Micrometastases detected by RT-PCR, but not IHC, may be of clinical value in identifying patients who may be at high risk for recurrence of CRC and who are therefore likely to benefit from systemic adjuvant therapy.

Purpose: Our aim was to determine the effects of cyclin D1 inhibition on tumor-associated neovascularization and endothelial cell growth. Experimental Design: We have generated adenovirus system for antisense to cyclin D1 (AS CyD1) and evaluated in vitro and in vivo effects. Small interfering RNA against cyclin D1 was also used to analyze cyclin D1 inhibition-associated vascular endothelial growth factor (VEGF) regulation. Results: The xenografts treated with adenoviral AS CyD1 showed less vessel density and displayed smaller tumor size in colon cancer cell lines HCT116 and DLD1. In vitro studies indicated that AS CyD1 decreased VEGF protein expression in DLD1 but not in HCT116. Cyclin D1 small interfering RNA caused a decrease in VEGF expression at protein and RNA levels in DLD1. A modest decrease was noted in the VEGF promoter activity, with inactivation of the STAT3 transcription factor through dephosphorylation. On the hand, the cyclin D1inhibition plus STAT3 inhibitor markedly decreased VEGF expression in HCT116, although VEGF did not change by the STAT3 inhibitor alone. In cultures of human umbilical vein endothelial cells (HUVEC), VEGF augmented cyclin D1expression and cell growth. AS CyD1significantly inhibited HUVEC growth even in the presence of VEGF. AS CyD1 also significantly suppressed in vitro tube formation in VEGF-treated HUVEC and in vivo macroaneurysm formation inVEGF-treated Matrigel plug. Conclusions: Our results suggest that cyclin D1 may play a role in the maintenance of VEGF expression and that AS CyD1could be potentially useful for targeting both cancer cells and their microenvironment of tumor vessels.Cyclin D1, a putative G 1 cyclin, preferentially associates with CDK4 and positively regulates the cell cycle transition from G 1 to S phase (1). Cyclin D1 is considered an oncogene because forced expression in rodent fibroblasts induces tumorigenicity in nude mice and cyclin D1 transgenic mice develop tumors of breast, esophagus, stomach, and tongue (2 -4). In human carcinomas, increased expression of cyclin D1 is one of the most frequent abnormalities because it is detected in f60% of breast cancers, 40% of colorectal cancers, 40% of squamous carcinomas of the head and neck, and 20% of prostate cancers (5 -8). Furthermore, overexpression of cyclin D1 is associated with poor prognosis of patients with carcinomas of colorectum, esophagus, stomach, pancreas, and liver (9 -13). Therefore, cyclin D1 is a crucial target for various types of human malignancies.To suppress the malignant potential of carcinomas, the strategy of antisense to cyclin D1 (AS CyD1) was first assessed in human esophageal squamous cell carcinoma and colon cancer cells (14,15). These studies clearly showed that AS CyD1 reversed the transformed phenotype of tumor cells, inhibited cell growth of tumor cells, and resulted in loss of tumorigenicity. Subsequently, AS CyD1 was found to enhance chemosensitivity of 5-fluorouracil, mitoxantrone, and cisplatinum in pancreatic cancer cells and head and neck cancer cells and...

We investigated the wide variability of 18F-2-fluoro-2-deoxy-D: -glucose (FDG) uptake, semiquantified as standardized uptake value (SUV), in positron emission tomography (PET) scanning, in 20 patients with colorectal cancer (CRC), including 1 with synchronous hepatic metastasis. The sensitivity of PET in CRC diagnosis was 100%, with a mean SUV of 8.0 (3.1-11.9). Tumor size and depth of invasion were associated with higher SUVs (P=.0004, .042, respectively). Strong glucose transporter-1 (GLUT-1) expression had significantly positive correlation with the SUV (r=.619, P=.003). GLUT-1 expression revealed positive staining in 17 (85%) of the 20 primary lesions. The central part of the tumor, thought to be relatively hypoxic, had stronger GLUT-1 expression and a higher SUV than the periphery, in both the primary tumor and hepatic metastatic foci. Our data suggest that the SUVs of FDG uptake in PET may be a noninvasive biomarker for advanced CRC, indicative of a large hypoxic tumor with deep invasion.

Background The appropriate surgical procedure for patients with upper third early gastric cancer is controversial. We compared total gastrectomy (TG) with proximal gastrectomy (PG) in this patient population. Methods A multicenter, non-randomized trial was conducted, with patients treated with PG or TG. We compared short-and long-term outcomes between these procedures. Results Between 2009 and 2014, we enrolled 254 patients from 22 institutions; data from 252 were included in the analysis. These 252 patients were assigned to either the PG (n = 159) or TG (n = 93) group. Percentage of body weight loss (%BWL) at 1 year after surgery, i.e., the primary endpoint, in the PG group was significantly less than that of the TG group (− 12.8% versus − 16.9%; p = 0.0001). For short-term outcomes, operation time was significantly shorter for PG than TG (252 min versus 303 min; p < 0.0001), but there were no group-dependent differences in blood loss and postoperative complications. For long-term outcomes, incidence of reflux esophagitis in the PG group was significantly higher than that of the TG group (14.5% versus 5.4%; p = 0.02), while there were no differences in the incidence of anastomotic stenosis between the two (5.7% versus 5.4%; p = 0.92). Overall patient survival rates were similar between the two groups (3-year survival rates: 96% versus 92% in the PG and TG groups, respectively; p = 0.49). Conclusions Patients who underwent PG were better able to control weight loss without worsening the prognosis, relative to those in the TG group. Optimization of a reconstruction method to reduce reflux in PG patients will be important.

This randomized clinical trial assesses whether etoposide plus cisplatin or irinotecan plus cisplatin is a more effective treatment regimen in terms of overall survival in patients with advanced neuroendocrine carcinoma of the digestive system.