This week in Lancet Oncology, researchers in the Netherlands and Norway present a systematic review and meta-analysis of sentinel lymph node procedures in colon cancer and rectal cancer. The team searched literature databases for studies published before March 20, 2010 and identified 52 studies including 3,767 sentinel lymph node procedures. The team found that every patient diagnosed with colon or rectal cancer without clinical evidence of lymph node involvement or metastatic disease should still consider sentinel lymph node procedures in addition to conventional resection, as the prognostic information that can be gleaned from using the technique could prove to be "clinically significant."
Also in Lancet Oncology this week, researchers in the Netherlands and Sweden present findings from a 12-year follow-up of a trial evaluating preoperative radiotherapy with mesorectal excision for resectable rectal cancer. Between January 1996 and December 1999, 1,861 patients were randomly assigned to receive either total mesorectal excision together with radiotherapy, or excision alone. Cumulative incidence of local recurrence over 10 years was 5 percent in the combination therapy group, compared to 11 percent in the group that received surgery alone, the researchers write. Overall, survival didn't differ between groups. "Preoperative short-term radiotherapy significantly improved 10-year survival in patients with a negative circumferential margin and TNM stage III. Future staging techniques should offer possibilities to select patient groups for which the balance between benefits and side-effects will result in sufficiently large gains," the authors add.
And finally in Lancet Oncology this week, an editorial asks why cancer risk is so high in men who have sex with men, and how that risk can be decreased. A recent study in Cancer has shown that heterosexual men have a cancer prevalence of 5.04 percent, compared to homosexual men at 8.25 percent. The likely factors were that homosexual men were more likely to smoke and abuse alcohol, have higher rates of HIV, and have different transmission patterns of HPV than straight men, the editorial says. Co-infection also plays a part with HIV-infected men developing malignancies associated with Epstein-Barr virus or hepatitis. "A reluctance to seek early medical help coupled with stereotypical male behaviors on compliance are likely contributing factors, but the underlying tumor biology and milieu might also have a role," the editorial says. The data supports the notion of vaccinating boys against HPV, as well as re-educating the general public on things like smoking cessation and the importance of safe sex, the editorial adds.