Overexpression of MutL homolog 1 and MutS homolog 2 proteins have reversed prognostic implications for stage I–II colon cancer patients

Purpose. This study aimed at evaluating the impact of comorbid diabetes on short-term postoperative outcomes in patients with stage I/II colon cancer after open colectomy. Methods. The data were extracted from the National Inpatient Sample database (2005-2010). Short-term surgical outcomes included in-hospital mortality, postoperative complications, and hospital length of stay. Results. A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in-hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in-hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in-hospital mortality than patients without any comorbidity. Conclusion. The present results suggested the protective effects of uncomplicated diabetes on short-term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.

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Molecularly determined total tumour load in lymph nodes of stage I–II colon cancer patients correlates with high-risk factors. A multicentre prospective study

Virchows Archiv ◽

10.1007/s00428-016-1990-1 ◽

2016 ◽

Vol 469 (4) ◽

pp. 385-394 ◽

Cited By ~ 10

Author(s):

Iban Aldecoa ◽

Begoña Atares ◽

Jordi Tarragona ◽

Laia Bernet ◽

Jose Domingo Sardon ◽

...

Keyword(s):

Risk Factors ◽

Colon Cancer ◽

High Risk ◽

Lymph Nodes ◽

Prospective Study ◽

Cancer Patients ◽

Stage I ◽

High Risk Factors ◽

Tumour Load ◽

Multicentre Prospective Study

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Hospital Center Effect for Laparoscopic Colectomy Among Elderly Stage I-III Colon Cancer Patients

Annals of Surgery ◽

10.1097/sla.0b013e31829d0468 ◽

2014 ◽

Vol 259 (5) ◽

pp. 924-929 ◽

Cited By ~ 9

Author(s):

Zhiyuan Zheng ◽

Nader Hanna ◽

Eberechukwu Onukwugha ◽

Kaloyan A. Bikov ◽

C. Daniel Mullins

Keyword(s):

Colon Cancer ◽

Cancer Patients ◽

Laparoscopic Colectomy ◽

Stage I ◽

Center Effect ◽

Hospital Center

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Prognostic value of signet ring cell histology for survival in stage I and II colon cancer patients: a population-based, propensity score matched analysis

Annals of Oncology ◽

10.1093/annonc/mdw370.141 ◽

2016 ◽

Vol 27 ◽

pp. vi199-vi200

Author(s):

U. Gueller ◽

T. Cerny ◽

B. Schmied ◽

R. Warschkow

Keyword(s):

Colon Cancer ◽

Propensity Score ◽

Cancer Patients ◽

Prognostic Value ◽

Population Based ◽

Signet Ring Cell ◽

Stage I ◽

Signet Ring ◽

Ring Cell

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QIM19-124: Does Virtual Navigation Improve Care Continuity and Compliance in Patients With Early Stage Colon Cancer?

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7127 ◽

2019 ◽

Vol 17 (3.5) ◽

pp. QIM19-124

Author(s):

Dayna Crawford ◽

Brook Blackmore ◽

Jeremy Ortega ◽

Erica Williams

Keyword(s):

Colon Cancer ◽

Cancer Patients ◽

Early Stage ◽

Stage I ◽

Stage Iii ◽

Nccn Guidelines ◽

Care Continuity ◽

Colon Cancers ◽

Follow Up Care

Background: Colon cancer is the 3rd most common cancer in men and women combined, with an occurrence rate of 4.49% for men and 4.15% for women. The 2018 expectation is 50,630 deaths related to colon cancer in the United States (American Cancer Society Facts and Figures 2018). Early detection is increasing with nearly 45% of colon cancers diagnosed as stage I/II (Sarah Cannon Cancer Registry 2015). Treatment for early stage I/II colon cancer patients usually involves surgery then surveillance. On-site navigators perform their duties by patient need and barriers to care. Late stage III/IV colon cancer patients require more assistance and face more barriers, which often leaves early stage I/II patients without an advocate. This disparity can lead to lower rates of follow-up care for early stage I/II patients. Sarah Cannon created a program for virtual colon navigation (VCN) to determine if early stage I/II patients benefit from a virtual navigator who offers support by phone throughout their disease process. Objectives: The goal was to increase early stage I/II patients’ knowledge of their cancer and convey the importance of compliance with follow-up care, such as repeat colonoscopy as recommended by their physician and NCCN Guidelines. Methods: By developing software that utilizes artificial intelligence, Sarah Cannon created an automated process to identify colon cancer patients at the time of diagnosis. This technology then routes positive pathology reports to a VCN who contacts the early stage I/II patients by telephone, ensuring patient connection to the suitable physician for treatment. The VCN helps patients understand their diagnosis, provides education, assesses barriers to care, connects to resources, provides emotional support, and offers assistance with follow-up for physician visits, imaging and procedures such as colonoscopies, based upon NCCN Guidelines and physician guidelines. The VCN also connects stage III/IV patients with an on-site navigator in their region for more hands-on navigation. Results: Through September 2018, Sarah Cannon navigated 734 colon cancers, 332 stage I/II and 402 stage III/IV. With our increased capacity, Sarah Cannon/HCA maintained a 98% rate of follow-up care with new diagnoses of all stages of colon cancer. Conclusions: The VCN program allowed Sarah Cannon/HCA to improve care continuity and compliance based upon NCCN Guidelines for early stage I/II colon cancer patients throughout 5 regions and 37 facilities.

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Prognostic impact of preoperative albumin to globulin ratio in curative colon cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.647 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 647-647

Author(s):

Yuji Toiyama ◽

Hiroyuki Fujikawa ◽

Yasuhiro Inoue ◽

Hiroki Imaoka ◽

Masato Okigami ◽

...

Keyword(s):

Colon Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Poor Prognosis ◽

Early Recurrence ◽

Stage I ◽

Stage Iii ◽

Prognostic Impact ◽

Stage Iii Colon Cancer ◽

Albumin To Globulin Ratio

647 Background: Albumin to globulin ratio (AGR) has been reported to predict long term mortality in patients with several cancers. However, prognostic impact of preoperative AGR in colon cancer patients with curative intent has not yet been fully addressed. Therefore, we, for the first time, investigated the association between AGR and clinico-pathological findings including overall survival (OS) and disease free survival (DFS) in stage I-III colon cancer patients. Methods: Clinicopathological findings including preoperative laboratory data (carcinoembryonic antigen [CEA] and AGR) from 251 curative colon cancer patients were assessed as indicators of early recurrence and poor prognosis in this retrospective study. AGR was calculated as [AGR = albumin/ (total protein - albumin)]. The cut-off value of AGR was 1.32 in current study. Results: Several clinicopathological categories related with tumor progression such as lymph node metastasis, T4 tumor, large tumor size, undifferentiated tumor, venous and lymphatic invasion, and high CEA were significantly associated with low AGR level. The patients with low AGR were significantly poorer OS (P = 0.001) and DFS (P = 0.003) than those with high AGR, respectively. In addition, multivariate analyses demonstrated that low AGR was independently associated with early recurrence (HR = 2.87, P = 0.007) and poor prognosis (HR = 2.56, P = 0.008), respectively. On the other hand, sub analysis of survival curves revealed that stage III colon cancer patients with low AGR were significantly poorer OS (P = 0.007) and DFS (P = 0.02) than those with high AGR, respectively. Furthermore, significantly poorer OS and DFS were also shown in stage I-II colon cancer patients with low AGR, respectively (OS: P = 0.02, DFS: P = 0.01). Conclusions: Preoperative AGR was an independent predictor of early recurrence and poor prognosis in curative colon cancer patients. AGR may represent a simple, potentially useful predictive biomarker for selecting stage I-II colon cancer patients who might need adjuvant chemotherapy. Furthermore, AGR may select candidates who are better to introduce more intensive adjuvant chemotherapy after curative operation in stage III colon cancer patients.

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