Become a member and receive career-enhancing benefits
Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
Become a member and receive career-enhancing benefits
Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
Anastomotic stenosis (AS) is an important complication encountered in patients who undergo resection of rectal cancer following neoadjuvant chemoradiation therapy (nCRT). Structural alterations of collagen in the tumor microenvironment may be a significant contributor to the pathophysiology of AS, but this relationship has not been quantified.
This study reported analyses of collagen features visualized with multiphoton imaging in 371 patients who underwent rectal cancer resection following nCRT. Based on the findings, a collagen score nomogram was developed in a training cohort, and its reliability for prediction of AS was evaluated in a validation cohort.
AS occurred in 15.9% of patients in the validation cohort; the analysis showed that distance between the tumor and the resection margin, anastomotic leakage, and the collagen score were all independent predictors for AS.
The authors concluded that the collagen score was reliable and had potential value as a predictor of AS.
Hematochezia, Abdominal Pain Are Significantly Associated with Early Onset Colorectal Cancer Diagnosis
The increasing incidence of colorectal cancer in patients younger than 50 years (early onset colorectal cancer or EOCRC) has been documented, and available evidence shows that there are often delays in confirmation of the diagnosis in this age group.
Using a systematic review of the literature, the authors sought to determine the most important presenting signs and symptoms of EOCRC, provide estimates of EOCRC risk associated with these signs and symptoms, and confirm the intervals from sign and symptom recognition to definitive diagnosis.
The analysis included 78 studies involving more than 24 million patients. Hematochezia (45%) and abdominal pain (40%) were significantly associated with EOCRC diagnosis. Hematochezia carried the highest risk for diagnosis of EOCRC. The mean interval between symptom onset and confirmation of the diagnosis was 6.4 months.
The authors concluded that clinicians should be encouraged to conduct an immediate and thorough evaluation of patients with these symptoms and provide early referral for colonoscopy when an alternative diagnosis is not confirmed, or full symptom resolution is not achieved.
Study Examines Factors Predicting Readmission and Mortality in Patients Admitted for Malignant Bowel Obstruction
The authors presented data from a single-institution, retrospective study of patients (n = 210) admitted with malignant bowel obstruction (MBO). Statistical analysis was used to determine risk factors for readmission and mortality.
Included patients had been diagnosed with gastrointestinal or gynecologic malignancies. Non-English-speaking patients composed 19% of the cohort, and 35% of patients lived more than 50 miles from the healthcare center.
Predictors of increased risk for readmission were non-English patient language and younger patient age; earlier palliative care consultation decreased risk of readmission significantly. Diagnosis of ascites and earlier palliative care consultation were associated with higher 90-day risk for mortality.
These findings support the value of organized multidisciplinary plans of care that provide language support to maximize patient and family understanding of a care plan that focuses on quality of life.
