Volume 14 Issue 11, November 2017

The presence of lymph node metastases (LNM) is considered one of the most important features of colorectal cancer (CRC) staging, indicating the need for additional surgery after local excision and adjuvant chemotherapy after surgery. Now, a new study challenges the role of LNM in the progression of CRC.

Various mechanisms eliciting symptoms in GERD and its most common phenotypic presentation, nonerosive reflux disease (NERD), have been suspected and investigated. One study now suggests that superficial nerves in the oesophageal epithelium might have a key role in the pathogenesis of NERD and could represent a potential target for topical therapies.

KRAS oncogene mutations are commonly encountered in pancreatic ductal adenocarcinoma, driving tumour initiation, proliferation, progression and metastasis. Human exosomes engineered to deliver small interfering RNA silencing KRAS^G12D are highly efficient at specifically targeting pancreatic cancer cells to dramatically reduce RAS activation, cancer cell proliferation and metastatic processes.

Non-anatomical resection of colorectal liver metastases is the current preferred approach to maximize sparing of the hepatic parenchyma. A new study raises the question of whether resection in patients with KRAS-mutated colorectal liver metastases should be performed along segmental, anatomical lines to reduce the risk of local liver recurrence.

Direct-acting antiviral agents (DAAs) are highly effective treatments for HCV, but are not always accessible to people who inject drugs (PWID). Here, Grebely and colleagues outline the epidemiology of HCV in PWID, discuss current data on DAA outcomes in this population and highlight steps required to broaden access to HCV therapy with the eventual goal of HCV elimination.

Perianal fistulizing Crohn's disease has a major negative effect on a patient's quality of life and is a predictor of poor long-term outcome. Here, the authors provide an up-to-date overview on the pathogenesis and diagnosis of fistulizing Crohn's disease, as well as therapeutic strategies.

The diagnosis of GERD using functional oesophageal testing has been previously reported, but no updated expert recommendations have been made in over a decade. In this Consensus Statement, the authors describe modern oesophageal physiological tests and their analysis with an emphasis on establishing indications and interpretation parameters for evaluating GERD in clinical practice.

High-resolution manometry (HRM) has transformed our understanding of oesophageal motility disorders, in particular achalasia. In this Consensus Statement, the authors explore the effect HRM has had on the diagnosis and management of achalasia and related syndromes.