy) OR (preoperative radiotherapy). Among the 176 included in the analysis, only 13 studies were included for data extraction with a total number of 2095 patients. The results of the analysis are based on the articles concerning the expression of COX-2 in rectal cancer among patients treated with preoperative radiotherapy or radiochemotherapy. A COX-2 expression is an early event involved in rectal cancer development. In cases of negative COX-2 expression, radiotherapy and radiochemotherapy might contribute to the reduction of a local recurrence. Therefore, COX-2 may be considered as a biologic factor while selecting patients for more effective, less time-consuming and less expensive preoperative treatment. However, the utility of the administration of COX-2 inhibitors to patients with COX-2 overexpression, in an attempt to improve the patients’ response rate to the neoadjuvant treatment, needs an assessment in further clinical trials. Full article

(This article belongs to the Special Issue Colorectal Disorders: Diagnosis and Treatments)

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