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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2016; 8(8): 574-577
Published online Aug 27, 2016. doi: 10.4240/wjgs.v8.i8.574
Can the prognosis of colorectal cancer be improved by surgery?
Yasumasa Takii, Satoshi Maruyama, Hitoshi Nogami
Yasumasa Takii, Satoshi Maruyama, Hitoshi Nogami, Niigata Cancer Center Hospital, Niigata 951-8566, Japan
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Supported by National Cancer Research and Development Fund, No. 26-A-4.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yasumasa Takii, MD, Chief of Gastroenterological Surgery, Niigata Cancer Center Hospital, 15-3 Kawagishi-cho 2-chome, Chuo-ku, Niigata 951-8566, Japan. takii@niigata-cc.jp
Telephone: +81-25-2665111 Fax: +81-25-2333849
Received: March 27, 2016
Peer-review started: March 29, 2016
First decision: May 17, 2016
Revised: June 1, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: August 27, 2016
Abstract

Surgical resection is the only curative treatment modality for colorectal cancer limited locally. Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient. Prognosis improvement is expected with the no-touch isolation technique (NTIT), making it the most important resection procedure. We are conducting a multicenter randomized controlled trial (RCT) to confirm the efficacy of NTIT in patients with colorectal cancer. The present review serves as a preface to our trial, as it focuses on basic and clinical studies that support the efficacy of NTIT. The detection ratios of circulating tumor cells (CTCs) of peripheral blood indicate the progress and prognosis of colorectal cancer. In a rabbit liver tumor model, metastases increased after surgical manipulation. Also, CTCs increased during the radical excision of colorectal cancer. However, NTIT decreased the detection of CTCs of intraoperative portal vein blood in patients with colorectal cancer. Although these aforementioned results support the use of NTIT, a previous controlled prospective trial was not able to confirm the clinical benefit of NTIT, as it had an insufficient sample size and many patients were lost to follow-up. Therefore, we initiated a large-scale high-quality RCT to confirm the efficacy of NTIT for colorectal cancer.

Keywords: Colorectal cancer, General surgery, No-touch isolation technique, Circulating tumor cells, Randomized controlled trial

Core tip: Currently, we are conducting a multicenter randomized controlled trial to confirm the efficacy of the no-touch isolation technique (NTIT) in patients with colorectal cancer. A previous controlled prospective trial was not able to confirm the clinical benefit of NTIT, as it had an insufficient sample size and many patients were lost to follow-up. However, basic and clinical studies have supported the use of NTIT for treating colorectal cancer. The present review serves as a preface to our trial, as it provides background information on whether the prognosis of colorectal cancer is improved by surgery.