European Multidisciplinary Colorectal Cancer Congress 2012

A review of russian and foreign literature concerning clinical use of metronidazole as a radiosensitizer in oncologic treatment. New delivery form of metronidazole has been developed using a polymeric composition. Dose- and time-dependent pharmacodynamics has been analyzed. Personal long-term results of complex treatment of localized and locally-advanced rectal cancer using different radiosensitizers has been presented. The data allows to consider complex treatment as a method of choice for these patients. Using polyradiomodification allowed to decrease lymphohematogenic metastasing rate, decrease locoregional recurrence rate and improve disease-free survival.

Coloncancer is among leading causes of cancer morbidity and mortality both inRussiaand worldwide. Development of molecular biology lead to decoding of carcinogenesis and tumor progression mechanisms. These processes require accumulation of genetic and epigenetic alterations in a tumor cell.Coloncancer carcinogenesis is characterized by mutations cumulation in genes controlling growth and differentiation of epithelial cells, which leads to their genetic instability. Microsatellite instability is a type of genetic instability characterized by deterioration of mismatch DNA repair. This leads to faster accumulation of mutations in DNA. Loss of mismatch repair mechanism can easily be diagnosed by length of DNA microsatellites. These alterations are termed microsatellite instability. They can be found both in hereditary and sporadic colon cancers. This review covers the questions of microsatellite instability, its prognostic and predictive value in colon cancer.

A rare clinical presentation of colorectal cancer bone metastases is discussed in this article. Data on incidence and possible mechanism of isolated bone metastases is demonstrated, treatment options based on different clinics experience is discussed.

More than 30-year experience of the department of proctology of N.N. Blokhin Russian Cancer Research Center, which demonstrates the necessity in developing complex treatment for distal rectal cancer is presented in this article. An original treatment scheme has been developed, incorporating radiotherapy (short course 5 Ч 5 Gy) with 2 radiosensitizers and systemic cytotoxic therapy with fluorpyrimidines (capecitabine). The developed treatment scheme has acceptable toxicity and can be combined with all types of surgical interventions. A significant reduction in local and distant failures rates can be achieved as well an improvement of disease-free survival. This allows to increase indications to sphincter-sparing treatment by improving ablastics of surgery and provide high level of social rehabilitation.

This research is based on histological investigation of targeted biopsy material and resected polyps’ at 354 patients who applied to National Center of Oncology from 2005 to 2010. All patients underwent targeted biopsy at first with subsequent endoscopic polypectomy and 494 polyps were removed and histologically investigated. The most prevalence type was tubular polyp — 212 (43 %) cases. The rest types of polyps were distributed as follow: tubule-villous type — 125 (25.3 %), villous type — 16 (3.2 %), inflammatory type — 28 (5.7 %), hyperplastic type — 40 (8.1 %), hamartoma type — 21 (4.3 %) cases. In 52 (10.4 %) cases malignant polyps were revealed.Sensitivity of targeted biopsy in iagnostics of dysplasia was 65.1 % while in revealing of malignancy was even lower — just 36.5 %. So we consider performing of endoscopic polypectomy and histological evaluation of resected polyps in all case even after previous targeted biopsy.

Pathologic nutrients metabolism presents a severe problem in metastatic colorectal cancer patients, especially those with canceromatosis. A hypermetabolism-catabolism syndrome frequently develops in in patients with progressing canceromatosis. This leads to cachexia anorexia syndrome, which significantly impedes available treatment options. Artificial nutrition allows to improve available treatment in such patients. We present a successful case of concomitant parenteral nutrition and systemic cytotoxic therapy in metastatic colorectal cancer patient with peritoneal canceromatosis.

A successful treatment of a young patient with a 15-year anamnesis of ulcerative colitis, who has been diagnosed with rectal cancer, is presented in this case report. A non-standard surgical intervention has been performed following all principles of oncologic surgery. A subtotal colectomy has been performed with ultra-low anterior resection of rectum. Ascendoanal anastomosis has been performed forming the neo-rectum. There were no complications in postoperative period. Considering disease stage (T3N1M0) adjuvant XELOX was administered for 6 months along with 2 cycles of prophylactic treatment with 5-aminosalycilic acid. During 2-years follow-up there are no signs of rectal cancer and ulcerative colitis progression. After pelvic electrostimulation defecation frequency decreased to 3–4 times per day, a patient has complete social rehabilitation.