BACKGROUND: Many studies have shown that open and laparoscopicsurgery for resection of colonic cancers produce similar short- and long-term results, but no data have been reported from Saudi Arabia.OBJECTIVE: Compare 3-year disease-free and overall survival after laparoscopic versus open curative resection for potentially curable colon cancer.DESIGN: Multicenter retrospective cohort study.SETTING: Tertiary academic hospital.PATIENTS AND METHODS: We analyzed data of patients who underwent curative resection for potentially curable colon cancer using the laparoscopic or open approach at three tertiary care centers during the period 2000-2015.MAIN OUTCOME MEASURES: Overall and disease-free 3-year survival were the primary endpoints. Secondary endpoints included conversion rate, duration of surgery, length of hospital stay, rate of wound infection, resumption of bowel function, number of lymph nodes retrieved, adequacy of resection and rate of recurrence. Risk factors for recurrence, including complete mesocolic excision, were assessed.SAMPLE SIZE: 721.RESULTS: Patient and tumor characteristics were similar in the two groups except for ASA class (P<.01), weight (P<.05) and tumor stage (P<.05). Over a median follow-up of 46 months, the 3-year overall survival was 76.7% for open resection and 90.3% for laparoscopic colon resection (P<.05). The 3-year disease-free survival was 55.3% for open colon resection and 64.9% for laparoscopic colon resection (P=.0714).CONCLUSION: Overall and disease-free survival after the laparoscopic approach for curative resection of colon cancer is comparable to the open approach.LIMITATIONS: Retrospective design and the possibility of selection bias.CONFLICT OF INTEREST: None.

BACKGROUND AND OBJECTIVESTo compare the complications and outcome after ileal pouch-anal anastomosis (IPAA) for mucosal ulcerative colitis (MUC) and familial adenomatous polyposis (FAP).DESIGN AND SETTINGSThis is a retrospective study. The study was conducted at a single tertiary referral center.METHODSAll patients who underwent restorative proctocolectomy with IPAA at a tertiary center in Saudi Arabia from 2001 till 2009 were retrieved. Data was obtained regarding preoperative status, postoperative complications, and functional outcome.RESULTSA total of 40 patients underwent IPAA, of which 21 cases were of FAP and 19 cases of MUC. Median age at operation for FAP and MUC was 31 (range: 16–45) and 43 (range: 15–65) years, respectively (P<.05). Median length of stay was 10 days (range: 6–42) for FAP and 12 days (range: 9–27) for MUC (P=.1). Postoperative morbidity was noted in 4 cases of FAP and 6 cases of MUC (P=.36). Specifically, wound infection was noted in 2 cases of FAP compared to 3 cases of MUC (P=.55); 1 MUC case had an anastomotic leak (P=.29). One mortality was recorded among the FAP cases (P=.35). The time between the creation of IPAA and the closure of ileostomy was 4.5 and 5 months for FAP and MUC, respectively (P=.87). Median follow-up was 36 months. Median bowel frequency per 24 hours was 6 (range: 3–24) for FAP and 7 (range 3–17) for MUC (P=.54). Intestinal obstruction was reported in 3 cases of FAP and 5 cases of MUC (P=.38). One pouch was excised in a FAP patient. One case of MUC developed pouchitis.CONCLUSIONSThe outcome after IPAA was inferior for MUC compared to FAP, but it was not statistically significant due to the small sample size. The morbid status of the MUC cases and their older age contributed to the minor differences.

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BACKGROUND: Data on long-term survival and recurrence of cancer after complete mesocolic excision (CME) for colon cancer has not been reported from our center and related to international data. OBJECTIVE: Describe overall and disease-free survival, survival by surgery site and stage, and recurrence rates after curative surgery. DESIGN: Retrospective chart review. SETTINGS: Academic tertiary care center. PATIENTS AND METHODS: The study included all patients who underwent either laparoscopic or open surgery for colon cancer with curative intent between 2001 and 2011. The colorectal database was reviewed for the following: demographic data, comorbidities, radiologic investigations, clinical stage, type of operation, complications, pathologic assessment, adjuvant treatment, recurrence and survival. Survival and recurrence rates were calculated, and survival curves were generated. MAIN OUTCOME MEASURES: 5-year overall survival, secondary endpoints were 5-year disease-free survival, survival by surgery site and stage, and recurrence rates. SAMPLE SIZE: 220. RESULTS: The mean (SD) age at diagnosis was 57 (13) years (CI 95%: 55-59 years). There were 112 males. Mean (SD) body mass index was 27.6 (5.7) kg/m 2 (CI 95%: 27-28). Pathological assessment revealed R0 (microscopically margin-negative) resection in 207 (94%). The overall 5-year survival and disease-free survival was 77.9% and 70%, respectively. The 5-year disease-free survival was 69% for the sigmoid/left colon and 69% for the right colon (difference statistically nonsignificant). Stages at the time of resection were stage 0 for 2 (0.01%) patients, stage I for 18 (8%), stage II for 92 (42%), stage III for 100 (46%), and stage IV for 6 (3%). The 5-year overall survival by stages I, II, III and IV was 94%, 80%, 75% and 50%, respectively (difference statistically non-significant). The overall 5-year recurrence rate was 23.4%. CONCLUSION: The outcomes of surgical treatment for colon cancer at our institution are equivalent to international sites. No difference was noted between left and right colon in terms of survival after CME. LIMITATIONS: Single center, retrospective, small sample size. CONFLICT OF INTEREST: None.

Autozygosity is a term used to denote the presence of two identical haplotypes that are derived from an ancestor shared by both parents, so it essentially represents a special type of homozygosity. Runs of homozygosity (ROH) in the genome is a measure of the extent of autozygosity and is directly correlated with the extent of inbreeding. While the role of ROH in unmasking recessively acting mutations is well established in Mendelian genetics, much less is known about their contribution to more complex disorders such as cancer. Recently, it has been suggested that ROH may contribute to the risk of colorectal cancer (CRC) perhaps through the unmasking of a recessively acting CRC-predisposing mutations in one or more genes. However, this observation could not be replicated. In this study, we examine the role of homozygosity in the CRC risk by asking four specific questions. First, do CRC patients have enrichment for ROH in particular chromosomal regions compared to controls? Second, do CRC patients have longer ROH compared to controls? Third, is there a particular SNP that is more likely to be homozygous in CRC patients compared to controls? And fourth, are CRC patients more inbred than controls? By comparing 48 Saudi CRC patients to 100 ethnically matched controls, all processed on Affy 250SytI SNP Chip platform and analyzed by Partek, we found that the answer is no to all these four questions. We note here that this is the first study to address these questions in an inbred population so the negative results in our study carry more significance than what has been previously reported in the literature. We also note that our subgroup analysis of patients with MSI-positive tumors compared to other groups did not significantly change our results. While these results do not rule out the potential presence of recessively acting CRC-predisposing genes in a small percentage of patients that our relatively small sample size could not capture, they do suggest that such genes are unlikely to account for the disturbingly high incidence of CRC in our consanguineous population and that future research should consider other mechanisms. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3768. doi:10.1158/1538-7445.AM2011-3768