Colorectal cancer (CRC) is the second greatest cause of cancer-related death in the world and chemotherapy, as an important part of CRC treatment, has some drawbacks, including systemic toxicity. Therefore, it is crucial to discover new and more effective CRC treatment plans. Rheum khorasanicum (R. khorasanicum) is a medicinal plant with high flavonoids, stilbenes, and anthraquinone contents, so it can be a potential source of antioxidants and can be used for therapeutic purposes and trigger apoptosis in cancer cells. In this study, we investigated the effects of hydroalcoholic root extract of R. khorasanicum treatment on inducing mitochondrial apoptosis of HT-29 and Caco-2 human colorectal adenocarcinoma cells. Firstly, the total phenolic and flavonoid content was determined. Then, the cytotoxic effects of R. khorasanicum on cells of three different types, including HT-29 and Caco-2 colon cancer cells as well as normal 3T3 cells were assessed using the MTT assay. To investigate the characteristics of cellular death, flow cytometry, and western blotting were performed. The results of this study indicated considerable phenolic (356.4±9.4 GAE/gDW) and flavonoid (934.55±17.1 QE/gDW) contents in R. khorasanicum. MTT assay\'s finding indicated that 100, 60, and 30μg/mL concentrations of R. khorasanicum reduce cell viability in HT-29 and Caco-2 cell lines significantly (P<0.05). It has been also revealed that R. khorasanicum extract induces apoptosis rather than necrosis in these cell lines. Moreover, Bcl-2 expression was significantly reduced in both HT-29 and Caco-2 cell lines, while Bax and cleaved caspase-3 expression soared considerably in the groups under R. khorasanicum treatment (P<0.05). In conclusion, our findings have suggested that high phenol and flavonoid contents of R. khorasanicum root extract possibly play an important role in cell cytotoxicity and apoptosis induction in HT-29 and Caco-2 colon cancer cells.

After more than a decade of good results using the combination of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal carcinosis of colorectal origin, the PRODIGE7 study, which specifically evaluated the role of HIPEC, failed to show any superiority in terms of overall and disease-free survival for the CRS+HIPEC combination compared with CRS alone. This study constituted a radical change in the knowledge and therapeutic attitudes observed to date. After reviewing the literature and the consensus of national and international experts, a synthesis is provided, together with an outlook on the questions raised and the therapeutic trials and innovations of the near future. An analysis of recent advances due to the advent of a new technique, PIPAC, is also proposed, as well as a review of current therapeutic trials in this field.

Among the molecular subgroups of interest in metastatic colorectal cancer (mCRC), innovations are underway for tumors with overexpression of HER2 (Human Epidermal Growth Factor Receptor 2). Overexpression of the HER2 protein concerns 2 to 5% of CRC at any stage mainly located in the distal colon and rectum. Diagnosis is based on immunohistochemistry, in situ hybridization with appropriate criteria for colorectal localization, and molecular biology (NGS: next-generation sequencing). Overexpression of HER2 is a predictive factor for resistance to treatments targeting EGFR which are indicated in the case where the tumor is wild-type RAS. It seems to be associated with a poor prognosis of mCRC with a higher risk of brain metastasis. Regarding treatments targeting HER2, no randomized controlled phase III has been published to date. However, several combinations have been evaluated in phase II with clinically meaningful objective response rates: trastuzumab-deruxtecan (45%), trastuzumab-tucatinib (46%), trastuzumab-pyrotinib (45%), trastuzumab-pertuzumab (30%) ou trastuzumab-lapatinib (30%). In this literature review, we present here the current state of knowledge on the diagnostic methods of HER2 overexpression in CRC, the main clinical, molecular and prognostic characteristics, and the efficacy results of the different therapeutic combinations for the patients with HER2 overexpressed mCRC. This justifies, despite the lack of marketing authorization in France and in Europe for agents targeting HER2 in CRC, the systematic evaluation of the HER2 status, as recommended in particular by the NCCN (National Comprehensive Cancer Network).

暂无摘要。

ADAM10 acts upstream of Notch signaling and plays oncogenic roles in various cancers. Tetraspanin family proteins regulate ADAM10 trafficking and activity. Here, we aimed to investigate whether and how tetraspanin-29 modulates ADAM10 in colorectal cancer (CRC). We found that ADAM10 expression was upregulated in CRC tissues and this was cross-validated in the TCGA COAD data set. The ADAM10 protein level and its α-secretase activity were enhanced in CRC cell lines compared with control cell lines. Co-immunoprecipitation showed ADAM10 interacted with tetraspanin-29 in the LoVo cell line. Tetraspanin-29 knockdown reduced the cell surface trafficking and α-secretase activity of ADAM10. In addition, tetraspanin-29 knockdown inhibited Notch activity in a luciferase reporter assay and reduced the levels of cleaved Notch1 and Notch target genes such as HES2, c-MYC, and cyclin D3. Consistently, tetraspanin-29 overexpression increased cleaved Notch1 and this effect was blocked by ADAM10 inhibitors. The TCGA COAD data set confirmed the positive correlations of tetraspanin-29 with HES2, c-MYC, and cyclin D3. Thus, the tetraspanin-29/ADAM10/Notch pathway plays an important role in CRC.

OBJECTIVE: The aim of this study was to describe the diagnostic and therapeutic aspects of the managment of obstructive colorectal cancer and to evaluate the different surgical methods.
METHODS: This retrospective, descriptive and analytical study was carry out from january 2008 to december 2014 in the visceral surgery department of Hospital Principal of Dakar and included 37 patients treated for obstructive colorectal cancer. The parameters studied were age, gender, unit of provenance, antecedents, clinical and paraclinical examination data, treatment and evolution. The data entered on Excel, was analyzed with SPSS software. Intergroup comparisons were made through Pearson or Fisher tests for qualitative values and Student or ANNOVA tests for quantitative values. The threshold of significance of the statistical tests was 5% in a bilateral situation.
RESULTS: We collected 22 men and 15 women. CT scan showed the tumor in 23 cases. In 14 cases, the tumor was seen on laparotomy. The tumeur was in left colon in 28 cases, in right colon in 4 cases, in rectum in 5 cases. The right colon tumor underwent palliative surgery in 3 cases (1 ileostomy, 1 internal diversion, 1 caecostomy) and staged surgery in 1 case (caecostomy followed by secondary hemicolectomy). In left colon tumor were performed, 5 one stage left colectomies, 2 Hartmann procedures, 1 Bouilly Wolkmann, 3 internal diversions and 17 primary colostomies in which 12 had a secondary tumor resection. In rectum tumor was done 5 colostomies without secondary tumor resection. Twenty seven patients had their histology in wich 26 was adenocarcinoma. Nine patients underwent chemotherapy. The global early morbidity and mortality were respectively 35% and 13,5%. In left colon tumor, morbidity and mortality of the primary colostomy followed by secondary resection were respectively 17,6% and 11,7%. In case of emergent one stage tumor resection it was respectively 40% and 20%.Survival at one year was 43,2%.
CONCLUSIONS: Our results confirm the poor outcome of colorectal cancer obstruction and suggest that 2 stage tumor resection is safer in left colon cancer.
OBJECTIVE: Décrire les aspects diagnostiques, thérapeutiques des cancers colorectaux en occlusion et évaluer les différentes modalités thérapeutiques chirurgicales.
UNASSIGNED: Il s\'agissait d\'une étude rétrospective, descriptive et analytique effectuée dans le service de chirurgie viscérale de l\'Hôpital Principal de Dakar, de janvier 2008 à décembre 2014, incluant 37 patients pris en charge pour cancer colique ou rectal en occlusion. Les paramètres étudiés étaient l\'âge, le genre, l\'unité de provenance, les antécédents, les données de l\'examen clinique et paraclinique, le traitement et l\'évolution. Les données saisies sur Excel, étaient analysées avec le logiciel SPSS. Des comparaisons intergroupes étaient effectuées grâce aux tests de Pearson ou de Fisher pour les valeurs qualitatives, de Student ou ANNOVA pour les valeurs quantitatives, avec un seuil de significativité de 5% en situation bilatérale.
UNASSIGNED: Les dossiers cliniques de 22 hommes et 15 femmes étaient colligés. L\'âge moyen des patients était de 61,2 ans. Le diagnostic d\'occlusion tumorale était tomodensitométrique dans 23 cas et dans 14 cas per opératoire. Quatre tumeurs siégeaient au côlon droit, 28 au côlon gauche et 5 au rectum. Pour les tumeurs du rectum, étaient réalisées 5 colostomies de décharge en urgence sans résection tumorale secondaire. Pour les tumeurs coliques droites, un patient avait bénéficié d\'une caecostomie en urgence suivie d\'une hémicolectomie droite et 3 patients d\'une chirurgie palliative en urgence (dérivation interne, caecostomie, iléostomie dans 1 cas respectivement). Pour le siège colique gauche, une résection tumorale en urgence était réalisée dans 8 cas (5 colectomies gauches idéales, 2 Hartmann, 1 Bouilly Wolkman). Dix sept patients avaient bénéficié d\'une colostomie de décharge en urgence suivie d\'une résection tumorale secondaire chez 12 d\'entre eux. Trois patients avaient bénéficié d\'une dérivation interne. L\'histologie obtenue dans 27 cas, était en faveur d\'un adénocarcinome dans 26 cas. Neuf patients avaient bénéficié d\'une chimiothérapie. La morbidité et la mortalité globale était respectivement de 35% et 13,5%. Pour les localisations coliques gauches, cette morbi-mortalité en cas de stratégie en 2 temps était respectivement de 17,6% et 11,7%. En cas de colectomie idéale en urgence, elle était respectivement de 40% et 20%.La survie globale à 1 an était de 43,2%.
CONCLUSIONS: Nos résultats confirment la gravité du cancer colorectal en occlusion et plaident pour la colostomie première suivie de la résection tumorale secondaire pour les tumeurs au côlon gauche.

Approximately a quarter of patients undergoing colorectal cancer surgery are over 75 years of age. Their care must therefore be adapted to minimise his functional consequences, which can be more significant in an elderly patient.

Medical treatment with chemotherapy is discussed in several situations in the treatment of colon cancer. In the adjuvant setting, chemotherapy with 5FU±oxaliplatin for six months should be considered in the case of lymph node involvement. In the metastatic setting, several protocols exist. The choice of treatments should be based on the expected objectives in terms of response and survival gain, but also of tolerance and quality of life for the patient. A thorough oncogeriatric assessment helps to better define the therapeutic programme. The continuation of geriatric follow-up throughout the treatment process shows a benefit for the patient in terms of quality of life and tolerance of treatments.

OBJECTIVE: The main aim of this national survey was to identify the levels of colorectal cancer screening knowledge and uptake in Lebanon.
METHODS: A total of 1200 participants were enrolled in this cross-sectional household survey targeting the Lebanese population aged 50 years and above. The sample was recruited using a two-stage stratified cluster sampling approach.
RESULTS: Of the total sample, 38.3% knew about any screening test for colorectal cancer but only 7.5% had ever used any. Thirty-nine percent of the participants rated their risk of getting colorectal cancer as very low or low, and only 53.5% were confident in their ability to undertake a screening test. Almost all participants agreed that medical advice and test reimbursement would encourage them to do a screening test. At the multivariate analysis level, hearing of an awareness campaign in the last two years showed the strongest association with the knowledge of a colorectal cancer screening test with an estimated ORadj = 5.12 (95%CI: 3.67 - 7.15). Other factors that were significantly associated with this knowledge variable included: a family history of colorectal cancer, a personal history of colorectal illness, having a health coverage, and knowledge of colorectal cancer signs and symptoms.
CONCLUSIONS: This national study highlights an alarming lack of uptake and low levels of knowledge of colorectal cancer screening tests even though it is among the most prevalent cancers in Lebanon and its prevalence has been continuously increasing in the past years. The evidence suggests that people who had an experience with colorectal cancer diagnostic tests, either personally or through a family member, and those who have heard of an awareness campaign about colorectal cancer in the last two years are more likely to know its screening tests.
CONCLUSIONS: Colorectal cancer screening knowledge and uptake in Lebanon are limited and justify the need for public health interventions. This study gives evidence that awareness campaigns, coupled with the involvement of medical providers and the reimbursement of screening test fees, would alleviate the burden of colorectal cancer in Lebanon.

Immunotherapies are part of the therapeutic strategy in many cancers and are indicated for metastatic colorectal adenocarcinoma with loss of expression of MisMatch Repair system proteins or with microsatelite instability (dMMR/MSI) in the United States. The rate of pathological response to immunotherapy remains poorly documented, but several cases of complete or major pathological response have recently been described. We decided to report the case of a complete pathological response to immunotherapy of a dMMR/MSI colorectal adenocarcinoma in a 74-year-old patient, initially inoperable due to duodenal invasion. Three months after the introduction of immunotherapy, the patient developed drug-induced colitis that contraindicated further treatment. Histological examination of the subtotal colectomy specimen revealed no residual tumour cells. The patterns of tumour regression were mainly represented by colloid regression, infarctoid-type necrosis and a resorptive inflammatory reaction. Although the operative indications for patients with metastatic dMMR/MSI colorectal cancer treated by immunotherapy are still very limited, the number of such specimens is expected to increase rapidly. The management of these specimens, as well as the possibility of a complete histological response, must be known by pathologists who play a key role in the pathophysiological knowledge of these lesions.