Robotic-assisted low anterior resection for rectal cancer shows similar clinical efficacy to laparoscopic surgery: A propensity score matched study

BACKGROUND Rectal cancer ranks as the second leading cause of cancer-related mortality worldwide,necessitating surgical resection as the sole treatment option.Over the years,there has been a growing adoption of minimally invasive surgical techni-ques such as robotic and laparoscopic approaches.Robotic surgery represents an innovative modality that effectively addresses the limitations associated with traditional laparoscopic techniques.While previous studies have reported favo-rable perioperative outcomes for robot-assisted radical resection in rectal cancer patients,further evidence regarding its oncological safety is still warranted.AIM To conduct a comparative analysis of perioperative and oncological outcomes between robot-assisted and laparoscopic-assisted low anterior resection(LALAR)procedures.METHODS The clinical data of 125 patients who underwent robot-assisted low anterior resection(RALAR)and 279 patients who underwent LALAR resection at Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2019 to November 2022 were retrospectively analyzed.After performing a 1:1 propensity score matching,the patients were divided into two groups:The RALAR group and the LALAR group(111 cases in each group).Subsequently,a comparison was made between the short-term outcomes within 30 d after surgery and the 3-year survival outcomes of these two groups.RESULTS Compared to the LALAR group,the RALAR group exhibited a significantly earlier time to first flatus[2(2-2)d vs 3(3-3)d,P=0.000],as well as a shorter time to first fluid diet[4(3-4)d vs 5(4-6)d,P=0.001].Additionally,the RALAR group demonstrated reduced postoperative indwelling catheter time[2(1-3)d vs 4(3-5)d,P=0.000]and decreased length of hospital stay after surgery[5(5-7)d vs 7(6-8)d,P=0.009].Moreover,there was an observed increase in total cost of hospitalization for the RALAR group compared to the LALAR group[10777(10780-11850)dollars vs 10550(8766-11715)dollars,P=0.012].No significant differences were found in terms of conversion rate to laparotomy or incidence of postoperative complications between both groups.Furthermore,no significant disparities were noted regarding the 3-year overall survival rate and 3-year disease-free survival rate between both groups.CONCLUSION Robotic surgery offers potential advantages in terms of accelerated recovery of gastrointestinal and urologic function compared to LALAR resection,while maintaining similar perioperative and 3-year oncological outcomes.

Effect of Neoadjuvant Chemotherapy Treatment on Prognosis of Patients with Advanced Gastric Cancer:a Retrospective Study

Objective To evaluate the prognostic effects of neoadjuvant chemotherapy(NAC) in patients with local advanced gastric cancer. Methods We retrospectively analyzed prognosis in 191 patients with advanced gastric cancer, of whom 71 were treated with NAC and 120 received surgery only between February 2007 and July 2013. Postoperative complication rate was recorded. Survival by clinicopathological features, pathological T and N stages, and histopathological tumor regression was retrospectively compared between the two groups. Results According to Response Evaluation Criteria in Solid Tumors, none of the 71 patients in the NAC followed by surgery group showed complete response, 36 showed partial response, 25 had stable disease, and 10 had progressive disease. The chemotherapy response rate was 50.7%; the disease control rate was 85.9%. Grade 3/4 adverse events were seen in less than 20% patients, with acceptable toxicities. No difference was found in the overall postoperative complication rates between the two groups(7 versus 22 cases, P=0.18). Median survival time was significantly different, at 54 months in the NAC combined with surgery group and 25 months in the surgery-only group(P=0.025). Conclusion In patients with operable gastric adenocarcinomas, NAC can significantly improve overall survival without increasing surgical complications.

MiR-30b suppresses tumor migration and invasion by targeting EIF5A2 in gastric cancer

AIM: To elucidate the potential biological role of mi R-30 b in gastric cancer and investigate the underlying molecular mechanisms of mi R-30 b to inhibit metastasis of gastric cancer cells.METHODS: The expression of mi R-30 b was detected in gastric cancer cell lines and samples by reverse transcription-polymerase chain reaction. CCK-8 assays were conducted to explore the impact of mi R-30 b overexpression on the proliferation of gastric cancer cells. Flow cytometry was used to examine the effect of mi R-30 b on the apoptosis. Transwell test was used for the migration and invasion assays. Luciferase reporter assays and Western blot were employed to validate regulation of putative target of mi R-30 b.RESULTS: The results showed that mi R-30 b was downregulated in gastric cancer tissues and cancer cell lines and functioned as a tumor suppressor. Overexpression of mi R-30 b promoted cell apoptosis,and suppressed proliferation,migration and invasion of the gastric cancer cell lines AGS and MGC803. Bioinformatic analysis identified the 3'-untranslated region of eukaryotic translation initiation factor 5A2(EIF5A2) as a putative binding site of mi R-30 b. Luciferase reporter assays and Western blot analysis confirmed the EIF5A2 gene as a target of mi R-30 b. Moreover,expression levels of theEIF5A2 targets E-cadherin and Vimentin were altered following transfection of mi R-30 b mimics.CONCLUSION: Our findings describe a link between mi R-30 b and EIF5A2,which plays an important role in mediating epithelial-mesenchymal transition.

LncRNA cancer susceptibility 20 regulates the metastasis of human gastric cancer cells via the miR-143-5p/MEMO1 molecular axis

BACKGROUND Gastric cancer(GC)is considered as one of the most widespread malignancies.Emerging evidence has shown that lncRNAs can function as important oncogenes or tumor suppressors during GC progression.AIM To investigate the effect and mechanism of lncRNA cancer susceptibility 20(CASC20)in the proliferation and metastasis of GC cells.METHODS Data mining and clinical samples were used to evaluate the expression of CASC20 in GC and adjacent tissues.CASC20 was down-regulated in GC cells by shortinterfering RNA.Cell proliferation was evaluated by CCK-8 assay,and cell migration and invasion were detected by wound healing and Transwell assays.The expressions of proteins related to epithelial-mesenchymal transition were detected by western blot assay.RESULTS The expression of CASC20 was increased in GC tumor tissues and various GC cell lines.High CASC20 expression was correlated with a high risk of lymphatic metastasis and poor prognosis in GC patients.In vitro assays showed that silencing CASC20 reduced cell proliferation,migration,and invasion in GC cells.Mechanistic studies revealed that CASC20 exhibits oncogenic functions by regulating MEMO1 expression through competitive endogenous binding to miR-143-5p,leading to induction of epithelial-mesenchymal transition.CONCLUSION Our findings indicate that CASC20 serves as a tumor promoter by regulating metastasis in GC via the miR-143-5p/MEMO1 axis.CASC20 may be a potential therapeutic target for GC.

E3 ubiquitin ligase TRIM55 promotes metastasis of gastric cancer cells by mediating epithelial-mesenchymal transition

BACKGROUND Gastric cancer(GC)is considered a major global health problem.The role of TRIM55,a member of the three-domain protein family,in GC is unknown.AIM To determine the expression of TRIM55 in GC tissues and its relationship with clinicopathological characteristics,and to investigate the effects of TRIM55 on the malignant biological behavior of GC cells.METHODS Differential expression of TRIM55 in GC and para-cancer tissues was detected by immunohistochemistry,and the relationship between TRIM55 level and clinicopathological characteristics and prognosis was analyzed.Gain-of-function,lossof-function,cell counting kit-8 assay,colony formation,transwell assay,wound healing assay,and western blot analysis were used to assess the potential role of TRIM55 in the development of GC.RESULTS TRIM55 expression was significantly increased in GC tissues compared with adjacent normal tissues.High expression of TRIM55 was associated with advanced pathological stage and poor prognosis.Overexpression of TRIM55 promoted invasion and metastasis of GC cells in vitro by regulating epithelial-mesenchymal transition(EMT),whereas knockdown of TRIM55 had the opposite effect.Our data showed that TRIM55 is highly expressed in GC tissues,and is associated with poor prognosis.TRIM55 plays the role of an oncogene in GC,and it promotes metastasis of GC through the regulation of EMT.CONCLUSION TRIM55 may be a possible target for the diagnosis and prognosis of GC patients.