Systematic postoperative surveillance of patients with rectal and colorectal cancer has demonstrated to produce an improvement in the survival of these patients. Nevertheless, it is currently discussed whether a more intensive surveillance strategy would provide significant advantage compared to a less aggressive strategy. The methodology currently used for testing and the frequency tests are applied are highly heterogeneous. So, in order to compare the efficiency of two surveillance strategies, a standard strategy and an intensive strategy, physicians of Hospital Clínic conducted a prospective, multicentre and randomised study in patients affected by this type of cancer. This trial, supported by the Medical Technology Agency of the Catalan Government, was led by Dr. Francisco Rodríguez-Moranta and Dr. Antoni Castells, from the IDIBAPS Physiopathology of the Gastrointestinal Lesions Group, and had the collaboration of specialists of Hospital de Terrassa and Hospital General de Vic. The results of these comparison were published in Journal of Clinical Oncology (24(3):386-93), and showed that the most intensive therapy benefited patients in certain stages of cancer and patients with rectal lesions, whose overall survival was increased.
To conduct this study, 259 patients from the three centres with colorectal cancer in stage II or III (which are intermediate states in a scale ranging I-IV) were recruited and were randomly distributed in two surveillance experimental groups. In the first group, 132 patients received the simplest standard surveillance, consisting in the clinical evaluation and in the monitoring of blood tumour markers every three months. In the second group, the 127 patients were applied a strategy that, in addition to the standard, consisted in an abdominal CT-scan or ultrasonography, chest x-ray and colonoscopy. Both groups of patients were similar with respect to baseline characteristics as disease, tumour recurrence rate and type of tumour. After 48 months of follow-up, researchers did not detect significant difference in the overall survival between patients the of the two groups. However, as specific subgroups were analysed, the intensive strategy was associated to a higher survival, in number of years, in patients of stage II tumours and those with rectal lesions. Thus, this type of surveillance benefited this subtype of patients since relapse could be detected earlier. Particularly, colonoscopy was the method responsible for the detection of the highest proportion (44%) of recurrences of operable tumours.
According to the authors, this invasive strategy would improve the prognosis of patients with stage II colorectal cancer and also patients with rectal lesions. In this sense, they recommend the periodical colonoscopy during the first 5 years of postoperatory follow-up, a practice that is already applied in Hospital Clínic. The level of cost efficiency of this strategy is justified by the higher healing rate in case of relapse, since tumours are detected in their onset. Nevertheless, this strategy does not show more efficiency in other cases and it is important to continue to search for the most specific techniques for every case in order to avoid nonessential health expense. Although these results do not permit to define the perfect strategy for the follow-up of all patients with colorectal cancer, it permits to establish a strategy suitable for an important subgroup of patients (nearly half of patients suffering from this disease). The journal has written an editorial comment about the article in which both the study and the Catalan Government Support are acclaimed.
Àlex Argemí Saburit | alfa
Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo
Chronic stress induces fatal organ dysfunctions via a new neural circuit
21.08.2017 | Hokkaido University
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
22.08.2017 | Life Sciences
22.08.2017 | Life Sciences
22.08.2017 | Life Sciences