• Chemotherapy
• Colloid carcinoma
• Colorectal cancer
• Drain site recurrence
• Metastasis

• HIPEC
• colorectal cancer
• cytoreductive surgery
• peritoneal metastases
• pseudomyxoma peritonei
• scar metastases

• No specific number. Bengt Ihres Foundation
• No specific number. Lion's research foundation in Uppsala

• colorectal (colon) cancer
• laparoscopic
• minimally invasive
• rectal cancer
• robotic

• Brachytherapy
• Interventional radiology
• Iodine-125 seed
• Metastatic colorectal neoplasm
• Radiotherapy

• Humans
• Treatment Outcome
• Brachytherapy/adverse effects
• Brachytherapy/methods
• Retrospective Studies
• Tomography, X-Ray Computed/methods
• Colorectal Neoplasms/etiology

• minimally invasive colorectal cancer resection plasma osteopontin levels

Colorectal carcinoma (CRC) is a very common cancer found worldwide. When metastasizing, it would often seed the liver via traveling through the portal circulation; however, locoregional metastasis is also possible. Abdominal wall seeding postoperatively has been described to happen rarely in those who underwent definitive surgery for CRC. Currently, five case reports are in publication describing this phenomenon.

Here, we present a case of a drain site abdominal wall tumor recurrence after definitive surgery with curative intent of a sigmoid adenocarcinoma. Those with higher tumor-node-metastasis (TNM) staging and a primary site at the sigmoid colon were found to be at a higher risk for recurrence. Despite this, abdominal wall recurrence of CRC is exceptionally rare, with less than 1% of those with locoregional recurrence presenting at the incision site or trocar site placement.

Because of the rarity of this complication, few studies are available that detail the management of abdominal wall recurrence of CRC. Further studies on this subject are currently warranted.

Despite concerns regarding oncologic safety, laparoscopic surgery for colon cancer has been proven in several trials in the lasts decades to be superior to open surgery. In addition, the benefits of laparoscopic surgery can be offered to other patients with malignant disease. The aim of the present study was to compare the quality of oncologic resection for non-metastatic, resectable colon cancer between laparoscopic and open surgery in terms of specimen margins and retrieved lymph nodes in a medium volume center in Romania. A total of 219 patients underwent surgery for non-metastatic colon cancer between January 2017 and December 2020. Of these, 52 underwent laparoscopic resection, while 167 had open surgery. None of the patients in the laparoscopic group had positive circumferential margins (P=0.035) while 12 (7.19%) patients in the open group (OG) had positive margins. A total of three patients in the laparoscopic group (5.77%) and seven patients (4.19%) in the OG had invaded axial margins. While the number of retrieved lymph nodes was not correlated with the type of procedure [laparoscopic group 16.12 (14±6.56), OG 17.31 (15±8.42), P=0.448], the lymph node ratio was significantly higher in the OG (P=0.003). Given the results of the present study, it is safe to conclude that laparoscopic surgery is not inferior to open surgery for non-metastatic colon cancer in a medium volume center.

Sister Mary-Joseph nodule (NSMJ) is a cutaneous metastasis of the umbilicus, rare and accounts for 2-3% of the patients with advanced stages of colorectal adenocarcinoma. Here we report the observation of a 48-year-old Moroccan man, referred to our hospital to manage a painful ulcero-budding nodule of the umbilicus; computed tomography revealed that the processes infiltrated the urachus and the bladder. Laboratory parameters were normal and radical surgery was performed to remove the tumor and embryological remnant of the umbilicus. The histological assessment confirmed the sigmoidal origin of the umbilical nodule. This kind of disease always poses a problem of treatment. It was considered for a long time as an outdated stage of tumor disease that deserves just palliative treatment. Several cases published in the international literature with radical treatment had good survival and evolution, which gives hope to patients with this disease.

• Sister Mary-Joseph nodule
• Umbilical skin metastasis
• case report
• radical surgery
• stages of the tumor

The incidence of abdominal wall metastasis from colorectal cancer (CRC) is very low, but it has a poor prognosis. Despite the advances in radiotherapy, chemotherapy, and targeted therapy, patient prognosis has not improved significantly. Through surgical treatment, some patients with locally advanced CRC with abdominal wall invasion can achieve tumor-free survival or an improved quality of life.

The clinical data of 15 patients in our department from January 2015 to January 2020 were retrospectively analyzed. All patients underwent preoperative three-dimensional reconstruction of the tumor and abdominal wall after discussion with a multidisciplinary team (MDT). Patient information, including tumor size, defect size, operation time, intraoperative bleeding, hospital stay, and other factors, was collected.

All 15 patients underwent resection followed by reconstruction for locally advanced CRC with abdominal wall invasion. The average tumor area and abdominal wall defects were 98.13±71.70 and 270.07±101.95 cm², respectively; and accurate abdominal wall classification and zoning were obtained for all patients. The average operation time was 431.7±189.2 min, and the average blood loss was 513.3±244.6 mL. The recurrence rates in the incisional hernia and abdominal wall were 6.0% and 13.3%, respectively. The patient survival rate was 87.7%.

Surgical treatment of locally advanced CRC with abdominal wall invasion is feasible, but requires accurate and comprehensive preoperative evaluation.

• Three dimensional visualization
• abdominal wall reconstruction
• complex abdominal wall defects
• locally advanced colorectal cancer with abdominal wall invasion (locally advanced CRC with abdominal wall invasion)

• gastrointestinal tumors
• laparoscopy
• metastasis
• port-site
• treatment

• Abdominal Wall
• Aged
• Female
• Gastrointestinal Neoplasms/pathology
• Gastrointestinal Neoplasms/surgery
• Humans
• Laparoscopy/adverse effects
• Male
• Middle Aged
• Neoplasm Metastasis/therapy
• Neoplasm Seeding
• Prognosis
• Retrospective Studies
• Survival Rate

• 18F-fluorodeoxyglucose positron emission tomography
• Anal cancer
• Chemoradiotherapy
• Solitary pelvic-wall mass
• Surgical tract recurrence

• Colorectal cancer
• Dual-ring wound protector
• Long-term outcomes
• Short-term outcomes

• Adult
• Aged
• Aged, 80 and over
• Colectomy/adverse effects
• Colectomy/instrumentation
• Colectomy/methods
• Colorectal Neoplasms/mortality
• Colorectal Neoplasms/surgery
• Disease-Free Survival
• Elective Surgical Procedures/adverse effects
• Elective Surgical Procedures/instrumentation
• Elective Surgical Procedures/methods
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local/epidemiology
• Neoplasm Recurrence, Local/prevention & control
• Proctectomy/adverse effects
• Proctectomy/instrumentation
• Proctectomy/methods
• Risk Factors
• Surgical Wound Infection/epidemiology
• Surgical Wound Infection/etiology
• Surgical Wound Infection/prevention & control
• Time Factors
• Young Adult

We report the case of a 65-year-old male with a metachronous abdominal wall metastasis secondary to colorectal cancer. The patient had presented 5 years ago to another facility with a perforated sigmoid colon cancer (pT4a[SE], N0, M0, pStage II), rectal cancer (T2[MP], N0, M0, pStage I), and Fournier gangrene. He had then undergone sigmoidectomy and rectal resection along with S-1 adjuvant chemotherapy. No relapse was observed thereafter. However, currently, 5 years after initial surgery, the patient noticed a palpable mass in the left lower abdomen and was referred to our hospital for further assessment and treatment. Percutaneous echo-guided needle biopsy of the tumor revealed an adenocarcinoma tissue. Following 6 courses of FOLFOX plus cetuximab chemotherapy, laparoscopic resection for abdominal wall metastasis was successfully performed. The resected tissue was pathologically characterized as adenocarcinoma, which was compatible with the recurrence of the primary colorectal carcinoma resected 5 years ago. The abdominal wall metastasis was attributed to the cancer cell implantation secondary to the perforated sigmoid colon cancer treated 5 years ago.

• Abdominal wall metastasis
• Colorectal cancer
• Laparoscopic surgery

• Chordoma
• Craniopharyngioma
• Ectopic recurrence
• Iatrogenic
• Sinonasal
• Skull base
• Tumor seeding

•

Skin Cancer.

Metastases represent one of the most outstanding characteristics of malignant neoplasms and are relatively rare in the skin, in spite of the great extension of the cutaneous organs.

Development of cutaneous metastases from colon cancer is a rare event, usually occurring in widely disseminated disease and commonly leading to a poor prognosis.

As to location, cutaneous metastases often favor areas close to the primary malignancy, such as lung cancer and skin metastases on the trunk. However, remote sites as the scalp may be also involved.

We present the case of a 92-year-old female patient with a massive single nodular skin lesion on her left supraclavicular area, that came back positive for cutaneous metastasis of colon adenocarcinoma.

Cutaneous metastasis of colorectal cancer a rare event (2.3%–6%) that usually occur two years after the detection or resection of the primary tumor. It seldom occurs before the identification of the primary tumor and involvement of secondary organs, such as the liver. There are few cases reported with only cutaneous metastases.

In conclusion, dermatological evaluation of patients who are undergoing screening or who have already been diagnosed with cancer is extremely important.

• Colon Cancer
• Cutaneous Metastasis
• Fasciocutaneous Flap
• Skin cancer

• Abdominal wall reconstruction
• Abdominal wall recurrence
• Abdominal wall resection
• Cytoreductive surgery
• Peritoneal neoplasm
• Wound complications

• Abdominal Wall/surgery
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Australia/epidemiology
• Cytoreduction Surgical Procedures/adverse effects
• Female
• Follow-Up Studies
• Humans
• Hyperthermia, Induced/adverse effects
• Male
• Middle Aged
• Morbidity/trends
• Peritoneal Neoplasms/diagnosis
• Peritoneal Neoplasms/secondary
• Peritoneal Neoplasms/therapy
• Postoperative Complications/epidemiology
• Retrospective Studies
• Saudi Arabia/epidemiology
• Survival Rate/trends
• Young Adult

• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Female
• Humans
• Middle Aged
• Neoplasm Invasiveness
• Perineum/pathology
• Rectal Neoplasms/pathology
• Rectal Neoplasms/surgery
• Skin Neoplasms/pathology

Robot-assisted radical cystectomy (RARC) has seen remarkable growth in the last decade. Despite a low level of evidence, numerous publications reporting on outcomes after RARC are now available. While definitive data on the long-term oncologic safety and efficacy of this technique are still lacking, similar oncological and functional outcomes compared to open radical cystectomy (ORC) have been reported. Several studies have also reported on atypical recurrences after RARC, including peritoneal carcinomatosis, extra-pelvic lymph node metastasis and port-site metastasis. While distant metastases overall do not appear to be affected by technique, it is possible that RARC may be associated with an increased risk of some atypical recurrences and this should be prospectively studied in RARC. However, atypical recurrences are rare events and are infrequent in their description. To date, there is no convincing evidence that, in the hands of equally experienced surgeons who treat bladder cancer routinely, a skillfully performed RARC is less oncologically efficacious than a skillfully performed ORC.

• Radical cystectomy
• atypical recurrence
• robotic-assisted

Skin metastases are relatively rare and occur most often when the cancer is already advanced, invading other organs. As to location, they often seem to elect areas located close to the primary tumor, although distant sites, such as the scalp, may be affected with some frequency. We present a case of a 76-year-old woman with colon adenocarcinoma that had a single metastatic lesion on the scalp.

• colon cancer
• colon surgery
• laparoscopy

Since laparoscopy was first used in cholecystectomy in 1987, it has developed quickly and has been used in most fields of traditional surgery. People have now accepted its advantages like small incision, quick recovery, light pain, beauty and short hospital stays. In early times, there are still controversies about the application of laparoscopy in malignant tumor treatments, especially about the problems of oncology efficacy, incision implantation and operation security. However, these concerns have been fully eliminated by evidences on the basis of evidence-basis medicine. In recent years, new minimally invasive technologies are appearing continually, but they still have challenges and may increase the difficulties of radical dissection and the risks of potential complications, so they are confined to benign or early malignant tumors. The core value of the laparoscopic technique is to ensure the high quality of tumor’s radical resection and less complications. On the basis of this, it is allowed to pursue more minimally invasive techniques. Since the development of laparoscopic colorectal surgery is rapid and unceasing, we have reasons to believe that laparoscopic surgery will become gold standard for colorectal surgery in the near future.

• Laparoscopy
• Minimally invasive surgery
• Core value
• Laparoscopic colorectal surgery

• adoption
• enhanced recovery
• laparoscopy

• Morcellation
• Peritoneal dissemination
• Power morcellation
• Uterine sarcoma

• Female
• Gynecologic Surgical Procedures/adverse effects
• Humans
• Hysterectomy/adverse effects
• Laparoscopy/adverse effects
• Minimally Invasive Surgical Procedures/adverse effects
• Morcellation/adverse effects
• Uterine Neoplasms/pathology
• Uterine Neoplasms/surgery

Carcinomas occurring at colostomy sites are rare, and most of these are metachronous colorectal cancers. The median time between colostomy and development of a carcinoma at a colostomy site is 22 years, which exceeds the length of the recommended follow-up period. We report a rare case of a carcinoma of the transverse colon occurring at a colostomy site in a patient without a history of colorectal cancer.

An 89-year-old woman presented with a tumor occurring at a colostomy site. Thirty-five years previously, she had undergone a transverse loop colostomy for an iatrogenic colon perforation that occurred during left ureteral lithotomy. Upon physical examination, the patient had a hard nodule measuring 3 cm at the colostomy site. A biopsy of the nodule suggested adenocarcinoma, and the preoperative diagnosis was transverse colon cancer. A laparotomy was performed via a peristomal incision with 5-mm skin margins, and the tumor was covered by a surgical glove to avoid any tumor seeding. The colon was separated from the tumor by 5-cm margins, and the specimen was removed en bloc. An end colostomy was constructed to a new site on the right side of the abdomen. The deficit in the abdominal wall was repaired, and the skin was closed via a purse-string suture. The final diagnosis of the stoma tumor was transverse colon cancer (T2, N0, M0, stage I). One year and five months after surgery, there was no evidence of recurrence.

The occurrence of carcinomas at colostomy sites in patients without a history of colorectal cancer is rare. It is important to train ostomates to monitor the stoma for possible tumor recurrence.

• Colectomy
• Colorectal surgery
• Laparoscopic
• Laparoscopy
• Open surgery
• Robot

• Colectomy/adverse effects
• Colectomy/methods
• Colectomy/trends
• Colonic Diseases/diagnosis
• Colonic Diseases/surgery
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Laparoscopy/trends
• Postoperative Complications/etiology
• Risk Assessment
• Risk Factors
• Treatment Outcome

• extended radical surgery
• multimodality treatment
• perineal invasion
• rectal cancer

• carcinoma
• laparoscopy
• neoplasm metastasis
• recurrence
• renal cell

• Colon cancer
• Laparoscopic surgery
• Oncologic outcomes
• Rectal cancer
• Surgical morbidity

• Laparoscopic surgery
• rectal cancer
• treatment outcome

• Colonic Neoplasms/diagnosis
• Colonic Neoplasms/surgery
• Colorectal Surgery/education
• Evidence-Based Medicine
• Humans
• Intestinal Obstruction/surgery
• Laparoscopy/education
• Laparoscopy/methods
• Magnetic Resonance Imaging
• Neoplasm Metastasis
• Neoplasm Recurrence, Local/prevention & control
• Neoplasm Seeding
• Preoperative Care/methods
• Rectal Neoplasms/diagnosis
• Rectal Neoplasms/surgery
• Robotics/methods
• Tissue Adhesions/surgery
• Tomography, X-Ray Computed
• Wound Closure Techniques

Diagnostic laparoscopy helps in diagnosing and staging Gastrointestinal (GI) cancers. Routine laparoscopy before laparotomy, especially in cancers that have equivocal operability, helps to avoid unnecessary laparotomies. Present study evaluates utility of laparoscopy in diagnosing and staging GI cancers.

Diagnostic laparoscopy was done in 41 patients with gastrointestinal (GI) cancers who were thought to have equivocal operability. Patients with suspected or known non-metastatic GI cancers, in whom resectability was found doubtful by clinical assessment and pre-operative imaging, were included. Patients with non-GI cancers (lymphoma, gynaecologic cancers, genitourinary cancers, retroperitoneal sarcoma, sarcoma and abdominal metastasis of non-GI cancers) and metastatic cancers which were beyond the scope of curative surgery were excluded from the study.

After diagnostic laparoscopy (DL) five patients had benign diagnosis. Out of 36 patients with malignant diagnosis, after DL, 22 patients (61.1%) were inoperable, 11 patients (30.6%) were operable, and three (8.3%) patients were of equivocal operability. Sensitivity, specificity, positive predictive value, and negative predictive value of laparoscopy in detecting operability were 100%, 91.7%, 81.8%, and 100%, respectively.

Laparoscopy helped in a significant number of patients with advanced GI cancers to avoid laparotomy. The morbidity of DL was acceptable.

• Diagnostic laparoscopy
• gastrointestinal cancer
• operability
• staging

• Incisional recurrence
• anterior skull base surgery
• transfacial surgery
• tumor implantation
• wound metastasis

• Antineoplastic Agents/therapeutic use
• Chemotherapy, Adjuvant
• Colectomy/methods
• Colonoscopy
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/epidemiology
• Colorectal Neoplasms/etiology
• Colorectal Neoplasms/therapy
• Early Detection of Cancer
• Genetic Predisposition to Disease
• Humans
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Laparoscopy
• Perioperative Care
• Risk Factors
• Robotics
• Sentinel Lymph Node Biopsy
• Stents
• United States/epidemiology