Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease

AbstractPurposeTo establish whether the use of a passive or active technique of planning target volume (PTV) definition and treatment methods for non-small cell lung cancer (NSCLC) deliver the most effective results. This literature review assesses the advantages and disadvantages in recent studies of each, while assessing the validity of the two approaches for planning and treatment.MethodsA systematic review of literature focusing on the planning and treatment of radiation therapy to NSCLC tumours. Different approaches which have been published in recent articles are subjected to critical appraisal in order to determine their relative efficacy.ResultsFree-breathing (FB) is the optimal method to perform planning scans for patients and departments, as it involves no significant increase in cost, workload or education. Maximum intensity projection (MIP) is the fastest form of delineation, however it is noted to be less accurate than the ten-phase overlap approach for computed tomography (CT). Although gating has proven to reduce margins and facilitate sparing of organs at risk, treatment times can be longer and planning time can be as much as 15 times higher for intensity modulated radiation therapy (IMRT). This raises issues with patient comfort and stabilisation, impacting on the chance of geometric miss. Stereotactic treatments can take up to 3 hours to treat, along with increases in planning and treatment, as well as the additional hardware, software and training required.ConclusionFour-dimensional computed tomography (4DCT) is superior to 3DCT, with the passive FB approach for PTV delineation and treatment optimal. Departments should use a combination of MIP with visual confirmation ensuring coverage for stage 1 disease. Stages 2–3 should be delineated using ten-phases overlaid. Stereotactic and gated treatments for early stage disease should be used accordingly; FB-IMRT is optimal for latter stage disease.

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Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study)

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-17-0200 ◽

2017 ◽

Vol 26 (7) ◽

pp. 1008-1015 ◽

Cited By ~ 99

Author(s):

Bette J. Caan ◽

Jeffrey A. Meyerhardt ◽

Candyce H. Kroenke ◽

Stacey Alexeeff ◽

Jingjie Xiao ◽

...

Keyword(s):

Colorectal Cancer ◽

Body Composition ◽

Cancer Survival ◽

Obesity Paradox ◽

Colorectal Cancer Survival

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Novel Biomarker-Targeted Therapies for Metastatic Colorectal Cancer

Digestive Disease Interventions ◽

10.1055/s-0041-1727225 ◽

2021 ◽

Author(s):

Shimoli V. Barot ◽

Suneel D. Kamath

Keyword(s):

Colorectal Cancer ◽

Growth Factor ◽

Metastatic Disease ◽

Targeted Therapies ◽

Early Stage ◽

Growth Factor Receptor ◽

Precision Oncology ◽

Dynamic Heterogeneity ◽

Early Stage Disease ◽

Stage Disease

AbstractColorectal cancer (CRC) is one of the most common and fatal malignancies worldwide. Screening, surgery, and adjuvant therapy have proved efficacious in improving outcomes for early-stage disease. Despite decades of research efforts, cytotoxic chemotherapy has been the mainstay of treatment for metastatic disease and the prognosis remains unsatisfactory. Compelling evidence suggests that a fundamental reason for the limited success is the cancer's inherent dynamic heterogeneity, which is more predominant in late-stage disease. As our understanding of this molecular blueprint of CRC has evolved, a new avenue of targeted therapies has emerged. Beginning with epidermal growth factor receptor and vascular endothelial growth factor inhibitors, numerous targeted agents have been developed and investigated in large, multicenter, prospective clinical trials. Testing for mutations in RAS (KRAS and NRAS), BRAF, and HER2 and for mismatch repair/microsatellite instability and NTRK fusions has now been incorporated in the management guidelines, with additional biomarkers rapidly surfacing. As we enter the latest paradigm of precision oncology in CRC, this article will provide an overview of the different molecular subsets of CRC and the current biomarker-targeted therapies in the management of metastatic disease.

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L1CAM expression in colorectal cancer identifies patients prone to metastasis already in early-stage disease

Annals of Oncology ◽

10.1093/annonc/mdz155.217 ◽

2019 ◽

Vol 30 ◽

pp. iv60

Author(s):

A. Tampakis ◽

E. Tampaki ◽

A. Nonni ◽

E. Patsouris ◽

M. von Flüe ◽

...

Keyword(s):

Colorectal Cancer ◽

Early Stage ◽

Early Stage Disease ◽

Stage Disease ◽

L1cam Expression

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Prognostic Significance of DNA Aneuploidy and p21ras Oncoprotein Expression in Colorectal Cancer and Their Role in the Determination of Treatment Modalities

The International Journal of Biological Markers ◽

10.1177/172460080101600203 ◽

2001 ◽

Vol 16 (2) ◽

pp. 97-104 ◽

Cited By ~ 5

Author(s):

N.H. Karelia ◽

D.D. Patel ◽

N.S. Desai ◽

H.V. Mehta ◽

P.K. Yadav ◽

...

Keyword(s):

Colorectal Cancer ◽

Dna Ploidy ◽

Early Stage ◽

Prognostic Significance ◽

S Phase ◽

Response To Therapy ◽

Phase Fraction ◽

Treatment Modalities ◽

Early Stage Disease ◽

Stage Disease

The purpose of the present study was to investigate the prognostic significance of DNA ploidy, S-phase fraction and p21ras oncoprotein expression in patients with colorectal cancer and to correlate these factors with the clinical behavior of the tumors and their response to therapy. Of 79 patients with colorectal cancer 57% (45/79) had early stage disease. Forty-one percent (32/79) had aneuploid tumors while 30% (24/79) of the tumors had a high (>10%) S-phase fraction. p21ras oncoprotein expression was detected in 38% (30/79) of tumors. Patients with aneuploid tumors had a worse prognosis than patients with diploid tumors (p=0.0002). Similarly, patients with high S-phase fraction tumors had a shorter survival than those with low S-phase fraction tumors (p=0.005). No such difference was found between p21ras-positive and p21ras-negative tumor subgroups. In early stage colorectal cancer, aneuploidy was closely correlated with disease outcome (p=0.029). Early stage patients with diploid tumors who received radiotherapy and chemotherapy had a better prognosis than patients with aneuploid tumors. In conclusion, DNA ploidy is a significant and independent prognostic factor in colorectal cancer. Aneuploidy and genetic alteration of the p21ras oncoprotein are important in determining the biological aggressiveness of colorectal cancer. Furthermore, DNA ploidy may identify those subgroups of patients with early stage disease who may benefit from more aggressive treatment.

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L1CAM expression in colorectal cancer identifies a high-risk group of patients with dismal prognosis already in early-stage disease

Acta Oncologica ◽

10.1080/0284186x.2019.1667022 ◽

2019 ◽

Vol 59 (1) ◽

pp. 55-59 ◽

Cited By ~ 1

Author(s):

Athanasios Tampakis ◽

Ekaterini Christina Tampaki ◽

Afroditi Nonni ◽

Gerasimos Tsourouflis ◽

Alberto Posabella ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Risk Group ◽

Early Stage ◽

High Risk Group ◽

Early Stage Disease ◽

Dismal Prognosis ◽

Stage Disease ◽

L1cam Expression

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MAP17 Expression in Colorectal Cancer Is a Prognostic Factor for Disease Recurrence and Dismal Prognosis Already in Early Stage Disease

Oncology ◽

10.1159/000515596 ◽

2021 ◽

pp. 1-11

Author(s):

Athanasios Tampakis ◽

Ekaterini Christina Tampaki ◽

Afroditi Nonni ◽

Michael Kontos ◽

Gerasimos Tsourouflis ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Cancer Cells ◽

Early Stage ◽

Progression Free Survival ◽

Disease Recurrence ◽

Morbidity And Mortality ◽

Early Stage Disease ◽

Free Survival ◽

Stage Disease

Background: Disease recurrence in colorectal cancer constitutes a major cause of significant cancer-associated morbidity and mortality. MAP17 is a small protein, and its overexpression in malignant tumors has been correlated with aggressive tumor phenotypes. The aim of the present study was to investigate the expression patterns of MAP17 in colorectal cancer specimens and to assess its clinical significance. Patients and Methods: Surgical specimens of 111 patients with primary resectable colorectal cancer constituted the study population. Expression of MAP17 was assessed by immunohistochemistry, and the results were correlated with clinical and survival data. Results: MAP17 was expressed in cancer cells and endothelial cells of tumor blood vessels. Expression of MAP17 more than 10% was correlated with advanced disease stage (p < 0.001), higher T classification (p = 0.007), the presence of lymph node metastasis (p < 0.001), vascular (p = 0.013) and perineural invasion (p = 0.012). Patients exhibiting MAP17 expression of more than 30% in cancer cells compared to those expressing MAP17 less than 10% demonstrated a significantly worse 3-year progression-free survival (35.2 vs. 91%, p < 0.001) and 5-year overall survival (40.8 vs. 91%, p < 0.001). Cox regression analysis confirmed MAP17 expression of more than 30% as a prognostic marker of progression free survival (HR 0.136, 95% CI = 0.056–0.329, p < 0.001) and overall survival (HR 0.144 [95% CI) = 0.049–0.419, p < 0.001) independent of other clinicopathological characteristics. Statistically significantly worse 3-year progression-free survival and 5-year overall survival was demonstrated in the subgroup analysis of patients with early stage cancer only and high expression of MAP17. Conclusions: High MAP17 expression in patients with colorectal cancer is a significant risk factor for cancer-associated morbidity and mortality already in early stage disease.

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