Surgical resection revealed superior outcomes in the treatment of resectable CRLMs, particularly in cases with a hepatic tumor size > 3 cm.

BackgroundIntersphincteric resection (ISR) has become an increasingly popular optional surgical tool for the treatment of very low rectal cancer. The purpose of this study was to assess the long-term oncological and functional outcomes of intersphincteric resection for T2 and T3 rectal cancer situated below 4 cm from the anal verge.MethodsA total of 62 consecutive patients with very low rectal cancer who underwent ISR from 2001 to 2010 were classified into standard ISR for T2 lesions (Group I, n = 24) and extended ISR for T3 lesions (Group II, n = 38).ResultsThe 5-year overall survival rates were 95.8 % for group I and 94.7 % for group II. The 5-year recurrence-free survival rates were 87.5 % for group I and 86.8 % for group II. Bowel functions were evaluated at the 12th and 24th months after ileostomy closure in both groups. The frequency of bowel evacuation was higher in patients who underwent extended ISR than in those who underwent standard ISR at the 12th month (p < 0.05). However, at the 24th month, the frequencies decreased in both groups, exhibiting no significant difference. In the comparison based on the Kirwan classification, group I showed better continence status than group II but no significant difference. The Wexner scores of both groups revealed that the average score was 7.33 ± 2.8 in group I and 8.18 ± 2.9 in group II at the 12th month, and at the 24th month, the average score was 5.21 ± 1.7 in group I and 5.82 ± 1.9 in group II. There were no statistically significant differences between the two groups.ConclusionsExtended ISR with quadrant resection of the upper external sphincter achieved good post-operative continence status, OS and RFS. Extended ISR can thus be an alternative to abdominoperineal resection for very low rectal cancer without compromising the chance of cure and improving quality of life.

Renal cell carcinoma (RCC) is the most common type of kidney malignancy. The pancreas is an infrequent site of metastasis in relation to any type of malignancy. However, RCC is one of the tumor types that most frequently metastasize to the pancreas. In this study, we report our experiences with two patients who underwent pancreatic resection for metastatic RCC tumors; of these two patients, one patient had a tumor was a metachronous pancreas-only tumor, and the other patient's tumor was synchronous with hematogenous lung metastasis. Following left-side pancreatic resection, the patients were administered tyrosine kinase inhibitors.

Purpose: The survival rates of patients with colorectal cancers have been well documented in many studies. Some studies have shown that proximal colon cancers have inferior survival rates when compared with distal colon cancers. However, the prognostic significance of tumor location with respect to survival remains controversial. By using data from a single physician, we analysed patient survival rates based on colon cancer subsite location, including rectal cancers. Methods: We retrospectively analysed 881 patients with colorectal cancers between 1987 and 2008. Colon subsite locations were defined as cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. Subsite-specific survival analyses were performed using Kaplan-Meier analysis and Cox proportional hazards ratios. The median follow-up time was 93 months. Results: A total of 689 colorectal cancer cases were included in our analysis, of which 14 were cecum (2.0%), 95 were ascending colon (13.8%), 21 were transverse colon (3.0%), 25 were descending colon (3.6%), 129 were sigmoid colon (18.7%), and 405 were rectum (58.8%) cancers. The 5-year overall survival rates were 77.8% for all colorectal cancers, which consisted of 92.9% for cecal cancer, 69.5% for ascending colon cancer, 76.2% for transverse colon cancer, 84.0% for descending colon cancer, 82.2% for sigmoid colon cancer, and 77.5% for rectal cancer. Conclusion: Ascending colon cancer was associated with the poorest survival outcome, whereas descending colon cancer was associated with the best survival outcome except cecal cancer. Moreover, the survival rate associated with left colon cancer was better than the survival for right colon and rectal cancer.

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