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TAS-102 significantly improves overall survival in patients with metastatic colorectal cancer. The most common adverse event of TAS-102 is bone marrow suppression, which leads to neutropenia. The incidence of neutropenia is high, and there is no known effective prevention method. Furthermore, the administration method of TAS-102 is complicated. We reported that neutropenia could be avoided by changing to a simple administration method of TAS-102. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of Tri-staple™ technology and slow firing using the Endo-GIA™ endoscopic linear stapler. Methods: The cardiac and pyloric portions of porcine stomachs were divided using the endoscopic linear stapler with different reload types. A total of 8 min of waiting time was employed during firing in the slow-firing group and no waiting time was employed in the normal-firing group. The shape of the staples was then evaluated. The length of the staple line and serosal laceration was also determined. Results: There was a moderate negative correlation between tissue thickness and secure staple formation. Tri-staple™ reloads (purple, black) offered more secure staple formation compared with Universal green reload. Although slow firing enhanced secure staple formation, its effect was greater when using green reload, compared with Tri-staple™ reloads. Significantly shorter staple line length and longer serosal laceration was observed in the thick tissue. Although the cartridge type did not influence lengths of the staple line or serosal laceration, both were better in the slow-firing group. Conclusions: Tri-staple™ reloads offered more secure staple formation compared with the Universal reload. Although slow firing improved staple line shortening and serosal laceration, its effect on secure stapling was relatively small when using Tri-staple™ reloads. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aim: The efficacy of neoadjuvant chemotherapy without radiation (NAC) in the treatment of rectal cancer remains unclear. This retrospective study was aimed at determining the pathological complete response rate and short-term outcomes of NAC in patients with locally advanced rectal cancer. Patients and Methods: We collected data on 159 consecutive patients treated for rectal cancer (cT3/cT4a, cN+, and cM0 status) at five tertiary referral hospitals between 2005 and 2010. Pathological complete response (pCR) and safety were assessed as the main outcomes in 124 eligible patients comprising 15 who received NAC (NAC group) and 109 who received no neoadjuvant chemotherapy (non-NAC group). Results: In the NAC group, 2 patients (13.3%) achieved a pCR (95% confidence interval: 1.7-40.5%) and 3 patients (20%) experienced grade 3/4 adverse events. No significant differences were found between the NAC and non-NAC groups in terms of short-term outcomes, including R0 proportion (100 vs. 96.3%, p = 0.45) and postoperative grade 3/4 complications (13.3 vs. 18.4%, p = 0.63). Conclusions: Neoadjuvant systemic chemotherapy without radiation appears to be safe, without worsening short-term outcomes, in patients with locally advanced rectal cancer. A further study is needed to verify these findings in larger samples. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background/Aim: Due to the recent development of several promising chemotherapeutic agents, such as S-1, irinotecan (CPT-11) and paclitaxel, response rates for advanced gastric cancer to chemotherapy have improved. Thus far, however, the efficacy and survival benefits of sequential chemotherapy using these agents have not been evaluated. An additional benefit of outpatient sequential chemotherapy, that is, without hospitalization, would be its contribution to the maintenance of patients’ social activities. The aim of this study was to retrospectively evaluate sequential outpatient chemotherapy for advanced gastric cancer. Patients and Methods: Patients with metastatic/recurrent gastric cancer treated with sequential outpatient chemotherapy were analyzed retrospectively. The sequential treatment consisted of S1-based chemotherapy as first-line therapy, low-dose CPT-11/CDDP as second-line therapy and weekly paclitaxel administration as third-line therapy. Results: A series of 32 patients was enrolled in this study. During the sequential chemotherapy, all patients were treated at the outpatient ward of Kyoto University Hospital without hospitalization. The overall response rate was 37.5% and the median survival time was 523 days (95% confidence interval: 323–723 days). The progression-free survival for the three therapies was 135 days for S-1, 148 days for low-dose CPT-11/CDDP and 57 days for paclitaxel. Grade 4 neutropenia was observed in 1 patient (3.1%), and there were no treatment-related deaths. Univariate analysis showed that factors with significant impact on survival were pathological type (intestinal vs. diffuse), clinical response (responder vs. non-responder) and prior chemotherapy. Factors with p values <0.1, including pathological type, clinical response, prior chemotherapy and age (>75 vs. ≤75 years), were evaluated by multivariate analysis, which disclosed that clinical response and patient age were significantly related to patient prognosis. Conclusion: In terms of survival and maintenance of social activities of patients, outpatient sequential chemotherapy appears to be both feasible and effective for advanced gastric cancer. Although prospective analysis of sequential chemotherapy is difficult because of its complex treatment protocol, clinical trials to assess the survival benefits of second-line chemotherapy for advanced gastric cancer are clearly warranted. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]