Effect of perioperative chemotherapy on resection of isolated pulmonary metastases from colorectal cancer:A single center experience

BACKGROUND Numerous studies have assessed surgical resection as a standard treatment option for patients with colorectal cancer(CRC)and resectable pulmonary metastases(PM).However,the role of perioperative chemotherapy after complete resection of isolated PM from patients with CRC patients remains controversial.We hypothesize that perioperative chemotherapy does not provide significant survival benefits for patients undergoing resection of PM from CRC.AIM To determine whether perioperative chemotherapy affects survival after radical resection of isolated PM from CRC.METHODS We retrospectively collected demographic,clinical,and pathologic data on patients who underwent radical surgery for isolated PM from CRC.Cancerspecific survival(CSS)and disease-free survival were calculated using Kaplan-Meier analysis.Inter-group differences were compared using the log-rank test.For multivariate analysis,Cox regression was utilized when indicated.RESULTS This study included 120 patients with a median age of 61.6 years.The 5-year CSS rate was 78.2%,with 36.7% experiencing recurrence.Surgical resection for isolated PM resulted in a 5-year CSS rate of 50.0% for second metastases.Perioperative chemotherapy(P=0.079)did not enhance survival post-resection.Factors associated with improved survival included fewer metastatic lesions[hazard ratio(HR):2.51,P=0.045],longer disease-free intervals(HR:0.35,P=0.016),and wedge lung resections(HR:0.42,P=0.035).Multiple PM predicted higher recurrence risk(HR:2.22,P=0.022).The log-rank test showed no significant difference in CSS between single and repeated metastasectomy(P=0.92).CONCLUSION Perioperative chemotherapy shows no survival benefit post-PM resection in CRC.Disease-free intervals and fewer metastatic lesions predict better survival.Repeated metastasectomy is warranted for eligible patients.

Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis

BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT in patients after PM resection for CRC.METHODS This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023.The primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication bias.Sur-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,respectively.ACT had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT groups.Multivariate analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved survival.CONCLUSION ACT does not improve survival after PM resection for CRC.Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.

Strong Current-Polarization and Negative Differential Resistance in FeN3-Embedded Armchair Graphene Nanoribbons

Motivated by the recent advances of transition-metal-nitrogen-carbon (TM-N-C) materials in catalysis, we investigate the electronic structure and transport properties of FeN3-embedded armchair and zigzag graphene nanoribbons (FeN3@AGNRs, FeN3@ZGNRs) with different widths. The first-principles results indicate that the FeN3 induces significant changes on the band structures of both ZGNRs and AGNRs, making the resultant systems quite different from the pristine ones and own room-temperature stable ferromagnetic (FM) ground states. While only FeN3@AGNRs possess a significant spin-dependent negative differential resistance (NDR) and a striking current polarization (nearly 100%) behaviors, due to that FeN3 introduces two isolated spin-down states, which contribute current with different performances when they couple with different frontier orbits. It is suggested that by embedding FeN3 complexes, AGNRs can be used to build spin devices in spintronics.

Appendico-vesicocolonic fistula:A case report and review of literature

BACKGROUND Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic.To our knowledge,no more than 4 cases of appendico-vesicocolonic fistulas have been publicly reported throughout the world,and no more than 100 cases of appendiceal-colonic fistulas have been reported.Although the overall incidence is low,an early diagnosis is difficult due to their atypical initial symptoms,but these diseases still require our attention.CASE SUMMARY Here,we report a case of a 77-year-old male patient diagnosed with an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula.The main manifestations were diarrhea and urine that contained fecal material.The diagnosis was confirmed by multiple laboratory and imaging examinations.A routine urinalysis showed red blood cells and white blood cells.Abdominal and pelvic computed tomography scans showed close adhesions between the bowels and the bladder,and fistulas could be seen.Colonoscopy and cystoscopy and some other imaging examinations clearly showed fistulas.The preoperative diagnoses were a colovesical fistula and an appendiceal-colonic fistula.The fistulas were repaired by laparoscopic surgical treatment.The diseased bowel and part of the bladder wall were removed,followed by a protective ileostomy.The postoperative diagnosis was an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula,and the pathology suggested inflammatory changes.The patient recovered well after surgery,and all his symptoms resolved.CONCLUSION The final diagnosis in this case was a double fistula consisting of an appendicovesicocolonic fistula combined with an appendiceal-colonic fistula.