目的:吻合口漏(anastomotic leakage,AL)是低位直肠癌保肛术后的严重并发症,亟需确切有效的预防措施.本研究旨在评估机器人低位直肠癌前切除术(low anterior resection,LAR)联合创新技术预防AL的临床价值.方法:选取2012年5月至2017年5月,于复旦大学附属中山医院接受机器人LAR治疗的601例患者,其中191例患者为对照组(non-PST组),410例患者为治疗组(PST组).分析比较两组AL发生率、围手术期结局和长期生存率;多因素回归分析机器人LAR术后AL的高危因素.结果:依据ISREC分级,601例患者的总体AL发生率为6.8％,其中B级为5.7％,C级为1.1％.其中PST组的总体AL发生率(5.1％)明显低于non-PST组(10.5％,P=0.015);PST组的C级AL也明显改善(0.2％vs.3.2％,P=0.005).此外,PST组的手术并发症率(17.3％vs.20.9％,P=0.286)和再手术率(2.7％vs.6.3％,P=0.038)较non-PST组均显著降低.长期结局分析提示两组的局部复发率和长期生存率无显著差异.多因素回归分析提示non-PST技术、术中出血量≥100 mL、吻合口距离肛缘<5 cm以及远端切缘距离肿瘤<2 cm分别是机器人LAR术后AL发生的高危因素.结论:机器人LAR联合PST技术是一种有效预防AL的方法,在临床实践中可避免常规实施保护性造口术.

Background: Anastomotic leakage (AL) is a severe complication of low anterior resection (LAR) for rectal cancer, and effective prevention is urgently needed. In the robotic era, this study aimed to explore the role of innovative techniques in preventing AL in rectal cancer patients undergoing robotic LAR. Methods: From May 2012 to May 2017, a total of 601 patients underwent robotic LAR, with 191 patients participated as control subjects (non-PST group) and 410 patients are subjected to a trinity technique (PST group). The AL rate, short-term and long-term outcomes are analyzed and compared. Results: The overall rate of AL was 6.8% out of 601 patients, with Grade B at 5.7% and Grade C at 1.1%, using the ISREC grading system. The PST group presented lower incidence of both overall AL (5.1% vs 10.5%, P = 0.015) and major AL (0.2% vs 3.2%, P = 0.005), when compared with the non-PST group, respectively. Furthermore, the PST group had similar surgical complications (17.3% vs 20.9%, P = 0.286), while with lower re-hospitalization rate (2.7% vs 6.3%, P = 0.038) and reoperation rate (0.2% vs 4.2%, P = 0.001), compared with the non-PST group, respectively. Short-term recovery and long-term oncological outcomes were not significant in the two groups. By multivariate logistic regression models, the risk factors of AL of robotic LAR are confirmed as non-PST technique, estimated blood loss >= 100 mL, anastomosis from anal verge <5 cm, and distal resection margin from tumor <2 cm. Conclusions: The innovative PST technique may shed light on an effective method for preventing occurrence of AL in robotic LAR. (C) 2020 Published by Elsevier Ltd.

Abstract Backgrounds Cancer-related mortality in patients with colorectal cancer (CRC) is predominantly caused by development of colorectal liver metastases (CLMs). How to screen the sensitive chemotherapy and targeted therapy is the key element to improve the prognosis of CLMs patients. The study aims to develop patient-derived organoids-based xenografted liver metastases (PDOX-LM) model of CRC, to recapitulate the clinical drug response. Methods We transplanted human CRC primary tumor derived organoids in murine spleen to obtain xenografted liver metastases in murine liver. Immunohistochemistry (IHC) staining, whole-exome and RNA sequencing, and drug response testing were utilized to identify the homogeneity in biological and genetic characteristics, and drug response between the PDOX-LM models and donor liver metastases. Results We successfully established PDOX-LM models from patients with CLMs. IHC staining showed that positive expression of CEA, Ki67, VEGF, FGFR2 in donor liver metastases were also well preserved in matched xenografted liver metastases. Whole-exon sequencing and transcriptome analysis showed that both xenografted and donor liver metastases were highly concordant in somatic variants (≥ 0.90 frequency of concordance) and co-expression of driver genes (Pearson’s correlation coefficient reach up to 0.99, P = 0.001). Furthermore, drug response testing showed that the PDOX-LM models can closely recapitulated the clinical response to mFOLFOX6 regiments. Conclusions This PDOX-LM model provides a more convenient and informative platform for preclinical testing of individual tumors by retaining the histologic and genetic features of donor liver metastases. This technology holds great promise to predict treatment sensitivity for patients with CLMs undergoing chemotherapy.

Introduction of the da Vinci robotic surgical system has revolutionized the field of minimally invasive surgery for rectal cancer. Da Vinci robotic technologies could help surgeons overcome the technical difficulties of conventional laparoscopic surgery, showing significant superiority in aspects of 3D visualization, articulated instruments and filtering operating tremor. Accumulated studies have confirmed the safety and feasibility of the da Vinci robotic surgery for rectal cancer. Compared with conventional laparoscopic surgery, the da Vinci robotic rectal surgery has latent advantage in decreasing conversion rate, reducing postoperative morbidity and improving postoperative life quality. In terms of oncological outcome, the robotic rectal surgery has shown comparable long-term outcomes with either open or laparoscopic surgery. At present, natural orifice specimen extraction surgery (NOSES) has been an important branch of robotic rectal surgery. In addition, in the era of high-speed communication, the robotic surgical system would be a key module in telemedicine, actively promoting the innovation of remote consultation, academic communication, hospital construction and even medical treatment model. Key words: Rectal neoplasms; Robotics; Surgical procedures, minimally invasive

The tumor-derived factors involved in the expansion and accumulation of myeloid-derived suppressor cells (MDSCs) in metastatic dissemination of colorectal cancer (CRC) to the liver has not been studied. Immunohistochemistry was used to detect sphingosine-1-phosphate receptor 1 (S1PR1) and signal transducer and activator of transcription-3 (STAT3) in human colorectal tumors. IL-6 and interferon-γ were detected by enzyme-linked immunosorbent assay (ELISA). Tumor growth, invasion, and migration were evaluated by MTT, transwell, and wound healing assays, respectively. Subcutaneous tumor-bearing and CRC liver metastasis (CRLM) nude mouse models were constructed. The percentage of MDSCs was measured using multicolor flow cytometry. Western blot assay was used to evaluate S1PR1 and p-STAT3 expression in MDSCs after separation from the liver and tumor by magnetic antibody. T-cell suppression assay was detected by carboxyfluorescein succinimidyl ester (CFSE). Aberrant co-expressed S1PR1 and p-STAT3 was correlated with metachronous liver metastasis and poor prognosis in CRC. A mutual activation loop between S1PR1 and STAT3 can enhance CRC cell proliferation, migration, and invasion in vitro and in vivo. The expression of p-STAT3 and its downstream proteins can be regulated by S1PR1. p-STAT3 was the dependent signaling pathway of S1PR1 in the promotion of cell growth and liver metastasis in CRC. The level of IL-6 and the associated MDSCs stimulated by the S1PR1–STAT3 correlated with the number of liver metastatic nodes in the CRLM mouse models and patients. Increased CD14 + HLA-DR −/low MDSCs from CRLM patients inhibited autologous T-cell proliferation and predict poor prognosis. The S1PR1–STAT3–IL-6–MDSCs axis operates in both tumor cells and MDSCs involved in the promotion of growth and liver metastasis in CRC. MDSCs induced by S1PR1–STAT3 in CRC cells formed the premetastatic niche in the liver can promote organ-specific metastasis.

Purpose: To evaluate the role of hepatic steatosis (HS) in patients with synchronous colorectal liver-limited metastases (CLLMs) undergoing conversion therapy. Patients and methods: From March 2013 to March 2017, a total of 406 patients with initially unresectable CLLMs accepted conversion therapy in multidisciplinary team (MDT). Before the implementation of conversion therapy, all patients underwent CT scan to assess the presence of hepatic steatosis and divided into the HS group (n = 124) and the non-HS group (n = 282). After using propensity score matching (PSM) to eliminate the potential confounding bias of the two groups, the conversion hepatectomy rate and long-term oncological survival in two groups were compared. Results: After 1:1 PSM, no significant difference was observed at baseline between patients in the HS group (n = 119) and the non-HS group (n = 119). Patients in the HS group had higher conversion hepatectomy rate from MDT evaluation (31.1% vs 18.5%, P = 0.029) and actual hepatectomy rate (30.2% vs 18.5%, P = 0.030), when compared with patients in the non-HS group, respectively. In addition, the HS group achieved better progression-free survival (PFS, P = 0.047) and overall survival (OS, P = 0.035) than that of the non-HS group. Multivariate logistic analysis confirmed that pretreatment HS was an independent predictor for conversion hepatectomy rate (OR, 2.393; 95% CI, 1.463-4.315, P = 0.001), and multivariate Cox analysis revealed that HS was an independent prognostic factor for PFS (HR, 0.493, 95% CI 0.281-0.866, P = 0.014) and OS (HR, 0.559, 95% CI 0.398-0.785, P = 0.001). Conclusion: For CLLM patients who underwent conversion therapy, hepatic steatosis could be an effective predictor for conversion hepatectomy rate and an independent prognostic factor for PFS and OS.

Background Due to a limited patient sample size, substantial data on robotic rectal resection (RRR) is lacking. Here, we reported a large consecutive cases from the real word data to assess the safety and efficacy of RRR. Methods From September 2010 to June 2017, a total of 1145 consecutive RRR procedures were performed in patients with stage I–IV disease. We conducted an analysis based on information from a prospectively designed database to evaluate surgical outcomes, urogenital function, and long-term oncological outcomes. Results Of three types of RRR performed, 227 (24.2%) were abdominoperineal resections, 865 (75.5%) were anterior resections, and 3 (0.3%) were Hartmann. Conversion to an open procedure occurred in 5.9% of patients. The overall positive circumferential margin rate was 1.3%. Surgical complication rate and mortality were 16.2% and 0.8% within 30 days of surgery, respectively. Mean hospital stay after surgery and hospital cost were 6.3 ± 2.9 days and 10442.5 ± 3321.5 US dollars, respectively. Risk factors for surgical complications included male gender, tumor location (mid-low rectum), combined organ resection, and clinical T category (cT3–4). Urinary function and general sexual satisfaction decreased significantly 1 month after surgery for both sexes. Subsequently, both parameters increased progressively, and the values 1 year after surgery were comparable to those measured before surgery. At a median follow-up of 34.6 months, local recurrence and distant metastases occurred in 2.3% and 21.1% of patients, respectively. Conclusions Robotic rectal resection was safe with preserved urogenital function and arrived equivalent oncological outcomes in a nonselected group of patients with rectal cancer.

[This corrects the article DOI: 10.7150/jca.35380.].

Objective Using genetic mice and lineage trace to identify gastric antral stem cells and its role in tumorigenesis.Methods Cck2r-BAC-CreERT mice,Apcflox mice and R26-Td Tomato mice were established by gene editing technique.The role of CCK2R + stem cells in tumorigenesis was demonstrated in Cck2r-CreERT/R26-Td Tomato/Apcflox/flox mice and a chemical-induced gastric cancer model based on N-methyl-N-nitrosourea (MNU).Results CCK2R + stem cells at + 4 position of antral gland accounted for about 0.8％ of whole gland cells,maintained self-renew and differentiated into multiple antral epithelial and endocrine cells.In the H.felis/MNU induction gastric cancer model,the number of CD44 + cell (13.7 ± 2.8 vs.4.3 ± 0.2,t =4.152,P ＜ 0.01),Muc2 + cell (21.8 ± 4.1 vs.0.8±0.2,t=5.673,P＜0.01) and Ki-67+ cell (30.3 ±5.9 vs.20.7 ±2.4,t=3.854,P＜0.01) were higher at 18 weeks than vehicle,while Tff2+ cell decreased (0.7 ±0.2 vs.4.3 ± 1.8,t =4.346,P ＜0.01) in MNU group.CCK2R+ stem cells derived cancer cells account for 70％ at 36 weeks.Apc gene mutation lead to WNT/β-Catenin signaling pathway continuous activation,CCK2R+ stem cells rapidly proliferate and differentiate,and give rise to tumors in 28 d.Conclusion Apc mutation or H.felis/MNU induction stimulated CCK2R + stem cells give rise to gastric antrum tumors.

This study is aimed to assess the role of hepatic steatosis (HS) on outcome of conversion 15 therapy for patients with initially unresectable synchronous colorectal liver-limited metastases 16 (CLLMs). We identified 346 patients with initially unresectable CLLMs received conversion therapy 17 under the guidance of multidisciplinary team (MDT) in Zhongshan hospital (2013 to 2016). HS 18 status of all patients was evaluated before the first circle of conversion therapy. The objective 19 response rate (ORR), hepatectomy rate, predictor of conversion hepatectomy, and overall survival 20 (OS) were compared using propensity-score matching (PSM). Predictive value of HS in conversion 21 hepatectomy was validated with a separate cohort of 60 patients initially unresectable CLLMs who 22 received conversion therapy (2017 to 2018). Before conversion therapy start, 108 (31.2%) patients 23 were detected with HS status. In study set after PSM, compared with non-HS group, HS group 24 supplied improved ORR (36.7% vs 23.9%, P=0.020), hepatectomy rate from MDT (27.7% vs. 16.9%, 25 P<0.001) following conversion therapy. Multivariate analysis confirmed that HS (OR, 5.234; 95%CI, 26 2.398-11.423, P<0.001), targeted therapy and transarterial chemoembolization treatment were 27 independent predictors of hepatectomy rate. In the validation cohort, patients with HS had an 28 improved conversion hepatectomy rate (43.7% vs. 15.9%, P=0.038) following conversion therapy. 29 Hepatic steatosis status could be a predictor of conversion hepatectomy in patients with 30 synchronous colorectal liver-limited metastases. This effect appears to be independent of use of 31 targeted therapy. 32

Growing evidence indicates that primary tumor location of metastatic colorectal cancer (mCRC) can affect response to specific therapy. This study aimed to assess the impact of primary tumor location on efficacy of cetuximab in Chinese patients with mCRC. We included patients with RAS wild type liver-limited mCRC treated with first-line cetuximab plus chemotherapy or chemotherapy alone between June 2008 and December 2016. All patients were categorized as having left-sided tumors or right-sided tumors. Progression free survival (PFS), overall survival (OS), objective response rate (ORR) and conversion rate of surgery for liver metastases was analyzed according to tumor location and treatment. Right-sided tumors were characterized with larger primary tumor, poorer differentiation, more lymph node metastases and larger and more liver metastases. For patients with left-sided tumors (N=233), addition of cetuximab to chemotherapy significantly improved ORR (68.9% vs. 30.6%, OR=5.01, P < 0.001), conversion rate of liver surgery (33.5% vs. 10.8%, OR=4.18, P < 0.001), PFS (12.1 months vs. 6.1 months, HR=0.42, P < 0.001), and OS (not evaluable vs. 23.1 months, HR=0.31, P < 0.001). Among patients with right sided tumors (N=85), cetuximab plus chemotherapy, compared with chemotherapy alone, also significantly improved ORR (56.8% vs. 29.3%, OR=3.18, P=0.010), PFS (9.3 months vs. 5.1 months, OR=0.57, P=0.012) and OS (25.3 months vs. 16.8 months, HR=0.56, P=0.032) but conversion rate of liver surgery (20.5% vs. 9.8%, HR=2.38, P=0.171). Our results demonstrated differential effect of cetuximab on efficacy outcomes based on tumor sidedness. Also, we found that patients with right-sided tumors also benefit from cetuximab plus chemotherapy but not as great as left-sided tumors and in general, did worse. In conclusion, findings of previous studies about differential effect of anti-EGFR therapy based on tumor sidedness are applicable to an Asian population.

This study aimed to explore the prognostic impact of KRAS and BRAF mutations in patients who underwent simultaneous resection for synchronous colorectal liver metastases (SCRLMs) that were initially resectable. Clinicopathological and outcome data of 139 consecutive patients with SCRLMs who underwent resection between July 2003 and July 2013 was collected from our prospectively established SCRLM database. The KRAS and BRAF genotypes were evaluated in the primary cancer tissues by pyrosequencing. The prognostic value of KRAS and BRAF status was assessed by Kaplan-Meier and Cox regression analyses. KRAS and BRAF mutated in 28.8% and 7.2% of the patients with SCRLMs, respectively, but the genotypes did not significantly associate with any clinicopathologic characteristics. By Kaplan-Meier survival analysis, we found KRAS mutation was not significantly associated with short overall survival (OS) (P = 0.213), but was significantly correlated with short disease-free survival (DFS) (P = 0.041); BRAF mutation was significantly associated with both short OS and DFS (P = 0.001, P<0.001, respectively). Multivariate survival analysis showed KRAS mutation was an independent negative prognostic factor for DFS (P = 0.005) and BRAF mutation was an independent negative prognostic factor for OS and DFS (P = 0.001, P<0.001, respectively). KRAS and BRAF mutation similarly contributed to an adverse prognostic effect in patients who underwent simultaneous resection for SCRLMs that were initially resectable. These findings should suggest the use of KRAS and BRAF status in current practice as an important determinant for precision surgery for initially resectable SCRLMs.

Purpose: To investigate differences in clinical characteristics and mutational patterns between synchronous and metachronous colorectal liver metastases (CLMs). Patients and methods: From June 2008 to December 2014, patients with RAS wild-type CLMs treated at Zhongshan Hospital, Fudan University were included. DNA extracted from formalin-fixed paraffin-embedded tissue of primary tumors was sequenced with next-generation sequencing for single-nucleotide polymorphism of 96 genes according to custom panel. Mutations were compared between synchronous and metachronous liver metastases and correlated with clinical characteristics. Results: A total of 161 patients were included: 93 patients with synchronous CLM and 68 patients with metachronous CLM. Patients with metachronous CLM were obviously elder. For pathology of primary tumors, synchronous CLMs were larger in size, poorly differentiated, and more frequently local advanced and lymph node positive. For evaluation of liver metastases, synchronous CLM had more and larger metastatic lesions. The median number of mutations in synchronous CLMs was significantly higher than in metachronous group (22 vs. 18, p< 0.001). EGFR rs2227983 is the most prevalent mutation in both groups and only a part of prevalent mutations is shared in both groups. Prevalent mutations were correlated with many clinical characteristics. EGFR rs2227983, RBMXL3 rs12399211, and PTCH1 rs357564 were prognostic for latency of metachronous CLM. Conclusion: Clinically, synchronous CLMs, compared with metachronous CLMs, were younger and showed heavier tumor burden for both primaries and liver metastases. Genetically, we identified different mutational patterns between synchronous and metachronous CLMs and several correlations between mutations and clinical characteristics. Further researches were needed to confirm these potential key mutations of CLMs.

The invention relates to a three-dimensional culture system based on thermo-sensitive biogel. The three-dimensional culture system is prepared by combining the following reagents: thermo-sensitive biogel, digestive fluid required for separating and culturing tumor cells, a basal culture medium and a human intestinal stem cell culture medium. The invention also provides a method for establishing acolorectal cancer patient-derived xenograft model through the three-dimensional culture system based on thermo-sensitive biogel. The three-dimensional culture system has the advantages that colorectalcancer cells can be further amplified and grown in the three-dimensional culture system based on thermo-sensitive biogel, and the tumor formation capability of the colorectal cancer cells in the immune deficient mice can be enhanced. Polyclonal tumor cells cultured in the system have high subcutaneous tumor formation capability in nude mice. The three-dimensional culture system has the advantagesof simple preparation method and mature technology, and is capable of greatly reducing the time and the cost for establishing the human-derived colorectal cancer xenograft model.

Purpose We aimed to identify new predictive biomarkers for cetuximab in first-line treatment for patients with RAS wild-type metastatic colorectal cancer (mCRC). Methods The study included patients with KRAS wild-type unresectable liver-limited mCRC treated with chemotherapy with or without cetuximab. Next-generation sequencing was done for single nucleotide polymorphism according to custom panel. Potential predictive biomarkers were identified and integrated into a predictive model within a training cohort. The model was validated in a validation cohort. Results Thirty-one of 247(12.6%) patients harbored RAS mutations. In training cohort (N=93), six potential predictive genes, namely, ATP6V1B1, CUL9, ERBB2, LY6G6D, PTCH1, and RBMXL3, were identified. According to predictive model, patients were divided into responsive group (n=66) or refractory group (n=27). In responsive group, efficacy outcomes were significantly improved by addition of cetuximab to chemotherapy. In refractory group, no benefit was observed. Interaction test was significant across all endpoints. In validation cohort (N=123), similar results were also observed. Conclusions In the first-line treatment of mCRC, the predictive model integrating six new predictive mutations divided patients well, indicating a promising approach to further refine patient selection for cetuximab on the basis of RAS mutations.

Translational medicine is characterized by its close association with precision medicine in the field of colorectal cancer.In particular,the studies of life histology promote the prevention and treatment of colorectal cancer entered the stage of precision medicine.Accurate molecular typing of colorectal cancer has been used to guide clinical practice is an important breakthrough in the field of colorectal cancer translational medicine in recent years,and its clinical value has been verified.As an important tool for the effective integration of clinical data and life histology data,the biomedical big data platform is expected to contribute to the continued breakthrough of translational medicine in precision molecular typing.New treatment methods,such as liquid biopsy technology with non-invasive,flexible features can be dynamically detected as soon as possible to find the state of somatic mutations.Among them,circulating tumor DNA has a good detection sensitivity and specificity,highlighting the value of early recurrence monitoring.In addition,new therapeutic strategies,such as immunological checkpoints and chimeric antigen receptor genetically modified T-cell therapy,are under intense study in the field of colorectal cancer.Based on the biomedical big data analysis in the context of the precise molecular typing,dynamic liquid biopsy monitoring technology,new immunotherapy and other fields will be the future of colorectal cancer translational medicine research hot and breakthrough direction.

Previous studies on the prognostic impact of survivin expression in gastrointestinal (GI) cancer have yielded inconsistent results. This study was initiated to assess the relationship between survivin expression and overall survival (OS) or disease free survival (DFS) in GI cancer patients. We applied system literature searches on EMBASE, PubMed, Web of science, and the Cochrane library to conduct this up-to-date meta-analysis. Thirty studies with totally 3622 GI cancer patients were collected. The prevalence of high survivin expression in GI cancer was 0.57 (95% CI: 0.51-0.63). High survivin expression was significantly associated with shorter OS (HR 1.57, 95% CI: 1.42-1.74) and DFS (HR 1.38, 95% CI: 1.21-1.58). Subgroup analysis also showed significant association between high survivin expression and poorer OS or DFS in gastric cancer or colorectal cancer. In summary, our study indicated that high survivin expression was related to poor prognosis in GI cancer. Well-designed studies with large sample and more convincing data are needed to confirm our conclusion.

3575 Background: The simultaneous resecting both colorectal cancer and liver metastases is a safety and efficacy surgical procedure for treating colorectal cancer patients with liver metastases (CRCLM).The safety and efficacy of robot-assisted simultaneous resection of CRCLM is unclear. Furthermore, what kind of selective CRCLM patients would obtain benefits from robotic procedure need identify. The aim of this study was designed to compare robotic procedure with open surgery, and establish robotic surgery indications to identify benefit population of CRCLM. Methods: CRCLM patients were evaluated and confirmed with surgical indication by multidisciplinary team (MDT), and randomized to two groups, robotic arm (n = 58) and open arm (n = 57). The primary endpoint is 3-year DFS, the second endpoints include short-term surgical outcomes, complications and safety. Results: A total of 115 patients were randomized between September 2013 and September 2016. Despite longer operating time, patients assigned to robot-assisted surgery had less blood loss (100ml vs. 150ml, P < 0.001), a shorter time to pass first flatus (3 d vs. 4 d, P < 0.001) and return to diet (3 d vs. 5 d, P = 0.002), shorter hospital stay with improved sexual function. Furthermore, followed benefits were observed in robotic arm versus open arm: lower serum C reactive protein (CRP) level on postoperative day 1 (POD1) (16 mg/L vs. 37 mg/L,P < 0.001), and POD3 (112 mg/L vs. 160 mg/L, P < 0.001), lower level of liver transaminase on POD5, and lower liver-related complication morbidity(10.3% vs 28.1%, p = 0.016). In addition, we identified and recommended selective CRCLM patients with the number of liver metastases < 3, maximal tumor size < 5cm, tumor not located in segment I to accept robotic procedure. Conclusions: We identified and recommended selective CRCLM patients to accept robotic surgery for treating liver metastases. Robotic surgery result in similar safety as open procedure, with shorter recovery time, decreased morbidity, and improved sexual function. Clinical trial information: NCT02642978.

An increasing number of studies have demonstrated that circular RNAs (circRNAs) can regulate gene expression through interacting with microRNAs. In this study, we analyzed the expression of antisense to CDR1as in colorectal cancer (CRC). CDR1as had a higher expression in CRC tissues compared to adjacent, normal mucosa and was positively associated with tumor size, T stage, lymph node metastasis, and poor overall survival (OS). Downregulation of CDR1as suppressed CRC cell proliferation and invasion and increased microRNA-7 (miR-7) expression. Intriguingly, ectopic expression of miR-7 in CRC cells consistently inhibited proliferation and invasion, and the miR-7 inhibitor was able to rescue the function of CDR1as knockdown. Mechanistic studies demonstrated that CDR1as silencing suppressed EGFR and IGF-1R expression, which could be partially blocked by the miR-7 inhibitor. Finally, positive correlations between CDR1as expression and EGFR and IGF-1R expression were observed in CRC samples. Thus, given the importance of CDR1as in blocking miR-7 and positively regulating EGFR and IGF-1R, dysregulated CDR1as expression may play an important role in CRC progression.