Colorectal Cancer

Primary sclerosing cholangitis in children with inflammatory bowel disease: An ESPGHAN position paper from the Hepatology Committee and the IBD Porto group.

Journal of pediatric gastroenterology and nutrition · 2025 · PMID 39741383

OBJECTIVE: We aimed to provide an evidence-supported approach to diagnose, monitor, and treat children with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC). METHODS: The core group formulated seven PICO-structured clinical questions. A systematic literature search from inception to December 2022 was conducted by a medical librarian using MEDLINE and EMBASE. Core messages from the literature were phrased as position statements and then circulated to a sounding board composed of internationa…

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

JAMA · 2016 · PMID 27305422

IMPORTANCE: Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States. OBJECTIVE: To systematically review the effectiveness, diagnostic accuracy, and harms of screening for CRC. DATA SOURCES: Searches of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials for relevant studies published from January 1, 2008, through December 31, 2014, with surveillance through February 23, 2016. STUDY SELECTION: English-language studies conducted in asymptomatic populati…

Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric, Version 3.2024, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2024 · PMID 39689429

Multigene panel testing has allowed for the detection of a growing number of inherited pathogenic/likely pathogenic variants in people at high risk of cancer, including endometrial cancer (EC). Hereditary syndromes associated with EC include Lynch syndrome, PTEN hamartoma tumor syndrome, and Peutz-Jeghers syndrome. This manuscript provides the latest recommendations from the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric on the screening and management of EC in patie…

ACG Clinical Guideline: Colonic Diverticulitis.

The American journal of gastroenterology · 2026 · PMID 42390126

Colonic diverticulitis is a common and costly disease, with a lifetime risk of 3%-5%, that drives substantial healthcare use. This guideline provides practical, evidence-based recommendations for the management of diverticulitis in the outpatient gastroenterology setting. Consultations should address diagnosis, typical clinical course, risk factors, the role of antibiotics, and prevention. Computed tomography imaging is essential to confirm the diagnosis of diverticulitis, particularly at the first presentation and…

ACG Clinical Guideline: Diagnosis and Management of Adenomatous Colorectal Polyposis Syndromes.

The American journal of gastroenterology · 2026 · PMID 42683623

The hereditary adenomatous colorectal polyposis syndromes are incurable, systemic, cancer risk predisposition syndromes with substantial morbidity and mortality. They differ in their mode of inheritance, age at disease onset, phenotypic expression, and cancer risk. The most common cancer risks involve the gastrointestinal tract including the colon, rectum, duodenum, ampulla, and stomach. Identifying these syndromes through personal and family history risk assessment and germline genetic testing, along with timely s…

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

NANETS Guidelines for the diagnosis and management of stage I-III rectal neuroendocrine tumors.

Endocrine-related cancer · 2026 · PMID 41562331

Well-differentiated rectal neuroendocrine tumors (rNETs) are among the most common NETs and account for approximately 12-27% of all gastrointestinal NETs in North America. Significant discrepancies persist in the management of NETs regarding surveillance strategies, staging modalities, high-risk features, and criteria for surgical intervention. This guideline updates current practices of stage I-III rectal NETs with the utilization of GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) metho…

Survival benefit of oral systemic monotherapy in previously treated metastatic colorectal cancer: a meta-analysis.

The oncologist · 2026 · PMID 42104118

BACKGROUND: Guideline-recommended nontargeted systemic therapies for previously treated metastatic colorectal cancer (mCRC) include regorafenib, trifluridine/tipiracil, and fruquintinib, but no consensus exists on the definition of clinically meaningful improvements for later-line mCRC treatments. MATERIALS AND METHODS: Trials were identified from systematic searches in MEDLINE, Embase, and the Cochrane Library. Meta-analyses were performed to characterize overall survival (OS) and progression-free survival (PFS) i…

Evidence Gap in Managing Lateral Pelvic Lymph Nodes in Rectal Cancer: a Systematic Review of Radiation Boost Strategies.

Journal of gastrointestinal cancer · 2026 · PMID 42704578

PURPOSE: Lateral pelvic lymph node (LPLN) involvement is a significant predictor of local recurrence in patients with locally advanced rectal cancer (LARC). While lateral pelvic lymph node dissection (LPLND) is routinely used in some countries to manage suspicious nodes, it is associated with increased morbidity and is not widely adopted in Western practice. Radiation boost (dose escalation) to involved LPLNs during neoadjuvant chemoradiotherapy (nCRT) has emerged as a potential non-surgical alternative. Despite in…

Executive summary of American Radium Society Appropriate Use Criteria for the treatment of locoregionally recurrent rectal cancer.

Cancer · 2026 · PMID 42246062

This literature-based systematic review and associated guidelines provide evidence-based paradigms for the management of locoregionally recurrent rectal cancer (LRRC). This multispecialty committee included gastrointestinal radiation and medical oncology, gastroenterology, radiology, and colorectal surgery. As is the standard, the previously described American Radium Society Appropriate Use Criteria methodology for this project was followed rigorously, with the Population, Intervention, Comparator, Outcome, Timing,…

Adiposity and cancer: systematic review and meta-analysis.

Nature metabolism · 2026 · PMID 42297908

Obesity is a major health challenge. Here we show that body mass index is positively associated with risk of 19 cancers and inversely associated with 3, based on a systematic review and meta-analysis of prospective studies of 25 cancer types. We searched PubMed, EMBASE and Scopus through to 23 April 2025, identifying 226 articles comprising 1.5 million incident cancers. We identified positive associations for leukaemia, non-Hodgkin lymphoma, bladder cancer and glioma, not previously identified by major consensus re…

Blood-based cell-free DNA and multitarget stool RNA screening tests to detect colorectal cancer: A systematic review.

Cancer · 2026 · PMID 42200475

Two new tests, a cell-free DNA (cfDNA) blood-based test (BBT) and multitarget stool RNA (mt-sRNA) test with in-laboratory fecal immunochemical testing, were recently approved by the US Food and Drug Administration, and a second BBT is under review. These tests have the potential to overcome barriers to screening. This review evaluates the current evidence to better understand their utility for routine screening. The authors searched PubMed, other databases, and gray literature sources through March 30, 2026. Includ…

Executive Summary of the American Radium Society Appropriate Use Criteria for Selective Use of Pelvic Radiation Therapy in Locally Advanced Rectal Cancer: A Consensus Statement.

International journal of radiation oncology, biology, physics · 2026 · PMID 41895479

Pelvic radiotherapy is commonly incorporated in the treatment of locally-advanced rectal cancer to reduce the risk of locoregional recurrence, but can be associated with substantial acute toxicity and long-term morbidity. However, treatment may be personalized for selective use of radiotherapy in a subset of patients identified to be at low to intermediate risk of locoregional recurrence following resection. This multi-specialty-led committee included gastrointestinal radiation and medical oncology, gastroenterolog…

Clinical spotlight review: best practices for the management of colorectal cancer in the emergency and acute care setting.

Surgical endoscopy · 2026 · PMID 42209860

BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer mortality, and up to one-third of patients present with obstruction, perforation, or bleeding. Emergency presentation is associated with advanced stage, higher rates of open surgery and stoma formation, and worse survival. This review synthesizes current evidence and provides practical guidance for emergency and acute care management of CRC. METHODS: We conducted a comprehensive search of MEDLINE and EMBASE for English-language studies from 2000 throu…

The Role of Computational Models in the Detection of Colorectal Carcinoma and Precancerous Lesions.

International journal of molecular sciences · 2026 · PMID 42737839

Colonoscopy is a key screening method for colorectal cancer (CRC), but its effectiveness is limited. Computer-aided detection (CADe) and computer-aided diagnostics (CADx), as part of an artificial intelligence (AI) system, improve the detection and optical characterization of lesions. This review maps and analyzes the evidence on the application of AI in colonoscopy, with a focus on the detection, segmentation, and characterization of colon neoplasms, available platforms, architectural models and implementation. Th…

Quality of life assessment for colorectal cancer follow-up: A latent profile analysis of EORTC measures.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42494069

AIM: To identify distinct health-related quality of life (HRQoL) profiles among colorectal cancer (CRC) patients using patient-reported outcome measures (PROMs), with the aim of informing more personalised follow-up strategies. METHODS: Baseline HRQoL data from CRC patients enrolled in the FUTURE-primary study, a multicentre implementation study on home-based follow-up, were analysed. Patients completed the EORTC QLQ-C30 and QLQ-CR29 questionnaires. Aggregated symptom and function scales were developed using factor…

Prior response to anti-VEGF agents predicts the efficacy of trifluridine/tipiracil plus bevacizumab in patients with metastatic colorectal cancer.

International journal of clinical oncology · 2026 · PMID 42062697

BACKGROUND: Trifluridine/Tipiracil (FTD/TPI) combined with bevacizumab (Bev) is a standard treatment for patients with unresectable metastatic colorectal cancer (mCRC) in later-line therapy. Despite the availability of other drugs like regorafenib and fruquintinib, there is no consensus on the optimal treatment choice or sequence for later-line therapies due to a lack of clearly defined prognostic indicators. This multicenter real-world analysis aimed to identify predictive factors related to the effectiveness of F…

Root-Cause Analysis of Post-Endoscopy Esophageal Neoplasia in a Multicenter Prospective Barrett's Esophagus/Esophageal Adenocarcinoma Registry.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026 · PMID 41115582

Endoscopic surveillance is pivotal for the detection of dysplasia in Barrett's esophagus (BE), the only known precursor to esophageal adenocarcinoma (EAC). However, the effectiveness of endoscopic surveillance remains suboptimal. Similar to post-colonoscopy colorectal cancer (PCCRC), post-endoscopy esophageal neoplasia (PEEN) is a potential explanation for this reduced effectiveness.1 PEEN is defined as BE-related high-grade dysplasia (HGD) or EAC detected before the next recommended surveillance endoscopy after a …

Image-based consensus molecular subtypes and colon cancer recurrence: Understanding the impact of lifestyle factors across subtypes of colon cancer.

Cancer epidemiology · 2026 · PMID 42242067

AIM: We investigated associations between consensus molecular subtype (CMS) and colon cancer recurrence, and explored how the inflammatory potential of diet and lifestyle relate to recurrence across CMS subgroups. METHODS: A nested case-control study was implemented in two prospective cohorts of colon cancer patients. Cases were patients with recurrence (n = 167), and controls (n = 668) were matched using incidence density sampling. Formalin-fixed paraffin-embedded tumour tissue was used to determine image-based CM…

Healthcare-associated infections after elective surgery for gastrointestinal cancer in a Romanian tertiary center: incidence, microbiological profile, and the role of neoadjuvant radiotherapy as an independent risk factor.

Frontiers in public health · 2026 · PMID 42620635

BACKGROUND: Healthcare-associated infections following gastrointestinal cancer surgery are typically reported in terms of surgical site infection alone, with limited data on the broader infectious spectrum, comparative microbiology between upper and lower gastrointestinal surgery, and antimicrobial resistance in Eastern European centers. We aimed to describe the incidence, types, risk factors, and microbiological profile of all healthcare-associated infections occurring within 30 days of surgery in a Romanian terti…

Proposal of a new visual analogue scale to describe the extent of lymphadenectomy in right-sided colectomy for cancer-a prospective observational study.

Techniques in coloproctology · 2025 · PMID 40892141

BACKGROUND: Lymphadenectomy in right-sided colon cancer lacks standardized reporting. The aim was to develop a visual analogue scale (VAS) based on mesenteric vessels to describe the extent of lymphadenectomy. METHODS: We included patients undergoing surgery for right-sided colon cancer from January 2021 to September 2024. Data were collected via a web-based database. Immediately after surgery, surgeons recorded the VAS score, vascular visualization, and specimen quality. RESULTS: Data from 155 patients were analyz…

Assessing the Benefit of Adjuvant Chemotherapy in Rectal Cancer: An International Real-World Analysis.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42570607

AIM: There is no consensus for the use of adjuvant chemotherapy (ACT) after radical resection in rectal cancer. We use real-world data from the Netherlands (NL), England and Scotland, from patients who underwent surgery without neoadjuvant chemotherapy, to explore the potential benefit of ACT. MATERIALS AND METHODS: Routine administrative healthcare data from the NL (2012-2017), England (2014-2019) and Scotland (2013-2017) were used to identify patients with a clinical or pathological T3, T4, or N+ rectal cancer; m…

Colorectal Cancer Incidence in Steatotic Liver Disease (MASLD, MetALD, and ALD).

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025 · PMID 39892626

BACKGROUND & AIMS: Obesity and alcohol consumption are established risk factors for colorectal cancer (CRC). Recently, a multisociety consensus group has introduced a new classification for steatotic liver disease (SLD), which encompasses metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD). However, the risk of developing CRC in each of these SLD subgroups is unknown. This nationwide cohort study investigated the r…

Deep Learning on Histologic Slides Accurately Predicts Consensus Molecular Subtypes and Spatial Heterogeneity in Colon Cancer.

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2025 · PMID 40865918

Colon cancer (CC) is the third most prevalent cancer type. It is highly heterogeneous, particularly in terms of molecular profiles, which have both prognostic and predictive impacts on the treatment efficacy. However, CC treatment in adjuvant situations is currently guided solely by T and N staging. In this context, consensus molecular subtypes (CMSs) were introduced to stratify patients with CC based on molecular profiles. Recent studies have shown that CMS can be heterogeneous in CC, leading to a worse prognosis.…

One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.

BMC gastroenterology · 2026 · PMID 42298417

BACKGROUND: Whether collecting one or two fecal samples for immunochemical testing (FIT) optimizes colorectal cancer screening outcomes remains unclear. METHODS: We systematically searched multiple databases until October 2025 for studies directly comparing 1-FIT and 2-FIT strategies. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes. RESULTS: Five studies (n = 45,888) and three economic evaluations were included. Participation was higher with 1-FIT (RR = 1.05, P …

Prognostic Models and Predictors of Recurrence in Resectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis.

Critical reviews in oncology/hematology · 2026 · PMID 42669322

We systematically reviewed prognostic models for recurrence after curative-intent locoregional treatment of colorectal liver metastases (CRLM) and quantitatively synthesized prognostic factors associated with recurrence-free survival (RFS). From 2,208 records across 26 years of literature, 293 studies were included, encompassing 85,150 patients in development cohorts and 5,549 patients in validation cohorts. Most models targeted risk stratification rather than clinically actionable prediction, and Cox proportional …

Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis.

Surgical endoscopy · 2026 · PMID 42443688

BACKGROUND AND AIMS: Both artificial intelligence (AI) and mucosal exposure devices (MEDs) have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. However, the effectiveness of AI combined with MEDs remains unclear. In this meta-analysis, we have evaluated the combined effect of AI with MEDs on enhancing detection rates of various colonic lesions. METHODS: Several databases were reviewed to identify studies reporting data on outcomes of interest from inception to December 10, 2025…

Diagnostic accuracy of deep learning models for colorectal cancer detection in histopathological whole-slide images: a systematic review and diagnostic test accuracy meta-analysis.

Frontiers in oncology · 2026 · PMID 42676821

BACKGROUND: Deep learning systems are increasingly used for colorectal cancer detection in digital histopathology, but studies often report heterogeneous endpoints, patch-level metrics, or non-thresholded area under the curve (AUC) values. We estimated the diagnostic accuracy of clinically interpretable slide-level or patient-level models. METHODS: We searched PubMed, Embase, Scopus, Web of Science Core Collection, and IEEE Xplore for deep learning studies of human colorectal histopathology or whole-slide images. E…

Incorporating Individual Early Response in the Dose-Effect Relationship of Complete Pathological Response Following Neoadjuvant Radiochemotherapy for Rectal Cancer.

International journal of radiation oncology, biology, physics · 2026 · PMID 41354181

PURPOSE: To develop and externally validate a model predicting pathological complete response (pCR) in patients with rectal cancer treated with neoadjuvant radiochemotherapy. The approach combines the classical logit dose-effect curve with individual early response assessed by magnetic resonance imaging during radiochemotherapy. METHODS AND MATERIALS: The dose-response model incorporating the early regression index (ERI) was derived from 2 published data sets. A population-averaged dose-response curve was obtained …

Effectiveness of multitarget stool DNA versus faecal immunochemical testing alone in detecting colorectal cancer and advanced polyps: A systematic review.

Cancer epidemiology · 2026 · PMID 42600473

BACKGROUND: Colorectal cancer screening (CRC) permits early detection of colorectal neoplasms. While faecal immunochemical test (FIT) is commonly used, multitarget stool DNA (mt-sDNA) has emerged as a promising alternative due to FIT's low sensitivity for advanced adenomas but has yet to be widely adopted. The objective of this review was to summarise the findings of studies comparing characteristics of mt-sDNA versus FIT in samples which completed both tests. METHODS: A comprehensive search was conducted across th…

Diagnostic performance of serum metabolites biomarker associated with colorectal adenoma: a systematic review.

PeerJ · 2024 · PMID 39314843

Evidence on serum biomarkers as a non-invasive tool to detect colorectal adenoma (CRA) in the general population is quite promising. However, the sensitivity and specificity of these serum biomarkers in detecting disease are still questionable. This study aimed to systematically review the evidence on the diagnostic performance of serum biomarkers associated with CRA. Database searches on PubMed, Scopus, and WoS from January 2014 to December 2023 using PRISMA guidelines resulted in 4,380 citations, nine of which me…

A randomized controlled superiority trial of 1 L (Plenvu) versus 2 L (Moviprep) polyethelene glycol plus ascorbate in a FIT-based colorectal cancer screening setting (PLEMO).

BMC gastroenterology · 2026 · PMID 42163134

BACKGROUND: Sufficient cleansing of the colonic mucosa is of great importance during colonoscopy emphasizing the need for effective preparation agents. Studies evaluating the efficacy of a novel 1 L polyethylene glycol with ascorbate (1 L-PEG-Asc), Plenvu®, versus standard 2 L polyethylene glycol with ascorbate (2 L-PEG-Asc), Moviprep®, have shown promising results regarding bowel cleansing. Nonetheless superiority of 1 L-PEG-Asc has not been shown. METHODS: In this single-center randomized controlled superiority t…

Mailed Outreach for Colorectal Cancer Screening in Community Health Centers: The CARES Pragmatic Cluster Randomized Clinical Trial.

JAMA internal medicine · 2026 · PMID 42043827

IMPORTANCE: Colorectal cancer (CRC) is the second most common cause of cancer mortality in the US and disproportionately impacts individuals in underresourced settings. OBJECTIVE: To compare 2 mailed population outreach approaches to increase CRC screening uptake among screening-eligible adults in community health centers (CHCs). DESIGN, SETTING, AND PARTICIPANTS: This pragmatic cluster randomized clinical trial was conducted in 8 CHCs and an additional site in a nonrandomized parallel protocol. The CHCs were locat…

Endoscopic Surveillance in Serrated Polyposis Syndrome, Two or Three-Year Intervals: A Non-inferiority Randomized Trial.

Digestive diseases and sciences · 2026 · PMID 42012787

BACKGROUND: Serrated polyposis syndrome, the most prevalent colonic polyposis, confers an increased colorectal cancer risk. Guidelines recommend close colonoscopy surveillance, but recent data suggest low neoplasia rates, supporting longer colonoscopy intervals. AIMS: Compare advanced neoplasia incidence between two- and three-year surveillance. METHODS: A multicentre, randomized non-inferiority trial was conducted (May 2021-November 2024) in six Spanish hospitals. Patients fulfilling the 2019 WHO criteria for serr…

Impact of methodological variability on the prognostic performance of circulating tumor DNA in colorectal cancer: A systematic review and meta-analysis.

The journal of liquid biopsy · 2026 · PMID 42668443

Circulating tumor DNA (ctDNA) has demonstrated utility for treatment monitoring, risk stratification, and prognostication in colorectal cancer (CRC). However, substantial methodological heterogeneity across studies may influence its reported prognostic performance. Here, we systematically searched four databases up to October 2025. Eligible studies included patients with CRC who underwent mutation-based plasma ctDNA analysis reported as a binary variable (positive/negative) and provided hazard ratios (HRs) with 95%…

Gel Immersion Improves Visualization in Underwater Endoscopic Mucosal Resection for Colorectal Lesions: A Prospective Crossover Trial.

Journal of gastroenterology and hepatology · 2026 · PMID 42472638

OBJECTIVE: Underwater endoscopic mucosal resection (UEMR) is widely used for colorectal polyp resection, but visualization may be impaired with poor bowel preparation. Gel-immersion endoscopy has been proposed to enhance image clarity. In this study, digital image analysis was applied to quantitatively compare lesion visibility during UEMR with water or gel immersion. METHODS: In this prospective, randomized crossover trial, patients with non-pedunculated colorectal adenomatous lesions measuring 6-19 mm were sequen…

A Multilevel Intervention to Identify Individuals for Genetic Testing and Treatment: The IGNITE-TX Pilot Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42658496

IMPORTANCE: Cascade genetic testing (CGT) is a key strategy for cancer prevention in families with hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome (LS), yet uptake among at-risk relatives remains persistently low, particularly in medically underserved populations where structural and informational barriers limit access to genetic services. OBJECTIVE: To evaluate the feasibility and preliminary effects of IGNITE-TX (Identifying Individuals for Genetic Testing and Treatment), a scalable, bilin…

Pooled analysis of 2 clinical trials of first-line chemoimmunotherapy for metastatic microsatellite stable colorectal cancer MEDITREME and METIMMOX studies.

Oncoimmunology · 2026 · PMID 42322272

BACKGROUND: Colorectal cancer with microsatellite stable (MSS) status is intrinsically resistant to immune checkpoint inhibitor monotherapy targeting PD-1 or PD-L1. However, emerging evidence suggests that chemotherapies may overcome this resistance when combined with immunotherapy. METHODS: We conducted a pooled analysis of individual patient data from two phase II trials evaluating oxaliplatin-based chemotherapy combined with checkpoint inhibitors as first-line treatment for MSS metastatic colorectal cancer. The …

[Anal cancer screening: who, how, and why?].

Virologie (Montrouge, France) · 2026 · PMID 41789701

Although anal cancer remains rare in the general population, it is becoming more prevalent, particularly in high-income countries such as France, where the incidence rate is among the highest in the world. Over 90 % of anal cancers are caused by high-risk human papillomavirus (HR-HPV), particularly HPV16. Although two-thirds of cases occur in women, certain groups are at a higher risk, including men who have sex with men (MSM) living with HIV, women living with HIV, women with a history of high-grade vulvar lesions…

Impact of offering blood-based testing alongside existing modalities for colorectal cancer screening among those who previously declined screening: an economic evaluation.

Journal of medical economics · 2026 · PMID 41764032

AIM: Inadequate adherence to colorectal cancer screening reduces individual and population level health benefits. Blood-based tests offer a new modality that may help patients overcome barriers, but there are concerns about the impact of patients switching from existing guideline-recommended screening modalities. This study estimates the population health outcomes and cost-effectiveness of offering blood-based testing using a validated individual-level simulation model based on patient preference evidence from rand…

Fusion of MRI-radiomics and clinical features to improve pathological T-stage prediction of rectal cancer: a multicenter study.

BMC cancer · 2026 · PMID 42277750

BACKGROUND: Developing a rational model for precise preoperative staging of rectal cancer using magnetic resonance imaging is crucial for improving the therapeutic effect and prognosis of patients. To investigate the feasibility and efficacy of a T2-weighted imaging (T2WI) based radiomics model combined with clinical features for preoperative T1-2/T3 staging prediction in rectal cancer. METHODS: A total of 968 rectal adenocarcinoma patients (T1-2 stage, n = 562; T3 stage, n = 406) were retrospectively enrolled in t…

Preoperative identification of tumor deposits in rectal cancer using a transformer-based multimodal fusion model: a multicenter retrospective study.

BMC medical imaging · 2026 · PMID 42163131

OBJECTIVE: To develop and validate a transformer-based deep learning-radiomics model for the non-invasive preoperative discrimination of tumor deposits (TDs) in rectal cancer by integrating multi-sequence MRI features and clinical risk factors. METHODS: This multicenter retrospective study enrolled 684 patients with pathologically confirmed rectal adenocarcinoma from three hospitals. The cohort distribution was as follows: 425 patients from Center 1 were randomly split in a 7:3 ratio into an internal training set a…

An albumin-based immune-nutritional score for predicting complete response, organ preservation, and toxicity after neoadjuvant PD-1-based therapy in low rectal cancer.

Frontiers in immunology · 2026 · PMID 42597332

BACKGROUND: Programmed death-1 (PD-1) inhibitors are increasingly used in neoadjuvant therapy for low rectal cancer, but complete response and toxicity remain heterogeneous. We developed and validated an albumin-based immune-nutritional score (ABINS) to capture host factors not reflected by tumor biomarkers. METHODS: This multicenter retrospective study included 480 consecutive patients with low rectal adenocarcinoma (≤5 cm from the anal verge) treated with neoadjuvant PD-1-based therapy at three tertiary centers f…

Body Mass Index at Diagnosis, Prediagnostic Weight Loss, and Survival in Colorectal Cancer.

JAMA network open · 2026 · PMID 42599706

IMPORTANCE: Evidence on the association of excess adiposity with colorectal cancer (CRC) prognosis is conflicting, with some studies reporting better survival in patients with elevated body mass index (BMI)-often referred to as the obesity paradox. OBJECTIVE: To investigate to what extent the obesity paradox can be explained by prediagnostic cancer-associated weight loss. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, population-based case-control study with prospective follow-up included patients aged 30 yea…

Body composition analysis for predicting response to first-line bevacizumab in patients with unresectable colorectal liver metastases: A multicenter study.

European journal of radiology · 2026 · PMID 42229038

OBJECTIVES: To investigate the association between baseline body composition and objective response to first-line bevacizumab-based chemotherapy in patients with unresectable colorectal liver metastases (CRLM), and to develop a model for response prediction in this treatment setting. METHODS: This multicenter retrospective cohort included 185 patients with newly diagnosed unresectable CRLM from three hospitals who received first-line bevacizumab therapy. Pre-treatment body composition parameters were quantified at …

Interpretable Artificial Intelligence in Assisting Treatment Response Prediction for Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy: A Prospective, Multicenter, Human-Model Interaction Study.

International journal of radiation oncology, biology, physics · 2026 · PMID 41556864

PURPOSE: Preoperative assessment of pathologic complete response (pCR) to neoadjuvant therapy is an urgent need for anorectal preservation in patients with locally advanced rectal cancer (LARC). Artificial intelligence assistance remains challenging due to a lack of prospective validation and reliable interpretability. METHODS AND MATERIALS: Eligible patients with LARC were retrospectively collected. Radiomic features extracted from postneoadjuvant therapy magnetic resonance imaging were applied to train a Deep Res…

MRI-based AI framework for predicting lymph node metastasis and prognosis in rectal cancer after neoadjuvant chemoradiotherapy: a multicenter study.

Abdominal radiology (New York) · 2026 · PMID 41860709

BACKGROUND: Early prediction of lymph node metastasis (LNM) after neoadjuvant chemoradiotherapy (nCRT) is crucial for improving treatment planning and prognosis in rectal cancer (RC) patients. This study aims to develop an MRI-based AI framework integrating clinical, radiomics, and autoencoder features to predict LNM and prognosis post-nCRT. METHODS: This study included 577 RC patients who underwent nCRT followed by surgical resection, with data collected from three centers. The dataset was divided into training se…

Clinical and environmental impact of diagnostic endoscopic dissection strategy versus first-line surgery for colorectal lesions with focal deep invasion.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026 · PMID 42471304

BACKGROUND: Endoscopic submucosal dissection (ESD) can achieve curative resection for selected T1 colorectal cancers, but optical diagnosis poorly predicts invasion depth. Consequently, focal deep invasive pattern (FDIP) lesions are often referred to surgery. A diagnostic endoscopic dissection approach may represent a cost-effective alternative. We evaluated the clinical impact of a diagnostic endoscopic dissection strategy and modeled its environmental and economic impact versus upfront surgery. METHODS: This mult…

Development and validation of an interpretable MRI-based multimodal fusion model for predicting lymph node metastasis after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicenter study.

Abdominal radiology (New York) · 2026 · PMID 41801383

OBJECTIVE: To develop an interpretable multimodal model that integrates pre-treatment Magnetic resonance imaging (MRI)-based deep learning radiomics (DLR) features with Node-RADS scores to predict Lymph node metastasis (LNM) in locally advanced rectal cancer (LARC) patients after neoadjuvant chemoradiotherapy (nCRT). METHODS: In total, 190 LARC patients from three independent centers were retrospectively included. Deep learning and radiomics features were derived from T2-weighted and diffusion-weighted imaging sequ…

Beyond predictive performance: A systematic review and critical methodological appraisal of AI/ML and conventional modelling strategies in breast, colorectal, and pancreatic Cancer.

Artificial intelligence in medicine · 2026 · PMID 42641254

BACKGROUND: Predictive modelling for cancer risk, treatment-related complications, and survival is central to precision oncology. Conventional logistic regression (LR) and Cox proportional hazards (CoxPH) regression remain widely used but are limited when modelling nonlinear interactions, high-dimensional imaging features, and multimodal clinical-metabolic predictors. Artificial intelligence (AI) and machine learning (ML) methods offer expanded capability through automated feature extraction, ensemble learning, and…

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Predictive Performance of Radiomics-Based Machine Learning for Colorectal Cancer Recurrence Risk: Systematic Review and Meta-Analysis.

JMIR medical informatics · 2025 · PMID 41328447

BACKGROUND: Predicting colorectal cancer (CRC) recurrence risk remains a challenge in clinical practice. Owing to the widespread use of radiomics in CRC diagnosis and treatment, some researchers recently explored the effectiveness of radiomics-based models in forecasting CRC recurrence risk. Nonetheless, the lack of systematic evidence of the efficacy of such models has hampered their clinical adoption. OBJECTIVE: This study aimed to explore the value of radiomics in predicting CRC recurrence, providing a scholarly…

Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric, Version 3.2024, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2024 · PMID 39689429

Multigene panel testing has allowed for the detection of a growing number of inherited pathogenic/likely pathogenic variants in people at high risk of cancer, including endometrial cancer (EC). Hereditary syndromes associated with EC include Lynch syndrome, PTEN hamartoma tumor syndrome, and Peutz-Jeghers syndrome. This manuscript provides the latest recommendations from the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric on the screening and management of EC in patie…

A comparison of overall survival from early-onset and late-onset colorectal cancer stratified by TNM stage: a systematic review.

British journal of cancer · 2026 · PMID 42082649

BACKGROUND: There is conflicting evidence whether survival outcomes are better for early-onset colorectal cancer (EOCRC) or late-onset (LO) CRC. This review aimed to determine overall survival (OS) differences between EOCRC and LOCRC stratified by TNM stage. METHODS: EMBASE, Ovid MEDLINE and Cochrane Library were searched using approved search terms for CRC, survival outcomes and early onset disease. Studies which compared OS between early- and late-onset CRC, irrespective of age cut-off, stratified by TNM stage, w…

Is robotic colorectal surgery worth the cost? An umbrella review integrating clinical outcomes, learning curve, and economic evidence.

Journal of robotic surgery · 2026 · PMID 42565915

Robotic technology has progressively expanded within colorectal surgery owing to its enhanced instrument articulation and superior operative visualization. Despite these technical benefits, its adoption remains constrained by concerns regarding acquisition and procedural costs. Furthermore, the influence of surgeon proficiency and learning-curve progression on economic outcomes has rarely been considered in existing assessments of value. An umbrella review was conducted according to the Joanna Briggs Institute fram…

ACG Clinical Guideline: Diagnosis and Management of Adenomatous Colorectal Polyposis Syndromes.

The American journal of gastroenterology · 2026 · PMID 42683623

The hereditary adenomatous colorectal polyposis syndromes are incurable, systemic, cancer risk predisposition syndromes with substantial morbidity and mortality. They differ in their mode of inheritance, age at disease onset, phenotypic expression, and cancer risk. The most common cancer risks involve the gastrointestinal tract including the colon, rectum, duodenum, ampulla, and stomach. Identifying these syndromes through personal and family history risk assessment and germline genetic testing, along with timely s…

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.

BMC gastroenterology · 2026 · PMID 42298417

BACKGROUND: Whether collecting one or two fecal samples for immunochemical testing (FIT) optimizes colorectal cancer screening outcomes remains unclear. METHODS: We systematically searched multiple databases until October 2025 for studies directly comparing 1-FIT and 2-FIT strategies. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes. RESULTS: Five studies (n = 45,888) and three economic evaluations were included. Participation was higher with 1-FIT (RR = 1.05, P …

Comparative Efficacy of Different AI Systems for Polyp Detection by Size During Colonoscopy: Systematic Review and Network Meta-Analysis.

Journal of medical Internet research · 2026 · PMID 42714031

BACKGROUND: Colorectal cancer remains a leading cause of death despite being largely preventable through polypectomy. AI systems designed to enhance polyp detection during colonoscopy have shown promise, but the extent to which they improve detection of different-sized polyps remains unclear. OBJECTIVE: This study compared the size-stratified efficacy of AI-assisted colonoscopy vs standard colonoscopy using the Hartung-Knapp-Sidik-Jonkman (HKSJ) method, and generated exploratory rankings while acknowledging all cro…

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Risk of lymph-node metastasis in early onset T1 colorectal cancer: a systematic review and meta-analysis.

Journal of gastroenterology · 2026 · PMID 42371097

BACKGROUND: Despite the increasing incidence of early onset T1 colorectal cancer (T1 CRC), its features remain poorly understood. We examined whether early onset T1 CRC is associated with a higher rate of lymph-node metastasis (LNM). METHODS: We included studies reporting age-specific LNM rates for patients aged < 50 and ≥ 50 years. Sensitivity analyses were performed to assess the impact of overlapping and selected subset datasets. Subgroup analyses were conducted to evaluate the association between clinicopatholo…

Comparative Outcomes of Primary Sclerosing Cholangitis With and Without Comorbid Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2026 · PMID 42084721

PURPOSE: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease frequently associated with inflammatory bowel disease (IBD). While PSC with IBD is recognized as a distinct entity, comparative outcomes of PSC with IBD versus PSC alone remain uncertain. This systematic review and meta-analysis aimed to compare clinical outcomes in patients with PSC with and without comorbid IBD. METHODS: We conducted a systematic review and meta-analysis following PRISMA and MOOSE guidelines. MEDLINE, PubMed, Emb…

Diagnostic yield and usefulness of terminal ileal intubation in asymptomatic patients undergoing colonoscopy for colorectal cancer screening or postpolypectomy surveillance: a systematic review and meta-analysis.

Gastrointestinal endoscopy · 2026 · PMID 41833622

BACKGROUND AND AIMS: The role of routine terminal ileal intubation (TII) in asymptomatic patients undergoing colonoscopy for colorectal cancer (CRC) screening or postpolypectomy surveillance is debated. Although considered a quality indicator in some settings, its clinical utility in this population remains unclear. This systematic review and meta-analysis aimed to evaluate the diagnostic yield, clinical utility, and procedural impact of routine TII in patients undergoing CRC screening or postpolypectomy surveillan…

Novel Technologies for Gastrointestinal Cancer Detection: A Systematic Review and Meta-Analysis of Diagnostic Accuracy.

Clinical and translational gastroenterology · 2026 · PMID 42242200

INTRODUCTION: Gastrointestinal (GI) cancers account for a quarter of all cancers and one-third of cancer-related deaths worldwide. Novel diagnostic approaches are crucial to enhance early detection and improve patient outcomes. This review systematically identified and evaluated novel GI cancer detection approaches. METHODS: A systematic review was conducted using PubMed, EMBASE, Scopus, and the Cochrane Library on December 11, 2024, and updated on June 2, 2025. Cohort studies and randomized controlled studies, pub…

Systematic Review and Meta-Analysis of Resection Sequence in Synchronous Colorectal Liver Metastasis: Primary vs. Liver First.

Journal of surgical oncology · 2026 · PMID 42296400

BACKGROUND: This present systematic review and meta-analysis aims to compare overall survival (OS), disease-free survival (DFS), morbidity and mortality outcomes in patients undergoing colorectal first (CRf) versus liver first (Lf) resections with synchronous colorectal liver metastases. METHODOLOGY: A literature search was performed in PubMed, Cochrane Central trials register, and Google Scholar databases. This was conducted in line with current PRISMA guidelines. 95% confidence intervals were calculated for the p…

A meta-analysis of the effects of preoperative mechanical intestinal preparation and oral antibiotics on surgical site infection after rectal tumor resection.

Updates in surgery · 2026 · PMID 42310252

To systematically evaluate the effect of preoperative mechanical bowel preparation combined with oral antibiotics on surgical site infection after elective rectal resection. PubMed, Web of Science, Embase, Cochrane library, CNKI database, Wanfang database, Chinese Science and Technology Journal full text database, Chinese Biomedical Literature Database, In addition, the relevant studies on the effects of mechanical bowel preparation before rectal resection combined with oral antibiotics and surgical site infection …

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

The effect of excess body weight on short-term outcomes following minimally invasive rectal cancer surgery: a systematic review and meta-analysis.

Techniques in coloproctology · 2026 · PMID 42307793

BACKGROUND: The converging trends of a global increase in the incidence of colorectal cancer (CRC) and the prevalence of obesity suggest that surgery for CRC in patients with excess body weight (EBW) will become an increasingly common clinical entity. We aimed to evaluate the effect of EBW, defined as being overweight or obese, on short-term perioperative outcomes following minimally invasive rectal cancer surgery (MIRCS). MATERIALS AND METHODS: The review was conducted in accordance with the Preferred Reporting It…

Incidence and outcomes of metachronous peritoneal metastasis in the setting of obstructing colon cancer: a systematic review.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42335798

BACKGROUND: Colorectal peritoneal metastases are challenging to diagnose and confer a poorer prognosis than disease recurrence at other sites. Obstruction at presentation in colonic carcinoma is associated with worse survival outcomes. There is little data on its specific influence on the incidence of peritoneal recurrence, including by the varying strategies employed to address the obstruction. METHODS: A systematic review of the literature was performed to investigate rates of peritoneal recurrence in obstructing…

Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis.

Surgical endoscopy · 2026 · PMID 42443688

BACKGROUND AND AIMS: Both artificial intelligence (AI) and mucosal exposure devices (MEDs) have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. However, the effectiveness of AI combined with MEDs remains unclear. In this meta-analysis, we have evaluated the combined effect of AI with MEDs on enhancing detection rates of various colonic lesions. METHODS: Several databases were reviewed to identify studies reporting data on outcomes of interest from inception to December 10, 2025…

The impact of visceral obesity on the outcomes after resection of colorectal cancer: a systematic review and meta-analysis.

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026 · PMID 42236440

Obesity is closely associated with the initiation and progression of colorectal cancer (CRC) and is widely recognized as a risk factor for unfavorable surgical outcomes. Nevertheless, the extent to which visceral obesity specifically influences perioperative safety and long-term oncologic outcomes following CRC resection remains to be established. We performed a systematic review and meta-analysis by comprehensively searching PubMed, Web of Science, Embase, Scopus, and the Cochrane Library. Continuous, dichotomous,…

Comparison of Functional Outcomes Between Robotic and Laparoscopic Surgery in Rectal Cancer Patients: Systematic Review and Meta-Analysis.

Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026 · PMID 42037577

BACKGROUND: Robotic and laparoscopic approaches are widely used for rectal cancer surgery. Although robotic systems provide enhanced visualization and dexterity, it remains unclear whether these advantages improve postoperative urinary and sexual function. METHODS: MEDLINE, Embase, Web of Science, and CENTRAL (2000-2025) were searched for studies comparing robotic and laparoscopic rectal cancer surgery. Outcomes included postoperative ileus, urinary retention, and urinary and sexual function. Random-effects meta-an…

Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis.

PloS one · 2024 · PMID 38771764

PURPOSE: To identify the predictive role of sarcopenia in long-term survival among rectal cancer patients who underwent surgery based on available evidence. METHODS: The Medline, EMBASE and Web of Science databases were searched up to October 20, 2023, for relevant studies. Overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were the endpoints. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to evaluate the association between sarcopenia and survival. RESULTS: …

Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in colorectal cancer: a meta-analysis.

Annals of medicine · 2025 · PMID 40650392

BACKGROUND: The fibrinogen-to-albumin ratio (FAR) has been extensively studied for its potential to predict the prognosis of patients with colorectal cancer (CRC). However, findings have been inconsistent. Therefore, this meta-analysis aims to examine the prognostic value of FAR in CRC. METHODS: A comprehensive search of PubMed, Web of Science, Cochrane Library, and Embase was conducted up to January 14, 2025. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the value of FAR for esti…

Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis.

The American journal of gastroenterology · 2024 · PMID 38832708

INTRODUCTION: Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS: PubMed, Embase, and Cochrane …

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

Serum uric acid and the risk of colorectal cancer: a meta-analysis.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2024 · PMID 37669167

BACKGROUND: A meta-analysis was performed in this study to evaluate the association between serum uric acid and the risk of colorectal cancer (CRC). METHODS: Relevant observational studies observing the relationship between uric acid and the incidence of CRC were obtained by the search of electronic databases, including Medline, Embase, Cochrane Library and Web of Science . A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. RESULTS: Eight observationa…

One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.

BMC gastroenterology · 2026 · PMID 42298417

BACKGROUND: Whether collecting one or two fecal samples for immunochemical testing (FIT) optimizes colorectal cancer screening outcomes remains unclear. METHODS: We systematically searched multiple databases until October 2025 for studies directly comparing 1-FIT and 2-FIT strategies. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes. RESULTS: Five studies (n = 45,888) and three economic evaluations were included. Participation was higher with 1-FIT (RR = 1.05, P …

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Application of radiomics for preoperative prediction of lymph node metastasis in colorectal cancer: a systematic review and meta-analysis.

International journal of surgery (London, England) · 2024 · PMID 38935817

BACKGROUND: Colorectal cancer (CRC) stands as the third most prevalent cancer globally, projecting 3.2 million new cases and 1.6 million deaths by 2040. Accurate lymph node metastasis (LNM) detection is critical for determining optimal surgical approaches, including preoperative neoadjuvant chemoradiotherapy and surgery, which significantly influence CRC prognosis. However, conventional imaging lacks adequate precision, prompting exploration into radiomics, which addresses this shortfall by converting medical image…

Network meta-analysis of RTCs for efficacy of neoadjuvant treatment in rectal cancer.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025 · PMID 40233522

BACKGROUND: This network meta-analysis examined the efficacy of different types of neoadjuvant therapy (NAT) for rectal cancer in improving clinical and pathologic outcomes. METHODS: PRISMA-compliant systematic review of PubMed and Scopus including only randomized clinical trials comparing two or more NAT regimens for rectal cancer. A network meta-analysis was undertaken for the main outcomes, including pathological complete response (pCR), disease downstaging, R0 resection, permanent stoma, and major adverse effec…

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis.

Surgical endoscopy · 2026 · PMID 42443688

BACKGROUND AND AIMS: Both artificial intelligence (AI) and mucosal exposure devices (MEDs) have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. However, the effectiveness of AI combined with MEDs remains unclear. In this meta-analysis, we have evaluated the combined effect of AI with MEDs on enhancing detection rates of various colonic lesions. METHODS: Several databases were reviewed to identify studies reporting data on outcomes of interest from inception to December 10, 2025…

Contact X-ray brachytherapy in rectal cancer: A systematic review and meta-analysis.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025 · PMID 40174334

Rectal cancer is a highly prevalent disease. Evidence presented in the 2025 phase-III OPERA randomised trial suggests that Contact X-ray Brachytherapy (CXB), with external beam chemoradiotherapy, is a viable organ-preserving alternative to radical surgery. We conducted a systematic review and meta-analysis to assess the clinical effectiveness of CXB in the treatment of rectal cancer. This systematic review was prospectively registered (CRD42021284969) and reported following PRISMA guidelines. Multiple electronic da…

Antibiotics use and risk of colorectal neoplasia: An updated meta-analysis.

International journal of colorectal disease · 2022 · PMID 36329204

PURPOSE: Accumulating evidence indicate that antibiotic use could induce microbiome dysbiosis, which was a critical driver to the onset and progression of colorectal cancer (CRC). But the relationship between antibiotics use and CRC was still disputed. Hence, we conducted this systematic review and meta-analysis to appraise and synthesize the present available evidence to clarify the association. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were systematically searched for relevant observational st…

Functional outcomes and quality of life following open versus laparoscopic versus robot-assisted versus transanal total mesorectal excision in rectal cancer patients: a systematic review and meta-analysis.

Surgical endoscopy · 2024 · PMID 38898341

BACKGROUND: The standard surgical treatment for rectal cancer is total mesorectal excision (TME), which may negatively affect patients' functional outcomes and quality of life (QoL). However, it is unclear how different TME techniques may impact patients' functional outcomes and QoL. This systematic review and meta-analysis evaluated functional outcomes of urinary, sexual, and fecal functioning as well as QoL after open, laparoscopic (L-TME), robot-assisted (R-TME), and transanal total mesorectal excision (TaTME). …

Association of computed tomography-derived body composition and complications after colorectal cancer surgery: A systematic review and meta-analysis.

Journal of cachexia, sarcopenia and muscle · 2024 · PMID 39370740

The prediction of the risk of developing complications after colorectal surgery for colorectal carcinoma remains imprecise. Body composition measurements on a computed tomography (CT) scan can potentially contribute to a better preoperative risk assessment. The aim of this systematic review is to evaluate the evidence for the use of body composition measurements on CT scans to predict short-term complications after colorectal cancer surgery. A literature search (in PubMed, Embase and Web of Science) was performed u…

Lateral pelvic lymphadenectomy for low rectal cancer: a META-analysis of recurrence rates.

International journal of colorectal disease · 2021 · PMID 33242114

BACKGROUND: Locoregional recurrence (LR) remains a problem for patients with lower rectal cancer despite standardized surgery and improved neoadjuvant treatment regimens. Lateral pelvic lymph node dissection (LPLND) has been routine practice for some time in the Orient/East, but other regions have concerns about morbidity. As perioperative care and surgical approaches are refined, this has been revisited for selected patients. The question as to whether LPLND improves oncological outcomes was explored here. METHODS…

Racial and Socioeconomic Disparities After Surgical Resection for Rectal Cancer.

The Journal of surgical research · 2020 · PMID 32798992

BACKGROUND: There are various racial, socioeconomic, and tumor-specific factors that can impact rectal cancer outcomes. The current systematic review and meta-analysis evaluate the effect socioeconomic and racial variables on overall survival of rectal cancer patients after surgical resection. METHODS: A literature search was performed via electronic databases according to Systematic Reviews and Meta-Analyses and Meta-analysis Of Observational Studies in Epidemiology guidelines. All studies were evaluated by three …

Robotic rectal resection preserves anorectal function: Systematic review and meta-analysis.

The international journal of medical robotics + computer assisted surgery : MRCAS · 2021 · PMID 34463416

BACKGROUND: Improving survival rates in rectal cancer patients has generated a growing interest in functional outcomes after total mesorectal excision (TME). The well-established low anterior resection syndrome (LARS) score assesses postoperative anorectal impairment after TME. Our meta-analysis is the first to compare bowel function after open, laparoscopic, transanal, and robotic TME. METHODS: All studies reporting functional outcomes after rectal cancer surgery (LARS score) were included, and were compared with …

Proton beam therapy in rectal cancer: A systematic review and meta-analysis.

Surgical oncology · 2021 · PMID 34340196

INTRODUCTION: Locally advanced rectal cancer is often treated with neoadjuvant chemoradiotherapy and surgery. Radiotherapy carries significant risk of toxicity to organs at risk (OAR). Proton beam therapy (PBT) has demonstrated to be effective in other cancers, delivering equivalent dosimetric radiation but with the benefit of improved sparing of OAR. This review compares dosimetric irradiation of OAR and oncological outcomes for PBT versus conventional photon-based radiotherapy in locally advanced rectal cancer. M…

Laparoscopic colorectal cancer resections in the obese: a systematic review.

Surgical endoscopy · 2017 · PMID 27778169

BACKGROUND: Laparoscopic colorectal cancer operations in obese patients pose technical challenges that may negatively impact oncologic adequacy. A meta-analysis was performed to assess the oncologic outcomes of laparoscopic colorectal cancer resections in obese compared to non-obese patients. Short- and long-term outcomes were assessed secondarily. METHODS: A systematic literature search was conducted from inception until October 01, 2014. Studies that compared outcomes of laparoscopic colorectal malignant neoplasm…

First-line anlotinib versus bevacizumab plus CapeOX in RAS/BRAF wild-type unresectable metastatic colorectal cancer (ANCHOR): a multicenter, prospective, randomized, phase 3 trial.

Signal transduction and targeted therapy · 2026 · PMID 42675036

Bevacizumab plus chemotherapy is the standard first-line therapy for metastatic colorectal cancer (mCRC). To date, no phase 3 trial has compared first-line oral multitargeted TKI versus bevacizumab plus chemotherapy in RAS/BRAF wild-type mCRC. The open-label, noninferiority, randomized, phase 3 trial (ANCHOR; NCT04854668; CTR20210940) evaluated first-line anlotinib versus bevacizumab plus oxaliplatin and capecitabine (CapeOX) in this setting. Patients were centrally randomized (1:1) to receive 4-8 cycles of CapeOX …

Continuity of transcriptomes among colorectal cancer subtypes based on meta-analysis.

Genome biology · 2018 · PMID 30253799

BACKGROUND: Previous approaches to defining subtypes of colorectal carcinoma (CRC) and other cancers based on transcriptomes have assumed the existence of discrete subtypes. We analyze gene expression patterns of colorectal tumors from a large number of patients to test this assumption and propose an approach to identify potentially a continuum of subtypes that are present across independent studies and cohorts. RESULTS: We examine the assumption of discrete CRC subtypes by integrating 18 published gene expression …

Preclinical efficacy of drug delivery systems in colon cancer therapy: a systematic review and meta-analysis of in vivo animal studies.

Journal of the Egyptian National Cancer Institute · 2026 · PMID 42156606

BACKGROUND: Drug delivery systems (DDS) offer a promising strategy to enhance the therapeutic index of chemotherapeutic agents in colon cancer by improving tumor targeting, circulation time, and controlled drug release. Despite extensive preclinical research, a quantitative synthesis evaluating the efficacy of DDS and the influence of design parameters remains lacking. METHODS: We conducted a systematic review and meta-analysis of preclinical in vivo studies assessing DDS-based chemotherapy in murine models of colo…

Antibiotic exposure and cancer risk: an umbrella review elucidating the direction of risk across 14 malignancies.

Journal of public health (Oxford, England) · 2026 · PMID 42361054

BACKGROUND: Antibiotics are among the most frequently prescribed medications worldwide. However, previous studies have yielded inconsistent findings regarding the association between antibiotic exposure and the risk of various cancers, and the credibility of the available evidence remains uncertain. METHODS: We conducted an umbrella review based on published meta-analyses and systematic reviews to evaluate the association between past or current antibiotic exposure and cancer risk. PubMed, Embase, Cochrane Library,…

Underwater versus conventional endoscopic mucosal resection for ≥10 mm sessile or flat colorectal polyps: A systematic review and meta-analysis.

PloS one · 2024 · PMID 38451998

BACKGROUND AND AIM: Underwater endoscopic mucosal resection (UEMR) has been an emerging substitute for conventional EMR (CEMR). This systematic review and meta-analysis aimed at comparing the efficiency and safety of the two techniques for removing ≥10 mm sessile or flat colorectal polyps. METHODS: PubMed, Cochrane Library and Embase databases were searched up to February 2023 to identify eligible studies that compared the outcomes of UEMR and CEMR. This meta-analysis was conducted on the en bloc resection rate, R0…

Diagnostic performance of serum metabolites biomarker associated with colorectal adenoma: a systematic review.

PeerJ · 2024 · PMID 39314843

Evidence on serum biomarkers as a non-invasive tool to detect colorectal adenoma (CRA) in the general population is quite promising. However, the sensitivity and specificity of these serum biomarkers in detecting disease are still questionable. This study aimed to systematically review the evidence on the diagnostic performance of serum biomarkers associated with CRA. Database searches on PubMed, Scopus, and WoS from January 2014 to December 2023 using PRISMA guidelines resulted in 4,380 citations, nine of which me…

Effect of serum uric acid and gout on the incidence of colorectal cancer: A meta-analysis.

The American journal of the medical sciences · 2024 · PMID 37984737

OBJECTIVE: Pathogenesis of colorectal cancer (CRC) depends on multiple factors. Identifying risk factors for CRC may facilitate the early prevention of the disease. We aimed to assess whether existing evidence suggests that serum uric acid (SUA) levels and gout are associated with CRC incidence. METHODS: The study was registered on PROSPERO (CRD42022371591). Searches of PubMed, Embase, and Cochrane Library were conducted from the establishment to November 11, 2022. Pooled relative risk (RR) with 95 % confidence int…

Beyond predictive performance: A systematic review and critical methodological appraisal of AI/ML and conventional modelling strategies in breast, colorectal, and pancreatic Cancer.

Artificial intelligence in medicine · 2026 · PMID 42641254

BACKGROUND: Predictive modelling for cancer risk, treatment-related complications, and survival is central to precision oncology. Conventional logistic regression (LR) and Cox proportional hazards (CoxPH) regression remain widely used but are limited when modelling nonlinear interactions, high-dimensional imaging features, and multimodal clinical-metabolic predictors. Artificial intelligence (AI) and machine learning (ML) methods offer expanded capability through automated feature extraction, ensemble learning, and…

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Predictive Performance of Radiomics-Based Machine Learning for Colorectal Cancer Recurrence Risk: Systematic Review and Meta-Analysis.

JMIR medical informatics · 2025 · PMID 41328447

BACKGROUND: Predicting colorectal cancer (CRC) recurrence risk remains a challenge in clinical practice. Owing to the widespread use of radiomics in CRC diagnosis and treatment, some researchers recently explored the effectiveness of radiomics-based models in forecasting CRC recurrence risk. Nonetheless, the lack of systematic evidence of the efficacy of such models has hampered their clinical adoption. OBJECTIVE: This study aimed to explore the value of radiomics in predicting CRC recurrence, providing a scholarly…

Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric, Version 3.2024, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2024 · PMID 39689429

Multigene panel testing has allowed for the detection of a growing number of inherited pathogenic/likely pathogenic variants in people at high risk of cancer, including endometrial cancer (EC). Hereditary syndromes associated with EC include Lynch syndrome, PTEN hamartoma tumor syndrome, and Peutz-Jeghers syndrome. This manuscript provides the latest recommendations from the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric on the screening and management of EC in patie…

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

ACG Clinical Guideline: Diagnosis and Management of Adenomatous Colorectal Polyposis Syndromes.

The American journal of gastroenterology · 2026 · PMID 42683623

The hereditary adenomatous colorectal polyposis syndromes are incurable, systemic, cancer risk predisposition syndromes with substantial morbidity and mortality. They differ in their mode of inheritance, age at disease onset, phenotypic expression, and cancer risk. The most common cancer risks involve the gastrointestinal tract including the colon, rectum, duodenum, ampulla, and stomach. Identifying these syndromes through personal and family history risk assessment and germline genetic testing, along with timely s…

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Comparative Outcomes of Primary Sclerosing Cholangitis With and Without Comorbid Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2026 · PMID 42084721

PURPOSE: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease frequently associated with inflammatory bowel disease (IBD). While PSC with IBD is recognized as a distinct entity, comparative outcomes of PSC with IBD versus PSC alone remain uncertain. This systematic review and meta-analysis aimed to compare clinical outcomes in patients with PSC with and without comorbid IBD. METHODS: We conducted a systematic review and meta-analysis following PRISMA and MOOSE guidelines. MEDLINE, PubMed, Emb…

Systematic Review and Meta-Analysis of Resection Sequence in Synchronous Colorectal Liver Metastasis: Primary vs. Liver First.

Journal of surgical oncology · 2026 · PMID 42296400

BACKGROUND: This present systematic review and meta-analysis aims to compare overall survival (OS), disease-free survival (DFS), morbidity and mortality outcomes in patients undergoing colorectal first (CRf) versus liver first (Lf) resections with synchronous colorectal liver metastases. METHODOLOGY: A literature search was performed in PubMed, Cochrane Central trials register, and Google Scholar databases. This was conducted in line with current PRISMA guidelines. 95% confidence intervals were calculated for the p…

A meta-analysis of the effects of preoperative mechanical intestinal preparation and oral antibiotics on surgical site infection after rectal tumor resection.

Updates in surgery · 2026 · PMID 42310252

To systematically evaluate the effect of preoperative mechanical bowel preparation combined with oral antibiotics on surgical site infection after elective rectal resection. PubMed, Web of Science, Embase, Cochrane library, CNKI database, Wanfang database, Chinese Science and Technology Journal full text database, Chinese Biomedical Literature Database, In addition, the relevant studies on the effects of mechanical bowel preparation before rectal resection combined with oral antibiotics and surgical site infection …

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

The impact of visceral obesity on the outcomes after resection of colorectal cancer: a systematic review and meta-analysis.

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026 · PMID 42236440

Obesity is closely associated with the initiation and progression of colorectal cancer (CRC) and is widely recognized as a risk factor for unfavorable surgical outcomes. Nevertheless, the extent to which visceral obesity specifically influences perioperative safety and long-term oncologic outcomes following CRC resection remains to be established. We performed a systematic review and meta-analysis by comprehensively searching PubMed, Web of Science, Embase, Scopus, and the Cochrane Library. Continuous, dichotomous,…

Comparison of Functional Outcomes Between Robotic and Laparoscopic Surgery in Rectal Cancer Patients: Systematic Review and Meta-Analysis.

Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026 · PMID 42037577

BACKGROUND: Robotic and laparoscopic approaches are widely used for rectal cancer surgery. Although robotic systems provide enhanced visualization and dexterity, it remains unclear whether these advantages improve postoperative urinary and sexual function. METHODS: MEDLINE, Embase, Web of Science, and CENTRAL (2000-2025) were searched for studies comparing robotic and laparoscopic rectal cancer surgery. Outcomes included postoperative ileus, urinary retention, and urinary and sexual function. Random-effects meta-an…

Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis.

PloS one · 2024 · PMID 38771764

PURPOSE: To identify the predictive role of sarcopenia in long-term survival among rectal cancer patients who underwent surgery based on available evidence. METHODS: The Medline, EMBASE and Web of Science databases were searched up to October 20, 2023, for relevant studies. Overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were the endpoints. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to evaluate the association between sarcopenia and survival. RESULTS: …

Prognostic and clinicopathological value of fibrinogen-to-albumin ratio in colorectal cancer: a meta-analysis.

Annals of medicine · 2025 · PMID 40650392

BACKGROUND: The fibrinogen-to-albumin ratio (FAR) has been extensively studied for its potential to predict the prognosis of patients with colorectal cancer (CRC). However, findings have been inconsistent. Therefore, this meta-analysis aims to examine the prognostic value of FAR in CRC. METHODS: A comprehensive search of PubMed, Web of Science, Cochrane Library, and Embase was conducted up to January 14, 2025. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the value of FAR for esti…

Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis.

Computer assisted surgery (Abingdon, England) · 2026 · PMID 41454717

Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rate…

Prevalence and risk factors of low anterior resection syndrome: Meta-analysis with Subgroup Analysis.

La Tunisie medicale · 2026 · PMID 42578777

BACKGROUND: The prevalence of major LARS and its associated risk factors remains variably reported in the literature. This meta-analysis aimed to assess the pooled prevalence of major LARS and to identify its predictive factors. METHODS: We conducted a meta-analysis in accordance with PRISMA 2020 and AMSTAR 2 guidelines to identify studies reporting the prevalence of major LARS or its associated risk factors. Subgroup analyses was used to explain heterogeneity. RESULTS: A total of 21 studies comprising 3,730 patien…

Distinct outcome patterns according to RAS and BRAF status in MSI-H/dMMR mCRC treated with immune checkpoint inhibitors: A systematic review and meta-analysis.

Cancer treatment reviews · 2026 · PMID 42497817

BACKGROUND: Immune checkpoint inhibitors (ICIs) are superior to chemotherapy in metastatic colorectal cancer (mCRC) with MSI-H/dMMR. However, whether oncogenic driver alterations contribute to clinically meaningful heterogeneity in outcomes within this immunotherapy-sensitive population remains unclear. We conducted a systematic review and meta-analysis to evaluate the association between RAS and BRAF mutational status and outcomes in ICI-treated MSI-H/dMMR mCRC. METHODS: A systematic literature search identified s…

Fusobacterium nucleatum and response to treatment in colon and rectal cancer: a systematic review.

Cancer treatment reviews · 2026 · PMID 42435617

UNLABELLED: Fusobacterium nucleatum (Fn) has been implicated in the progression of colorectal cancer (CRC), immune modulation, and resistance to systemic therapies. However, its role as a predictive biomarker of treatment response remains unclear. We conducted a systematic review to evaluate the association between Fn and oncologic treatment outcomes in CRC. METHODS: This systematic review was performed according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420261327958). MEDLINE, Scopus, and CENTRA…

Comparative effectiveness of preoperative prehabilitation modalities for postoperative recovery in colorectal cancer: A systematic review and network meta-analysis.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026 · PMID 42263810

BACKGROUND: Preoperative prehabilitation has been increasingly incorporated into perioperative care for colorectal cancer (CRC), yet the comparative effectiveness of different prehabilitation modalities remains unclear. This study aimed to compare the relative effects of major preoperative prehabilitation models on postoperative recovery in patients who undergo surgery for CRC. METHODS: A systematic review and network meta-analysis (NMA) were conducted by searching PubMed, Embase, the Cochrane Central Register of C…

A Comprehensive Evaluation of the Effectiveness and Safety of Pembrolizumab for the Treatment of Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.

Current cancer drug targets · 2026 · PMID 40277063

AIM: This comprehensive assessment and quantitative synthesis aimed to assess the effectiveness and safety profile of pembrolizumab, an antagonist of the programmed cell death protein 1 [PD-1] pathway, for individuals with metastatic colorectal carcinoma (mCRC). METHODS: A comprehensive search of scholarly articles was performed using the PubMed and Web of Science [WOS] databases from January 2015 to August 2024. The scope of the search was limited to randomized controlled trials and clinical studies that reported …

Complete Mesocolic Excision Versus D2 Lymphadenectomy for Right Colon Cancer: A Bayesian Meta-Analysis of Randomized Trials Assessing Surgical and Perioperative Outcomes.

Journal of laparoendoscopic & advanced surgical techniques. Part A · 2026 · PMID 41841469

INTRODUCTION: Complete mesocolic excision (CME) may increase lymph node retrieval and provide a more complete oncologic excision compared with D2 dissection, although its perioperative safety remains uncertain. This systematic review and Bayesian meta-analysis compared clinical and operative outcomes between CME and D2 in right colectomy. METHODS: PubMed, EMBASE, and Cochrane Central were searched through November 2025. Randomized controlled trials comparing CME with D2 were included. Frequentist analyses used rand…

Effect of Digital Health Interventions on the Nutritional Status and Quality of Life of Patients With Colorectal Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Journal of medical Internet research · 2026 · PMID 42613928

BACKGROUND: Digital health interventions may improve clinical outcomes in patients with colorectal cancer (CRC), but their impact on nutritional status (NS) and quality of life (QoL) remains unclear. OBJECTIVE: This study systematically evaluated the impact of digital health interventions on the NS and QoL in patients with CRC. METHODS: A systematic search was performed across PubMed, Embase, Cochrane, and Web of Science from inception to March 2026 to identify randomized controlled trials evaluating digital health…

Comparative efficacy and safety of nivolumab-based combination therapies (with ipilimumab or binimetinib) in patients with microsatellite-stable and microsatellite-instability-high metastatic colorectal cancer: a systematic review and meta-analysis.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026 · PMID 41934582

BACKGROUND: Colorectal cancer (CRC) is the third most frequently diagnosed malignancy worldwide and the second leading cause of cancer-related mortality. Despite immune checkpoint inhibitors improving outcomes for patients with microsatellite instability high (MSI-H) CRC, their effectiveness against microsatellite-stable (MSS) cancers remains restricted. Nivolumab-based combination regimens, which include ipilimumab or binimetinib as components, have shown potential to improve treatment results, but existing studie…

Outcomes of Response-Based Watch-and-Wait and Surgical Management After Total Neoadjuvant Therapy for Rectal Cancer: A Systematic Review and Meta-analysis.

The American surgeon · 2026 · PMID 42178612

BackgroundTotal neoadjuvant therapy (TNT) increases clinical complete response rates in locally advanced rectal cancer (RC), allowing response-based management strategies such as watch-and-wait (WW) as an alternative to total mesorectal excision (TME). Outcomes associated with WW after TNT remain incompletely defined. This study aimed to compare oncologic and organ-preservation outcomes between WW and surgical management following TNT.MethodsA systematic search was conducted in PubMed, Scopus, and Cochrane Central …

One- versus two-sample fecal immunochemical testing for colorectal cancer screening: a systematic review and meta-analysis of participation, diagnostic performance, and cost-effectiveness.

BMC gastroenterology · 2026 · PMID 42298417

BACKGROUND: Whether collecting one or two fecal samples for immunochemical testing (FIT) optimizes colorectal cancer screening outcomes remains unclear. METHODS: We systematically searched multiple databases until October 2025 for studies directly comparing 1-FIT and 2-FIT strategies. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes. RESULTS: Five studies (n = 45,888) and three economic evaluations were included. Participation was higher with 1-FIT (RR = 1.05, P …

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Prognostic Models and Predictors of Recurrence in Resectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis.

Critical reviews in oncology/hematology · 2026 · PMID 42669322

We systematically reviewed prognostic models for recurrence after curative-intent locoregional treatment of colorectal liver metastases (CRLM) and quantitatively synthesized prognostic factors associated with recurrence-free survival (RFS). From 2,208 records across 26 years of literature, 293 studies were included, encompassing 85,150 patients in development cohorts and 5,549 patients in validation cohorts. Most models targeted risk stratification rather than clinically actionable prediction, and Cox proportional …

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis.

Surgical endoscopy · 2026 · PMID 42443688

BACKGROUND AND AIMS: Both artificial intelligence (AI) and mucosal exposure devices (MEDs) have been shown to improve adenoma detection rate and reduce miss rate during colonoscopy. However, the effectiveness of AI combined with MEDs remains unclear. In this meta-analysis, we have evaluated the combined effect of AI with MEDs on enhancing detection rates of various colonic lesions. METHODS: Several databases were reviewed to identify studies reporting data on outcomes of interest from inception to December 10, 2025…

Diagnostic accuracy of deep learning models for colorectal cancer detection in histopathological whole-slide images: a systematic review and diagnostic test accuracy meta-analysis.

Frontiers in oncology · 2026 · PMID 42676821

BACKGROUND: Deep learning systems are increasingly used for colorectal cancer detection in digital histopathology, but studies often report heterogeneous endpoints, patch-level metrics, or non-thresholded area under the curve (AUC) values. We estimated the diagnostic accuracy of clinically interpretable slide-level or patient-level models. METHODS: We searched PubMed, Embase, Scopus, Web of Science Core Collection, and IEEE Xplore for deep learning studies of human colorectal histopathology or whole-slide images. E…

Incorporating Individual Early Response in the Dose-Effect Relationship of Complete Pathological Response Following Neoadjuvant Radiochemotherapy for Rectal Cancer.

International journal of radiation oncology, biology, physics · 2026 · PMID 41354181

PURPOSE: To develop and externally validate a model predicting pathological complete response (pCR) in patients with rectal cancer treated with neoadjuvant radiochemotherapy. The approach combines the classical logit dose-effect curve with individual early response assessed by magnetic resonance imaging during radiochemotherapy. METHODS AND MATERIALS: The dose-response model incorporating the early regression index (ERI) was derived from 2 published data sets. A population-averaged dose-response curve was obtained …

First-line anlotinib versus bevacizumab plus CapeOX in RAS/BRAF wild-type unresectable metastatic colorectal cancer (ANCHOR): a multicenter, prospective, randomized, phase 3 trial.

Signal transduction and targeted therapy · 2026 · PMID 42675036

Bevacizumab plus chemotherapy is the standard first-line therapy for metastatic colorectal cancer (mCRC). To date, no phase 3 trial has compared first-line oral multitargeted TKI versus bevacizumab plus chemotherapy in RAS/BRAF wild-type mCRC. The open-label, noninferiority, randomized, phase 3 trial (ANCHOR; NCT04854668; CTR20210940) evaluated first-line anlotinib versus bevacizumab plus oxaliplatin and capecitabine (CapeOX) in this setting. Patients were centrally randomized (1:1) to receive 4-8 cycles of CapeOX …

Preclinical efficacy of drug delivery systems in colon cancer therapy: a systematic review and meta-analysis of in vivo animal studies.

Journal of the Egyptian National Cancer Institute · 2026 · PMID 42156606

BACKGROUND: Drug delivery systems (DDS) offer a promising strategy to enhance the therapeutic index of chemotherapeutic agents in colon cancer by improving tumor targeting, circulation time, and controlled drug release. Despite extensive preclinical research, a quantitative synthesis evaluating the efficacy of DDS and the influence of design parameters remains lacking. METHODS: We conducted a systematic review and meta-analysis of preclinical in vivo studies assessing DDS-based chemotherapy in murine models of colo…

Antibiotic exposure and cancer risk: an umbrella review elucidating the direction of risk across 14 malignancies.

Journal of public health (Oxford, England) · 2026 · PMID 42361054

BACKGROUND: Antibiotics are among the most frequently prescribed medications worldwide. However, previous studies have yielded inconsistent findings regarding the association between antibiotic exposure and the risk of various cancers, and the credibility of the available evidence remains uncertain. METHODS: We conducted an umbrella review based on published meta-analyses and systematic reviews to evaluate the association between past or current antibiotic exposure and cancer risk. PubMed, Embase, Cochrane Library,…

A randomized controlled superiority trial of 1 L (Plenvu) versus 2 L (Moviprep) polyethelene glycol plus ascorbate in a FIT-based colorectal cancer screening setting (PLEMO).

BMC gastroenterology · 2026 · PMID 42163134

BACKGROUND: Sufficient cleansing of the colonic mucosa is of great importance during colonoscopy emphasizing the need for effective preparation agents. Studies evaluating the efficacy of a novel 1 L polyethylene glycol with ascorbate (1 L-PEG-Asc), Plenvu®, versus standard 2 L polyethylene glycol with ascorbate (2 L-PEG-Asc), Moviprep®, have shown promising results regarding bowel cleansing. Nonetheless superiority of 1 L-PEG-Asc has not been shown. METHODS: In this single-center randomized controlled superiority t…

Mailed Outreach for Colorectal Cancer Screening in Community Health Centers: The CARES Pragmatic Cluster Randomized Clinical Trial.

JAMA internal medicine · 2026 · PMID 42043827

IMPORTANCE: Colorectal cancer (CRC) is the second most common cause of cancer mortality in the US and disproportionately impacts individuals in underresourced settings. OBJECTIVE: To compare 2 mailed population outreach approaches to increase CRC screening uptake among screening-eligible adults in community health centers (CHCs). DESIGN, SETTING, AND PARTICIPANTS: This pragmatic cluster randomized clinical trial was conducted in 8 CHCs and an additional site in a nonrandomized parallel protocol. The CHCs were locat…

Endoscopic Surveillance in Serrated Polyposis Syndrome, Two or Three-Year Intervals: A Non-inferiority Randomized Trial.

Digestive diseases and sciences · 2026 · PMID 42012787

BACKGROUND: Serrated polyposis syndrome, the most prevalent colonic polyposis, confers an increased colorectal cancer risk. Guidelines recommend close colonoscopy surveillance, but recent data suggest low neoplasia rates, supporting longer colonoscopy intervals. AIMS: Compare advanced neoplasia incidence between two- and three-year surveillance. METHODS: A multicentre, randomized non-inferiority trial was conducted (May 2021-November 2024) in six Spanish hospitals. Patients fulfilling the 2019 WHO criteria for serr…

Submucosal Lidocaine Injection in Colonic Endoscopic Submucosal Dissection: A Single-Center, Double-Blind, Randomized Controlled Trial.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026 · PMID 42666074

OBJECTIVES: Colonic spasm is one of the major technical challenges encountered during colonic endoscopic submucosal dissection (ESD), impairing visualization of the dissection plane and scope maneuverability. Submucosal lidocaine injection may help to overcome this challenge. This study aimed to evaluate the efficacy and safety of submucosal lidocaine injection during colonic ESD. METHODS: In this single-center, double-blind, randomized controlled trial, 110 patients scheduled for colonic ESD were randomly assigned…

Impact of methodological variability on the prognostic performance of circulating tumor DNA in colorectal cancer: A systematic review and meta-analysis.

The journal of liquid biopsy · 2026 · PMID 42668443

Circulating tumor DNA (ctDNA) has demonstrated utility for treatment monitoring, risk stratification, and prognostication in colorectal cancer (CRC). However, substantial methodological heterogeneity across studies may influence its reported prognostic performance. Here, we systematically searched four databases up to October 2025. Eligible studies included patients with CRC who underwent mutation-based plasma ctDNA analysis reported as a binary variable (positive/negative) and provided hazard ratios (HRs) with 95%…

Effectiveness of Electrocautery, Topical Cidofovir, and Topical Sinecatechins for the Treatment of Anal High-Grade Squamous Intraepithelial Lesions in Persons With HIV: An Open-Label, Randomized Controlled Trial.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025 · PMID 40036375

BACKGROUND: Doubts remain about the best treatment for managing premalignant lesions (high-grade squamous intraepithelial lesions [HSIL]) associated with anal cancer. METHODS: The TREATAIN trial was an open-label, randomized study conducted at Hospital Vall d'Hebron (Spain). Persons with human immunodeficiency virus and anal HSIL were randomly assigned 1:1:1 to receive treatment with electrocautery, topical cidofovir 1% ointment, or topical sinecatechins 10%. The primary outcome was histological resolution of HSIL.…

Optimization of DMH-Induced Colorectal Carcinogenesis in Rats: A Systematic Meta-Review.

Clinical and experimental gastroenterology · 2026 · PMID 42666973

Colorectal cancer (CRC) remains a major global health concern, and experimental animal models continue to play a key role in understanding its development and in evaluating preventive and therapeutic strategies. Among these, the 1,2-dimethylhydrazine (DMH)-induced rat model is widely used; however, substantial variability in dosing regimens and study design has limited consistency across studies. The present systematic review aimed to synthesize existing evidence on DMH-induced colorectal carcinogenesis in rats, wi…

Effect of a multimodal bundled intervention on quality of recovery after laparoscopic colorectal cancer surgery: a single-center, single-blind, pragmatic randomized controlled trial.

World journal of surgical oncology · 2026 · PMID 42310736

BACKGROUND: Despite the minimally invasive nature of laparoscopic colorectal surgery, postoperative recovery is frequently compromised by pain, fatigue, and delayed gastrointestinal function. Current rehabilitation strategies largely rely on unimodal approaches, and evidence for structured multimodal bundled interventions is limited. This study aimed to evaluate whether a multimodal bundled intervention comprising electroacupuncture, abdominal massage, structured breathing training, and symptom-titrated supervised …

Randomized phase-II trial of surufatinib plus FOLFOX/FOLFIRI versus FOLFOXIRI as second-line therapy for metastatic colorectal cancer.

Annals of medicine · 2026 · PMID 42421558

BACKGROUND: Second-line treatment for metastatic colorectal cancer (mCRC) typically involves oxaliplatin- or irinotecan-based doublet chemotherapy with or without anti-angiogenic antibodies. Triplet regimens such as FOLFOXIRI have demonstrated synergy and improved efficacy as first-line therapy. Surufatinib, an oral multi-kinase inhibitor targeting VEGFR1-3, FGFR1, and CSF-1R, may enhance chemotherapy efficacy. We evaluated surufatinib combined with doublet (FOLFOX/FOLFIRI) versus triplet (FOLFOXIRI) chemotherapy a…

Effects of Dexmedetomidine on Respiratory Mechanics in Elderly Patients Undergoing Laparoscopic Colorectal Tumor Resection: A Randomized Double-Blinded Trial.

Drug design, development and therapy · 2026 · PMID 42676941

BACKGROUND: Perioperative pulmonary dysfunction frequently occurs in elderly patients undergoing procedures involving pneumoperitoneum and the Trendelenburg position. This study aimed to evaluate the effect of Dex on respiratory mechanics in elderly patients undergoing laparoscopic resection of colorectal tumors. METHODS: This prospective randomized double-blind clinical trial had 64 elderly patients scheduled for laparoscopic resection of the rectum or sigmoid colon, who were assigned to receive either Dex or a pl…

The effects of mindfulness training on emotion and sleep quality in patients with colorectal cancer.

Scientific reports · 2025 · PMID 41339418

To explore the effects of mindfulness training on emotion and sleep quality in patients with colorectal cancer. A total of 44 patients diagnosed with colorectal cancer from a hospital in Chongqing were recruited between August 2021 and April 2023. These participants were randomly assigned to either a training group or a waiting group using a single-blind method. To evaluate emotions, mindfulness levels, and sleep quality, the Positive and Negative Emotion Scale, the Mindfulness Awareness Scale, and the Pittsburgh S…

Multiomic Analysis of the Gut Microbiome and Serum Metabolome in Response to a Low-Carbohydrate, High-Protein Diet in Individuals With Spinal Cord Injury.

Topics in spinal cord injury rehabilitation · 2025 · PMID 41268133

BACKGROUND: Dietary interventions play a significant role in preventing and managing cardiometabolic diseases partly through their impact on the gut microbiome and circulating metabolites. OBJECTIVES: To assess the impact of an 8-week low-carbohydrate, high-protein (LC/HP) diet on gut microbiome composition, function, and serum metabolome in individuals with spinal cord injury (SCI). METHODS: Twenty-four adults with chronic SCI were randomized into an LC/HP diet or a control group for 8 weeks. Stool and fasting ser…

Anal Human Papillomavirus Infection Progression to Disease Among Men Who Have Sex With Men.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026 · PMID 41162330

BACKGROUND: Critical gaps exist in our understanding of the progression from anal human papillomavirus (HPV) infection to same-type HPV-associated anal disease in human immunodeficiency virus (HIV)-negative men who have sex with men (MSM). We conducted a post hoc analysis of a phase 3 randomized 4-valent HPV vaccine trial (NCT00090285) to assess the natural progression of anal HPV infections to associated anal lesions among MSM. PARTICIPANTS: A total of 602 HIV-negative MSM aged 16-27 years. METHODS: HIV-negative M…

A Multilevel Intervention to Identify Individuals for Genetic Testing and Treatment: The IGNITE-TX Pilot Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42658496

IMPORTANCE: Cascade genetic testing (CGT) is a key strategy for cancer prevention in families with hereditary breast and ovarian cancer syndrome (HBOC) and Lynch syndrome (LS), yet uptake among at-risk relatives remains persistently low, particularly in medically underserved populations where structural and informational barriers limit access to genetic services. OBJECTIVE: To evaluate the feasibility and preliminary effects of IGNITE-TX (Identifying Individuals for Genetic Testing and Treatment), a scalable, bilin…

ASO Visual Abstract: Neoadjuvant Immunotherapy in Localized dMMR/MSI-H Colon Cancer: A Systematic Review of Pathological Response and Surgical Outcomes.

Annals of surgical oncology · 2026 · PMID 42675353

Preclinical efficacy of drug delivery systems in colon cancer therapy: a systematic review and meta-analysis of in vivo animal studies.

Journal of the Egyptian National Cancer Institute · 2026 · PMID 42156606

BACKGROUND: Drug delivery systems (DDS) offer a promising strategy to enhance the therapeutic index of chemotherapeutic agents in colon cancer by improving tumor targeting, circulation time, and controlled drug release. Despite extensive preclinical research, a quantitative synthesis evaluating the efficacy of DDS and the influence of design parameters remains lacking. METHODS: We conducted a systematic review and meta-analysis of preclinical in vivo studies assessing DDS-based chemotherapy in murine models of colo…

Antiparasitic agents in oncology: Innovative mechanisms, emerging evidence and clinical potential in cancer treatment.

European journal of medicinal chemistry · 2026 · PMID 42217373

The repurpose of established antiparasitic agents for oncological applications represents a promising and cost-effective strategy in the search for novel anticancer therapeutics. Drugs originally developed to treat parasitic infections, including ivermectin, mebendazole, niclosamide, albendazole, artesunate, flubendazole, and other antiparasitic agents, have demonstrated compelling anticancer properties across a wide range of preclinical models. Their mechanisms of action are multifaceted, encompassing disruption o…

Preclinical characterization and phase I results of TQB2102, a first-in-class HER2 biparatopic antibody-drug conjugate, in patients with advanced solid tumors.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 42142622

BACKGROUND: TQB2102 is a next-generation biparatopic antibody-drug conjugate targeting human epidermal growth factor receptor 2 (HER2) extracellular domain 2 (ECD2) and ECD4 epitopes that is conjugated to a topoisomerase I inhibitor via an enzyme-cleavable linker. This study evaluated the safety, efficacy, and pharmacokinetics of TQB2102 in patients with advanced solid tumors. PATIENTS AND METHODS: In this phase I, multicenter, first-in-human trial, patients with advanced solid tumors were recruited from 12 centers…

A Phase I Trial of Trebananib, an Angiopoietin 1 and 2 Neutralizing Peptibody, Combined with Pembrolizumab in Patients with Advanced Ovarian and Colorectal Cancer.

Cancer immunology research · 2025 · PMID 39348472

Ovarian cancers and microsatellite stable (MSS) colorectal cancers are insensitive to anti-programmed cell death 1 (PD-1) immunotherapy, and new immunotherapeutic approaches are needed. Preclinical data suggest a relationship between immunotherapy resistance and elevated angiopoietin 2 levels. We performed a phase I dose escalation study of pembrolizumab and the angiopoietin 1/2 inhibitor trebananib (NCT03239145). This multicenter trial enrolled patients with metastatic ovarian cancer or MSS colorectal cancer. Treb…

The phosphatase inhibitor LB-100 creates neoantigens in colon cancer cells through perturbation of mRNA splicing.

EMBO reports · 2024 · PMID 38600345

Perturbation of protein phosphorylation represents an attractive approach to cancer treatment. Besides kinase inhibitors, protein phosphatase inhibitors have been shown to have anti-cancer activity. A prime example is the small molecule LB-100, an inhibitor of protein phosphatases 2A/5 (PP2A/PP5), enzymes that affect cellular physiology. LB-100 has proven effective in pre-clinical models in combination with immunotherapy, but the molecular underpinnings of this synergy remain understood poorly. We report here a sen…

Intestinal stem cells as innate immune sentinels: coupling environmental sensing to epithelial adaptation.

Frontiers in immunology · 2026 · PMID 42676836

Intestinal stem cells (ISCs) are essential for maintaining epithelial homeostasis and tissue repair. Traditionally considered passive regenerative cells, ISCs are now recognized as active environmental sensing hubs that integrate microbial, immune, metabolic, mechanical, and neural signals from the intestinal microenvironment. Through intrinsic sensing mechanisms and interactions with niche components, ISCs translate environmental cues into distinct fate decisions, including proliferative regeneration, defensive di…

WNT-Driven Immune Evasion Promotes Malignant Transformation of BRAF-Mutant Colorectal Cancer.

Gastroenterology · 2026 · PMID 42612882

BACKGROUND & AIMS: BRAF-mutant colorectal cancer (CRC) is a clinically aggressive subtype arising from the serrated pathway and is associated with poor prognosis and therapy resistance. The mechanisms driving malignant transformation in microsatellite-stable (MSS) BRAF-mutant CRC remain incompletely understood. We aimed to define the role of WNT pathway activation in serrated CRC progression and tumor-immune interactions. METHODS: We generated multiple genetically engineered mouse models of BRAF-mutant MSS CRC and …

Xiao-Chai-Hu-Tang alleviates irinotecan-induced diarrhea via promoting bile acid reabsorption and decreasing focal adhesion kinase signaling revealed by metabolomics and proteomics.

Phytomedicine : international journal of phytotherapy and phytopharmacology · 2026 · PMID 42555992

BACKGROUND: Irinotecan (CPT-11) is widely used for colorectal cancer treatment, with delayed-onset diarrhea as its primary side effect. Xiao-Chai-Hu-Tang (XCHT) has been clinically observed to alleviate chemotherapy-induced diarrhea, but its underlying mechanisms remain unclear. PURPOSE: This study aimed to elucidate the regulatory mechanisms through which XCHT alleviated CPT-11-induced diarrhea using an integrated multi-omics approach. METHODS: The chemical components of XCHT were detected using UHPLC-QE-Orbitrap-…

Integrated In Vivo and In Silico Approaches for Targeting JAK2/STAT3/SOCS3: Repurposing Boeravinone B and Resveratrol as Chemopreventive Agents in Colon Cancer.

Assay and drug development technologies · 2026 · PMID 42488968

Colon cancer ranks among the most prevalent malignancies worldwide and contributes substantially to cancer-related mortality. This study employed an integrated approach to evaluate the chemopreventive effects of Boeravinone B (BB) and Resveratrol (REV), administered individually and in combination, in the azoxymethane (AOM)-induced rat model of colon cancer, with particular emphasis on cytokine signaling pathways and mitochondrial regulation of apoptosis. The combination of BB (15 mg/kg) and REV (8 mg/kg) exhibited…

In depth study on the mechanism of Xiao-Chai-Hu-Tang in ameliorating irinotecan-induced intestinal toxicity and enhancing antitumor immunity via intestinal microbiota and fecal metabolomics.

Journal of pharmaceutical and biomedical analysis · 2026 · PMID 42546541

Irinotecan (CPT-11) is a cornerstone chemotherapeutic for advanced colorectal cancer (CRC), but its clinical use is limited by dose-dependent gastrointestinal (GI) toxicity. Xiao-Chai-Hu-Tang (XCHT), a classical traditional Chinese medicine formula, alleviates CPT-11-induced adverse effects, yet its mechanism remains unclear. This study established a CPT-11-induced intestinal toxicity model in CRC rats, using multi-omics analyses (16S rRNA sequencing, fecal metabolomics, SCFA quantification) and an antibiotic deple…

A patient-derived organoid model captures fetal-like plasticity in colorectal cancer.

Cell research · 2025 · PMID 40615635

Phenotypic plasticity is a hallmark feature driving cancer progression, metastasis, and therapy resistance. Fetal-like transcriptional programs have been increasingly implicated in promoting plastic cell states, yet their roles remain difficult to study due to limitations of existing culture models. Here, we establish a chemically defined patient-derived organoid system that enables long-term expansion of colorectal cancer (CRC) cells while preserving fetal-like features associated with phenotypic plasticity. Using…

Photothermal-immunotherapy of colon carcinoma by carbon nanoparticle-Fe(II) complex with immunoadjuvant.

Colloids and surfaces. B, Biointerfaces · 2026 · PMID 42217851

Ferroptosis is a regulated necrotic cell death pathway, which demonstrates significant anticancer potential. As the only ferroptosis-based nanomedicine under clinical trial evaluation, carbon nanoparticle-Fe (II) complex (CNSI-Fe) not only induces ferroptosis in tumor cells, but also serves as photothermal conversion agents for tumor photothermal therapy. In this study, we combined the treatments of CNSI-Fe, NIR irradiation and immunoadjuvant glycated chitosan (GC) to extend the use of CNSI-Fe from partial treatmen…

Colibactin produced by a honeybee gut symbiont mediates pathogen defence.

Nature microbiology · 2026 · PMID 42637888

Colibactin is a bacterial genotoxin that damages DNA and is linked to colorectal cancer. It is implicated in interbacterial competition but its role in natural microbiomes is unclear. Here we show that Frischella perrara, a colibactin-producing symbiont restricted to honeybee guts, lowers bee lifespan but increases survivorship following challenge with the opportunistic bee pathogen Serratia marcescens. F. perrara mutants lacking colibactin production fail to improve survivorship following challenge. The symbiont r…

Paliurus ramosissimus extract partially ameliorates AOM/DSS-induced colitis-associated colorectal cancer in mice: insights from transcriptomic and gut microbiota analyses.

Journal of ethnopharmacology · 2027 · PMID 42476202

ETHNOPHARMACOLOGICAL RELEVANCE: Paliurus ramosissimus (PR) is a traditional folk medicinal plant recorded in Zhonghua Bencao (Chinese Materia Medica) and local medicinal records. In this study, Paliurus ramosissimus extract (PRex) was defined as an ethanol extract prepared from PR leaves. PR leaves have traditionally been used for heat-clearing and detoxification and for relieving swelling and pain. These traditional uses are closely related to inflammation-associated conditions. Because colitis-associated colorect…

Multi-omics analysis of saccharomyces boulardii supplementation reveals coordinated microbiome, metabolic, and immune signaling changes accompanying tumor suppression.

Gut microbes · 2026 · PMID 42381379

The gut microbiome shapes cancer progression and treatment responses, yet scalable microbiome-targeted interventions remain limited. We screened commercial probiotics for activation of the host aryl hydrocarbon receptor (AhR) and identified the yeast Saccharomyces boulardii as a consistent AhR activator. In an immunocompetent syngeneic colorectal cancer model, daily oral gavage of S. boulardii slowed growth of established subcutaneous tumors without detectable tumor colonization. Integrated profiling of the gut mic…

The Trispecific Antibody IBI3019 Integrates CDH17-Enhanced EGFR Antagonism with Optimized CD16A Engagement to Elicit Potent Antitumor Activity with Minimal Toxicity.

Cancer research · 2026 · PMID 42678245

Potent and sustained inhibition of epidermal growth factor receptor (EGFR) signaling is critical for suppressing colorectal cancer (CRC) growth, yet current EGFR therapies are often limited by incomplete EGFR blockade and on-target/off-tumor toxicities, particularly skin rash. Here, we co-targeted EGFR and cadherin-17 (CDH17) with a bispecific antibody (bsAb), overcoming these limitations by reducing skin-related toxicities and achieving superior tumor growth inhibition compared to EGFR- or c-MET/EGFR-targeting ant…

Cellular prion protein suppresses colitis and colorectal carcinogenesis via modulating inflammatory responses.

Biochimica et biophysica acta. Molecular basis of disease · 2026 · PMID 42364787

Reducing prion protein (PrP) levels is a leading therapeutic strategy against prion disease. However, the normal function of PrP remains incompletely understood, creating uncertainty about the potential consequences of this approach. We investigated the role of PrP on intestinal tumorigenesis using the ApcMin/+ familial adenomatous polyposis model and the Azoxymethane/Dextran Sodium Sulfate (AOM/DSS) induced colitis-associated colorectal cancer model. In Prnp-/- background, both tumor burden and survival rates of A…

Sequential STING and CD40 agonism drives massive expansion of tumor-specific T cells in liposomal peptide vaccines.

Cellular & molecular immunology · 2025 · PMID 39741195

The clinical use of cancer vaccines is hampered by the low magnitude of induced T-cell responses and the need for repetitive antigen stimulation. Here, we demonstrate that liposomal formulations with incorporated STING agonists are optimally suited to deliver peptide antigens to dendritic cells in vivo and to activate dendritic cells in secondary lymphoid organs. One week after liposomal priming, systemic administration of peptides and a costimulatory agonistic CD40 antibody enables ultrarapid expansion of T cells,…

Multicohort Construction, Immune Landscape Analysis, and PCOLCE2 Functional Validation of an Inflammation-Related Prognostic Model in Colorectal Cancer.

BioFactors (Oxford, England) · 2026 · PMID 42666044

Colorectal cancer (CRC) prognosis remains challenging due to tumor heterogeneity and immune evasion driven by aberrant inflammatory signaling, and robust multicohort validated prognostic tools with clear therapeutic implications are still lacking. To address this gap, we integrated five independent CRC cohorts (TCGA, GSE17536, GSE17537, GSE29621, and GSE38832; n = 931) and applied single-sample gene set enrichment analysis (ssGSEA) across 15 inflammation-related signaling pathways to construct a prognostic risk sco…

Co-clinical CT radiomics pipeline to establish candidate imaging biomarkers for colorectal cancer.

European journal of radiology · 2026 · PMID 42385277

Here, we establish a co-clinical computed tomography (CT) radiomics pipeline for the identification of candidate imaging biomarkers in RAS-mutant metastatic colorectal cancer (mCRC). Orthotopic KRAS-mutant xenograft models (LOVO-Luc2 (N = 52) and SW480-Luc2 (N = 52)) were treated with standard-of-care regimens (FOLFOX, bevacizumab, or combination) and longitudinally imaged by CT (N = 104 tumour scans, N = 156 liver scans collected over 4 timepoints). Radiomic features derived from primary tumour and liver parenchym…

Microbiome-Driven Carcinogenesis and Circulating Microbial Signals in Genitourinary Cancers.

Cancer science · 2026 · PMID 42333742

The microbiome is increasingly recognized as a regulator of carcinogenesis, tumor immunity, and response to immune checkpoint inhibitors (ICIs), but its role in genitourinary cancers remains less clearly defined than in melanoma or colorectal cancer. In this review, we summarize evidence that microbiome-related pathways influence urothelial carcinoma (UC) and renal cell carcinoma (RCC) across the continuum from tumor initiation to immunotherapy outcome. We highlight recent preclinical studies showing that gut micro…

T-cell responses in colorectal peritoneal metastases are recapitulated in a humanized immune system mouse model.

Frontiers in immunology · 2024 · PMID 39044825

BACKGROUND: The occurrence of peritoneal metastasis (PM) in patients with colorectal cancer (CRC) has a dismal prognosis. There is often limited response to systemic- and immunotherapy, even in microsatellite unstable (MSI) CRC. To overcome therapy resistance, it is critical to understand local immune environment in the peritoneal cavity, and to develop models to study anti-tumor immune responses. Here, we defined the peritoneal immune system (PerIS) in PM-CRC patients and evaluate the pre-clinical potential of a h…

Low, plasma level‑informed native curcumin concentrations fail to induce cell death in human lung and colorectal cancer cells.

Pharmaceutical biology · 2026 · PMID 41858052

BACKGROUND/OBJECTIVES: Curcumin, a dietary polyphenol derived from turmeric, has been widely studied for its anti-cancer properties, yet its effects at clinically relevant concentrations remain unclear. This study investigates the anti-cancer effects of curcumin at low in vitro concentrations selected based on reported plasma ranges using in vitro lung and CRC models, with a focus on underlying cellular mechanisms. METHODS: Curcumin was tested at 4, 10, 20, and 50 µg/mL in two CRC cell lines (Caco-2 and HT29) and t…

Hypoxia-induced lnc-IRP drives oxaliplatin resistance in colorectal cancer through IRP2 sequestration and iron metabolism reprogramming.

Journal of translational medicine · 2026 · PMID 42332736

BACKGROUND: Hypoxic microenvironment is an important characteristic of solid tumors. A series of adaptations associated with hypoxia occur in cancer cells, including reprogramming of multiple metabolic pathways. Gastrointestinal bleeding is a common clinical symptom of CRC, resulting in anemia and iron deficiency. CRC patients have unbalanced iron homeostasis due to blood loss, chronic inflammation, etc. However, the molecular mechanisms underlying the effect of hypoxia-induced reprogramming of iron metabolism on c…

lncRNA PCA3 plays a key role in colon cancer occurrence and development.

Archives of medical science : AMS · 2026 · PMID 42540560

INTRODUCTION: This study aimed to investigate the effects of the lncRNA PCA3 in colon cancer and the associated mechanisms. MATERIAL AND METHODS: Adjacent normal and cancer tissues were collected from colon cancer patients, and their PCA3 expression was measured by ISH and RT-qPCR assays. The correlations of PCA3 with clinical pathology and prognosis were also analysed. In addition, PCA3 and si-PCA3 were transfected into colon cancer cells (HT-29 and SW620). Moreover, cell proliferation, apoptosis, number of invadi…

Chemoradiotherapy versus short-course radiotherapy for response-adapted organ preservation in early-stage and intermediate-stage rectal cancer (STAR-TREC): 12-month results of an international, multicentre, open-label, parallel-group, randomised, phase 2/3 trial.

The Lancet. Oncology · 2026 · PMID 42633754

BACKGROUND: Total mesorectal excision (TME) is the standard treatment for most early-stage and intermediate-stage rectal cancer but can cause substantial perioperative morbidity, functional impairment, and reduced quality of life. We assessed whether long-course chemoradiotherapy (LCCRT) or short-course radiotherapy (SCRT) could increase organ preservation and reduce surgery, toxicity, and quality-of-life harms without compromising oncological outcomes. METHODS: STAR-TREC is an international, multicentre, open-labe…

Modulatory role of Blastocystis-derived solubilized antigens in colorectal carcinogenesis: A systematic review.

Molecular and biochemical parasitology · 2026 · PMID 42546905

Colorectal cancer develops through complex interactions among genetic alterations, immune responses, and the intestinal microenvironment. Increasing evidence suggests that intestinal parasites may also contribute to colorectal carcinogenesis (CRC). Blastocystis sp. (Blastocystis) is one of the most common intestinal protozoans worldwide. Although its role in disease remains controversial, it has been associated with chronic inflammation and disruption of normal gut homoeostasis. Therefore, this systematic review ai…

Tumour cell density quantified by artificial intelligence is associated with differential benefit from irinotecan-based chemo-radiotherapy in locally advanced rectal cancer: a post-hoc study of the phase 3 ARISTOTLE trial.

EBioMedicine · 2026 · PMID 42509089

BACKGROUND: Tumour cells and tumour-associated stroma are key components of the tumour microenvironment, and their interaction impacts disease progression and treatment resistance in rectal cancer. This study introduces a computational approach to quantify tumour cell density (TCD) within epithelial and stromal regions and assess whether treatment response differs according to TCD status in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT). METHODS: The data of 414 …

Randomized phase-II trial of surufatinib plus FOLFOX/FOLFIRI versus FOLFOXIRI as second-line therapy for metastatic colorectal cancer.

Annals of medicine · 2026 · PMID 42421558

BACKGROUND: Second-line treatment for metastatic colorectal cancer (mCRC) typically involves oxaliplatin- or irinotecan-based doublet chemotherapy with or without anti-angiogenic antibodies. Triplet regimens such as FOLFOXIRI have demonstrated synergy and improved efficacy as first-line therapy. Surufatinib, an oral multi-kinase inhibitor targeting VEGFR1-3, FGFR1, and CSF-1R, may enhance chemotherapy efficacy. We evaluated surufatinib combined with doublet (FOLFOX/FOLFIRI) versus triplet (FOLFOXIRI) chemotherapy a…

Ifebemtinib plus garsorasib in previously treated metastatic colorectal cancer with KRASG12C mutation: a multicentre, randomised, phase 1b/2 trial.

The Lancet. Oncology · 2026 · PMID 42636835

BACKGROUND: Ifebemtinib is a potent oral focal adhesion kinase inhibitor. Preclinical evidence supports combining ifebemtinib with the KRASG12C inhibitor garsorasib. This study aimed to evaluate this combination in KRASG12C-mutated solid tumours. METHODS: This multicentre, phase 1b/2 study had a phase 1b component to establish the recommended phase 2 dose and a phase 2 multitumour expansion component. In phase 1b, the safety and tolerability of ifebemtinib combined with garsorasib was assessed using a 3 + 3 design …

Metformin enhances the pathological response in nondiabetic patients with rectal cancer undergoing neoadjuvant chemoradiotherapy: A randomized controlled trial.

The Journal of pharmacology and experimental therapeutics · 2026 · PMID 42456199

This randomized, single-blind controlled pilot phase II trial evaluated whether adding metformin to neoadjuvant chemoradiotherapy (nCRT) increases pathological complete response (pCR) rates in nondiabetic patients with locally advanced rectal adenocarcinoma. Eighty-five nondiabetic patients treated between May 2024 and June 2025 were randomized to receive standard nCRT-radiotherapy 50.4 Gy in 28 daily fractions with concurrent oral capecitabine 825 mg/m2 twice daily (group A, n = 43)-or the same regimen plus oral m…

Antiparasitic agents in oncology: Innovative mechanisms, emerging evidence and clinical potential in cancer treatment.

European journal of medicinal chemistry · 2026 · PMID 42217373

The repurpose of established antiparasitic agents for oncological applications represents a promising and cost-effective strategy in the search for novel anticancer therapeutics. Drugs originally developed to treat parasitic infections, including ivermectin, mebendazole, niclosamide, albendazole, artesunate, flubendazole, and other antiparasitic agents, have demonstrated compelling anticancer properties across a wide range of preclinical models. Their mechanisms of action are multifaceted, encompassing disruption o…

Two-Year Outcomes after Direct-to-Surgery in Good Prognosis Margin-Clear Stage II or III Rectal Cancer: The QuickSilver Study.

Annals of surgical oncology · 2026 · PMID 42310267

BACKGROUND: Patients with clinical Stage II or III rectal cancer routinely receive neoadjuvant radiotherapy and chemotherapy. But pelvic magnetic resonance imaging may identify patients who can safely avoid neoadjuvant treatments. We evaluated 2-year oncologic outcomes for patients with "margin-clear" Stage II or III rectal cancer going directly to a planned low anterior resection. PATIENTS AND METHODS: This prospective, non-randomized, phase II trial was performed at 12 high-volume hospitals across Canada. Patient…

A multicohort, biomarker-driven phase 2 trial of personalized total neoadjuvant therapy with targeted agents for high-risk rectal cancer (The TRAINER study).

Signal transduction and targeted therapy · 2026 · PMID 42608395

This multicohort, single-center, phase II trial explored the efficacy and safety of a biomarker-driven total neoadjuvant therapy (TNT) regimen in high-risk locally advanced rectal cancer (LARC) patients. The regimen included induction chemotherapy (4 cycles of mFOLFOX6) with targeted agents (bevacizumab for cohort B and cetuximab for cohort C), followed by short-course radiotherapy (25 Gy/5Fx) and consolidation chemotherapy (2 cycles of mFOLFOX6, with cetuximab in cohort C). The primary endpoint was complete respon…

Preoperative Assessment of Peritoneal Carcinomatosis with [68Ga]Ga-FAPI-46 PET/CT: Agreement with Surgicopathologic PCI and Comparison with MRI and [18F]FDG PET/CT.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026 · PMID 42167805

Accurate preoperative mapping of peritoneal carcinomatosis (PC) is critical for selecting patients for cytoreductive surgery and guiding treatment planning. Conventional imaging, including [18F]FDG PET/CT (FDG PET), may underestimate PC extent. This study evaluated [68Ga]Ga-fibroblast activation protein inhibitor (FAPI)-46 PET/CT (FAPI PET) for preoperative PC assessment, examining agreement with the surgicopathologic reference standard and comparing its performance with MRI and FDG PET. Methods: In this prospectiv…

A Phase II Clinical Trial of Chemotherapy Rechallenge with or without Targeted Therapy in Refractory Metastatic Colorectal Cancer.

Oncology research · 2026 · PMID 42630712

Background: Patients with refractory metastatic colorectal cancer (mCRC) face limited treatment options after failure of standard therapies. This single-arm, phase II study aimed to evaluate the efficacy and safety of rechallenge strategies using previously effective regimens in late-line mCRC. Methods: Patients who progressed after ≥2 lines of prior chemotherapy, with a prior progression-free survival (PFS) ≥4 months and a ≥4-month treatment-free interval on that regimen were enrolled. Patients received rechalleng…

Dose-expansion study of OBI-999, a Globo H-targeting antibody-drug conjugate, in patients with advanced solid tumors.

The oncologist · 2026 · PMID 42371780

BACKGROUND: OBI-999 is an antibody-drug conjugate consisting of the Globo H-targeting antibody OBI-888 linked to the cytotoxic payload monomethyl auristatin E. In a dose-escalation study, the OBI-999 recommended phase 2 dose (RP2D) was 1.2 mg/kg every 3 weeks. This dose-expansion study evaluated the efficacy and safety of OBI-999 in patients with pancreatic cancer, colorectal cancer (CRC), or other tumor types ("basket cohort") and tumoral Globo H H-scores ≥100 (NCT04084366). PATIENTS AND METHODS: Patients were tre…

Phase II Trial of Encapsulated Rapamycin to Reduce Polyp Burden Associated with Familial Adenomatous Polyposis.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42048421

PURPOSE: Familial adenomatous polyposis (FAP) confers a significant risk of colorectal/duodenal cancer. Encapsulated rapamycin (eRapa) has demonstrated promise as FAP chemoprevention in early clinical studies. PATIENTS AND METHODS: Thirty patients with FAP enrolled to three dosing regimens of eRapa (0.5 mg): cohort 1-every other day, cohort 2-daily every other week, or cohort 3-daily. The primary endpoints were safety/tolerability, pharmacokinetics, and percentage change from baseline (PCFB) in colorectal polyp bur…

Preclinical characterization and phase I results of TQB2102, a first-in-class HER2 biparatopic antibody-drug conjugate, in patients with advanced solid tumors.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 42142622

BACKGROUND: TQB2102 is a next-generation biparatopic antibody-drug conjugate targeting human epidermal growth factor receptor 2 (HER2) extracellular domain 2 (ECD2) and ECD4 epitopes that is conjugated to a topoisomerase I inhibitor via an enzyme-cleavable linker. This study evaluated the safety, efficacy, and pharmacokinetics of TQB2102 in patients with advanced solid tumors. PATIENTS AND METHODS: In this phase I, multicenter, first-in-human trial, patients with advanced solid tumors were recruited from 12 centers…

A Phase I Trial of Trebananib, an Angiopoietin 1 and 2 Neutralizing Peptibody, Combined with Pembrolizumab in Patients with Advanced Ovarian and Colorectal Cancer.

Cancer immunology research · 2025 · PMID 39348472

Ovarian cancers and microsatellite stable (MSS) colorectal cancers are insensitive to anti-programmed cell death 1 (PD-1) immunotherapy, and new immunotherapeutic approaches are needed. Preclinical data suggest a relationship between immunotherapy resistance and elevated angiopoietin 2 levels. We performed a phase I dose escalation study of pembrolizumab and the angiopoietin 1/2 inhibitor trebananib (NCT03239145). This multicenter trial enrolled patients with metastatic ovarian cancer or MSS colorectal cancer. Treb…

Deciphering immune and cellular reprogramming during the progression from inflammatory bowel disease to colorectal cancer using multi-omics single-cell and spatial transcriptomics.

Journal of translational medicine · 2026 · PMID 42001187

BACKGROUND: Inflammatory bowel disease (IBD) represents a group of chronic and relapsing inflammatory disorders of the gastrointestinal tract, primarily encompassing Crohn’s disease (CD) and ulcerative colitis (UC). To elucidate immune heterogeneity and molecular mechanisms underlying IBD pathogenesis, we performed an integrated high-resolution transcriptomic and experimental analysis across 1436 patients with IBD and CRC. METHODS: 436 samples in transcriptomics level were analyzed, including 415 bulk RNA-seq, 18 s…

Mitochondrial metabolism and succinylation-related gene signatures for predicting prognosis and drug resistance in colon adenocarcinoma.

Clinica chimica acta; international journal of clinical chemistry · 2026 · PMID 42176930

BACKGROUND: Colon adenocarcinoma (COAD) has high incidence and mortality but lacks reliable molecular biomarkers for prognosis and individualized therapy. Mitochondrial metabolic reprogramming and succinylation are closely implicated in COAD progression, yet their synergistic mechanism remains unclear. This study aimed to analyze mitochondrial metabolism and succinylation-related gene (MMSRG) signatures, identify key biomarkers for COAD prognosis and drug resistance, and establish a robust prognostic model. METHODS…

From Germline Variants to Tumor Outcome: GWAS-Based Functional Genomics Prioritizes Colorectal Cancer Susceptibility Genes and Links SMAD9 to Prognosis.

Human mutation · 2026 · PMID 42626603

INTRODUCTION: Genome-wide association studies (GWAS) have identified over 200 germline risk loci for colorectal cancer (CRC), yet the causal variants and genes behind most GWAS signals remain unknown and the link between inherited risk and tumor outcome is largely unexplored. Connecting germline single nucleotide polymorphisms (SNPs) to gene expression through expression quantitative trait loci (eQTL) and to clinical outcome is needed to interpret this inherited risk. METHODS: We combined CRC GWAS summary data (73,…

From Periodontal Pocket to Systemic Diseases: Mechanistic Insights Into the Role of Porphyromonas gingivalis in Host Pathology.

Journal of cellular and molecular medicine · 2026 · PMID 42658102

Porphyromonas gingivalis (P. gingivalis), a keystone pathogen in periodontitis, has been increasingly recognised as a mechanistic bridge linking periodontal infection to pathological destruction in distant organs. P. gingivalis virulence factors, including gingipains, lipopolysaccharides (LPS), and outer membrane vesicles (OMVs), mediate complex host-pathogen interactions. In this review, we critically evaluated recent experimental studies which demonstrate the effects of P. gingivalis oral infection on systemic di…

Effects of low and moderate doses of ionizing radiation on colon carcinogenesis: Experimental models and current evidence.

Biochimica et biophysica acta. Reviews on cancer · 2026 · PMID 42114593

Millions of people are exposed annually to low and moderate doses of ionizing radiation (LMDR), mostly as a result of medical diagnostic procedures. These individuals may be at increased risk of developing colon cancer (CC), as predicted by the linear no-threshold model used for radioprotection. However, risk estimates derived from epidemiological studies remain subject to considerable uncertainty, necessitating a better mechanistic understanding of how LMDR may contribute to CC development. This review examines av…

Isobonducellin phytocompound from Artemisia annua L. plant exhibits anti-colorectal cancer activity via AKT1 regulation: an in-silico study.

Computers in biology and medicine · 2026 · PMID 42431013

Colorectal cancer (CRC) is one of the leading contributors to cancer related mortality worldwide highlighting the need for novel therapeutic agents. This study investigated the potential anti-colorectal cancer activity of phytochemicals from Artemisia annua L. plant using an integrated in silico approaches. Gene expression analysis, ADMET screening, network pharmacology, molecular docking, density functional theory (DFT), molecular dynamics (MD) simulation, and post-simulation trajectory analyses were employed to i…

Efficient colorectal cancer classification from histopathological images utilizing lightweight convolutional neural networks.

Computers in biology and medicine · 2026 · PMID 42263434

As one of the most fatal malignancies worldwide, colorectal cancer demands accurate histopathological image analysis to support timely diagnosis and effective clinical decision-making. This study investigates four lightweight convolutional neural network (CNN) variants for binary classification of colon histopathology patches into Colon_Adenocarcinoma and Colon_Benign_Tissue. A unified experimental framework is employed, incorporating standardized preprocessing, data augmentation, class-weighted optimization, and m…

The Preventive Effect of Introducing Glutamine on Chemotherapy-Induced Diarrhea in Colorectal Cancer and Its Influence on Inflammatory Factors Such as CRP and IL-6.

Molecular nutrition & food research · 2026 · PMID 42529890

To assess the protective effects of live combined bifidobacterium, lactobacillus, enterococcus, and glutamine on diarrhea associated with chemotherapy and inflammatory markers in colorectal cancer patients (CCP). A retrospective analysis was conducted on the clinical data of patients with colorectal cancer who received chemotherapy at the People's Hospital of Pailin County, Chongqing from December 2022 to December 2024. There were 59 cases in the control group and 59 cases in the study group. The control group rece…

S100P as a Shared Biomarker in Inflammatory Bowel Disease, Colorectal Cancer, and Pancreatic Adenocarcinoma: An Integrated Transcriptomic Analysis.

Journal of visualized experiments : JoVE · 2026 · PMID 42611775

Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC) and pancreatic adenocarcinoma (PAAD), yet the molecular features shared among these diseases remain incompletely understood. This study aimed to identify common genes and biological pathways associated with IBD, CRC, and PAAD through integrated transcriptomic analysis and experimental validation. Gene expression datasets for IBD, CRC, and PAAD were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databa…

The E2F1-KIF14 axis drives focal adhesion formation and promotes colorectal cancer metastasis.

Acta biochimica et biophysica Sinica · 2026 · PMID 40931756

Kinesin family member 14 (KIF14) has been implicated in the progression of multiple cancer types, yet its role in colorectal cancer (CRC) metastasis remains undefined. Here, we assesse KIF14 expression in CRC specimens and explore its clinical and functional significance. KIF14 upregulation is frequently observed in CRC tissues and is correlated with advanced tumor stage and reduced overall survival. Functional assays reveal that KIF14 depletion in CRC cells inhibits migration, invasion, and in vivo metastatic colo…

Efficacy and Safety of High Versus Low Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery a Systematic Review and Meta-analysis.

The Journal of surgical research · 2026 · PMID 42208212

INTRODUCTION: To assess the impact of high-tie (HT) versus low-tie (LT) ligation of the inferior mesenteric artery, with or without left colic artery (LCA) preservation, on surgical, oncological, and functional outcomes in colorectal cancer surgery. METHODS: A systematic review and meta-analysis of 31 randomized controlled trials, cohort, and cadaveric studies (including 10 randomized controlled trials, 11 retrospective cohort studies, 9 prospective cohort studies, and 1 cadaveric study) was conducted. Outcomes inc…

Interventions targeting quality of life in patients with colorectal cancer and a fecal ostomy: A systematic review.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026 · PMID 42140309

BACKGROUND: Patients undergoing fecal ostomy surgery often struggle to adapt to life, particularly when the surgery is performed for colorectal cancer. Maladaptation to life with an ostomy is associated with psychosocial challenges that affect daily quality of life (QoL). The aim of this systematic review was to identify interventions that address the self-care education and psychosocial needs of patients with colorectal cancer living with an ostomy and to examine their efficacy and effectiveness. METHODS: A system…

Inferior Mesenteric Artery Ligation Level and Anastomotic Leakage in Low Anterior Resection: A Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 42340709

IMPORTANCE: The optimal level of inferior mesenteric artery (IMA) ligation during rectal cancer resection remains controversial because of potential trade-offs between anastomotic integrity and functional outcomes. OBJECTIVE: To determine whether low ligation of the IMA reduces the rate of anastomotic leakage compared with high ligation in patients undergoing minimally invasive anterior resection for rectal cancer. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective, randomized clinical trial enrolled …

The Efficacy of Pan-Indigo Carmine Chromoendoscopy by Water-Jet Pump in the Detection of Colorectal Lesions: A Randomized Controlled Trial.

Journal of gastroenterology and hepatology · 2026 · PMID 42333873

BACKGROUND: Pump-based chromoendoscopy is recommended for the surveillance of dysplasia associated with inflammatory bowel disease. This study was designed to compare the efficacy of pump-based pan chromoendoscopy (PCE) with white-light endoscopy (WLE) for the detection of colorectal neoplasia in patients at high risk of colorectal cancer (CRC). METHOD: This randomized controlled trial prospectively recruited 366 participants who were randomly allocated in a 1:1 ratio to the WLE group and the PCE group. PRIMARY OUT…

Phase III randomized placebo-controlled trial on repurposing olanzapine for prevention of radiotherapy induced nausea and vomiting (RINV): CTRI/2022/01/039723.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026 · PMID 42119640

PURPOSE: Prospective, double-blind, phase III randomized placebo-controlled study evaluated the efficacy of olanzapine in preventing RINV during abdominal-pelvic radiation therapy. METHODS: Patients receiving abdominal/pelvic RT without prior radiation were randomized to receive either olanzapine 5 mg or placebo once daily, alongside standard ondansetron (4 mg BID). Primary endpoint was nausea prevention; secondary endpoints included emesis control, rescue medication use, toxicity, anxiety, depression, and quality …

The Addition of Computer-Aided Detection (CADe) to Texture and Color Enhancement Imaging (TXI) Does Not Improve Adenoma Detection Rate During Colonoscopy: A Prospective Study.

Journal of gastroenterology and hepatology · 2026 · PMID 42363424

OBJECTIVES: Early detection and resection of colorectal polyps prevent their progression toward advanced adenocarcinomas. The use of Texture and Color Enhancement Imaging (TXI) has been demonstrated to enhance adenoma detection compared to white light imaging. It remains unknown whether there is an additive benefit when using computer-aided detection (CADe) in addition to enhanced imaging technologies. METHODS: This prospective study involved the combined use of TXI and CADe during colonoscope withdrawal in the int…

Quality of life, bowel dysfunction, and long-term oncological outcomes after transanal versus laparoscopic total mesorectal excision for mid- and low- rectal cancer (Ta-LaTME study): multicentre randomized open-label trial.

BJS open · 2026 · PMID 42551037

BACKGROUND: Quality of life (QoL) and bowel function are key outcomes in mid- and low rectal cancer. The comparative impact of laparoscopic total mesorectal excision (LaTME) versus transanal total mesorectal excision (TaTME) on patient-reported outcomes and long-term oncological results in randomized trials remains unclear. METHODS: This prospective multicentre randomized trial enrolled patients with resectable mid-low rectal adenocarcinoma. QoL was assessed using the 30- and 29-item European Organization for Resea…

Consistent Metabolomic and Genetic Evidence Supports Acisoga as a Key Contributor to Colorectal Neoplasia Progression.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026 · PMID 42201318

BACKGROUND: Colorectal cancer is a leading cause of cancer incidence and mortality worldwide. Early detection and accurate risk stratification of precursor lesions remain critical challenges. Integrating metabolomics with genetic analysis may improve the understanding of colorectal cancer development and identify disease determinants. METHODS: Untargeted serum metabolomics was performed in 513 individuals: 185 controls; 74 with low-, 98 with intermediate-, and 100 with high-risk lesions; and 56 colorectal cancer ca…

Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25 mm nonpedunculated colorectal polyps: a randomized controlled trial.

European journal of gastroenterology & hepatology · 2026 · PMID 42065991

BACKGROUND AND AIMS: Modified endoscopic mucosal resection (EMR) techniques using a snare tip, precutting EMR (P-EMR) and anchoring EMR (A-EMR), have been developed for the effective resection of nonpedunculated colorectal polyps measuring 10-25 mm. Although previous studies have compared either P-EMR or A-EMR with conventional EMR, no study has directly compared these two snare tip-assisted techniques within modified EMR. This study aimed to evaluate P-EMR and A-EMR in terms of the R0 resection rate and procedure …

Effects of Dexmedetomidine on Respiratory Mechanics in Elderly Patients Undergoing Laparoscopic Colorectal Tumor Resection: A Randomized Double-Blinded Trial.

Drug design, development and therapy · 2026 · PMID 42676941

BACKGROUND: Perioperative pulmonary dysfunction frequently occurs in elderly patients undergoing procedures involving pneumoperitoneum and the Trendelenburg position. This study aimed to evaluate the effect of Dex on respiratory mechanics in elderly patients undergoing laparoscopic resection of colorectal tumors. METHODS: This prospective randomized double-blind clinical trial had 64 elderly patients scheduled for laparoscopic resection of the rectum or sigmoid colon, who were assigned to receive either Dex or a pl…

Gel Immersion Improves Visualization in Underwater Endoscopic Mucosal Resection for Colorectal Lesions: A Prospective Crossover Trial.

Journal of gastroenterology and hepatology · 2026 · PMID 42472638

OBJECTIVE: Underwater endoscopic mucosal resection (UEMR) is widely used for colorectal polyp resection, but visualization may be impaired with poor bowel preparation. Gel-immersion endoscopy has been proposed to enhance image clarity. In this study, digital image analysis was applied to quantitatively compare lesion visibility during UEMR with water or gel immersion. METHODS: In this prospective, randomized crossover trial, patients with non-pedunculated colorectal adenomatous lesions measuring 6-19 mm were sequen…

Impact of Intravenous Lidocaine, Dexmedetomidine, and Intrathecal Morphine on Metastasis-Related Biomarkers and Cellular Immune Profiles in Colorectal Surgery: A Prospective, Randomized Controlled Trial.

Anesthesia and analgesia · 2026 · PMID 42228944

BACKGROUND: Anesthetic adjuvants used in multimodal analgesia-including intravenous lidocaine, dexmedetomidine, or intrathecal morphine (ITM)-may differentially affect immune responses and metastasis-related pathways in colorectal cancer surgery. Their comparative effects on these pathways remain poorly understood. METHODS: In this prospective, randomized, patient- and assessor-blinded trial, adults undergoing elective laparoscopic or robotic colorectal cancer resection were allocated to receive intravenous lidocai…

Effects of scalp lotion containing alpha lipoic acid derivatives for chemotherapy-induced alopecia in patients with gastrointestinal cancer: A prospective cohort study.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2026 · PMID 40183429

IntroductionChemotherapy-induced alopecia results in a poor quality of life, compromised immune system, and adverse effects on cancer prognosis. Its prevention is vital in patients with gastrointestinal cancer; however, there are no standard guidelines for prevention. The efficacy of a scalp alpha lipoic acid derivative-containing lotion (ALADL) remains unknown. Therefore, we evaluated the effects of ALADL on chemotherapy-induced alopecia in patients with gastrointestinal cancer.MethodsThis single-center prospectiv…

Expert Endoscopist Agreement for Size Measurement of Large (> 2 cm) Colorectal Laterally Spreading Tumors: A Prospective Video-Based Study.

Digestive diseases and sciences · 2026 · PMID 42087016

BACKGROUND: Accurate size estimation of large (≥ 20 mm) colorectal laterally spreading tumors (LSTs) is essential for procedural planning, risk stratification, and predicting technical difficulty. Yet, the reliability of visual LST size assessment among endoscopists has not been systematically evaluated. PATIENTS AND METHODS: 46 LSTs were recorded during colonoscopy. Twenty-four international expert endoscopists independently reviewed de-identified videos and provided visual estimates for (1) maximal diameter, (2) …

A Prospective Trial on Operability and Safety of a Simplified Robot-Assisted System (FASTER) for Colorectal Endoscopic Submucosal Dissection.

Surgical laparoscopy, endoscopy & percutaneous techniques · 2026 · PMID 42284444

BACKGROUND AND AIMS: One of the key challenges in endoscopic submucosal dissection (ESD) is achieving effective intraoperative mucosal traction. Although numerous countertraction technologies have been developed, there is still room for optimization. This randomized controlled trial was designed to assess the comparative effectiveness of a novel robotic assistance system (FASTER) versus conventional ESD techniques for managing colorectal neoplasia. METHODS: A total of 24 ESD procedures were performed on 6 different…

Bone-sparing chemoradiotherapy for anal cancer - Results of a phase II trial by the Danish Anal Cancer Group - The DACG II (NCT05385250).

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026 · PMID 42150737

INTRODUCTION: Radiotherapy-induced bone damage and pelvic insufficiency fractures (PIFs) are known complications from pelvic radiotherapy. In anal cancer (AC), PIFs have been reported in up to 50% of patients with associated pain. This multicenter phase II trial aimed to reduce PIF rates from 50% to < 35% using bone-specific MRIs and associated symptoms in AC. METHODS: Patients with localized AC eligible for curatively intended chemoradiotherapy (CRT) were prospectively included. Detailed bone substructure delineat…

Two-Year Outcomes after Direct-to-Surgery in Good Prognosis Margin-Clear Stage II or III Rectal Cancer: The QuickSilver Study.

Annals of surgical oncology · 2026 · PMID 42310267

BACKGROUND: Patients with clinical Stage II or III rectal cancer routinely receive neoadjuvant radiotherapy and chemotherapy. But pelvic magnetic resonance imaging may identify patients who can safely avoid neoadjuvant treatments. We evaluated 2-year oncologic outcomes for patients with "margin-clear" Stage II or III rectal cancer going directly to a planned low anterior resection. PATIENTS AND METHODS: This prospective, non-randomized, phase II trial was performed at 12 high-volume hospitals across Canada. Patient…

Preoperative Assessment of Peritoneal Carcinomatosis with [68Ga]Ga-FAPI-46 PET/CT: Agreement with Surgicopathologic PCI and Comparison with MRI and [18F]FDG PET/CT.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026 · PMID 42167805

Accurate preoperative mapping of peritoneal carcinomatosis (PC) is critical for selecting patients for cytoreductive surgery and guiding treatment planning. Conventional imaging, including [18F]FDG PET/CT (FDG PET), may underestimate PC extent. This study evaluated [68Ga]Ga-fibroblast activation protein inhibitor (FAPI)-46 PET/CT (FAPI PET) for preoperative PC assessment, examining agreement with the surgicopathologic reference standard and comparing its performance with MRI and FDG PET. Methods: In this prospectiv…

Body Mass Index at Diagnosis, Prediagnostic Weight Loss, and Survival in Colorectal Cancer.

JAMA network open · 2026 · PMID 42599706

IMPORTANCE: Evidence on the association of excess adiposity with colorectal cancer (CRC) prognosis is conflicting, with some studies reporting better survival in patients with elevated body mass index (BMI)-often referred to as the obesity paradox. OBJECTIVE: To investigate to what extent the obesity paradox can be explained by prediagnostic cancer-associated weight loss. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, population-based case-control study with prospective follow-up included patients aged 30 yea…

Radiomics-based outcome prediction for irinotecan-TACE in colorectal liver metastases: advanced analysis from the prospective CIREL trial.

European radiology · 2026 · PMID 42053592

OBJECTIVES: Transarterial chemoembolization (TACE) is a promising locoregional therapy for unresectable colorectal liver metastases, but patient selection remains challenging. We aimed to develop and validate prognostic radiomics-based machine learning models in a multicenter, prospectively collected drug-eluting microsphere TACE cohort. MATERIALS AND METHODS: We retrospectively analyzed 76 patients (176 lesions) from the prospective CIREL registry trial. Radiomic features were extracted from each lesion. We tested…

A multicenter survey on BRAF screening for the implementation of perioperative cancer genomic medicine for resectable colorectal oligometastases.

International journal of clinical oncology · 2026 · PMID 42262686

BACKGROUND: Genomic screening is an essential, but potentially time-consuming procedure, especially in neoadjuvant settings. We evaluated the preoperative screening of the BRAF V600E mutation for recruitment to a clinical trial among patients with resectable colorectal oligometastases (CRM). METHODS: In April 2022, an investigator-initiated trial was launched to investigate the efficacy and safety of perioperative use of the BEACON triplet regimen for BRAF V600E mutant resectable CRM. BRAF screening was retrospecti…

Interpretable Artificial Intelligence in Assisting Treatment Response Prediction for Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy: A Prospective, Multicenter, Human-Model Interaction Study.

International journal of radiation oncology, biology, physics · 2026 · PMID 41556864

PURPOSE: Preoperative assessment of pathologic complete response (pCR) to neoadjuvant therapy is an urgent need for anorectal preservation in patients with locally advanced rectal cancer (LARC). Artificial intelligence assistance remains challenging due to a lack of prospective validation and reliable interpretability. METHODS AND MATERIALS: Eligible patients with LARC were retrospectively collected. Radiomic features extracted from postneoadjuvant therapy magnetic resonance imaging were applied to train a Deep Res…

Laparoscopic versus robotic surgery in the setting of combined resection of colorectal cancer and liver metastases: an experience from the I Go MILS registry.

Updates in surgery · 2026 · PMID 42166096

Approximately 25% of patients with colorectal cancer (CRC) are diagnosed with distant metastases, with the liver being the most common site. A simultaneous approach to resections in these patients may lead to higher complication rates. Recent research suggests that minimally invasive surgical (MIS) techniques can help reduce this additional morbidity. This study examines a multicenter Italian experience, comparing perioperative outcomes of robotic (RS) and laparoscopic surgery (LS) in this setting. Patients from th…

Real-World Evidence for Oncology Patients With Rare NTRK Gene Fusions: Final Results From the German Multicenter Patient Cohort Study REALTRK.

JCO precision oncology · 2026 · PMID 42550993

PURPOSE: TRK inhibitors (TRKis) have transformed the therapeutic landscape for patients with neurotrophic tyrosine receptor kinase (NTRK) gene fusion-positive tumors. However, approval of TRKis is based on evidence derived mainly from small, pooled, single-arm clinical trial cohorts. The REALTRK registry aims to describe real-world molecular diagnostic practices, treatment patterns, and clinical outcomes for adult patients with NTRK fusion-positive cancers. PATIENTS AND METHODS: The REALTRK registry was a multicent…

Colonic resection or self-expanding metal stents for obstructive left colon cancer: results of a national multicenter prospective cohort study (CROSCO-1).

Surgical endoscopy · 2026 · PMID 42236555

BACKGROUND: The optimal management of acute left-sided malignant colonic obstruction remains controversial. Emergency surgery (ES) is associated with substantial morbidity and high stoma rates, whereas self-expanding metal stents (SEMS) as a bridge to surgery (BtS) may convert an emergency into an elective setting. This study aimed to compare the safety, efficacy, and quality-of-life outcomes of ES versus SEMS/BtS. METHODS: CROSCO-1 is a national, multicenter, prospective observational cohort study conducted in Ita…

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Comparative effectiveness of preoperative prehabilitation modalities for postoperative recovery in colorectal cancer: A systematic review and network meta-analysis.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026 · PMID 42263810

BACKGROUND: Preoperative prehabilitation has been increasingly incorporated into perioperative care for colorectal cancer (CRC), yet the comparative effectiveness of different prehabilitation modalities remains unclear. This study aimed to compare the relative effects of major preoperative prehabilitation models on postoperative recovery in patients who undergo surgery for CRC. METHODS: A systematic review and network meta-analysis (NMA) were conducted by searching PubMed, Embase, the Cochrane Central Register of C…

Effect of Digital Health Interventions on the Nutritional Status and Quality of Life of Patients With Colorectal Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Journal of medical Internet research · 2026 · PMID 42613928

BACKGROUND: Digital health interventions may improve clinical outcomes in patients with colorectal cancer (CRC), but their impact on nutritional status (NS) and quality of life (QoL) remains unclear. OBJECTIVE: This study systematically evaluated the impact of digital health interventions on the NS and QoL in patients with CRC. METHODS: A systematic search was performed across PubMed, Embase, Cochrane, and Web of Science from inception to March 2026 to identify randomized controlled trials evaluating digital health…

Gaps in the Evidence for High Versus Low Inferior Mesenteric Artery Ligation in Rectal Cancer Surgery.

The Journal of surgical research · 2026 · PMID 42617376

INTRODUCTION: The optimal level of inferior mesenteric artery ligation in rectal cancer surgery remains controversial. This meta-analysis of randomized controlled trials (RCTs) compares clinical and functional outcomes between high ligation (HL), performed at the origin of the inferior mesenteric artery, and low ligation (LL), performed distal to the left colic artery with preservation of the left colic artery. METHODS: Registered with PROSPERO, we systematically searched Embase, PubMed, and Cochrane Library (up to…

Changes in quality of life in colorectal cancer screening: A multicentre trial in populations in China.

Journal of medical screening · 2026 · PMID 41816867

ObjectiveEvidence is scarce about whether colorectal cancer screening can affect the quality of life of participants, particularly in terms of novel screening strategies in Eastern populations.MethodsFrom 2018 to 2021, the TARGET-C trial randomly allocated 19,373 participants to one of three screening strategies: (A) one-time colonoscopy; (B) annual faecal immunochemical test with positives referred for colonoscopy; and (C) annual risk-adapted screening with low-risk participants referred for faecal immunochemical …

Effects of Prehabilitation by Physical Activity on Fatigue After Surgery for Colorectal Cancer. Results From Secondary Analyses in the Randomized Controlled Trial PHYSSURG-C.

Cancer medicine · 2026 · PMID 42568293

OBJECTIVE: The objective of this study is to explore effects on self-reported fatigue at 4 weeks and 12 months after surgery in patients with colorectal cancer undergoing a pre- and postoperative exercise intervention compared to standard care in a randomized trial. BACKGROUND: Fatigue after cancer surgery is common and evidence suggests it could be alleviated by physical activity. In this post hoc exploratory study, we analyzed fatigue and other secondary outcomes from a randomized trial aimed at exploring if preh…

Interventions targeting quality of life in patients with colorectal cancer and a fecal ostomy: A systematic review.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026 · PMID 42140309

BACKGROUND: Patients undergoing fecal ostomy surgery often struggle to adapt to life, particularly when the surgery is performed for colorectal cancer. Maladaptation to life with an ostomy is associated with psychosocial challenges that affect daily quality of life (QoL). The aim of this systematic review was to identify interventions that address the self-care education and psychosocial needs of patients with colorectal cancer living with an ostomy and to examine their efficacy and effectiveness. METHODS: A system…

Inferior Mesenteric Artery Ligation Level and Anastomotic Leakage in Low Anterior Resection: A Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 42340709

IMPORTANCE: The optimal level of inferior mesenteric artery (IMA) ligation during rectal cancer resection remains controversial because of potential trade-offs between anastomotic integrity and functional outcomes. OBJECTIVE: To determine whether low ligation of the IMA reduces the rate of anastomotic leakage compared with high ligation in patients undergoing minimally invasive anterior resection for rectal cancer. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective, randomized clinical trial enrolled …

Chemoradiotherapy versus short-course radiotherapy for response-adapted organ preservation in early-stage and intermediate-stage rectal cancer (STAR-TREC): 12-month results of an international, multicentre, open-label, parallel-group, randomised, phase 2/3 trial.

The Lancet. Oncology · 2026 · PMID 42633754

BACKGROUND: Total mesorectal excision (TME) is the standard treatment for most early-stage and intermediate-stage rectal cancer but can cause substantial perioperative morbidity, functional impairment, and reduced quality of life. We assessed whether long-course chemoradiotherapy (LCCRT) or short-course radiotherapy (SCRT) could increase organ preservation and reduce surgery, toxicity, and quality-of-life harms without compromising oncological outcomes. METHODS: STAR-TREC is an international, multicentre, open-labe…

Phase III randomized placebo-controlled trial on repurposing olanzapine for prevention of radiotherapy induced nausea and vomiting (RINV): CTRI/2022/01/039723.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026 · PMID 42119640

PURPOSE: Prospective, double-blind, phase III randomized placebo-controlled study evaluated the efficacy of olanzapine in preventing RINV during abdominal-pelvic radiation therapy. METHODS: Patients receiving abdominal/pelvic RT without prior radiation were randomized to receive either olanzapine 5 mg or placebo once daily, alongside standard ondansetron (4 mg BID). Primary endpoint was nausea prevention; secondary endpoints included emesis control, rescue medication use, toxicity, anxiety, depression, and quality …

Integrated psychosocial, sleep, and immunonutritional intervention improves psychological adaptation, sleep disturbance, and inflammatory activation in rectal cancer: a randomized controlled trial.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026 · PMID 41714581

BACKGROUND: Patients undergoing abdominoperineal or intersphincteric resection for low rectal cancer experience profound physiological and psychological stress. Conventional Enhanced Recovery After Surgery (ERAS) protocols mainly address surgical and metabolic factors but rarely target the host's psychosocial and immunometabolic recovery. STUDY DESIGN: In this single-center randomized controlled trial, 240 patients with stage II-III low rectal cancer (September 2019-September 2021) were randomized (1:1) to receive …

Patient-led, home-based follow-up for colorectal cancer: DISTANCE multicentre stepped-wedge cluster randomised trial.

The British journal of surgery · 2026 · PMID 42359543

BACKGROUND: Colorectal cancer (CRC) incidence is rising; consequently, traditional follow-up care models are increasingly unsustainable. Patient-led, home-based follow-up (PHFU) may offer a promising alternative to reduce hospital visits while maintaining patient well-being. METHODS: The DISTANCE trial was a stepped-wedge cluster randomised trial conducted in six hospitals in the Netherlands. A total of 354 stage I-III CRC survivors, disease-free at 12 months after surgery, were assigned to either PHFU or standard …

Effect of a multimodal bundled intervention on quality of recovery after laparoscopic colorectal cancer surgery: a single-center, single-blind, pragmatic randomized controlled trial.

World journal of surgical oncology · 2026 · PMID 42310736

BACKGROUND: Despite the minimally invasive nature of laparoscopic colorectal surgery, postoperative recovery is frequently compromised by pain, fatigue, and delayed gastrointestinal function. Current rehabilitation strategies largely rely on unimodal approaches, and evidence for structured multimodal bundled interventions is limited. This study aimed to evaluate whether a multimodal bundled intervention comprising electroacupuncture, abdominal massage, structured breathing training, and symptom-titrated supervised …

Are probiotics effective for preventing chemotherapy-induced diarrhea? Conditional benefits and remaining evidence gaps.

Current opinion in clinical nutrition and metabolic care · 2026 · PMID 42165233

PURPOSE OF REVIEW: Chemotherapy-induced diarrhea (CID) is a clinically significant toxicity that may impair nutritional status, quality of life, treatment continuity, and dose intensity. As CID is increasingly linked to gut dysbiosis, epithelial barrier dysfunction, inflammatory activation, and altered microbiota-host interactions, probiotics have been proposed as a potential preventive strategy. This review evaluates recent clinical and translational evidence on whether probiotics can prevent CID and in which sett…

Comparison of Perioperative, Oncologic, and Functional Outcomes Following Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Systematic Review and Meta-Analysis.

Journal of clinical medicine · 2026 · PMID 42652886

Background: Intersphincteric resection (ISR) is a technically demanding sphincter-preserving procedure for low rectal cancer. While robotic surgery may offer technical advantages, evidence comparing robotic ISR (R-ISR) and laparoscopic ISR (L-ISR) remains limited. This study aimed to compare perioperative, oncologic, and functional outcomes between R-ISR and L-ISR. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020. PubMed, Scopus, and Cochrane Library were searched up to 1 …

Clinical efficacy and safety evaluation of Buzhongyiqi pills on appetite improvement in patients with colorectal cancer receiving chemotherapy: a pilot randomized cross-over clinical trial.

Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2024 · PMID 39617711

OBJECTIVE: To evaluate the clinical efficacy and safety of Buzhongyiqi pills (BZYQP, ) in improving the appetite of patients with colorectal cancer (CRC) receiving chemotherapy. TRIAL DESIGN: A pilot, randomized, single-blind cross-over clinical trial was conducted on diagnosed stage II-IV CRC patients receiving chemotherapy. METHODS: Patients were randomly assigned to either the BZYQP-placebo or placebo-BZYQP groups. The BZYQP-placebo group received BZYQP for 1-2 d before the first cycle of chemotherapy and contin…

The effects of mindfulness training on emotion and sleep quality in patients with colorectal cancer.

Scientific reports · 2025 · PMID 41339418

To explore the effects of mindfulness training on emotion and sleep quality in patients with colorectal cancer. A total of 44 patients diagnosed with colorectal cancer from a hospital in Chongqing were recruited between August 2021 and April 2023. These participants were randomly assigned to either a training group or a waiting group using a single-blind method. To evaluate emotions, mindfulness levels, and sleep quality, the Positive and Negative Emotion Scale, the Mindfulness Awareness Scale, and the Pittsburgh S…

Cost-Effectiveness of Pelvic Floor Reconstruction Using Biological Mesh After Extralevator Abdominoperineal Resection for Rectal Cancer.

Diseases of the colon and rectum · 2026 · PMID 42290606

BACKGROUND: Perineal complications are a major source of morbidity after extralevator abdominoperineal resection for low rectal cancer, especially after neoadjuvant (chemo)radiotherapy. Biological mesh reconstruction can reduce perineal hernia formation, but its cost-effectiveness remains unclear. OBJECTIVE: To evaluate the cost-effectiveness of biological mesh reconstruction compared with primary perineal closure after extralevator abdominoperineal resection in patients with low rectal cancer. DESIGN: This study w…

Empowering the Caregiving Experience: A Positive Psychotherapy-Based Psychoeducational Intervention for Caregivers of Oncology Patients.

Seminars in oncology nursing · 2026 · PMID 42414116

OBJECTIVES: This study aimed to examine the effect of a psychoeducational intervention based on the Positive Psychotherapy Balance Model on balanced living, psychological well-being, and self-efficacy among caregivers of patients diagnosed with colorectal cancer. METHODS: This study employed a randomized controlled trial with repeated measures (pretest, posttest, and follow-up). A total of 38 caregivers of patients with colorectal cancer were included. Nineteen caregivers in the intervention group received a struct…

Assessing the Effects of Yoga on Cognition and Immune Function in Colorectal Cancer: A Feasibility Study.

Cancer nursing · 2026 · PMID 39964165

BACKGROUND: Cancer-related cognitive impairment can interfere with daily functioning and negatively affect quality of life. To date, there are no validated treatments. Yoga may be a promising intervention that combines physical activity and meditation to improve cognition. OBJECTIVES: The aim of this study was to assess the feasibility of a randomized controlled trial with yoga, physical activity, and waitlist control arms in colorectal cancer survivors, determine effect sizes, and explore differences among groups.…

Adaptive anastomosis for anterior resection in sigmoid and proximal rectal cancer or premalignant lesions: protocol for a multicentre, non-randomised, clinical effectiveness trial (ADAPT).

Digestive surgery · 2026 · PMID 42623320

INTRODUCTION: Anastomotic leakage (AL) after colorectal surgery is an impactful complication, associated with increased morbidity and reduced quality of life. The circular stapler commonly used for anterior resections (AR), introduces risks of cross-stapling, dog-ears, overcompression, and foreign body response, all associated with AL. An adaptive anastomosis technique eliminates these risk factors, potentially lowering the incidence of AL. METHODS: The ADAPT trial is an international multicentre, non-randomised, p…

The Danish randomized trial of trifluridine-tipiracil and bevacizumab in metastatic colorectal cancer: final survival and post hoc neutropenia and quality-of-life analyses.

ESMO gastrointestinal oncology · 2026 · PMID 42583256

BACKGROUND: In 2020, we published the first randomized trial demonstrating the efficacy of trifluridine-tipiracil (FTD-TPI) with bevacizumab compared with FTD-TPI monotherapy in chemorefractory metastatic colorectal cancer. This study aims to: (i) analyze final survival data, (ii) perform post hoc analyses of the prognostic role of chemotherapy-induced neutropenia (CIN), and (iii) assess time to deterioration of performance status (PS) as a measure associated with quality of life in post hoc analyses. MATERIALS AND…

Short-Course Radiotherapy Combined With CapeOx and PD-1 Inhibitor Following Local Excision in High-Risk Early Rectal Cancer: Study Protocol for a Prospective Phase II Trial (TORCH-LE).

Clinical Medicine Insights. Oncology · 2026 · PMID 42571219

BACKGROUND: Local excision (LE) has emerged as an organ-preserving option for patients with early rectal cancer, but high-risk pathological features significantly increase the risk of local recurrence. When completion total mesorectal excision (TME) is refused or medically unfeasible, combining radiotherapy, chemotherapy, and immunotherapy offers an adjuvant organ-preservation strategy in microsatellite-stable (MSS) rectal cancer. OBJECTIVES: The TORCH-LE trial aims to evaluate the efficacy and safety of combining …

PROSPER: a phase III trial of lecithinized superoxide dismutase to prevent oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer.

ESMO gastrointestinal oncology · 2026 · PMID 42583153

BACKGROUND: Oxaliplatin-based chemotherapy is a standard adjuvant therapy for stage II or stage III colorectal cancer (CRC); however, its use is limited by chemotherapy-induced peripheral neuropathy (CIPN), which reduces the quality of life of patients and often persists for months or years after chemotherapy ends. Compared with superoxide dismutase (SOD), lecithinized SOD (PC-SOD) exhibits much longer stability in plasma, thus reducing oxidative stress, which is a key mechanism of CIPN. A randomized phase II trial…

Risk of lymph-node metastasis in early onset T1 colorectal cancer: a systematic review and meta-analysis.

Journal of gastroenterology · 2026 · PMID 42371097

BACKGROUND: Despite the increasing incidence of early onset T1 colorectal cancer (T1 CRC), its features remain poorly understood. We examined whether early onset T1 CRC is associated with a higher rate of lymph-node metastasis (LNM). METHODS: We included studies reporting age-specific LNM rates for patients aged < 50 and ≥ 50 years. Sensitivity analyses were performed to assess the impact of overlapping and selected subset datasets. Subgroup analyses were conducted to evaluate the association between clinicopatholo…

Novel Technologies for Gastrointestinal Cancer Detection: A Systematic Review and Meta-Analysis of Diagnostic Accuracy.

Clinical and translational gastroenterology · 2026 · PMID 42242200

INTRODUCTION: Gastrointestinal (GI) cancers account for a quarter of all cancers and one-third of cancer-related deaths worldwide. Novel diagnostic approaches are crucial to enhance early detection and improve patient outcomes. This review systematically identified and evaluated novel GI cancer detection approaches. METHODS: A systematic review was conducted using PubMed, EMBASE, Scopus, and the Cochrane Library on December 11, 2024, and updated on June 2, 2025. Cohort studies and randomized controlled studies, pub…

Systematic Review and Meta-Analysis of Resection Sequence in Synchronous Colorectal Liver Metastasis: Primary vs. Liver First.

Journal of surgical oncology · 2026 · PMID 42296400

BACKGROUND: This present systematic review and meta-analysis aims to compare overall survival (OS), disease-free survival (DFS), morbidity and mortality outcomes in patients undergoing colorectal first (CRf) versus liver first (Lf) resections with synchronous colorectal liver metastases. METHODOLOGY: A literature search was performed in PubMed, Cochrane Central trials register, and Google Scholar databases. This was conducted in line with current PRISMA guidelines. 95% confidence intervals were calculated for the p…

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

Comparison of Functional Outcomes Between Robotic and Laparoscopic Surgery in Rectal Cancer Patients: Systematic Review and Meta-Analysis.

Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026 · PMID 42037577

BACKGROUND: Robotic and laparoscopic approaches are widely used for rectal cancer surgery. Although robotic systems provide enhanced visualization and dexterity, it remains unclear whether these advantages improve postoperative urinary and sexual function. METHODS: MEDLINE, Embase, Web of Science, and CENTRAL (2000-2025) were searched for studies comparing robotic and laparoscopic rectal cancer surgery. Outcomes included postoperative ileus, urinary retention, and urinary and sexual function. Random-effects meta-an…

Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis.

Computer assisted surgery (Abingdon, England) · 2026 · PMID 41454717

Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rate…

Prevalence and risk factors of low anterior resection syndrome: Meta-analysis with Subgroup Analysis.

La Tunisie medicale · 2026 · PMID 42578777

BACKGROUND: The prevalence of major LARS and its associated risk factors remains variably reported in the literature. This meta-analysis aimed to assess the pooled prevalence of major LARS and to identify its predictive factors. METHODS: We conducted a meta-analysis in accordance with PRISMA 2020 and AMSTAR 2 guidelines to identify studies reporting the prevalence of major LARS or its associated risk factors. Subgroup analyses was used to explain heterogeneity. RESULTS: A total of 21 studies comprising 3,730 patien…

Comparative effectiveness of preoperative prehabilitation modalities for postoperative recovery in colorectal cancer: A systematic review and network meta-analysis.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026 · PMID 42263810

BACKGROUND: Preoperative prehabilitation has been increasingly incorporated into perioperative care for colorectal cancer (CRC), yet the comparative effectiveness of different prehabilitation modalities remains unclear. This study aimed to compare the relative effects of major preoperative prehabilitation models on postoperative recovery in patients who undergo surgery for CRC. METHODS: A systematic review and network meta-analysis (NMA) were conducted by searching PubMed, Embase, the Cochrane Central Register of C…

A Comprehensive Evaluation of the Effectiveness and Safety of Pembrolizumab for the Treatment of Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.

Current cancer drug targets · 2026 · PMID 40277063

AIM: This comprehensive assessment and quantitative synthesis aimed to assess the effectiveness and safety profile of pembrolizumab, an antagonist of the programmed cell death protein 1 [PD-1] pathway, for individuals with metastatic colorectal carcinoma (mCRC). METHODS: A comprehensive search of scholarly articles was performed using the PubMed and Web of Science [WOS] databases from January 2015 to August 2024. The scope of the search was limited to randomized controlled trials and clinical studies that reported …

Adjuvant aspirin for colorectal cancer with PIK3CA-mutated and COX-2 overexpressed tumours: the ASCOLT translational research study and meta-analysis.

EBioMedicine · 2026 · PMID 42475879

BACKGROUND: ASCOLT compared adjuvant aspirin versus (vs) placebo in 1587 patients with colorectal cancer (CRC) and reported no significant improvement in disease-free survival (DFS). Subsequently, two randomised controlled trials (RCTs) reported benefit of adjuvant aspirin in CRC patients with somatic PI3K-related mutations. METHODS: The ASCOLT Translational Research (TR) study was a preplanned subgroup analysis by PIK3CA mutation status and COX-2 overexpression, and an exploratory analysis including PTEN mutation …

Complete Mesocolic Excision Versus D2 Lymphadenectomy for Right Colon Cancer: A Bayesian Meta-Analysis of Randomized Trials Assessing Surgical and Perioperative Outcomes.

Journal of laparoendoscopic & advanced surgical techniques. Part A · 2026 · PMID 41841469

INTRODUCTION: Complete mesocolic excision (CME) may increase lymph node retrieval and provide a more complete oncologic excision compared with D2 dissection, although its perioperative safety remains uncertain. This systematic review and Bayesian meta-analysis compared clinical and operative outcomes between CME and D2 in right colectomy. METHODS: PubMed, EMBASE, and Cochrane Central were searched through November 2025. Randomized controlled trials comparing CME with D2 were included. Frequentist analyses used rand…

Effect of Digital Health Interventions on the Nutritional Status and Quality of Life of Patients With Colorectal Cancer: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Journal of medical Internet research · 2026 · PMID 42613928

BACKGROUND: Digital health interventions may improve clinical outcomes in patients with colorectal cancer (CRC), but their impact on nutritional status (NS) and quality of life (QoL) remains unclear. OBJECTIVE: This study systematically evaluated the impact of digital health interventions on the NS and QoL in patients with CRC. METHODS: A systematic search was performed across PubMed, Embase, Cochrane, and Web of Science from inception to March 2026 to identify randomized controlled trials evaluating digital health…

Comparative efficacy and safety of nivolumab-based combination therapies (with ipilimumab or binimetinib) in patients with microsatellite-stable and microsatellite-instability-high metastatic colorectal cancer: a systematic review and meta-analysis.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026 · PMID 41934582

BACKGROUND: Colorectal cancer (CRC) is the third most frequently diagnosed malignancy worldwide and the second leading cause of cancer-related mortality. Despite immune checkpoint inhibitors improving outcomes for patients with microsatellite instability high (MSI-H) CRC, their effectiveness against microsatellite-stable (MSS) cancers remains restricted. Nivolumab-based combination regimens, which include ipilimumab or binimetinib as components, have shown potential to improve treatment results, but existing studie…

Comparative Performance of Image-Enhanced Endoscopy for Adenoma and Sessile Serrated Lesion Detection: A Network Meta-Analysis.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026 · PMID 42608031

BACKGROUND AND AIMS: Image-enhanced endoscopy (IEE) technologies have been developed to improve colorectal polyp detection, but their comparative efficacy remains uncertain. We performed a network meta-analysis to compare the efficacy of major IEE modalities on colorectal polyp detection. METHODS: We searched MEDLINE, Embase, and CENTRAL for randomized controlled trials comparing seven IEE modalities (autofluorescence imaging, blue-light imaging, flexible spectral imaging color enhancement, i-scan, linked color ima…

Robotic versus laparoscopic resection for transverse colon and splenic flexure cancer: a systematic review and meta-analysis.

Journal of robotic surgery · 2026 · PMID 42645693

Transverse colon and splenic flexure cancer resections are technically demanding because of variable vascular anatomy, multiquadrant dissection, and proximity to the pancreas and spleen. This systematic review and meta-analysis compared robotic and laparoscopic outcomes and separately summarized published robotic experience. MEDLINE/PubMed, Embase/Ovid, Scopus, and the Cochrane Database of Systematic Reviews were searched through 18 July 2026. Six non-randomized comparative studies included 167 robotic and 296 lapa…

Oncologic Outcomes After Liver Transplantation for Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-Analysis of Proportions.

Journal of surgical oncology · 2026 · PMID 42306995

Liver transplantation has emerged as a therapeutic option for highly selected patients with unresectable colorectal liver metastases (CRLM). This review evaluated oncologic and perioperative outcomes in 92 patients who underwent transplantation. One- and 3-year overall survival (OS) were 96.32% and 73.07%, respectively. Disease-free survival (DFS) was lower, with high rates of recurrence. Major complications occurred in 39.36%, and 90-day mortality was 1.03%. Further randomized studies are needed to better define t…

Different Acupuncture Combined With Three-Step Analgesic Therapy in the Treatment of Bone Metastatic Cancer Pain: A Network Meta-Analysis Based on Randomized Controlled Trials.

Pain research & management · 2026 · PMID 42684261

BACKGROUND: Cancer pain (CP) is predominantly caused by bone metastases, imposing a significant burden on both patients and society. The limitations of the three-step analgesic (TSA) therapy in managing CP have become increasingly evident. Although acupuncture demonstrates promising therapeutic effects for this condition, there is currently limited research comparing the efficacy of different acupuncture modalities. RESULTS: A total of 20 studies were included, involving 1640 patients. The tumor types included lung…

Text Messaging Versus Postal Reminders to Improve Participation in a Colorectal Cancer Screening Program: Randomized Controlled Trial.

JMIR mHealth and uHealth · 2025 · PMID 39742454

BACKGROUND: Mobile phone SMS text message reminders have shown moderate effects in improving participation rates in ongoing colorectal cancer screening programs. OBJECTIVE: This study aimed to assess the effectiveness of SMS text messages as a replacement for routine postal reminders in a fecal immunochemical test-based colorectal cancer screening program in Catalonia, Spain. METHODS: We conducted a randomized controlled trial among individuals aged 50 to 69 years who were invited to screening but had not completed…

Changes in quality of life in colorectal cancer screening: A multicentre trial in populations in China.

Journal of medical screening · 2026 · PMID 41816867

ObjectiveEvidence is scarce about whether colorectal cancer screening can affect the quality of life of participants, particularly in terms of novel screening strategies in Eastern populations.MethodsFrom 2018 to 2021, the TARGET-C trial randomly allocated 19,373 participants to one of three screening strategies: (A) one-time colonoscopy; (B) annual faecal immunochemical test with positives referred for colonoscopy; and (C) annual risk-adapted screening with low-risk participants referred for faecal immunochemical …

Effects of Prehabilitation by Physical Activity on Fatigue After Surgery for Colorectal Cancer. Results From Secondary Analyses in the Randomized Controlled Trial PHYSSURG-C.

Cancer medicine · 2026 · PMID 42568293

OBJECTIVE: The objective of this study is to explore effects on self-reported fatigue at 4 weeks and 12 months after surgery in patients with colorectal cancer undergoing a pre- and postoperative exercise intervention compared to standard care in a randomized trial. BACKGROUND: Fatigue after cancer surgery is common and evidence suggests it could be alleviated by physical activity. In this post hoc exploratory study, we analyzed fatigue and other secondary outcomes from a randomized trial aimed at exploring if preh…

Total Neoadjuvant Therapy With Long-Course Radiotherapy Versus Chemoradiotherapy in High-Risk Locally Advanced Rectal Cancer (TNTCRT): A Multicenter, Randomized, Phase III Trial.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42492015

PURPOSE: High-risk locally advanced rectal cancer (LARC) carries a substantial risk of distant recurrence, which limits disease-free survival (DFS). We compared total neoadjuvant therapy (TNT) integrating long-course radiotherapy (LCRT) with uninterrupted doublet chemotherapy (doublet-LC TNT) versus conventional neoadjuvant chemoradiotherapy (nCRT). METHODS: In this multicenter, randomized, phase III trial, patients with stage II/III LARC and at least 1 high-risk feature (cT4a-b, cN2, mesorectal fascia involvement,…

First-line anlotinib versus bevacizumab plus CapeOX in RAS/BRAF wild-type unresectable metastatic colorectal cancer (ANCHOR): a multicenter, prospective, randomized, phase 3 trial.

Signal transduction and targeted therapy · 2026 · PMID 42675036

Bevacizumab plus chemotherapy is the standard first-line therapy for metastatic colorectal cancer (mCRC). To date, no phase 3 trial has compared first-line oral multitargeted TKI versus bevacizumab plus chemotherapy in RAS/BRAF wild-type mCRC. The open-label, noninferiority, randomized, phase 3 trial (ANCHOR; NCT04854668; CTR20210940) evaluated first-line anlotinib versus bevacizumab plus oxaliplatin and capecitabine (CapeOX) in this setting. Patients were centrally randomized (1:1) to receive 4-8 cycles of CapeOX …

Neuroprotection and prevention of oxaliplatin-induced neuropathy with Huangqi Guizhi Wuwu Decoction: a 12-center randomized, double-blind trial with mechanistic validation.

Phytomedicine : international journal of phytotherapy and phytopharmacology · 2026 · PMID 42435525

BACKGROUND: Oxaliplatin-induced peripheral neuropathy (OIPN) affects up to 80% of patients receiving oxaliplatin-based chemotherapy, and effective preventive strategies remain limited. Huangqi Guizhi Wuwu Decoction (HQGZWWD), a traditional Chinese herbal formula included in China's National Classic Famous Formulas, is widely used for OIPN in clinical practice, but high-quality clinical evidence remains lacking. PURPOSE: This study evaluated the efficacy and safety of HQGZWWD for OIPN prevention and explored its neu…

The Impact of Prehabilitation on Postoperative Outcomes in Colorectal Cancer: A Meta-Analysis of Randomized Controlled Trials.

Journal of the American Medical Directors Association · 2026 · PMID 41698408

OBJECTIVES: To evaluate the impact of preoperative prehabilitation on physical functional recovery, postoperative complications, and length of hospital stay (LOS) in patients undergoing elective colorectal cancer surgery. DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING AND PARTICIPANTS: A total of 11 RCTs involving 976 adult patients scheduled for elective colorectal cancer resection were included. METHODS: A systematic literature search was conducted in PubMed, Web of Sc…

Comparative efficacy and safety of pharmacokinetically guided and body surface area-based 5-fluorouracil dosing in colorectal cancer: a systematic review and meta-analysis.

European journal of clinical pharmacology · 2026 · PMID 42687040

BACKGROUND: Body surface area (BSA)-based 5-fluorouracil (5-FU) dosing remains the standard in colorectal cancer despite substantial interpatient pharmacokinetic variability, which may lead to underexposure, treatment failure, or severe toxicity. This systematic review and meta-analysis evaluated whether pharmacokinetically guided 5-FU dosing improves efficacy and safety compared with conventional BSA-based dosing. METHODS: PubMed/MEDLINE, Embase, and Scopus databases were searched from inception to the final searc…

Executive Summary of the American Radium Society on Appropriate Use Criteria for Nonoperative Management of Rectal Adenocarcinoma: Systematic Review and Guidelines.

International journal of radiation oncology, biology, physics · 2024 · PMID 38797496

For patients with rectal cancer, the standard approach of chemotherapy, radiation therapy, and surgery (trimodality therapy) is associated with significant long-term toxicity and/or colostomy for most patients. Patient options focused on quality of life (QOL) have dramatically improved, but there remains limited guidance regarding comparative effectiveness. This systematic review and associated guidelines evaluate how various treatment strategies compare to each other in terms of oncologic outcomes and QOL. Cochran…

Sexual dysfunction outcomes and reporting disparities after multimodal treatment for rectal cancer: A systematic review and narrative synthesis.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42665960

BACKGROUND: Sexual dysfunction is a recognised adverse outcome after rectal cancer treatments, yet reporting is predominantly male-focused, with female sexual dysfunction less consistently assessed or reported. This systematic review aimed to assess sexual health domains studied, examine sex-based reporting disparities, and identify limitations in the current evidence. METHODS: A systematic review and narrative synthesis were conducted in accordance with PRISMA and registered with PROSPERO (CRD420251178502). PubMed…

Body mass index, adjuvant chemotherapy, toxicity, and survival in non-metastatic colorectal cancer: an individual participant data meta-analysis (OCTOPUS).

British journal of cancer · 2026 · PMID 42265335

INTRODUCTION: We aimed to disentangle whether elevated body mass index (BMI) is directly associated with adverse survival in primary colorectal cancer (CRC), or indirectly through treatment-related mechanisms, e.g., dose-capping adjuvant chemotherapy (ACT) and toxicity, using individual participant data meta-analysis (IPD-MA) and causal inference approaches. METHODS: Using BMI from four CRC-ACT randomised trials [OCTOPUS], and two ACT adherence measures (average cumulative relative dose [ACRD]; average relative dos…

Comparison of Functional Outcomes Between Robotic and Laparoscopic Surgery in Rectal Cancer Patients: Systematic Review and Meta-Analysis.

Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026 · PMID 42037577

BACKGROUND: Robotic and laparoscopic approaches are widely used for rectal cancer surgery. Although robotic systems provide enhanced visualization and dexterity, it remains unclear whether these advantages improve postoperative urinary and sexual function. METHODS: MEDLINE, Embase, Web of Science, and CENTRAL (2000-2025) were searched for studies comparing robotic and laparoscopic rectal cancer surgery. Outcomes included postoperative ileus, urinary retention, and urinary and sexual function. Random-effects meta-an…

Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis.

Computer assisted surgery (Abingdon, England) · 2026 · PMID 41454717

Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rate…

Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.

European journal of gastroenterology & hepatology · 2026 · PMID 41784442

Colonoscopy remains the gold standard for early detection and prevention of colorectal cancer, with adequate bowel cleansing being pivotal for its success. This systematic review aims to evaluate the efficacy and safety of split-dose ultra-low-volume polyethylene glycol (PEG) with ascorbic acid (Asc) versus sodium picosulfate magnesium citrate for bowel preparation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive literature search across Emba…

First-line anlotinib versus bevacizumab plus CapeOX in RAS/BRAF wild-type unresectable metastatic colorectal cancer (ANCHOR): a multicenter, prospective, randomized, phase 3 trial.

Signal transduction and targeted therapy · 2026 · PMID 42675036

Bevacizumab plus chemotherapy is the standard first-line therapy for metastatic colorectal cancer (mCRC). To date, no phase 3 trial has compared first-line oral multitargeted TKI versus bevacizumab plus chemotherapy in RAS/BRAF wild-type mCRC. The open-label, noninferiority, randomized, phase 3 trial (ANCHOR; NCT04854668; CTR20210940) evaluated first-line anlotinib versus bevacizumab plus oxaliplatin and capecitabine (CapeOX) in this setting. Patients were centrally randomized (1:1) to receive 4-8 cycles of CapeOX …

Antibiotic exposure and cancer risk: an umbrella review elucidating the direction of risk across 14 malignancies.

Journal of public health (Oxford, England) · 2026 · PMID 42361054

BACKGROUND: Antibiotics are among the most frequently prescribed medications worldwide. However, previous studies have yielded inconsistent findings regarding the association between antibiotic exposure and the risk of various cancers, and the credibility of the available evidence remains uncertain. METHODS: We conducted an umbrella review based on published meta-analyses and systematic reviews to evaluate the association between past or current antibiotic exposure and cancer risk. PubMed, Embase, Cochrane Library,…

Underwater versus conventional endoscopic mucosal resection for ≥10 mm sessile or flat colorectal polyps: A systematic review and meta-analysis.

PloS one · 2024 · PMID 38451998

BACKGROUND AND AIM: Underwater endoscopic mucosal resection (UEMR) has been an emerging substitute for conventional EMR (CEMR). This systematic review and meta-analysis aimed at comparing the efficiency and safety of the two techniques for removing ≥10 mm sessile or flat colorectal polyps. METHODS: PubMed, Cochrane Library and Embase databases were searched up to February 2023 to identify eligible studies that compared the outcomes of UEMR and CEMR. This meta-analysis was conducted on the en bloc resection rate, R0…

Preclinical efficacy of drug delivery systems in colon cancer therapy: a systematic review and meta-analysis of in vivo animal studies.

Journal of the Egyptian National Cancer Institute · 2026 · PMID 42156606

BACKGROUND: Drug delivery systems (DDS) offer a promising strategy to enhance the therapeutic index of chemotherapeutic agents in colon cancer by improving tumor targeting, circulation time, and controlled drug release. Despite extensive preclinical research, a quantitative synthesis evaluating the efficacy of DDS and the influence of design parameters remains lacking. METHODS: We conducted a systematic review and meta-analysis of preclinical in vivo studies assessing DDS-based chemotherapy in murine models of colo…

Aspirin after completion of standard adjuvant therapy for colorectal cancer (ASCOLT): A systematic review and meta-analysis.

American journal of surgery · 2026 · PMID 42275677

BACKGROUND: Colorectal cancer (CRC) carries a high recurrence risk. Aspirin has been proposed for secondary prevention, but its benefit remains uncertain. This systematic review and meta-analysis evaluated aspirin's impact on disease-free survival (DFS) and overall survival (OS). METHODS: A systematic search of four databases (PubMed, Embase, Scopus, the Cochrane Library) was conducted from inception to January 2025 using predefined inclusion and exclusion criteria. Screening and data extraction were performed inde…

Antidepressant use and colorectal cancer risk: A systematic review and meta-analysis of epidemiological studies.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2026 · PMID 42143914

We conducted a systematic search of observational studies published up to March 2026 in PubMed, Embase, and Web of Science. Meta-analyses were performed using robust variance estimation to pool adjusted estimates from included studies. Subgroup analyses were conducted to explore variations in risk by type of antidepressant (AD), study design, and geographic region. Dose-response analysis assessed the relationship between dose levels and colorectal cancer (CRC) risk. Fifteen studies involving millions of participant…

A randomized controlled superiority trial of 1 L (Plenvu) versus 2 L (Moviprep) polyethelene glycol plus ascorbate in a FIT-based colorectal cancer screening setting (PLEMO).

BMC gastroenterology · 2026 · PMID 42163134

BACKGROUND: Sufficient cleansing of the colonic mucosa is of great importance during colonoscopy emphasizing the need for effective preparation agents. Studies evaluating the efficacy of a novel 1 L polyethylene glycol with ascorbate (1 L-PEG-Asc), Plenvu®, versus standard 2 L polyethylene glycol with ascorbate (2 L-PEG-Asc), Moviprep®, have shown promising results regarding bowel cleansing. Nonetheless superiority of 1 L-PEG-Asc has not been shown. METHODS: In this single-center randomized controlled superiority t…

Submucosal Lidocaine Injection in Colonic Endoscopic Submucosal Dissection: A Single-Center, Double-Blind, Randomized Controlled Trial.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026 · PMID 42666074

OBJECTIVES: Colonic spasm is one of the major technical challenges encountered during colonic endoscopic submucosal dissection (ESD), impairing visualization of the dissection plane and scope maneuverability. Submucosal lidocaine injection may help to overcome this challenge. This study aimed to evaluate the efficacy and safety of submucosal lidocaine injection during colonic ESD. METHODS: In this single-center, double-blind, randomized controlled trial, 110 patients scheduled for colonic ESD were randomly assigned…

Effect of a multimodal bundled intervention on quality of recovery after laparoscopic colorectal cancer surgery: a single-center, single-blind, pragmatic randomized controlled trial.

World journal of surgical oncology · 2026 · PMID 42310736

BACKGROUND: Despite the minimally invasive nature of laparoscopic colorectal surgery, postoperative recovery is frequently compromised by pain, fatigue, and delayed gastrointestinal function. Current rehabilitation strategies largely rely on unimodal approaches, and evidence for structured multimodal bundled interventions is limited. This study aimed to evaluate whether a multimodal bundled intervention comprising electroacupuncture, abdominal massage, structured breathing training, and symptom-titrated supervised …

Effectiveness of Electrocautery, Topical Cidofovir, and Topical Sinecatechins for the Treatment of Anal High-Grade Squamous Intraepithelial Lesions in Persons With HIV: An Open-Label, Randomized Controlled Trial.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025 · PMID 40036375

BACKGROUND: Doubts remain about the best treatment for managing premalignant lesions (high-grade squamous intraepithelial lesions [HSIL]) associated with anal cancer. METHODS: The TREATAIN trial was an open-label, randomized study conducted at Hospital Vall d'Hebron (Spain). Persons with human immunodeficiency virus and anal HSIL were randomly assigned 1:1:1 to receive treatment with electrocautery, topical cidofovir 1% ointment, or topical sinecatechins 10%. The primary outcome was histological resolution of HSIL.…

Clinical efficacy and safety evaluation of Buzhongyiqi pills on appetite improvement in patients with colorectal cancer receiving chemotherapy: a pilot randomized cross-over clinical trial.

Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2024 · PMID 39617711

OBJECTIVE: To evaluate the clinical efficacy and safety of Buzhongyiqi pills (BZYQP, ) in improving the appetite of patients with colorectal cancer (CRC) receiving chemotherapy. TRIAL DESIGN: A pilot, randomized, single-blind cross-over clinical trial was conducted on diagnosed stage II-IV CRC patients receiving chemotherapy. METHODS: Patients were randomly assigned to either the BZYQP-placebo or placebo-BZYQP groups. The BZYQP-placebo group received BZYQP for 1-2 d before the first cycle of chemotherapy and contin…

Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25 mm nonpedunculated colorectal polyps: a randomized controlled trial.

European journal of gastroenterology & hepatology · 2026 · PMID 42065991

BACKGROUND AND AIMS: Modified endoscopic mucosal resection (EMR) techniques using a snare tip, precutting EMR (P-EMR) and anchoring EMR (A-EMR), have been developed for the effective resection of nonpedunculated colorectal polyps measuring 10-25 mm. Although previous studies have compared either P-EMR or A-EMR with conventional EMR, no study has directly compared these two snare tip-assisted techniques within modified EMR. This study aimed to evaluate P-EMR and A-EMR in terms of the R0 resection rate and procedure …

Randomized phase-II trial of surufatinib plus FOLFOX/FOLFIRI versus FOLFOXIRI as second-line therapy for metastatic colorectal cancer.

Annals of medicine · 2026 · PMID 42421558

BACKGROUND: Second-line treatment for metastatic colorectal cancer (mCRC) typically involves oxaliplatin- or irinotecan-based doublet chemotherapy with or without anti-angiogenic antibodies. Triplet regimens such as FOLFOXIRI have demonstrated synergy and improved efficacy as first-line therapy. Surufatinib, an oral multi-kinase inhibitor targeting VEGFR1-3, FGFR1, and CSF-1R, may enhance chemotherapy efficacy. We evaluated surufatinib combined with doublet (FOLFOX/FOLFIRI) versus triplet (FOLFOXIRI) chemotherapy a…

Prophylactic endoluminal vacuum-assisted therapy in high-risk ultra-low rectal anastomoses: a retrospective comparative study of feasibility and clinical outcomes.

BMC surgery · 2026 · PMID 42661182

BACKGROUND: Anastomotic leakage (AL) remains a major cause of morbidity and mortality after ultra-low anterior resection (uLAR) for rectal cancer, when the anastomosis is located ≤ 5 cm from the anal verge, in patients with additionally risk factors. This study proposes the prophylactic endoluminal vacuum-assisted therapy (pEVAT) as a feasible strategy that may reduce AL incidence and promote healing in this subgroup of patients. METHODS: Thirty-three patients multiple established risk factors for AL who underwent …

An albumin-based immune-nutritional score for predicting complete response, organ preservation, and toxicity after neoadjuvant PD-1-based therapy in low rectal cancer.

Frontiers in immunology · 2026 · PMID 42597332

BACKGROUND: Programmed death-1 (PD-1) inhibitors are increasingly used in neoadjuvant therapy for low rectal cancer, but complete response and toxicity remain heterogeneous. We developed and validated an albumin-based immune-nutritional score (ABINS) to capture host factors not reflected by tumor biomarkers. METHODS: This multicenter retrospective study included 480 consecutive patients with low rectal adenocarcinoma (≤5 cm from the anal verge) treated with neoadjuvant PD-1-based therapy at three tertiary centers f…

Neoadjuvant anti-PD-1 monotherapy followed by watch-and-wait strategy in dMMR/MSI-H colorectal cancer: a multicenter real-world study.

Frontiers in immunology · 2026 · PMID 42609473

OBJECTIVE: This study aimed to assess the long-term results of the watch-and-wait (W&W) strategy in patients with clinical stage II/III mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H) colorectal cancer (CRC) who received neoadjuvant anti-PD-1 monotherapy. METHODS: This retrospective study enrolled stage II/III dMMR/MSI-H CRC patients from four Chinese tertiary hospitals between August 1, 2020 and February 28, 2025. All participants received neoadjuvant anti-PD-1 monotherapy followed by …

Associations of Outdoor Air Pollution With Incidence of Cancers Other Than Lung Cancer in a Large US Prospective Cohort.

International journal of cancer · 2026 · PMID 42071337

Outdoor air pollution, including particulate matter (PM), is a Group 1 carcinogen based on evidence for lung cancer; however, evidence for other cancers is limited. Further research on cancer incidence rather than mortality endpoints is needed as well as examinations in non-smokers. In the Cancer Prevention Study-II Nutrition Cohort, annual predictions of particulate and gaseous pollutant concentrations were assigned to residential addresses. Extended Cox regression estimated hazard ratios (HR) and 95% confidence i…

Predicting severe toxicities and mortality in older patients with colorectal cancer: An analysis of 3 clinical trials and 3 prospective cohorts.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42456539

INTRODUCTION: Patients over 75 years old account for 40% of incident colorectal cancer (CRC) cases. Predicting chemotherapy (CT)-related toxicities is crucial for guiding treatment decisions. This study aimed to identify predictors of severe toxicities (ST) after 3 months of CT in older CRC patients; the secondary endpoint was 36-month mortality. MATERIALS AND METHODS: We analyzed three prospective cohorts and three trials involving patients aged ≥ 75 years. ST was defined as grade ≥ 3 toxicity. Multivariable logis…

Preclinical characterization and phase I results of TQB2102, a first-in-class HER2 biparatopic antibody-drug conjugate, in patients with advanced solid tumors.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 42142622

BACKGROUND: TQB2102 is a next-generation biparatopic antibody-drug conjugate targeting human epidermal growth factor receptor 2 (HER2) extracellular domain 2 (ECD2) and ECD4 epitopes that is conjugated to a topoisomerase I inhibitor via an enzyme-cleavable linker. This study evaluated the safety, efficacy, and pharmacokinetics of TQB2102 in patients with advanced solid tumors. PATIENTS AND METHODS: In this phase I, multicenter, first-in-human trial, patients with advanced solid tumors were recruited from 12 centers…

Clinical study of pronase for improving visibility and safety in colonoscopy.

Chinese medical journal · 2026 · PMID 42260742

BACKGROUND: This is a multicenter, randomized, double-blind, placebo-controlled interventional clinical study to evaluate the efficacy and safety of pronase in improving visibility in colonoscopy and to evaluate whether pronase can increase the detection rate of intestinal lesions and the colonoscopist's satisfaction. METHODS: From June 2023 to December 2023, a total of 1942 patients undergoing air insufflation colonoscopy in 10 hospitals (The First Medical Center, Chinese PLA General Hospital, et al ) were selecte…

Short-term linaclotide plus polyethylene glycol in patients at increased risk of inadequate bowel preparation: A randomized, double-blind, multicenter trial.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026 · PMID 41692643

BACKGROUND AND AIM: The benefit of combining linaclotide with polyethylene glycol (PEG) for improving bowel preparation quality and adenoma detection in patients at risk for inadequate bowel preparation remains uncertain. This study aimed to evaluate its efficacy and safety. METHODS: From August 2022 to July 2023, a multicenter, randomized trial assigned participants to a 2-day linaclotide or placebo plus PEG regimen. The primary endpoints included adequate bowel preparation rate and mean number of adenomas detecte…

Chemotherapy for patients with circulating tumour DNA-positive, stage II colon cancer (CIRCULATE)-an AIO/ABCSG trial.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 42225236

BACKGROUND: Adjuvant chemotherapy provides limited benefit in unselected stage II colon cancer. Post-operative circulating tumour DNA (ctDNA) has higher prognostic value than classical clinical markers, with ctDNA positivity indicating an unfavourable outcome. PATIENTS AND METHODS: Patients with Union for International Cancer Control stage II, mismatch repair proficient/microsatellite stable colon cancer were tested for ctDNA using an academic, tumour-informed, next-generation sequencing-based test. ctDNA-positive …

Dynamic ctDNA Monitoring Guides Early Treatment Intensification in Locally Advanced Rectal Cancer Undergoing Neoadjuvant Chemotherapy.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41556959

PURPOSE: Neoadjuvant chemotherapy (NCT) has been accepted as the standard management for locally advanced rectal cancer (LARC) without high-risk factors. However, many patients experience poor pathologic response, necessitating early-prediction tools. We investigated dynamic circulating tumor DNA (ctDNA) analysis for early response monitoring in patients with LARC undergoing NCT. EXPERIMENTAL DESIGN: In this biomarker substudy of the multicenter randomized COPEC trial, 153 patients with low-/intermediate-risk LARC …

First-line anlotinib versus bevacizumab plus CapeOX in RAS/BRAF wild-type unresectable metastatic colorectal cancer (ANCHOR): a multicenter, prospective, randomized, phase 3 trial.

Signal transduction and targeted therapy · 2026 · PMID 42675036

Bevacizumab plus chemotherapy is the standard first-line therapy for metastatic colorectal cancer (mCRC). To date, no phase 3 trial has compared first-line oral multitargeted TKI versus bevacizumab plus chemotherapy in RAS/BRAF wild-type mCRC. The open-label, noninferiority, randomized, phase 3 trial (ANCHOR; NCT04854668; CTR20210940) evaluated first-line anlotinib versus bevacizumab plus oxaliplatin and capecitabine (CapeOX) in this setting. Patients were centrally randomized (1:1) to receive 4-8 cycles of CapeOX …

Exploratory Analysis of Urinary and Sexual Dysfunction in Patients With Low Anterior Resection Syndrome Undergoing Sacral Neuromodulation: Insights From the SANLARS Trial.

Diseases of the colon and rectum · 2026 · PMID 41538382

BACKGROUND: Limited evidence is available on the effects of sacral neuromodulation on concomitant nondigestive symptoms of low anterior resection syndrome. OBJECTIVE: To assess the impact of sacral neuromodulation on urinary and sexual dysfunction in patients with low anterior resection syndrome. DESIGN: Secondary analysis of a randomized, double-blinded, 2-phased, controlled, multicenter crossover trial (NCT02517853). SETTINGS: Three tertiary hospitals. PATIENTS: Patients with major low anterior resection syndrome…

Optimal endoscopic treatment for rectal neuroendocrine tumors, confirmed after forceps biopsy: a Korean Association for the Study of Intestinal Diseases multicenter, randomized noninferiority trial.

Gastrointestinal endoscopy · 2026 · PMID 41338400

BACKGROUND AND AIMS: Insufficient submucosal lifting because of pretreatment with forceps biopsy frequently complicates endoscopic treatment of rectal neuroendocrine tumors (NETs) and potentially affects procedural outcomes. Despite advances in endoscopic techniques, the optimal approach for achieving R0 resection in such cases remains to be clarified. This study aimed to investigate the optimal endoscopic technique for treating biopsy-proven rectal NETs ≤10 mm. METHODS: A multicenter, randomized noninferiority stu…

Consolidation Chemotherapy After Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer: 7-Year Follow-Up Results of a Randomized Multicenter Trial (KCSG CO 14-03).

International journal of radiation oncology, biology, physics · 2026 · PMID 41548612

PURPOSE: Total neoadjuvant therapy has become the standard treatment for locally advanced rectal cancer. However, the optimal sequence and duration of treatment remain unclear. Hence, the long-term follow-up results from our previous randomized phase 2 trial on consolidation chemotherapy, which demonstrated improved short-term pathologic outcomes, could provide valuable clinical evidence supporting total neoadjuvant therapy. METHODS AND MATERIALS: The KCSG CO 14-03 trial is a multicenter, randomized trial involving…

Prevention of Parastomal Hernia With Funnel-Shaped Intra-Abdominal Mesh vs No Mesh for Rectal Adenocarcinoma Surgery: 3-Year Follow-Up of a Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 42018309

IMPORTANCE: Parastomal hernia (PSH) is one of the most common complications after permanent colostomy, yet there is ongoing debate regarding the effectiveness and indications of preventive measures. OBJECTIVE: To evaluate the effectiveness and safety of funnel-shaped mesh in preventing PSH over a 3-year follow-up period. DESIGN, SETTING, AND PARTICIPANTS: The Chimney Trial was a randomized, single-blinded, multicenter study conducted at 4 university and central hospitals in Finland and 1 central hospital in Sweden.…

Promoting shared decision-making in colorectal cancer screening in primary care: A cluster randomized controlled trial.

PloS one · 2026 · PMID 42263092

INTRODUCTION: In Switzerland, primary care physicians (PCP) prescribe colonoscopy for colorectal cancer (CRC) screening rather than offering a choice between colonoscopy and faecal occult blood test (FOBT). This study evaluated a training program promoting shared decision-making for CRC screening. METHODS: PCP from a research network were randomized 1:1 into intervention or control. The intervention group received study materials, patient decision aids, evidence summary, FOBT sample kit, and personalized feedback o…

Tumor Debulking in Combination With Chemotherapy in Multiorgan Metastatic Colorectal Cancer: The ORCHESTRA Randomized Clinical Trial.

JAMA · 2026 · PMID 41837962

IMPORTANCE: Local therapy, including surgery, radiation, and ablation, is increasingly used in patients with multiorgan metastatic colorectal cancer (mCRC). However, prospective evidence for a survival benefit of tumor debulking is lacking. OBJECTIVE: To investigate whether tumor debulking added to palliative chemotherapy improves survival of patients with multiorgan mCRC. DESIGN, SETTING, AND PARTICIPANTS: This investigator-initiated, open-label, multicenter, randomized clinical trial enrolled patients with multio…

Effect of remimazolam on postoperative delirium in elderly patients undergoing laparoscopic radical resection for colorectal cancer: a randomized controlled trial.

BMC gastroenterology · 2026 · PMID 42215906

BACKGROUND: Our study aimed to compare remimazolam, midazolam, and no sedative on postoperative delirium (POD) incidence, cognitive function, inflammation, and recovery in elderly colorectal cancer (CRC) laparoscopic radical resection patients. METHODS: In this single-center, randomized, double-blind trial, 60 patients aged ≥ 60 years were assigned to the Control, Remimazolam, or Midazolam groups (n = 20 each). Anesthesia included remimazolam (6 mg/kg/h for 5 min), midazolam (0.04 mg/kg) before induction, or no sed…

Assessing the Impact of Media Coverage of the NordICC Trial on Public Perspectives on Colonoscopy for Colorectal Cancer Screening.

Journal of clinical gastroenterology · 2026 · PMID 39907707

INTRODUCTION: Screening tests like colonoscopy can prevent colorectal cancer (CRC), yet their effectiveness is often questioned. The Nordic-European Initiative on Colorectal Cancer (NordICC) trial demonstrated that colonoscopy significantly reduces CRC incidence and mortality in per-protocol analysis. However, media coverage of the trial often focused on intention-to-screen findings that showed no change in mortality, possibly contributing to public confusion about colonoscopy benefits. This study aimed to assess w…

Aspirin for cancer prevention in individuals with Lynch syndrome: first results from the CaPP3 multicentre, randomised, double-blind, non-inferiority trial.

The lancet. Gastroenterology & hepatology · 2026 · PMID 42425127

BACKGROUND: In CAPP2, 600 mg aspirin daily significantly reduced the incidence of colorectal cancer and the incidence of all Lynch syndrome cancers among participants with Lynch syndrome. CaPP3 aimed to assess the efficacy of two lower doses of aspirin. METHODS: CaPP3 was a multicentre, parallel-group, randomised, double-blind, dose non-inferiority trial that compared 100 mg or 300 mg daily aspirin with 600 mg daily aspirin in Lynch syndrome carriers aged older than 18 years; patients were recruited from clinical g…

Predictive Role of Circulating Tumor DNA in Stage III Colon Cancer Treated With Celecoxib: A Post Hoc Analysis of the CALGB (Alliance)/SWOG 80702 Phase 3 Randomized Clinical Trial.

JAMA oncology · 2026 · PMID 41343176

IMPORTANCE: Observational studies have associated use of aspirin and selective cyclooxygenase inhibitors with decreased recurrence and improved survival in patients with colon cancer. While randomized clinical trials have not shown benefit across all patients, these findings suggest that select subgroups may benefit from their use. Despite the well-established prognostic value of circulating tumor DNA (ctDNA), its role in guiding treatment remains unclear. OBJECTIVE: To investigate the predictive value of postopera…

Efficacy of artificial intelligence for adenoma detection in water exchange colonoscopy: a two-center randomized controlled trial.

Endoscopy · 2026 · PMID 40789324

BACKGROUND: Water exchange and artificial intelligence-based computer-aided detection (CADe) separately improve the adenoma detection rate (ADR) and number of adenomas detected per colonoscopy (APC). We aimed to determine whether combining water exchange with CADe enhanced APC versus water exchange alone. METHODS: This randomized controlled trial was conducted at hospitals in Italy and Taiwan using different CADe devices. Patients aged 45–75 years undergoing colonoscopy for screening, surveillance, or positive feca…

Intravenous lidocaine for gastrointestinal recovery after colorectal surgery: the ALLEGRO placebo-controlled randomised trial and cost-effectiveness analysis.

Health technology assessment (Winchester, England) · 2026 · PMID 41731962

BACKGROUND: Delayed return of gut function after colonic resection is a common impediment to early postoperative recovery. Small clinical studies, combined into meta-analyses, have suggested that intravenous lidocaine can improve return of gut function after colorectal surgery. OBJECTIVE(S): To determine the clinical effectiveness and cost-effectiveness of perioperative intravenous lidocaine infusion compared with placebo in return of gut function after elective minimally invasive colonic resection. DESIGN AND METH…

Tumour cell density quantified by artificial intelligence is associated with differential benefit from irinotecan-based chemo-radiotherapy in locally advanced rectal cancer: a post-hoc study of the phase 3 ARISTOTLE trial.

EBioMedicine · 2026 · PMID 42509089

BACKGROUND: Tumour cells and tumour-associated stroma are key components of the tumour microenvironment, and their interaction impacts disease progression and treatment resistance in rectal cancer. This study introduces a computational approach to quantify tumour cell density (TCD) within epithelial and stromal regions and assess whether treatment response differs according to TCD status in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT). METHODS: The data of 414 …

Minimum 18-week chemotherapy improves survival in locally advanced rectal cancer after neoadjuvant radiotherapy: a post hoc analysis of the STELLAR trial.

BMC medicine · 2026 · PMID 41742206

BACKGROUND: The survival benefit of adjuvant chemotherapy after chemoradiotherapy in locally advanced rectal cancer (LARC) remains unproven, whereas total neoadjuvant therapy (TNT) incorporating preoperative chemotherapy has demonstrated improved outcomes. However, the total chemotherapy duration delivered across neoadjuvant and adjuvant phases varies substantially in clinical practice. We investigated the impact of total chemotherapy duration in the STELLAR trial. METHODS: This post hoc analysis was based on the p…

Comparative Oncologic Outcomes of Laparoscopic versus Open Surgery for Early-Onset Low Rectal Cancer: 3-Year Results From the LASRE Trial.

World journal of surgery · 2026 · PMID 42272043

BACKGROUND: Low rectal cancer poses unique surgical challenges due to its anatomy, complicating the balance between radical resection and functional preservation. Early-onset low rectal cancer (EO-LRC, < 50 years) adds complexity: it has distinct, more aggressive biological/clinical features but no age-stratified surgical guidelines. Moreover, laparoscopic surgery's efficacy in EO-LRC is controversial-though non-inferior in general low rectal cancer, EO-LRC's aggressiveness may offset its benefits. This study aims …

Neoadjuvant Chemotherapy vs Upfront Surgery in Patients With Locally Advanced Colon Cancer: A Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 41779406

IMPORTANCE: Locally advanced colon cancer carries a high risk of recurrence. Neoadjuvant chemotherapy has been proposed to improve outcomes, but evidence from phase III trials remains limited. OBJECTIVE: To determine whether neoadjuvant chemotherapy improves disease-free survival (DFS) compared with upfront surgery in patients with locally advanced colon cancer. DESIGN, SETTING, AND PARTICIPANTS: This randomized, open-label, phase III clinical trial conducted from October 14, 2013, to November 27, 2020, with follow…

Cold snare polypectomy for 10-19 mm colorectal adenomas in familial adenomatous polyposis: a prospective randomized controlled trial.

Scandinavian journal of gastroenterology · 2026 · PMID 41736450

BACKGROUND AND AIMS: Evidence for cold snare polypectomy (CSP) in treating 10-19 mm colorectal adenomas in patients with familial adenomatous polyposis (FAP) is limited. This study compared the efficacy and safety of CSP vs. hot snare polypectomy (HSP). METHODS: This prospective non-inferiority randomized controlled trial predefined a non-inferiority margin of 4%. A total of 452 colorectal adenomas (10-19 mm) from 41 FAP patients were enrolled between May 2024 and May 2025 and randomized 1:1 to CSP (n = 220) or HSP…

Accuracy and reliability of preoperative CT in perforated diverticulitis: Post hoc secondary analysis from the SCANDIV trial.

Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society · 2026 · PMID 41692579

BACKGROUND AND AIMS: Undetected cancers and fecal contamination in perforated diverticulitis may lead to failure of laparoscopic lavage. This study aimed to evaluate the diagnostic accuracy of preoperative computed tomography (CT) examinations and the interobserver agreement for detecting colonic malignancy and fecal contamination in patients with perforated diverticulitis. METHODS: This study included 198 patients with suspected perforated diverticulitis from the SCANDIV trial, randomized to laparoscopic lavage or…

Application of one-stitch modified ileostomy in laparoscopic low anterior rectal resection: An open-label, randomized clinical trial.

Surgery · 2026 · PMID 41253074

BACKGROUND: To reduce anastomotic leakage risk, protective ileostomy is commonly used. This study aims to compare the clinical advantages of one-stitch modified ileostomy and conventional ileostomy in patients with rectal cancer. METHODS: This study was designed as a single-center, prospective, randomized, open-label, blinded endpoint (PROBE) trial (Registration No. ChiCTR1900025444). A total of 189 patients were enrolled: 93 cases in the conventional ileostomy group and 96 cases in the one-stitch modified ileostom…

The ILEOSTIM trial: A multicentre randomised controlled trial evaluating the impact of efferent loop stimulation prior to ileostomy reversal on postoperative ileus.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026 · PMID 42092745

BACKGROUND: Strategies to optimise bowel function before stoma reversal surgery (SRS) are needed to improve postoperative outcomes. Efferent bowel stimulation (EBS) prior to stoma closure has been proposed as a potential strategy to reduce postoperative ileus (POI) incidence and improve the patient's postoperative course. METHODS: A multicentre randomised controlled trial was designed to evaluate the effectiveness of pre-SRS EBS in reducing POI incidence. Patients scheduled for elective SRS were randomised 1:1 to e…