scholarly journals The impact of old age on cancer-specific and non-cancer-related survival following elective potentially curative surgery for Dukes A/B colorectal cancer

2008 ◽  
Vol 99 (7) ◽  
pp. 1046-1049 ◽  
Author(s):  
D C McMillan ◽  
D J Hole ◽  
C S McArdle
Keyword(s):  
Colorectal Cancer ◽  
Old Age ◽  
Curative Surgery ◽  
The Impact ◽  
Related Survival

The impact of preoperative dexamethasone on the postoperative systemic inflammatory response and complications following surgery for colorectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 692-692
Author(s):  
Stephen Thomas McSorley ◽  
Paul G. Horgan ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Response ◽  
Elective Surgery ◽  
Systemic Inflammatory Response ◽  
Curative Surgery ◽  
Association Table ◽  
L 14 ◽  
Induction Of Anaesthesia ◽  
The Impact

692 Background: It is now clear that there is a significant association between the magnitude of the systemic inflammatory response and postoperative complications (Adamina et al. Br J Surg 2015;102(6):590-8). The present study examined the impact of preoperative steroids on the postoperative systemic inflammatory response and complications, following elective surgery for colorectal cancer. Methods: The administration of dexamethasone at induction of anaesthesia was prospectively audited from a cohort of patients who underwent elective, potentially curative surgery for colorectal cancer at a single centre between 2008 and 2013. Results: 286 patients were included, of which the majority were male (161, 57%), over 65 (190, 66%) with colonic (183, 64%) and node negative disease (192, 67%). 114 (40%) received dexamethasone at induction of anaesthesia. There was a significant association (Table 1) between preoperative dexamethasone administration and the proportion of patients breaching established CRP thresholds on postoperative days 2 (190mg/L, 14% vs. 50%, p<0.001), and 3 (170mg/L, 27% vs. 49%, p<0.001) but not 4 (145mg/L, 50% vs. 36%, p=0.658). There was no significant association between preoperative dexamethasone and postoperative complications. Conclusions: The present study suggests that the systemic inflammatory response following surgery for colorectal cancer may be attenuated by preoperative steroids. It remains to be determined whether this will lead to a reduction in postoperative complications. [Table: see text]

Urgent Need for a New Staging System in Advanced Colorectal Cancer

2008 ◽  
Vol 26 (29) ◽  
pp. 4828-4833 ◽  
Author(s):  
Graeme J. Poston ◽  
Joan Figueras ◽  
Felice Giuliante ◽  
Gennaro Nuzzo ◽  
Alberto F. Sobrero ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Survival Rates ◽  
Surgical Techniques ◽  
Stage Iv ◽  
Staging System ◽  
Sequential Therapy ◽  
Rapid Expansion ◽  
Curative Surgery ◽  
The Impact

Despite recent advances in the medical treatment of metastatic colorectal cancer (mCRC), which include irinotecan- and oxaliplatin-based first-line regimens, the concept of planned sequential therapy involving three active agents during the course of a patient's treatment and the increasing use of targeted monoclonal antibodies, 5-year survival rates for patients with advanced CRC remain unacceptably low. For patients with CRC liver metastases, liver resection remains the only chance of cure, with 5-year survival rates ranging from 25% to 40%. However, 80% to 85% of patients with stage IV CRC have liver disease which is considered unresectable at presentation. The rapid expansion in the use of improved combination chemotherapy regimens plus or minus biologics, to render initially unresectable metastases resectable has increased the percentage of patients eligible for potentially curative surgery. However, the current staging criteria for CRC patients with metastatic disease do not reflect these recent changes or the fact that there is also a large variation in the survival of patients with stage IV CRC. For example the survival for a patient with a solitary, resectable liver metastasis is better than that for a patient with stage III disease. A new staging system is therefore needed that acknowledges both the improvements that have been made in surgical techniques for resectable metastases and the impact of modern chemotherapy on rendering initially unresectable CRC liver metastases resectable, while at the same time distinguishing between patients with a chance of cure at presentation and those for whom only palliative treatment is possible.

scholarly journals The impact of COVID-19 pandemic on colorectal cancer patients: a single-center retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Xu ◽  
Zong-Hao Huang ◽  
Charlie Zhi-Lin Zheng ◽  
Cong Li ◽  
Yu-Qin Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Major Complication ◽  
Control Group ◽  
Endoscopic Polypectomy ◽  
Curative Surgery ◽  
Neoadjuvant Radiotherapy ◽  
Number Of Patients ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Background Since December 2019, China has experienced a public health emergency from the coronavirus disease, which has become a pandemic and is impacting the care of cancer patients worldwide. This study evaluated the impact of the pandemic on colorectal cancer (CRC) patients at our center and aimed to share the lessons we learned with clinics currently experiencing this impact. Methods We retrospectively collected data on CRC patients admitted between January 1, 2020 and May 3, 2020; the control group comprised patients admitted between January 1, 2019 and May 3, 2019. Results During the pandemic, outpatient volumes decreased significantly, especially those of nonlocal and elderly patients, whereas the number of patients who received chemotherapy and surgery remained the same. During the pandemic, 710 CRC patients underwent curative resection. The proportion of patients who received laparoscopic surgeries was 49.4%, significantly higher than the 39.5% during the same period in 2019. The proportion of major complication during the pandemic was not significantly different from that of the control group. The mean hospital stay was significantly longer than that of the control group. Conclusions CRC patients confirmed to be infection-free can receive routine treatment. Using online medical counseling and appropriate identification, treatment and follow-up can be effectively maintained. Adjuvant and palliative chemotherapy should not be discontinued. Endoscopic polypectomy, elective, palliative, and multidisciplinary surgeries can be postponed, while curative surgery should proceed as usual. For elderly CRC patients, endoscopic surgery and neoadjuvant radiotherapy are recommended.

scholarly journals Impact of old age on resectable colorectal cancer outcomes

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6350 ◽  
Author(s):  
Jianfei Fu ◽  
Hang Ruan ◽  
Hongjuan Zheng ◽  
Cheng Cai ◽  
Shishi Zhou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Regression Model ◽  
Old Age ◽  
Older Patients ◽  
Cox Regression ◽  
External Validation ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Cox Regression Model ◽  
The Impact

Objective This study was performed to identify a reasonable cutoff age for defining older patients with colorectal cancer (CRC) and to examine whether old age was related with increased colorectal cancer-specific death (CSD) and poor colorectal cancer-specific survival (CSS). Methods A total of 76,858 eligible patients from the surveillance, epidemiology, and end results (SEER) database were included in this study. The Cox proportional hazard regression model and the Chow test were used to determine a suitable cutoff age for defining the older group. Furthermore, a propensity score matching analysis was performed to adjust for heterogeneity between groups. A competing risk regression model was used to explore the impact of age on CSD and non-colorectal cancer-specific death (non-CSD). Kaplan–Meier survival curves were plotted to compare CSS between groups. Also, a Cox regression model was used to validate the results. External validation was performed on data from 1998 to 2003 retrieved from the SEER database. Results Based on a cutoff age of 70 years, the examined cohort of patients was classified into a younger group (n = 51,915, <70 years of old) and an older group (n = 24,943, ≥70 years of old). Compared with younger patients, older patients were more likely to have fewer lymph nodes sampled and were less likely to receive chemotherapy and radiotherapy. When adjusted for other covariates, age-dependent differences of 5-year CSD and 5-year non-CSD were significant in the younger and older groups (15.84% and 22.42%, P < 0.001; 5.21% and 14.21%, P < 0.001). Also an age of ≥70 years remained associated with worse CSS comparing with younger group (subdistribution hazard ratio, 1.51 95% confidence interval (CI) [1.45–1.57], P < 0.001). The Cox regression model as a sensitivity analysis had a similar result. External validation also supported an age of 70 years as a suitable cutoff, and this older group was associated with having reduced CSS and increased CSD. Conclusions A total of 70 is a suitable cutoff age to define those considered as having elderly CRC. Elderly CRC was associated with not only increased non-CSD but also with increased CSD. Further research is needed to provide evidence of whether cases of elderly CRC should receive stronger treatment if possible.

scholarly journals The impact of COVID-19 pandemic on colorectal cancer patients: A single-center retrospective study

2020 ◽  
Author(s):  
Yun Xu ◽  
Zong-Hao Huang ◽  
Charlie Zhi-Lin Zheng ◽  
Cong Li ◽  
Yu-Qin Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Cancer Patients ◽  
Lessons Learned ◽  
Control Group ◽  
Endoscopic Polypectomy ◽  
Curative Surgery ◽  
Neoadjuvant Radiotherapy ◽  
Number Of Patients ◽  
The Impact

Abstract Background: Since December 2019, China has experienced the public health emergency of coronavirus disease, which has expanded globally and is impacting the care of cancer patients. This study evaluated the impact of the pandemic on colorectal cancer (CRC) patients at our center and aimed to share lessons learned with clinics currently experiencing this impact. Methods: We retrospectively collected data on CRC patients admitted between January 1, 2020 and May 3, 2020; the control group comprised patients admitted between January 1, 2019 and May 3, 2019. Results: During the pandemic, outpatient volumes decreased significantly, especially among nonlocal and elderly patients, whereas the number of patients who received chemotherapy and surgery were maintained. During the pandemic, 710 CRC patients underwent curative enterectomy. The proportion of laparoscopic surgery was 49.4%, which was significantly higher than the 39.5% patients who received a laparoscopic surgery during the same period in 2019. The proportion of major complication during the pandemic was not significantly different from that of the control group. The mean hospital stay was significantly longer than that of the control group. Conclusions: CRC patients who are confirmed to be infection-free can receive routine treatment. Using online medical counseling and appropriate identification, treatment and follow-up was effectively maintained. Adjuvant and palliative chemotherapy should not be discontinued. Endoscopic polypectomy, elective, palliative, and multidisciplinary surgeries can be postponed, whereas curative surgery should be performed. For elderly CRC patients, endoscopic surgery and neoadjuvant radiotherapy are recommended.

The impact of the peak (day 2) C-reactive protein (CRP) on the day 3 and day 4 CRP thresholds associated with infective complications following curative surgery in colorectal cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 595-595
Author(s):  
Michelle Leana Ramanathan ◽  
Paul G. Horgan ◽  
Donald C. Mcmillan
Keyword(s):  
Colorectal Cancer ◽  
C Reactive Protein ◽  
Tumour Site ◽  
Curative Surgery ◽  
Node Negative ◽  
Reactive Protein ◽  
The Impact ◽  
Infective Complications ◽  
Prospective Database ◽  
Colonic Tumours

595 Background: The postoperative systemic inflammatory response, as evidenced by C-reactive protein (CRP) on day 3 (threshold ~170 mg/L) and day 4 (threshold ~130mg/L), have been reported to be associated with the development of infective complications following surgery for colorectal cancer. The aim of the present study was to assess the impact of the peak, day 2 CRP, on CRP concentrations at day 3 and day 4. Methods: Patients with colorectal cancer who were considered to have undergone elective curative resection were recorded in a prospective database (n=396). CRP was measured preoperatively and on days 1 to 4 postoperatively. Correlations between day 2 CRP and other perioperative CRP concentrations were examined. Results: The majority of patients were 65 or older (67%), male (55%), had colonic tumours (66%), had node negative disease (57%) and were from a deprived area (55%). Day 2 CRP was not associated not with age (p=0.055), sex (p=0.185), deprivation (p=0.103), tumour site (p=0.529) or stage (p=0.395). Day 2 CRP was directly associated with day 1 (r2=0.421, p<0.001), day 3 (r2=0.617, p<0.001) and day 4 (r2=0.315, p<0.001) CRP, but not preoperative CRP (r2=0.008, p=0.084). The median day 2 CRP that corresponded with the previously described thresholds (~170mg/L and ~130mg/L at day 3 and 4 respectively) for predicting infective complications was 190mg/L. Similarly, the median day 2 CRP corresponding to the previously described thresholds (~190mg/L and ~140mg/L at day 3 and 4 respectively) for predicting an anastomotic leak was 200mg/L. Conclusions: A day 2 CRP concentration >190 - 200mg/L, was associated with day 3 and 4 CRP concentrations above established CRP thresholds for the development of infective complications. It remains to be determined whether reduction in day 2 CRP concentrations will reduce infective complications following surgery for colorectal cancer.

scholarly journals Evaluation of circulating tumor cells in colorectal cancer using flow cytometry

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052098021
Author(s):  
Ana-Maria Mușină ◽  
Mihaela Zlei ◽  
Mihaela Mentel ◽  
Dragoș-Viorel Scripcariu ◽  
Mădălina Ștefan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Flow Cytometry ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Skin Incision ◽  
Curative Surgery ◽  
Female Sex ◽  
The Impact

Objective We aimed to evaluate the prognostic value of circulating tumor cells (CTCs) and the impact of intraoperative tumor manipulation on CTCs in colorectal cancer (CRC) patients. Methods We performed a prospective study on 40 patients with CRC stages I to IV who received curative surgery using the no-touch technique. Flow cytometry was used to identify CTCs in peripheral blood samples (4 mL/sample) collected at two surgical moments: skin incision (T1) and after surgical resection (T2). A threshold of ≥4 CTCs/4 mL blood was established for considering patients CTC positive. Results In the univariate analysis, CTC evaluation at T2 was correlated with female sex, vascular invasion, tumor localization in the colon and metastatic lymph nodes. In the multivariate analysis, only female sex and colon cancer maintained statistical significance. At a medium follow-up of 15 months (1–25 months), the mortality rate was 10% (n = 4), with no significant differences between the overall survival of T1 or T2 CTC-positive and CTC-negative patients. Conclusions Flow cytometry is a feasible CTC identification technique in CRC, and although surgical manipulation has no influence on CTC numbers, CTCs may serve as a prognostic and predictive factor.

scholarly journals Cyclooxygenase-2 Expression Is a Predictive Marker for Late Recurrence in Colorectal Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Sung Hoo Kim ◽  
Byung Kyu Ahn ◽  
Seung Sam Paik ◽  
Kang Hong Lee
Keyword(s):  
Colorectal Cancer ◽  
Predictive Marker ◽  
Tissue Microarrays ◽  
Late Recurrence ◽  
Cyclooxygenase 2 ◽  
Stage I ◽  
Curative Surgery ◽  
The Status ◽  
Cox 2 ◽  
The Impact

Introduction. Cyclooxygenase-2 (COX-2) expression is elevated in colorectal cancer (CRC). However, data about the relation between COX-2 expression and the impact on the biologic behavior of recurrent disease are inconclusive as yet. The aim of this study is to investigate the relationship between the status of COX-2 expression in the primary CRC and the characteristics of recurrence after curative resection of stage I to III CRC. Materials and Methods. Ninety-eight patients with recurrence in 376 CRC patients, who underwent curative surgery between January 1991 and August 2001, were retrospectively assessed. Immunohistochemical staining, performed for the presence of COX-2 on tissue microarrays, was analyzed. Results. Forty-six patients showed elevated COX-2 expression, and 52 patients did not. The mean time to recurrence was significantly longer in the positive group than in the negative group (34.1 months ± 30.0 versus 21.9 months ± 17.4; P=0.019). Positive COX-2 expression was correlated with late recurrence (>3 years after surgery) [43.5% versus 13.5%; P=0.001]. In multivariate analysis, COX-2 expression was an independent factor associated with late recurrence (OR 4.656; 95% CI, 1.696 to 12.779; P=0.003). Recurrence pattern and postrecurrence survival were not different between the two groups. Conclusions. Elevated COX-2 expression in itself is not a prognostic factor, but COX-2 expression in tumor tissue may be an independent predictive marker of late recurrence for patients with stage I to III CRC.

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