scholarly journals Colorectal cancer under 20 years old: a retrospective analysis from three tertiary hospitals

2020 ◽  
Author(s):  
Chengjing Zhou ◽  
Weiwei Xiao ◽  
Xiaohao Wang ◽  
Haiyang Chen ◽  
Shaoqing Niu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Analysis ◽  
Distant Metastasis ◽  
Medical Records ◽  
Radical Surgery ◽  
Rectal Cancer Patient ◽  
Stage Iv ◽  
Signet Ring Cell ◽  
Laboratory Findings ◽  
Tertiary Hospitals

Abstract Purpose Colorectal cancer (CRC) rarely occurs in children and adolescents. This study aimed to perform a retrospective analysis and disclose more detailed information about CRC in patients under 20 years old. Methods Medical records of CRCs in patients under 20 years old referred to three tertiary hospitals in China from September 2000 to July 2019 were retrospectively reviewed. Clinicopathological characteristics, treatment processes and laboratory findings were summarized and treatment outcomes and prognostic factors were analyzed. Results A total of 33,394 CRC medical records were analyzed, and we identified seventy (0.21%) CRCs in patients under 20. The most common primary tumor location was the left hemicolon (35.7%). The prominent pathological types were mucinous adenocarcinoma (22.9%) and signet ring cell carcinoma (22.9%). Nearly half (47.1%) of the patients presented with distant metastasis at diagnosis. The fractions of patients with deficient mismatch repair (dMMR) protein expression and microsatellite instability-high (MSI-H) were 23.8% (5/21) and 71.4% (5/7), respectively. Forty-four patients underwent radical surgery. Fifty-five patients received chemotherapy and six patients received radiotherapy. One dMMR/MSI-H rectal cancer patient received immunotherapy and achieved a clinically complete response. The median overall survival (OS) time was 80 months. The 3-year and 5-year OS rates were 61.8% and 57.2%, respectively. An absence of distant metastasis was a favorable factor for OS. For stage II/III CRCs, classic adenocarcinoma and radical surgery were favorable factors for OS. For stage IV CRCs, primary location at the colon was a favorable factor for OS. Conclusion Child and adolescent CRC patients are likely to have distant metastasis, undifferentiated, left hemicolon location, and a dMMR/MSI-H phenotype at diagnosis. Additional efforts are needed to improve their survival outcomes.

scholarly journals Colorectal Signet Ring Cell Carcinoma in a Young Pregnant Woman

2020 ◽  
Vol 13 (1) ◽  
pp. 182-187
Author(s):  
Francisco Ibargüengoitia Ochoa ◽  
Gerardo Miranda Dévora ◽  
Leonardo Silva Lino ◽  
Cintia Sepulveda Rivera ◽  
Diego González Vázquez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cell Carcinoma ◽  
Stage Iv ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
High Morbidity ◽  
Cancer Stage ◽  
Signet Ring ◽  
Histologic Differentiation ◽  
Ring Cell

Colorectal cancer during pregnancy is one of the less common neoplasms with an incidence of 0.8 in 100,000 pregnancies. Primary colonic signet ring cell carcinoma is a weird variety, characterized by a poor histologic differentiation, with a high morbidity-mortality rate. The case of a 24-year-old patient with a 22-week-old pregnancy and colorectal cancer stage IV in palliative state is presented, with a devastating result. Early diagnosis represents a challenge because of the presentation form and the histologic aggressiveness of this disease. We suggest that colorectal cancer during pregnancy must be treated by a multidisciplinary team.

Retrospective analysis of pathologic response in colorectal cancer liver-only metastases following treatment with bevacizumab.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 674-674
Author(s):  
Ruth Vera ◽  
Joan Figueras ◽  
Maria Luisa Gomez Dorronsoro ◽  
S. Lopez-Ben ◽  
Antonio Viúdez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Retrospective Analysis ◽  
Hepatic Metastases ◽  
Stage Iv ◽  
Poor Response ◽  
Pathological Response ◽  
Residual Tumour ◽  
Tumour Location ◽  
Baseline Characteristics

674 Background: Recent reports have shown that pathological response predicts for better outcome (overall survival) following preoperative chemotherapy and surgical resection of colorectal cancer (CRC) liver-only metastases. The aim of this retrospective analysis was to evaluate the effect of adding bevacizumab to standard chemotherapy on pathological response in patients with CRC liver only metastases. Methods: Patients with stage IV CRC with liver metastases who received neoadjuvant chemotherapy (oxaliplatin-or irinotecan-based) at two Spanish centres were analysed retrospectively. Pathological response was evaluated as follows: complete pathological response (cPR), PR1 (25% of residual tumour), PR2 (25–50% of residual tumour), PR3 (>50% of residual tumour). cPR or PR1 was considered to be a good response, and PR2 or PR3 a poor response. Results: A total of 81 patients were evaluated. Of these, 43 received chemotherapy alone and 38 received chemotherapy plus bevacizumab. Baseline characteristics were as follows: median age 61.0 years (range 43.0–80.0 years); male/female (67%/33%); tumour location – colon (69%) / rectum (31%); hepatic metastases – synchronous (74%) / metachronous (26%); In terms of pathological response, 58% of patients receiving bevacizumab had a good response (cPR + PR1) compared with 28% of those receiving chemotherapy alone. At the end of the analysis, 68% of patients were still alive. Conclusions: Adding bevacizumab to oxaliplatin-based chemotherapy in the neoadjuvant setting improves the pathological response of liver metastases in patients with stage IV CRC. These findings indicate that pathological response might be a good indicator of outcome for patients receiving bevacizumab in the neoadjuvant setting.

Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis

2016 ◽  
Vol 22 (2) ◽  
pp. 297-306 ◽  
Author(s):  
Harunobu Sato ◽  
◽  
Koutarou Maeda ◽  
Zenichi Morise ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Stage Iv ◽  
R0 Resection ◽  
Stage Iv Colorectal Cancer

scholarly journals Stage IV colorectal cancer primary site and patterns of distant metastasis

2017 ◽  
Vol 48 ◽  
pp. 92-95 ◽  
Author(s):  
Jamaica R. Robinson ◽  
Polly A. Newcomb ◽  
Sheetal Hardikar ◽  
Stacey A. Cohen ◽  
Amanda I. Phipps
Keyword(s):  
Colorectal Cancer ◽  
Distant Metastasis ◽  
Stage Iv ◽  
Primary Site ◽  
Stage Iv Colorectal Cancer

scholarly journals Trends and Clinical Outcomes in Young-onset Colorectal Cancer Patients

2020 ◽  
Vol 49 (11) ◽  
pp. 848-856 ◽  
Author(s):  
Serene SN Goh ◽  
Edith XL Loo ◽  
Daniel JK Lee
Keyword(s):  
Colorectal Cancer ◽  
Emergency Surgery ◽  
Elective Surgery ◽  
Stage Iv ◽  
Tertiary Hospital ◽  
Signet Ring Cell ◽  
Factors Affecting ◽  
Young Onset ◽  
Signet Ring ◽  
Colorectal Cancer Patients

Introduction: Young individuals with colorectal cancer (CRC) tend to be diagnosed at advanced stages and are not routinely included in screening programmes. This study describes the incidence, disease pattern and factors affecting overall survival in young- onset CRC. Methods: A retrospective study of young-onset CRC patients diagnosed between 2010 and 2017 in a tertiary hospital was conducted. Results: There were 99 patients, 69.7% had left-sided while 30.3% had right-sided CRC. The mean age was 43.3 years (43.3±5.0) and 62 patients (62.6%) were male. The incidence of young-onset CRC has been on the rise since 2014. Out of 99 patients, 65 (65.7%) underwent elective surgery, 30 (30.3%) underwent emergency surgery and the remainder 5 (4.0%) were palliated. The most common presenting complaints for patients who underwent elective surgery were abdominal pain, per-rectal bleeding and altered bowel habits. For patients who required emergency surgery, 20 (66.6%) presented with intestinal obstruction and 10 (33.3%) had intestinal perforation. There were 42 (42.4%) stage III CRC and 20 (20.2%) stage IV CRC. The most frequent metastatic site was the liver (20/20, 100%). Five patients had signet ring cells (5.1%) in their histology while 15 (15.2%) had mucinous features. The overall 5-year survival of young-onset CRC was 82.0%. Advanced overall stage (hazard ratio (HR) 6.1, CI 1.03–3.62) and signet ring histology (HR 34.2, CI 2.24–5.23) were associated with poor prognosis. Conclusion: Young-onset CRC tend to be left-sided with advanced presentations. However, their 5-year survival remains favourable as compared to the general population. Keywords: Colorectal screening in the young, early-onset colorectal cancer, signet ring cell colorectal cancer

scholarly journals Nomogram for predicting overall survival in colorectal cancer with distant metastasis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Liu ◽  
Yao Xu ◽  
Guijun Xu ◽  
Vladimir P. Baklaushev ◽  
Vladimir P. Chekhonin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Distant Metastasis ◽  
Primary Tumour ◽  
Stage Iv ◽  
Cox Proportional Hazards ◽  
Stage Iv Colorectal Cancer ◽  
Colorectal Cancer Patients

Abstract Background Colorectal cancer (CRC) is a major cancer burden, and prognosis is determined by many demographic and clinicopathologic factors. The present study aimed to construct a prognostic nomogram for colorectal cancer patients with distant metastasis. Methods Colorectal cancer patients with distant metastasis diagnosed between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results database. Cox proportional hazards regression was used to identify independent prognostic factors. A nomogram was constructed to predict survival, and validation was performed. Results A total of 7099 stage IV colorectal cancer patients were enrolled in the construction cohort. The median overall survival was 20.0 (95% CI 19.3–20.7) months. Age at diagnosis, marital status, race, primary tumour site, tumour grade, CEA level, T stage, N stage, presence of bone, brain, liver and lung metastasis, surgery for primary site and performance of chemotherapy were independent prognostic factors. The nomogram was constructed and the calibration curve showed satisfactory agreement. The C-index was 0.742 (95% CI 0.726–0.758). In the validation cohort (7098 patients), the nomogram showed satisfactory discrimination and calibration with a C-index of 0.746 (95% CI 0.730–0.762). Conclusion A series of factors associated with the survival of CRC patients with distant metastasis were found. Based on the identified factors, a nomogram was generated to predict the survival of stage IV colorectal cancer patients. The predictive model showed satisfactory discrimination and calibration, which can provide a reference for survival estimation and individualized treatment decisions.

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