145 Background: Given that Deficient Mismatch Repair (dMMR) colon cancer patients respond poorly to conventional chemotherapy but immunotherapy significantly improves pCR rates in this population, this study aims to explore whether neoadjuvant immunotherapy can increase the rate of R0 resection with preservation of adjacent organs in dMMR T4 colon cancer patients and investigate the optimal regimen of immunotherapy. Methods: This single-arm, open-label, phase II trial was conducted at Peking Union Medical College Hospital in China. Patients were eligible for enrollment if they had immunohistochemically confirmed colon adenocarcinoma with confirmation of dMMR and clinical T 4 stage (defined as a tumor has invaded the serosal surface [cT 4a ] or has invaded or adhered to adjacent organs or structures [cT 4b ]). All patients are planned to receive three cycles of camrelizumab (200mg intravenously administered at the beginning of each cycle every 3 weeks) followed by radical surgery. Surgery was scheduled 2–4 weeks after three cycles. The primary endpoint of this study was the R0 resection rate in all patients who received surgery (defined as resection with a microscopic negative margin). Secondary endpoints included the rate of pCR (defined as no residual viable tumor in either the tumor bed or the lymph nodes), tumor regression grade (TRG), the incidence of adverse event (AE) during neoadjuvant immunotherapy. Results: A total of 18 patients with clinical T 4 stage and dMMR colon cancers were deemed eligible for enrollment and 17 patients were included in per-protocol set analysis from April 2024 to July 2025. The primary endpoint was evaluable in 17 patients, with 16 patients having R0 resection of 94.1%. Pathological response was observed in 14 of 16 patients, including 11 with pathological complete response. The pCR associated with a decreased trend density of PD-L1+ cells [139.3 (99.0, 272.6) cells/mm 2 vs 323.1 (114.3, 528.2) cells/mm 2 , P =0.157]. All patients experienced treatment-related AEs (100%) during neoadjuvant immunotherapy. Sixteen patients (94.1%) had Grade 1-2 AEs, while 1 patients had Grade 3 AE. Conclusions: Three cycles of mono-immunotherapy appear to be a regimen for patients with dMMR T 4 colon cancer with acceptable surgical efficacy and safety. Clinical trial information: NCT06215677 .

BACKGROUND:The tumor microenvironment, particularly the tumor stroma, plays a critical role in tumor progression, immune evasion, and therapeutic resistance. However, its interaction with the immune landscape in rectal cancer (RC) remains incompletely understood. This study aimed to comprehensively characterize the stromal-immune ecosystem associated with the tumor stroma ratio (TSR) in RC and to evaluate its clinical and therapeutic relevance. METHODS:We analyzed a multicenter cohort of 498 patients with treatment-naïve RC in whom TSR was assessed on H&E-stained sections. Integrative multi-omics analyses were performed, including bulk RNA sequencing (n=118) and single-cell RNA/T-cell receptor (TCR) sequencing (n=10). Key findings were validated by immunohistochemistry (n=114) and multiplex immunofluorescence (n=20). Survival analyses and statistical comparisons were conducted to evaluate clinical associations and treatment responses. RESULTS:High TSR was an independent predictor of unfavorable disease-free survival and cancer-specific survival and was associated with aggressive clinicopathological features. Single-cell analyses revealed that TSR-high tumors exhibited a profoundly immunosuppressive microenvironment, characterized by clonally expanded terminally exhausted CD8+ T cells (CD8+ Tex-CXCL13) and activated CD4+ regulatory T cells (CD4+ Treg-TNFRSF4). Two LRRC15+ cancer-associated fibroblast (CAF) subsets (mCAF-CTHRC1 and mCAF-FAP) were enriched in TSR-high tumors. Among them, mCAF-CTHRC1 was associated with increased Treg abundance and activation features, with predicted interactions with CD4+ Treg-TNFRSF4 cells through the LGALS9-CD44 signaling axis. In addition, SPP1-expressing monocytes (Mon-SPP1) and malignant epithelial cells were prominent in TSR-high tumors and showed a predicted SPP1-CD44 interaction with T-cell subsets, suggesting potential involvement in immunosuppressive stromal-immune interactions. In patients receiving neoadjuvant therapy, pretreatment TSR-low tumors showed improved pathological response and survival outcomes compared with TSR-high tumors. In the neoadjuvant chemoradiotherapy plus immunotherapy cohort, TSR-low tumors were associated with a significantly higher major pathological response rate, whereas pathological complete response showed a non-significant trend in the same direction. CONCLUSIONS:High TSR identifies a clinically aggressive subtype of RC characterized by a profoundly immunosuppressive stromal-immune ecosystem enriched for exhausted T cells, immunosuppressive CAF programs, and SPP1-associated stromal-myeloid interactions. These findings highlight LGALS9-, LRRC15-, and SPP1-related stromal-immune pathways as candidate stromal-immune therapeutic vulnerabilities that warrant further mechanistic and preclinical validation.

Acquired drug resistance is a major challenge for cancer therapy and is the leading cause of cancer mortality; however, the mechanisms of drug resistance are diverse and the strategy to specifically target drug-resistant cancer cells remains an unmet clinical issue. Here, we established a colorectal cancer-derived organoid biobank and induced acquired drug resistance by repeated low-level exposures of chemo-agents. Chemosensitivity profiling and transcriptomic analysis studies revealed that chemoresistant cancer-derived organoids exhibited elevated expression of LGR4 and activation of the Wnt signaling pathway. Further, we generated a monoclonal antibody (LGR4-mAb) that potently inhibited LGR4-Wnt signaling and found that treatment with LGR4-mAb notably sensitized drug-induced ferroptosis. Mechanistically, LGR4-dependent Wnt signaling transcriptionally upregulated SLC7A11, a key inhibitor of ferroptosis, to confer acquired drug resistance. Our findings reveal that targeting of Wnt signaling by LGR4-mAb augments ferroptosis when co-administrated with chemotherapeutic agents, demonstrating a potential opportunity to fight refractory and recurrent cancers.

Background: Earlier results from a multicenter randomized trial showed that colorectal cancer resection with KangDuo surgical robot KD-SR-01 (KD) and da Vinci Xi (DV) had similar perioperative and pathological outcomes, whereas long-term oncologic outcomes remained uncertain. Methods: Three-year follow-up data were analyzed for the full 100-patient cohort of the multicenter randomized trial (KD, n = 50; DV, n = 50). The long-term endpoints were disease-free survival (DFS) and overall survival (OS). Results: Median follow-up in both groups was 37 months (interquartile range [IQR], 34–40). Kaplan–Meier-estimated 3-year DFS rates were 85.3

Locally advanced rectal cancer (LARC) staged as mrT3 could be further subdivided into mrT3a to T3d based on depth of tumor invasion through the muscularis propria. Limited evidence exists to compare the differences across subgroups. Clinical data from patients between January 2018 and 2022 were collected. The study included patients with mrT3 LARC who received neoadjuvant chemoradiotherapy (NCRT). Based on depth of invasion through muscularis propria, patients were categorized into three groups: mrT3a (< 5 mm), mrT3b (5 10 mm), mrT3c d group (> 10 mm). The outcomes were disease-free survival (DFS), pathological complete response (pCR), tumor recurrence and metastasis. A total of 295 patients were identified, including 65 (22.0

To compare the overall survival (OS) and cancer-specific survival (CSS) of right-sided colon cancer patients undergoing CME versus D2 surgery after 5 years of follow-up, and to assess the heterogeneity of treatment effectiveness of CME between different subgroups. The 3-year result of the Radical Extent of lymphadenectomy of Laparoscopic Right Colectomy for colon cancer (RELARC) trial showed that standard D2 dissection should be performed in right-sided colon cancer patients. In patients with lymph node metastasis, complete mesocolic excision (CME) showed potentially favorable results. The parallel, open label, randomized controlled trial was conducted between January, 2016 to December, 2019 in 17 hospitals in China. Of a total of 1072 eligible patients enrolled, 995 patients were included in the modified intention-to-treat analysis. In the present study, the primary outcome was 5-year OS and the secondary outcome was 5-year CSS. The trial is registered with ClinicalTrials.gov (Identifier: NCT02619942). 995 patients were included in the final analysis. There was no significant difference between the 5-year OS (HR: 0.74, 95%CI: 0.51–1.07, P=0.105) or CSS (HR: 0.72, 95%CI: 0.49–1.06, P=0.091) in the CME and D2 groups. CME appears to improve 5-year outcomes in patients with stage III disease (OS: HR: 0.58, 95% CI: 0.37–0.93, P=0.023; CSS: HR: 0.59, 95% CI: 0.37–0.94, P=0.028), particularly in those with pN2 (OS: HR: 0.25, 95% CI: 0.11–0.57, P=0.001; CSS: HR: 0.25, 95% CI: 0.11–0.57, P=0.001), where a statistically significant interaction was identified. Patients with lymphovascular invasion also demonstrated favorable outcomes with CME with significant interaction effect (OS: HR: 0.34, 95% CI: 0.17–0.70; interaction P=0.009; CSS: HR: 0.32, 95% CI: 0.15–0.67, interaction P=0.008). The standard D2 dissection provides oncologic outcomes comparable to CME on the 5-year follow-up. However, CME seems to improve 5-year outcomes in patients with stage III, particularly those with pN2 status, and may confer benefit in patients with LVI.

Patients with a tumor regression grade of 0 or 1 (CAP), are classified as well-responders after neoadjuvant chemoradiotherapy (NCRT). Although well-responders are expected to have superior prognosis, occurrences of recurrence and metastasis still exist. Clinical data of patients from January 2017 to 2022 were analyzed. Inclusion criteria: adenocarcinoma, cT3-4N0 or cTanyN+, receiving NCRT and surgery, CAP 0 1. The primary endpoint was three-year disease-free survival (3y-DFS). According to occurrence of DFS events, patients were divided into DFS (470, 91.8

Background:Tumor location affects rectal cancer management, but no consensus exists on criteria. The anterior peritoneal reflection (aPR), an anatomical landmark, shows potential for defining tumor location but requires clinical validation. This study evaluated the utility of aPR in guiding neoadjuvant chemoradiotherapy (nCRT) decisions and predicting lateral lymph node (LLN)/distant metastasis patterns. Methods:This single-center retrospective cohort analyzed data from Peking Union Medical College Hospital (Beijing, China) between January 2016 and August 2022. Magnetic resonance imaging (MRI)-measured aPR parameters were pathologically validated. Patients were stratified by aPR-based definition and tumor height (10 cm). Kaplan-Meier survival curves, log-rank tests, and Cox regression were used for prognostic analysis. Results:Among 588 patients (439 tumors ≥5 cm from the anal verge), MRI identified aPR with an accuracy of 95.4%. For tumors ≥5 cm, aPR-defined middle-to-low rectal cancer showed lower 3-year disease-free survival (DFS) rate than the upper rectal cancer (P = 0.010), while their 3-year overall survival (OS) rates were comparable. Conversely, 10-cm-defined classification showed no DFS or OS differences (both P > 0.2). Cox regression confirmed aPR-defined classification as an independent DFS predictor (HR = 3.19, P = 0.014), while 10-cm classification was non-predictive. nCRT with tumor regression grade (TRG) 0-1 trended toward improved DFS compared with direct surgery (HR = 0.56, P = 0.072). The independent protective effect of nCRT with TRG 0-1 for DFS was exclusive to the aPR-defined middle-to-low rectal cancer subgroup (HR = 0.45, P = 0.026) and not observed in the 10-cm subgroup. aPR-defined classification was independently associated with LLNs on MRI and postoperative pulmonary metastasis. Conclusion:aPR may guide nCRT decision-making and predict LLN metastasis and postoperative distant organ metastasis.

Radiotherapy displays unique antitumor synergism with immune checkpoint inhibitors, which is indicated by high pathological complete response (pCR) rates from single-arm trials of locally advanced rectal cancer (LARC). Here we test the efficacy and safety of the radiation–immune checkpoint inhibitor combination in patients with LARC in a phase 2, randomized trial conducted in eight major colorectal cancer centers in Beijing. In total, 186 eligible all-comer (proficient mismatch repair and deficient mismatch repair) participants were enrolled. The patients were randomly assigned to receive neoadjuvant chemoradiation + concurrent/sequential PD-1 blockade (experiment groups A/B) or neoadjuvant chemoradiation alone (control group). Radical surgeries were scheduled after neoadjuvant treatments. The primary endpoint was the pCR rate. The pCR rates were 27.1 NCT05245474 ). In a multicenter, open-label, randomized phase 2 trial, neoadjuvant chemoradiation with PD-1 blockade elicited a pathological complete response rate superior to that with neoadjuvant chemoradiation alone in patients with locally advanced rectal cancer.

PURPOSE:The clinical benefit of incorporating oxaliplatin into conventional neoadjuvant chemoradiotherapy (nCRT) for patients with high-risk locally advanced rectal cancer (LARC) remains controversial. METHODS AND MATERIALS:This multicenter, open-label, randomized controlled trial enrolled 505 patients with high-risk LARC, defined by the presence of at least 1 of the following adverse features: clinical T4 stage, clinical N2 stage, high tumor grade, extramural vascular invasion, involvement of the mesorectal fascia, or perianal musculature involvement. Enrollment took place between August 2017 and April 2022. Patients were randomly assigned to receive long-course radiation therapy combined with a 3-cycle chemotherapy regimen of capecitabine and oxaliplatin (CapeOX group; n = 248) or capecitabine alone (Cape group; n = 257). The primary endpoint was 3-year disease-free survival (3y-DFS). RESULTS:Following nCRT, radical surgery was performed in 91.5% of the CapeOX group and 92.2% in the Cape group (P = .778). Pathologic complete response rates were comparable between the CapeOX and Cape groups (25.5% vs 25.3%; P = .954). A significantly greater proportion of patients in the CapeOX group achieved marked tumor regression (College of American Pathologists (CAP 0-1)) compared with the Cape group (58.6% vs 46.8%; P = .011). The incidence of grade 3 to 4 treatment-related toxicities was similar between the groups (CapeOX: 14.1% vs Cape: 9.3%; P = .095). After a median follow-up of 37 months, 3y-DFS and 3-year overall survival rates were comparable between the groups (both P > .050). Overall, patients who achieved CAP 0 to 1 had significantly better 3y-DFS than those with CAP 2 to 3 (89.0% vs 80.9%; P = .018). CONCLUSIONS:The addition of oxaliplatin to conventional nCRT may enhance pathologic tumor regression in patients with high-risk LARC without a significant increase in severe adverse events. However, this intensified 3-cycle chemotherapy regimen did not translate into a long-term survival benefit.

OBJECTIVE:To compare the overall survival (OS) and cancer-specific survival (CSS) of right-sided colon cancer patients undergoing CME versus D2 surgery after 5 years of follow-up, and to assess the heterogeneity of treatment effectiveness of CME between different subgroups. SUMMARY BACKGROUND DATA:The 3-year result of the Radical Extent of lymphadenectomy of Laparoscopic Right Colectomy for colon cancer (RELARC) trial showed that standard D2 dissection should be performed in right-sided colon cancer patients. In patients with lymph node metastasis, complete mesocolic excision (CME) showed potentially favorable results. METHODS:The parallel, open label, randomized controlled trial was conducted between January, 2016 to December, 2019 in 17 hospitals in China. Of a total of 1072 eligible patients enrolled, 995 patients were included in the modified intention-to-treat analysis. In the present study, the primary outcome was 5-year OS and the secondary outcome was 5-year CSS. The trial is registered with ClinicalTrials.gov (Identifier: NCT02619942). RESULTS:995 patients were included in the final analysis. There was no significant difference between the 5-year OS (HR: 0.74, 95%CI: 0.51-1.07, P=0.105) or CSS (HR: 0.72, 95%CI: 0.49-1.06, P=0.091) in the CME and D2 groups. CME appears to improve 5-year outcomes in patients with stage III disease (OS: HR: 0.58, 95% CI: 0.37-0.93, P=0.023; CSS: HR: 0.59, 95% CI: 0.37-0.94, P=0.028), particularly in those with pN2 (OS: HR: 0.25, 95% CI: 0.11-0.57, P=0.001; CSS: HR: 0.25, 95% CI: 0.11-0.57, P=0.001), where a statistically significant interaction was identified. Patients with lymphovascular invasion also demonstrated favorable outcomes with CME with significant interaction effect (OS: HR: 0.34, 95% CI: 0.17-0.70; interaction P=0.009; CSS: HR: 0.32, 95% CI: 0.15-0.67, interaction P=0.008). CONCLUSION:The standard D2 dissection provides oncologic outcomes comparable to CME on the 5-year follow-up. However, CME seems to improve 5-year outcomes in patients with stage III, particularly those with pN2 status, and may confer benefit in patients with LVI.

Tissue engineering and regenerative medicine is a new interdisciplinary subject integrating life science, material science, engineering technology, and clinical medicine. Over the last ten years, significant advancements have been achieved in the study of biomaterials and tissue engineering. Progress in the field of tissue engineering and regenerative medicine can result in optimal tissue regeneration and effective functional reconstruction. Spinal cord injury (SCI) is the most severe complication of spinal trauma and frequently results in significant functional impairments in the lower extremities of the affected segment. Repair of SCI is a medical challenge worldwide. Advancements in tissue engineering theory and technology offer fresh opportunities for addressing SCI, as well as providing new strategies and methodologies to tackle the challenges associated with repairing and reconstructing spinal cord function. This article provides an overview of the latest developments in tissue engineering and SCI repair, focusing on biomaterials, cells, and active factors. It also introduces nine key components related to SCI and proposes innovative approaches for repairing and functionally reconstructing the injured spinal cord.

BACKGROUND:While emergency laparoscopic cholecystectomy (ELC) is the standard treatment for acute cholecystitis (AC), optimal management of complex cases, particularly those with symptom duration ≥7 days or severe inflammation, remains controversial. OBJECTIVE:To assess the feasibility and safety of a proactive protocol for ELC in patients with complex AC, including high-risk cases defined by advanced age, prolonged symptoms, or severe inflammation (Tokyo Guidelines grade II/III). METHODS:From 1 August 2020 to 1 February 2024, the emergent surgical teams at Peking Union Medical College Hospital (National Emergent Surgery Center in North China) prospectively implemented proactive ELC for AC patients, irrespective of symptom duration and inflammatory severity. Intraoperative indocyanine green cholangiography (ICG-C) was selectively employed based on the surgeon's discretion. Clinicopathological data and perioperative outcomes were analyzed to assess safety and efficacy. Logistic regression and multi-way ANOVA were employed to assess the effects of multiple independent variables. RESULTS:Among 721 enrolled patients, 576 (79.9%) were interprovincial referrals, and 342 (47.7%) were transferred from external hospitals. More than half of the patients suffered from at least one comorbidity. The median age was 60 ± 16.7 years, with 11.5% aged >80 years. Symptom duration exceeded 3 days in 343 (47.6%) and 7 days in 190 (26.4%) of cases. Most patients had advanced disease (334 (46.3%) grade II, 199 (27.6%) grade III). Mean operative time was 64 ± 36.5 minutes, with intraoperative blood loss (IBL) of 65.0 ± 177.4 ml. Seven cases (1%) required conversion to open surgery, 39 (5.4%) underwent partial cholecystectomy, and 3 (0.4%) experienced iatrogenic colon injuries. Reoperation occurred in 2 cases (0.3%). The overall postoperative complication rate was 6.9%, with severe complications (Clavien-Dindo grade ≥III) at 1.2%. Patients older than 80 years did not have a higher rate of complications (P = 0.14). Patients with symptom duration ≥ 7 days had similar rates of partial resection and overall complications to those with 4-6 days. Although grade II/III had substantial adverse intraoperative and postoperative effects (all items, P ≤ 0.001), the overall rate of complications remains low (8.4%). ICGC correlated with reduced partial resection rates (0.7% vs. 6.3%, P = 0.005) and lower intraoperative blood loss (44.7 ± 82.8 mL vs. 69.4 ± 194.0 mL, P < 0.001). CONCLUSIONS:Proactive ELC could be safe and effective for complex AC, even in elderly patients (≥80 years), prolonged symptom duration (≥7 days), and severe disease (grade II/III), when performed in high-volume centers. ICGC enhances precision, mitigating incomplete resections and bleeding.

Background/Objectives: The metastatic patterns of apical lymph node (ALN) in rectal and sigmoid colon cancer are currently unclear, and there is no consensus on the indications for dissection of ALN. This study aimed to analyze the impact of ALN metastasis on prognosis, determine the metastatic patterns of ALN and provide evidence for indications of ALN dissection in rectal and sigmoid colon cancer. Methods: In this multicenter, retrospective cohort study, patients from five centers with stage I-III rectal or sigmoid colon cancer who underwent laparoscopic radical surgery with ALN dissection without neoadjuvant treatment from January 2015 to December 2019 were enrolled. Results: Among 2809 patients, the positive rate of ALN was 1.9%. The 5-year overall survival and cancer-specific survival rate for patients with metastatic ALN were 37.5% and 41.0%, respectively. ALN metastasis was the independent risk factor for poor prognosis. Tumor size ≥5 cm (OR = 2.32, 95% CI: 1.30–4.13, p = 0.004), signet ring cell cancer/mucinous adenocarcinoma (vs. poor differentiated adenocarcinoma, OR = 0.19, 95% CI: 0.08–0.45, p < 0.001; vs. moderate to well differentiated adenocarcinoma, OR = 0.22, 95% CI: 0.11–0.42, p < 0.001), T4 stage (OR = 1.93, 95% CI: 1.05–3.55, p = 0.034), N2 stage (OR = 8.86, 95% CI: 4.45–17.65, p < 0.001) and radiologic evidence of extramural venous invasion (OR = 1.88, 95% CI: 1.03–3.42, p = 0.040) were independent risk factors for ALN metastasis. The nomogram model developed by these factors achieved a good predictive performance. Conclusions: This research offered insights into the incidence, risk factors, and prognostic significance of apical lymph node metastasis in cases of rectal and sigmoid colon cancer. Additionally, the study furnished empirical support for the criteria guiding ALN dissection. Furthermore, a pragmatic risk assessment model was developed to predict ALN metastasis.

Background Neoadjuvant chemoradiotherapy (nCRT) is the standard for locally advanced rectal cancer (LARC). However, distant metastasis remains the primary cause of treatment failure. Early identification of high-risk individuals for personalized treatment may offer a solution. Circulating tumour DNA (ctDNA) could assist in this process. Methods From September 2017 to June 2019, the study prospectively recruited 113 patients with LARC (cT3-4N0M0 or cTanyN + M0) who underwent nCRT followed by radical surgery across 8 tertiary centers. ctDNA was analysed using large-panel targeted sequencing at baseline, during nCRT, pre-surgery, post-surgery, post-adjuvant chemotherapy (ACT), and during annual follow-ups for 3 years. Findings We analysed 103 tissue and 669 plasma samples from 103 patients. With a median 53-month follow-up, significantly worse progression-free survival (PFS) and overall survival (OS) were observed if median variant allele frequency (mVAF) of baseline ctDNA per patient was >= 0.5% (PFS, HR 4.39, p < 0.001; OS, HR 5.61, p = 0.004) or ctDNA was still detectable two weeks into nCRT (PFS, HR 7.63, p < 0.001; OS, HR 5.08, p < 0.001). Furthermore, when compared to the low-risk (C1) group (characterized by " ctDNA undetected during nCRT with baseline mVAF <0.5%" or " ctDNA undetected during nCRT with TMB (tumour mutational burden) >= 20/Mb " ), the high-risk (C2) group (characterized by " ctDNA detected during nCRT" or " baseline mVAF >= 0.5% with TMB <20/Mb") showed significantly worse long-term outcomes (3 y-PFS, 55.9% vs. 94.2%; 3 y-OS, 79.4% vs. 100%). The ctDNA clearance during nCRT, baseline mVAF, and TMB may be effective prognostic indicators. Interpretation Our findings reaffirm the clinical monitoring value of ctDNA and demonstrate the strong prognostic value of baseline ctDNA and its early clearance status in patients with LARC undergoing nCRT. This highlights the potential of dynamic ctDNA monitoring as actionable stratified indicators to guide personalized neoadjuvant treatment strategies. Copyright (c) 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

PURPOSE Complete mesocolic excision (CME) is being increasingly used for the treatment of right-sided colon cancer, although there is still no strong evidence that CME provides better long-term oncological outcomes than D2 dissection. The controversy is mainly regarding the survival benefit from extended lymph node dissection emphasized by CME. METHODS This multicenter, open-label, randomized controlled trial (ClinicalTrials.gov identifier: NCT02619942 ) was performed across 17 hospitals in China. Patients diagnosed with stage T2-T4aNanyM0 or TanyN + M0 right-sided colon cancer were randomly assigned (1:1) to undergo either CME or D2 dissection during laparoscopic right colectomy. The primary outcome was the 3-year disease-free survival (DFS), and the main secondary outcome was the 3-year overall survival (OS). RESULTS Between January 11, 2016, and December 26, 2019, 1,072 patients were randomly assigned (536 patients to CME and 536 patients to D2 dissection). In total, 995 patients (median age 61 years, 59% male) were included in the primary analysis (CME [n = 495] v D2 dissection [n = 500]). No significant differences were found between the groups in 3-year DFS (hazard ratio [HR], 0.74 [95% CI, 0.54 to 1.02]; P = .06; 86.1% in the CME group v 81.9% in the D2 group) or in 3-year OS (HR, 0.70 [95% CI, 0.43 to 1.16]; P = .17; 94.7% in the CME group v 92.6% in the D2 group). CONCLUSION This trial failed to find evidence of superior DFS outcome for CME compared with standard D2 lymph node dissection in primary surgical excision of right-sided colon cancer. Standard D2 dissection should be the routine procedure for these patients. CME should only be considered in patients with obvious mesocolic lymph node involvement.

Removal of multiple organic pollutants in one port is the target of wastewater treatment. In this study, paramagnetic Janus particles as recyclable and catalytic colloidal surfactants were employed to achieve this goal. In this method, water-insoluble organic pollutants can be stabilized with paramagnetic Janus particles and removed directly by an external magnetic field. Most importantly, water-soluble organic pollutants can be catalyzed into water-insoluble products, transferred to the original water-insoluble organic pollutants, and removed together. Consequently, both water-soluble and water-insoluble organic pollutants in wastewater can be removed in one step. Using water-soluble methyl orange (MO) and water-insoluble n-decane as models, MO was efficiently degraded and the water-insoluble degradation products were transferred into the n-decane phase. Subsequently, 98.6% of MO and 99.9% of n-decane were efficiently removed in one port. This approach represented a general and practical strategy for treating mixtures of multiple organic pollutants in actual organically polluted water.