A radiomics model fusing clinical features to predict microsatellite status preoperatively in colorectal cancer liver metastasis.

PURPOSE: To study the combined model of radiomic features and clinical features based on enhanced CT images for noninvasive evaluation of microsatellite instability (MSI) status in colorectal liver metastasis (CRLM) before surgery. METHODS: The study included 104 patients retrospectively and collected CT images of patients. We adjusted the region of interest to increase the number of MSI-H images. Radiomic features were extracted from these CT images. The logistic models of simple clinical features, simple radiomic features, and radiomic features with clinical features were constructed from the original image data and the expanded data, respectively. The six models were evaluated in the validation set. A nomogram was made to conveniently show the probability of the patient having a high MSI (MSI-H). RESULTS: The model including radiomic features and clinical features in the expanded data worked best in the validation group. CONCLUSION: A logistic regression prediction model based on enhanced CT images combining clinical features and radiomic features after increasing the number of MSI-H images can effectively identify patients with CRLM with MSI-H and low-frequency microsatellite instability (MSI-L), and provide effective guidance for clinical immunotherapy of CRLM patients with unknown MSI status.

Oridonin Enhances the Anti-Metastasis Effect of Oxaliplatinliplatin on Colorectal Cancer Liver Metastasis.

The anti-metastasis effect of oridonin in combination with oxaliplatin on colorectal cancer liver metastasis was studied using a BALB/c nude mouse model. The liver condition, bloody ascites, cholestasis, and liver metastasis scores in the three groups receiving oxaliplatin combined with oridonin were significantly milder than in the control group and importantly the anti-migratory effect of oxaliplatin combined with oridonin was obviously the strongest (p<0.05). Oridonin possessed no hepatotoxicity; instead, it effectively alleviated liver injury caused by oxaliplatin. Oridonin alone or in combination with oxaliplatin significantly decreased serum levels of α-fetoprotein and carcinoembryonic antigen. Therefore, oridonin combined with oxaliplatin displays great potential to markedly increase the anti-metastasis effect of oxaliplatin in the treatment of liver metastases of colorectal cancer.

A new strategy based on fluorodeoxyglucose-positron emission tomography for managing liver metastasis from colorectal cancer.

BACKGROUND: Prognostic models are needed to manage liver metastasis from colorectal cancer (CRLM). Thus, we developed an algorithm to guide treatment based on the standardized uptake value (SUV) from fluorodeoxyglucose-positron emission tomography (FDG-PET). METHODS: We retrospectively evaluated 148 patients who underwent surgery for CRLM, including 107 cases of primary surgery and 41 cases with preoperative chemotherapy before conversion surgery. We evaluated the prognostic value of perioperative SUV among primary surgery cases, as well as the prognostic value of the SUV change ratio after conversion surgery (postchemotherapy/prechemotherapy SUV). RESULTS: In the primary surgery group, recurrence-free survival (RFS) was independently predicted by an SUV of ≥6.04 (P = 0.042) and ≥4 liver metastases ( P = 0.003). The combination of an SUV of ≥6.04 and ≥4 liver metastases was strongly associated with poor RFS ( P < 0.001). In the conversion surgery group, the SUV change ratio was associated with tumor size change and pathological response. An SUV change ratio of ≥0.293 was associated with shorter RFS ( P = 0.006) and independently predicted RFS ( P = 0.026). We established a therapeutic algorithm for managing CRLM based on these results. CONCLUSION: FDG-PET may be useful for predicting recurrence and prognosis in cases of CRLM, and our algorithm may be useful for managing multiple CRLMs.

Malnutrition as an unfavorable prognostic factor after surgical treatment for metastatic colorectal cancer.

<b><br>Introduction:</b> Colorectal cancer (CRC) is the second-leading cause of cancer-related deaths worldwide. Distant metastases are usually located in the liver and are present in 50% of patients.</br> <b><br>Aim:</b> The aim of this study is to evaluate changes in body composition and phase angle before and after surgical treatment of CRC liver metastases, as well as survival time and treatment costs.</br> <b><br>Material and methods:</b> The study included 134 patients who received 174 surgeries for CRC liver metastases. Bioelectrical impedance analysis (BIA) was performed using an AKERN BIA 101 analyzer.</br> <b><br>Results:</b> BIA was performed before and after surgery. The results of tests (total body water content [TBW], body cell mass [BCM], and phase angle) showed a reduction in BCM by 2.21 kg and a statistically significant decrease in phase angle values after surgery (from 5.06 to 4.25 in women and from 5.34 to 4.76 in men). These values are below the reference range for both sexes. There was a correlation between phase angle values and muscle mass, both before (R = 0.528, p<0001) and after surgery (R = 0.634, p<000.1). Preoperative levels of the tumor marker CEA were elevated in more than half of the patients. The median survival time after resection of liver metastases was 37.6 months.</br> <b><br>Discussion:</b> A significant factor that increases complications, mortality, and treatment costs of cancer patients is malnutrition, which could be the earliest symptom of malignant disease.</br> <b><br>Conclusions:</b> Successful treatment of CRC requires the patients to participate in follow-up examinations and to be aware of early signs associated with recurrence (e.g., blood in the stool or weight loss). The patients' nutritional status should be monitored and recorded in a DILO card.</br>.

[Retracted] PEA15 promotes liver metastasis of colorectal cancer by upregulating the ERK/MAPK signaling pathway.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the tumor images shown in Fig. 4G and H were strikingly similar to tumor images (albeit oriented differently) which had previously appeared in Fig. 8A in another article published in the journal International Journal of Oncology [Tang B, Li Y, Yuan S, Tomlinson S and He S: Upregulation of the δ opioid receptor in liver cancer promotes liver cancer progression both in vitro and in vivo. Int J Oncol 43: 1281­1290, 2013], indicating that results which were purported to have been obtained under different experimental conditions had been derived from the same original source. In view of the fact that these data had already appeared in another publication prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a satisfactory reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 41: 43­56, 2019; DOI: 10.3892/or.2018.6825].

Enhanced recovery nursing and mental health education on postoperative recovery and mental health of laparoscopic liver resection.

BACKGROUND: Patients undergoing laparoscopic resection of liver metastases of colorectal cancer are prone to negative emotions and decrease of digestive function. Early nursing and psychological intervention are necessary. AIM: To observe the effect of enhanced recovery nursing combined with mental health education on postoperative recovery and mental health of patients undergoing laparoscopic resection of liver metastases of colorectal cancer. METHODS: One hundred and twenty patients who underwent laparoscopic resection of liver metastases of colorectal cancer at our hospital between March 2021 and March 2023, were selected as participants. The patients admitted from March 1, 2021 to February 28, 2022 were set as the control group, and they were given routine nursing combined with mental health education intervention. While the patients admitted from March 1, 2022 to March 31, 2023 were set as the observation group, they were given accelerated rehabilitation surgical nursing combined with mental health education intervention. The differences in postoperative recovery-related indices, complications and pain degrees, and mental health-related scores were compared between groups. The T lymphocyte subset levels of the two groups were also compared. RESULTS: The postoperative exhaust, defecation, eating and drainage time of the observation group were shorter than those of the control group. The pain scores of the observation group were lower than those of the control group at 6, 12, 24, 48, and 72 h after surgery. The cumulative complication rate of the observation group was lower than that of the control group (P < 0.05). The CD4+/CD8+ in the observation group was higher than that in the control group 3 d after surgery (P < 0.05). After intervention, the self-rating depression scale, self-rating anxiety scale, avoidance dimension, and yielding dimension in Medical coping style (MCMQ) scores of the two groups were lower than those prior to intervention, and the scores in the observation group were lower than those in the control group (P < 0.05). The face dimension score in the MCMQ score was higher than that before intervention, and that of the observation group was higher than that of the control group (P < 0.05). After intervention, the total scores of the life function index scale (FLIC) and psychological well-being scores of cancer patients in the two groups, and the physical and social well-being scores in the observation group, were higher than those before intervention. The nursing satisfaction of the observation group was higher than that of the control group (P < 0.05). The physical, psychological, and social well-being, and the total FLIC scores of the observation group were higher than those in the control group after surgery (P < 0.05). CONCLUSION: Enhanced recovery nursing combined with mental health education can promote the recovery of gastrointestinal function, improve the mental health and quality of life of patients after laparoscopic resection of colorectal cancer liver metastases, and reduce the incidence of complications.

Complement C5 is a novel biomarker for liver metastasis of colorectal cancer.

Background: Colorectal cancer (CRC) is one of the most prominent malignant diseases, with a high incidence and a dismal prognosis. Metastasis to the liver is the leading cause of death in CRC patients. This study aimed to identify accurate metastatic biomarkers of CRC and investigate the potential molecular mechanisms of liver metastasis of colorectal cancer (LMCRC). Methods: Three independent datasets were screened and downloaded from the Gene Expression Omnibus (GEO) database. The GEO2R tool was used to identify differentially expressed genes (DEGs) in CRC tissues and liver metastases. Next, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted using the Database for Annotation, Visualization, and Integrated Discovery (DAVID). Furthermore, the protein-protein interactions (PPIs) of the DEGs were analyzed using the Search Tool for the Retrieval of Interacting Genes (STRING) database, Cytoscape, and Molecular Complex Detection (MCODE). Next, the expression levels and Kaplan-Meier survival analysis of the target gene between normal colon and CRC tissues were performed by UALCAN. The expression of the target gene in tissues and cell lines was verified by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), western blot, and immunohistochemistry (IHC) assay. The impact of the target gene on the proliferation, invasion, and migration ability of COAD cells was explored in vitro. Results: A total of 92 common DEGs were found in the three independent datasets. GO/KEGG enrichment analysis showed that the DEGs were mainly involved in 14 different pathways. The protein-protein interaction (PPI) network revealed that complement 5 (C5), the upstream gene of C8A in the complement system, was associated with C8 and other key hub genes. Meanwhile, the online UALCAN resource showed that C5 was up-regulated and facilitated malignant progression in COAD samples. Next, we confirmed that C5 remarkably increased and promoted cell proliferation, migration, and invasion in CRC cell lines, SW620 and SW480. The IHC assay showed C5 was also highly expressed in a majority of LMCRC tissues compared with paired CRC tissues. Conclusions: The findings of our integrated bioinformatics study suggest that complement C5 might serve as a potential therapeutic target in patients with CRC.

Is CA19-9 effective in predicting chemotherapeutic response in patients with synchronous liver metastases with colorectal cancer?

Evaluation of response to chemotherapy in colorectal cancer patients with synchronous liver metastases is important in terms of treatment management. In this Letter to the Editor, several issues in the article are discussed. For the comparison of carbohydrate antigen 19-9 (CA19-9) values referenced in the study, the patient group was not matched for cancer stage. Therefore, it may be more appropriate to select and compare CA19-9 values in patients with same-stage cancer.

HMGB1, the Next Predictor of Transcatheter Arterial Chemoembolization for Liver Metastasis of Colorectal Cancer?

HMGB1 is an important mediator of inflammation during ischemia-reperfusion injury on organs. The serum expression of HMGB1 was increased significantly on the 1st day after TACE and decreased significantly which was lower on the 30th day after TACE. Tumor markers of post-DEB-TACE decreased significantly. The correlational analysis showed that patients with low HMGB1 expression had lower risks of fever and liver injury compared those with the higher expression, while the ORR is relatively worse. Patients with lower expression of HMGB1 had longer PFS, better efficacy, and higher quality of life. With the high post-expression, the low expression had lower incidence of fever and liver injury too. There was no statistical difference in the one-year survival among the different groups. The quality of life of all patients was improved significantly. The over-expression of HMGB1 in LMCRC is an adverse prognostic feature and a positive predictor of response to TACE.

Advance in clinical research of radiotherapy for primary and metastatic liver malignancies / 肿瘤

Surgical treatment is the primary curative treatment for hepatocellular carcinoma and liver metastasis of colorectal cancer, but most patients are ineligible for the treatment upon initial diagnosis. And the overall efficacy of topical treatments such as radiofrequency ablation or transcatheter arterial chemoembolization remains limited. As an important supplementary treatment for surgery, radiotherapy plays an increasingly important role in the treatment of hepatic malignancies with the development of radiotherapy and the progress of liver cancer research. At the same time, the focus of liver radiation is on the safety of radiotherapy, especially the risk of radiation-induced liver disease. In this review, the recent advances in the clinical studies and safety of radiotherapy for hepatocellular carcinoma and liver metastasis of colorectal cancer were summarized.