Su1715 PREOPERATIVE COLONIC STENTING IS NOT ASSOCIATED WITH AN INCREASED RISK OF RECURRENT DISEASE OR OSTOMY RATE COMPARED TO UPFRONT SURGERY IN PATIENTS WITH OBSTRUCTIVE COLORECTAL CANCER

441 Background: To provide population-based data on the patterns, risk factors, treatment, and survival of distant recurrences of colorectal cancer (CRC). Methods: All patients (n=6,066) diagnosed with CRC M0 in 10 large Dutch non-academic hospitals between 2003 and 2008 were included. By means of active follow-up, data on distant recurrences and systemic treatment were collected. Median follow-up was 4.4 year. Results: 1,074 (18%) patients were diagnosed with distant recurrent disease during follow-up of which 85% within 3 years. Most common affected sites were liver (60%), lung (39%), extra-regional lymph nodes (22%) and peritoneum (19%) (multiple sites possible). Male sex (female=ref (17%), 19%/HR 1.1 95%CI 1.0-1.3), advanced primary tumor stage (T1=ref (4%), T2 9%/HR 3.0 95%CI 1.8-4.9, T3 21%/HR 6.1 95%CI 3.8-9.9, T4 29%/HR 11.0 95%CI 6.7-18.1), advanced lymph node stage (N0=ref (11%), N1 29%/HR 2.8 95%CI 2.4-3.3, N2 41%/HR 4.5 95%CI 3.7-5.4), primary tumor localization (left colon=ref (17%), right colon 16%/HR 0.8 95%CI 0.7-1.0, rectum 25%/HR 1.2 95%CI 1.0-1.4), and tumor differentiation grade (well differentiated=ref [16%], poorly differentiated 26%/HR 1.4 95%CI 1.2-1.7) were associated with increased risk recurrences while chemotherapy for the primary tumor was associated with reduced risk (HR 0.8 95%CI 0.7-0.9). Recurrence rates did not differ between hospitals. 52% of patients with recurrences received systemic therapy, ranging from 34-62% between the 10 hospitals (p<0.01). Half of these patients (52%) was also treated with bevacizumab, ranging from 39-73% between hospitals (p<0.05). Median survival since diagnosis of recurrence was 31 months for patients with lung metastases only, 16 months for liver metastases only, 14 months for lung metastases only, and 5 months for metastases confined to the peritoneum. Conclusions: The development of distant recurrent disease was strongly related to tumor characteristics, but not correlated with hospital of primary treatment. Population-based data on distant recurrences may ultimately contribute to more accurate patient information, and more efficient follow-up schemes.

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A comparative study on efficacy of chemotherapy after endoscopic colonic stenting vs. that after colonic surgery in the management of obstructive colorectal cancer

10.26226/morressier.59a6b348d462b80290b55036 ◽

2017 ◽

Author(s):

Norihiro Hanabata

Keyword(s):

Colorectal Cancer ◽

Comparative Study ◽

Colonic Surgery ◽

Obstructive Colorectal Cancer ◽

Colonic Stenting

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ANALYSING OUTCOMES FROM ELECTIVE COLONIC STENTING FOR COLORECTAL CANCER AT A DISTRICT GENERAL HOSPITAL

10.1055/s-0040-1704581 ◽

2020 ◽

Author(s):

D Mohandas ◽

A Sinha ◽

S Tewari ◽

MM San ◽

R Mead ◽

...

Keyword(s):

Colorectal Cancer ◽

General Hospital ◽

District General Hospital ◽

Colonic Stenting

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Clinical outcome when using Self Expanding Metal Stent in obstructive colorectal cancer in 248 patients; 7 years experience from a tertiary center.

10.26226/morressier.59a6b34bd462b80290b55692 ◽

2017 ◽

Author(s):

Morteza Shafazand

Keyword(s):

Colorectal Cancer ◽

Clinical Outcome ◽

Metal Stent ◽

Obstructive Colorectal Cancer ◽

Tertiary Center

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Su1228 Increased Risk of Colorectal Cancer in Patients With Prior Ovarian Cancer Diagnosis: A Population Based US Study

Gastroenterology ◽

10.1016/s0016-5085(14)61474-8 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-408

Author(s):

Yezaz A. Ghouri ◽

Sachin Batra ◽

Nirav C. Thosani ◽

Sushovan Guha

Keyword(s):

Colorectal Cancer ◽

Ovarian Cancer ◽

Cancer Diagnosis ◽

Population Based ◽

Increased Risk

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Consumption of Lactose, Other FODMAPs and Diarrhoea during Adjuvant 5-Fluorouracil Chemotherapy for Colorectal Cancer

Nutrients ◽

10.3390/nu12020407 ◽

2020 ◽

Vol 12 (2) ◽

pp. 407

Author(s):

Reetta Holma ◽

Reijo Laatikainen ◽

Helena Orell ◽

Heikki Joensuu ◽

Katri Peuhkuri ◽

...

Keyword(s):

Colorectal Cancer ◽

Adjuvant Therapy ◽

Gastrointestinal Symptoms ◽

Mucosal Injury ◽

Dietary Carbohydrates ◽

Food Diary ◽

High Consumption ◽

Increased Risk ◽

Symptom Diary ◽

Low Consumption

Chemotherapy-induced mucosal injury of the small intestine may interfere with the enzymes and transporters responsible for the hydrolysis and absorption of dietary carbohydrates causing diarrhoea, abdominal discomfort and pain. The aim of this study was to investigate the association between the consumption of foods rich in FODMAPs (fermentable oligo-, di- and monosaccharides and polyols) and gastrointestinal symptoms in patients receiving adjuvant therapy for colorectal cancer. The patients (n = 52) filled in a 4-day food diary at baseline and during therapy and kept a symptom diary. The intakes of FODMAP-rich foods were calculated as portions and the intakes were divided into two consumption categories. Patients with high consumption of FODMAP-rich foods had diarrhoea more frequently than those with low consumption (for lactose-rich foods the odds ratio (OR) was 2.63, P = 0.03; and for other FODMAP-rich foods 1.82, P = 0.20). Patients with high consumption of both lactose-rich and other FODMAP-rich foods had an over 4-fold risk of developing diarrhoea as compared to those with low consumption of both (OR, 4.18; P = 0.02). These results were confirmed in multivariate models. Conclusion: Consumption of lactose-rich foods results in an increased risk of diarrhoea during adjuvant therapy for colorectal cancer, especially when the consumption of other FODMAP-rich foods is also high.

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37 Monitoring the evolution of inflammatory bowel disease (IBD) in pediatric and adult cohorts of patients to identify biomarkers to predict cancer risk

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0037 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A38-A38

Author(s):

Shilpa Ravindran ◽

Heba Sidahmed ◽

Harshitha Manjunath ◽

Rebecca Mathew ◽

Tanwir Habib ◽

...

Keyword(s):

Oxidative Stress ◽

Gene Expression ◽

Colorectal Cancer ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Mesenchymal Transition ◽

Increased Risk ◽

Hamad Medical Corporation ◽

Inflammatory Bowel ◽

Left And Right

BackgroundPatients with inflammatory bowel disease (IBD) have increased risk of developing colorectal cancer (CRC), depending on the duration and severity of the disease. The evolutionary process in IBD is driven by chronic inflammation leading to epithelial-to-mesenchymal transition (EMT) events in colonic fibrotic areas. EMT plays a determinant role in tumor formation and progression, through the acquisition of ‘stemness’ properties and the generation of neoplastic cells. The aim of this study is to monitor EMT/cancer initiating tracts in IBD in association with the deep characterization of inflammation in order to assess the mechanisms of IBD severity and progression towards malignancy.Methods10 pediatric and 20 adult IBD patients, admitted at Sidra Medicine (SM) and Hamad Medical Corporation (HMC) respectively, have been enrolled in this study, from whom gut tissue biopsies (from both left and right side) were collected. Retrospectively collected tissues (N=10) from patients with malignancy and history of IBD were included in the study. DNA and RNA were extracted from fresh small size (2–4 mm in diameter) gut tissues using the BioMasher II (Kimble) and All Prep DNA/RNA kits (Qiagen). MicroRNA (miRNA; N=700) and gene expression (N=800) profiling have been performed (cCounter platform; Nanostring) as well as the methylation profiling microarray (Infinium Methylation Epic Bead Chip kit, Illumina) to interrogate up to 850,000 methylation sites across the genome.ResultsDifferential miRNA profile (N=27 miRNA; p<0.05) was found by the comparison of tissues from pediatric and adult patients. These miRNAs regulate: i. oxidative stress damage (e.g., miR 99b), ii. hypoxia induced autophagy; iii. genes associated with the susceptibility to IBD (ATG16L1, NOD2, IRGM), iv. immune responses, such as TH17 T cell subset (miR 29). N=6 miRNAs (miR135b, 10a196b, 125b, let7c, 375) linked with the regulation of Wnt/b-catenin, EM-transaction, autophagy, oxidative stress and play role also in cell proliferation and mobilization and colorectal cancer development were differentially expressed (p<0.05) in tissues from left and right sides of gut. Gene expression signature, including genes associated with inflammation, stemness and fibrosis, has also been performed for the IBD tissues mentioned above. Methylation sites at single nucleotide resolution have been analyzed.ConclusionsAlthough the results warrant further investigation, differential genomic profiling suggestive of altered pathways involved in oxidative stress, EMT, and of the possible stemness signature was found. The integration of data from multiple platforms will provide insights of the overall molecular determinants in IBD patients along with the evolution of the disease.Ethics ApprovalThis study was approved by Sidra Medicine and Hamad Medical Corporation Ethics Boards; approval number 180402817 and MRC-02-18-096, respectively.

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