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Article ; Online: Colorectal cancer para-aortic lymph node metastases-surgery should be considered.

Peacock, Oliver

2024 Volume 111, Issue 3

MeSH term(s)	Humans ; Lymphatic Metastasis/pathology ; Lymph Nodes/surgery ; Lymph Nodes/pathology ; Lymph Node Excision ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/pathology ; Retrospective Studies ; Neoplasm Staging
Language	English
Publishing date	2024-02-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad445
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Article ; Online: Expert Commentary on Management of Colorectal Cancer With Synchronous Liver Metastases.

Peacock, Oliver

Diseases of the colon and rectum

2023 Volume 67, Issue 1, Page(s) 16–17

MeSH term(s)	Humans ; Colorectal Neoplasms/surgery ; Liver Neoplasms/secondary ; Hepatectomy
Language	English
Publishing date	2023-10-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000003134
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Article ; Online: A practical framework for the targeted use of total neoadjuvant therapy for rectal cancer.

Bhutiani, Neal / Peacock, Oliver / Chang, George J

Cancer

2022 Volume 128, Issue 11, Page(s) 2064–2072

Abstract: Total neoadjuvant therapy (TNT) for rectal cancer is the preoperative delivery of radiation or chemoradiotherapy as well as systemic chemotherapy for the purpose of improving treatment completion rates and decreasing toxicity, maximizing the primary ... ...

Abstract	Total neoadjuvant therapy (TNT) for rectal cancer is the preoperative delivery of radiation or chemoradiotherapy as well as systemic chemotherapy for the purpose of improving treatment completion rates and decreasing toxicity, maximizing the primary tumor response, and improving survival for patients with rectal cancer. This review summarizes the data surrounding TNT, including several recent randomized controlled trials. Moreover, it reviews the literature regarding high-quality surgery and the role of radiation and chemotherapy in the treatment of rectal cancer in the modern era. Finally, it presents an evidence-based protocol for the selective use of TNT in the treatment of patients with rectal cancer.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols ; Chemoradiotherapy/methods ; Humans ; Neoadjuvant Therapy/methods ; Neoplasm Staging ; Rectal Neoplasms/pathology
Language	English
Publishing date	2022-04-04
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/cncr.34149
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Article ; Online: ASO Author Reflections: Superior Mesenteric Vein (SMV): First Approach for Complete Mesocolic Excision.

Peacock, Oliver / Chang, George J

Annals of surgical oncology

2020 Volume 27, Issue 9, Page(s) 3501–3502

MeSH term(s)	Colectomy ; Humans ; Mesenteric Veins/surgery ; Mesocolon/surgery ; Portal Vein
Language	English
Publishing date	2020-04-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-08496-5
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Article ; Online: The Landmark Series: Management of Lateral Lymph Nodes in Locally Advanced Rectal Cancer.

Peacock, Oliver / Chang, George J

Annals of surgical oncology

2020 Volume 27, Issue 8, Page(s) 2723–2731

Abstract: There has historically been a significant divide in the approach to the management of lateral pelvic lymph nodes in patients with rectal cancer. These differing paradigms have developed based upon competing priorities. In the West, the circumferential ... ...

Abstract	There has historically been a significant divide in the approach to the management of lateral pelvic lymph nodes in patients with rectal cancer. These differing paradigms have developed based upon competing priorities. In the West, the circumferential resection margin has been the main focus because it is a strong predictor of local recurrence, distal recurrence, and survival. This approach was supplemented by radiation and chemotherapy to treat the lateral pelvic lymph nodes and micrometastatic disease. In the East, lateral pelvic lymph nodes are considered to be locoregional; thus, surgical treatment has traditionally included routine dissection of this compartment for low rectal cancers without the use of neoadjuvant chemoradiotherapy. However, neither approach has adequately addressed the important issue of lateral compartment recurrence in patients with clinically evident lateral pelvic lymph node metastasis. The aims of the review were to present the recent key studies and evolution of lateral pelvic lymph node management in locally advanced rectal cancer and secondly to propose a management strategy for the lateral compartment based on the current evidence.
MeSH term(s)	Humans ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Neoplasm Recurrence, Local/therapy ; Pelvis ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-08639-8
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Article ; Online: Perceived barriers and facilitators of physical activity in adults living in activity-friendly urban environments: A qualitative study in Sri Lanka.

Perera, Madhawa / Arambepola, Carukshi / Gillison, Fiona / Peacock, Oliver / Thompson, Dylan

PloS one

2022 Volume 17, Issue 6, Page(s) e0268817

Abstract: Background: Despite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in ...

Abstract	Background: Despite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in such environments need to be identified. The aim of this study was to explore the barriers and facilitators for physical activity, as perceived by adult urban dwellers in activity-friendly environments in Colombo District, Sri Lanka. Methods: A qualitative study using in-depth interviews was conducted among adults aged 20-60 years living in an urban area which has been recently re-designed for recreational and rejuvenating purposes in Sri Lanka. Recruitment targeted varying socio-economic status and risk of non-communicable diseases; and was continued until the data saturation point was reached. Interviews were conducted in homes, primary healthcare units and fitness centres, and were transcribed verbatim and analysed using framework analysis. Results: A total of 31 eligible and consenting adults were interviewed. Of the reported barriers to physical activity, lack of time was very common. Other frequently reported barriers included unpleasant experiences following exercise and misconceptions about exercise, whereas physical environmental factors, weather and road safety were reported less frequently. All participants reported at least one facilitator for engaging in exercise. Expectations of preventing diseases, improving health, physical fitness, psycho-social wellbeing, optimising body functions and increasing lifespan were frequently cited as reasons to be active, while social factors such as positive attitudes of family members and the influence of peers were found to be motivating. Conclusions: The study showed that while participants valued the health benefits of physical activity and refurbished activity-friendly urban environments, these were not sufficient to support them to overcome key perceived barriers to being physically active.
MeSH term(s)	Adult ; Exercise ; Fitness Centers ; Humans ; Physical Fitness ; Qualitative Research ; Sri Lanka
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0268817
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Article ; Online: Rectal Adenocarcinoma Presenting as a Cervical Mass: A Case Report.

Stanietzky, Nir / Bednarski, Brian / Shafer, Aaron / Taggart, Melissa W / Peacock, Oliver / Vikram, Raghunandan

The American journal of case reports

2023 Volume 24, Page(s) e941884

Abstract: BACKGROUND Invasive cervical tumors are often seen in clinical practice. However, there are multiple structures within the pelvis, and invasion of the cervix from another site must be included in the differential diagnosis. In such cases, a ... ...

Abstract	BACKGROUND Invasive cervical tumors are often seen in clinical practice. However, there are multiple structures within the pelvis, and invasion of the cervix from another site must be included in the differential diagnosis. In such cases, a multidisciplinary approach is needed to define the organ of tumor origin. Ensuring proper staging and histologic analysis are critical for optimal management. CASE REPORT We present a case of a 68-year-old woman who presented to her gynecologist with painless post-menopausal vaginal bleeding. She was diagnosed with a locally aggressive cervical adenocarcinoma, which was histologically confirmed by an in-office biopsy. She was referred to the gynecologic oncology service at a tertiary care hospital for definitive management, where a thorough clinical workup was performed. Physical exam revealed that the mass had invaded the anterior rectal wall. Through a multidisciplinary approach and a repeat biopsy, she was correctly diagnosed with an invasive rectal adenocarcinoma. She was treated with neoadjuvant chemoradiotherapy and underwent curative surgery. Had she been incorrectly treated as having a primary cervical adenocarcinoma, there would have been no role for surgery. The change in the organ of primary drastically altered the patient's management and outcome. She is currently undergoing surveillance with cross-sectional imaging. CONCLUSIONS Cervical masses originating from non-gynecologic organs can be difficult to differentiate on physical exam and histologic analysis. When a mass involves the rectum, an invasive primary rectal adenocarcinoma must be included in the differential. This will have a significant impact on patient management and ultimately on patient survival.
MeSH term(s)	Humans ; Female ; Aged ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/therapy ; Rectum ; Biopsy ; Neoadjuvant Therapy ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/therapy ; Adenocarcinoma/diagnosis ; Adenocarcinoma/therapy ; Adenocarcinoma/pathology
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.941884
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Article ; Online: "Watch and Wait" for complete clinical response after neoadjuvant chemoradiotherapy for rectal cancer.

Peacock, Oliver / Chang, George J

Minerva chirurgica

2019 Volume 74, Issue 6, Page(s) 481–495

Abstract: The management of rectal cancer has evolved substantially over recent decades, becoming increasingly complex. This was once a disease associated with high mortality and limited treatment options that typically necessitated a permanent colostomy, has now ... ...

Abstract	The management of rectal cancer has evolved substantially over recent decades, becoming increasingly complex. This was once a disease associated with high mortality and limited treatment options that typically necessitated a permanent colostomy, has now become a model for multidisciplinary evaluation, treatment and surgical advancement. Despite advances in the rates of total mesorectal excision, decreased local recurrence and increased 5-year survival rates, the multimodal treatment of rectal cancer is associated with a significant impact on long-term functional and quality of life outcomes including risks of bowel, bladder and sexual dysfunction, and potential need for a permanent stoma. There is great interest in strategies to decrease the toxicity of treatment, including selective use of radiation, chemotherapy or even surgery. The modern concept of selective use of surgery for patients with rectal cancer are based on the observed pathological complete response in approximately 10-20% of patients following long-course chemoradiation therapy. While definitive surgical resection remains the standard of care for all patients with non-metastatic rectal cancer, a growing number of studies are providing supportive evidence for a watch-and-wait, organ preserving approach in highly selected patients with rectal cancer. However, questions regarding the heterogeneity of patient selection, optimal method for inducing pathological complete response, methods and intervals for assessing treatment response and adequacy of follow-up remain unanswered. The aim of this review is to provide an up-to-date summary of the current evidence for the watch-and-wait management of rectal cancer following a complete clinical response after neoadjuvant chemoradiation.
MeSH term(s)	Chemoradiotherapy, Adjuvant ; Humans ; Neoadjuvant Therapy/methods ; Organ Sparing Treatments ; Patient Selection ; Prognosis ; Quality of Life ; Rectal Neoplasms/surgery ; Rectal Neoplasms/therapy ; Treatment Outcome ; Watchful Waiting
Language	English
Publishing date	2019-09-30
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
DOI	10.23736/S0026-4733.19.08184-7
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Article ; Online: Evolving survival gains in patients with young-onset colorectal cancer and synchronous resectable liver metastases.

Maki, Harufumi / Haddad, Antony / Lendoire, Mateo / Newhook, Timothy E / Peacock, Oliver / Bednarski, Brian K / Konishi, Tsuyoshi / Vauthey, Jean-Nicolas / You, Y Nancy

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2024 Volume 50, Issue 4, Page(s) 108057

Abstract: We aimed to evaluate the practice and the associated outcomes of surgical treatment for young-onset colorectal cancer (YOCRC) patients presenting with synchronous liver metastases. The study cohort was divided into two groups according to surgery date: ... ...

Abstract	We aimed to evaluate the practice and the associated outcomes of surgical treatment for young-onset colorectal cancer (YOCRC) patients presenting with synchronous liver metastases. The study cohort was divided into two groups according to surgery date: 131 patients in the early era (EE, 1998-2011) and 179 in the contemporary era (CE, 2012-2020). The CE had a higher rate of node-positive primary tumors, higher carcinoembryonic antigen level, and lower rate of RAS/BRAF mutations. The CE had higher rates of reverse or combined resection, multi-drug prehepatectomy chemotherapy, and two-stage hepatectomy. The median survival was 8.4 years in the CE and 4.3 years in the EE (p = 0.011). On multivariate analysis, hepatectomy in the CE was independently associated with improved overall survival (HR 0.48, p = 0.001). With a combination of perioperative systemic therapy, careful selection of treatment approach, and coordinated resections, durable cure can be achieved in YOCRC patients.
MeSH term(s)	Humans ; Colorectal Neoplasms/pathology ; Liver Neoplasms/genetics ; Liver Neoplasms/surgery ; Liver Neoplasms/secondary ; Hepatectomy/adverse effects ; Retrospective Studies
Language	English
Publishing date	2024-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2024.108057
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Article ; Online: The understanding, acceptability, and relevance of personalised multidimensional physical activity feedback among urban adults: evidence from a qualitative feasibility study in Sri Lanka.

Arambepola, Carukshi / Perera, Madhawa / Gillison, Fiona / Peacock, Oliver / Thompson, Dylan

BMC public health

2021 Volume 21, Issue 1, Page(s) 715

Abstract: Background: Wearable technologies are being used to provide personalised feedback across multiple physical activity dimensions in countries such as the UK, but their feasibility has not been tested in South Asia, where physical inactivity is increasing. ...

Abstract	Background: Wearable technologies are being used to provide personalised feedback across multiple physical activity dimensions in countries such as the UK, but their feasibility has not been tested in South Asia, where physical inactivity is increasing. This study assessed the understanding, acceptability, and relevance of personalised multidimensional physical activity feedback in urban dwellers in Colombo, Sri Lanka. Methods: A qualitative feasibility study was conducted among 35 adults to assess a community-based approach to provide multidimensional physical activity feedback. Healthy adults, adults at risk of non-communicable diseases and community-based primary healthcare professionals wore a physical activity monitor for 7 days and were then guided through their personalised multidimensional physical activity feedback. One-to-one interviews were conducted, transcribed verbatim and analysed using framework analysis. Results: Four themes were generated: understanding of personalised physical activity feedback, perceived novelty of the feedback, motivation, and consideration of the multidimensional nature of physical activity. A majority of participants required guidance initially to understand the feedback, following which most were quickly able to interpret the data shown, and were willing to use the feedback as a basis for identifying goals to improve physical activity. Participants perceived the feedback and its delivery as novel because it provided new knowledge about physical activity guidelines and awareness on their own behaviour through graphics. Comparisons of personal performance against recommended physical activity levels and information on sedentary time were the most commonly motivating aspects of the feedback, prompting talk about behaviour change. All three groups showed poor planning on goal achievement, with some noticeable differences between those with and without health risk of non-communicable diseases. Following the feedback, most participants understood that physical activity is composed of several dimensions, while around half could recognise more suitable options to change behaviour. Of the physical activity dimensions, calorie burn received more attention than others. Conclusions: Multidimensional physical activity feedback was considered understandable and acceptable and has the potential to support behaviour change among urban Sri Lankans with or without identified health risk. These findings highlight the feasibility of this technology-enabled approach as a personalised intervention to improve knowledge and motivation for physical activity behaviour.
MeSH term(s)	Adult ; Exercise ; Feasibility Studies ; Feedback ; Humans ; Sedentary Behavior ; Sri Lanka
Language	English
Publishing date	2021-04-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/s12889-021-10774-0
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