scholarly journals 1029 Evaluation of Significant Polyp and Early Colorectal Cancer (SPECC) MDT In A District General Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
I Pereira ◽  
N Kulkarni ◽  
M Dalton ◽  
A Azhar
Keyword(s):  
Colorectal Cancer ◽  
District General Hospital ◽  
Lymph Node Involvement ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion ◽  
Definitive Answer ◽  
Retrospective Audit ◽  
Co Morbidity ◽  
Bowel Cancer Screening ◽  
Endoscopic Assessment

Abstract Aim There is an increase in the number of complex SPECC cases presented at colorectal MDT meetings with a wide variation in the treatments offered to patients, many of whom undergo high-risk and life-changing surgical resection. This study aimed to evaluate the detection, diagnosis and treatment of early colorectal cancer since the introduction of a SPECC MDT. Method This was a retrospective audit of 108 patients, from the SPECC MDT database from January 2014 to December 2019. Primary outcome assessed the recognition of lesions using endoscopy and radiological evaluation to assess depth of invasion and lymph node involvement. Secondary outcomes included definite treatment, pathological reporting and recurrence. Results Overall, mean age of 72, 79% had one or more significant co-morbidity. Clinical presentation; 61 asymptomatic, 46 symptomatic and 31 referred from the national bowel cancer-screening programme. All patients (n = 108) had endoscopic assessment the lesions were, 53% sessile and 47% pedunculated; 78% of the lesions were found in the rectum. We observed surgical management in 31 cases, endoscopic in 28, chemo-radiotherapy in 12 and 3 cases were palliative. However, 17 (n = 108) underwent failed endoscopic resection and required surgical intervention. Recurrence was observed in 17.6% of cases and mortality in 4%. Conclusions Pathological reports provide a definitive answer to questions of malignancy but SPECC can be challenging in all areas. A specialist MDT allows for appropriate assessment and treatment of lesions and leads to better patient outcomes.

scholarly journals 434 Incidence of Normal Colonoscopy in Faecal Immunochemical Test (FIT) Positive Patients in The Colorectal 2-Week-Wait (2WW) Pathway at A District General Hospital (DGH)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Al-Habsi ◽  
G S Divya ◽  
A Hemandas
Keyword(s):  
Screening Programme ◽  
District General Hospital ◽  
Specific Test ◽  
Retrospective Audit ◽  
Cancer Screening Programme ◽  
Fit Testing ◽  
Bowel Cancer Screening ◽  
Immunochemical Test ◽  
Clinically Significant ◽  
Group 1

Abstract Introduction FIT is a quantitative, highly specific test to detect blood in stool for malignant and non-malignant colorectal diagnoses. Incidence of normal colonoscopy following positive FIT is not widely reported. We conducted a retrospective audit to analyse this patient cohort to evaluate diagnostic accuracy and reporting standards of colonoscopy. Method FIT-positive was defined as > 10µgHb/g faeces. Using FIT value, patients were separated into Groups 1, 2 and 3: 10-99, 100-200 and >200µgHb/g faeces respectively. Normal colonoscopy was defined as no neoplastic or benign findings reported. Patients referred in the 2WW-pathway after introduction of FIT-testing in October 2019 to the onset of COVID-19 pandemic in March 2020 were included. Data on age, gender, comorbidities and additional investigations were collected. Results There were 1072 referrals in the study period; 405 had FIT done, 265 were FIT-positive and had colonoscopy referral. Four patients were excluded after further investigations showed diverticulosis and gastritis. FIT-stratified normal-colonoscopy rate was 13.3% (28/210) overall, and 14.1% (23/163), 16.7% (2/12) and 8.6% (3/35) for Group 1, 2 and 3 respectively. Conclusions Our study was limited by the onset of COVID-19 pandemic. In the short study period, 13.3% FIT-positive patients had normal colonoscopy. There are no comparative data in literature for this parameter. Higher FIT-values were associated with lower normal colonoscopy incidence. It is possible that some endoscopists failed to record positive, non-clinically significant findings. We are currently studying larger patient cohorts and in parallel, looking at Bowel Cancer Screening Programme (BCSP) patients.

scholarly journals Retrospective analysis of LNM risk factors and the effect of chemotherapy in early colorectal cancer: A Chinese multicenter study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chunyan Zeng ◽  
Dandan Xiong ◽  
Fei Cheng ◽  
Qingtian Luo ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multicenter Study ◽  
Tumor Size ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion ◽  
Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC. Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P = 0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P = 0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P = 0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P = 0.729 and 0.052). Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

Predictors of circulating tumor-derived methylated BCAT1 and IKZF1 DNA in colorectal cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 567-567
Author(s):  
Erin L Symonds ◽  
Susanne Kartin Pedersen ◽  
David Murray ◽  
Rohan Baker ◽  
Graeme P Young
Keyword(s):  
Colorectal Cancer ◽  
Blood Test ◽  
Tumor Biology ◽  
Multivariate Logistic Regression Analysis ◽  
Sociodemographic Factors ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Crc Screening ◽  
T Stage ◽  
Surgery Patient

567 Background: Blood tests detecting circulating tumor-derived DNA (ctDNA) are being developed for colorectal cancer (CRC) screening and monitoring. However, the underlying tumor biology resulting in circulating DNA is not well understood. This study aimed to elucidate tumor features associated with methylated BCAT1 and IKZF1 DNA in blood as well as patient demographics that predict biomarker appearance. Methods: 129 people with invasive CRC had blood collected prior to surgery. Patient sociodemographic factors were recorded. Extracted circulating cell-free DNA was assayed for methylated BCAT1 and IKZF1. Patient factors and tumor features including location, size, depth of invasion (T stage), degree of differentiation, vascularity, lymphatic and perineurial invasion, lymph node involvement and presence of metastasis were compared with blood test results using multivariate logistic regression analysis. Results: The distribution of CRC stages I to IV were 34, 43, 41 and 11, respectively and 72 (56%) were blood positive for methylated BCAT1/IKZF1. Positivity was associated with distally located tumors and a higher T stage (Table). Gender, age, BMI, race, smoking and medications were not associated with blood positivity rates, but increased alcohol intake ( > 7 drinks/week, n = 31) was associated (OR 5.7, 95% CI 1.1-28.7, p = 0.036). Conclusions: The strongest predictor for appearance of ctDNA was invasion depth of the tumor. Demographic features did not influence the positivity rate of the BCAT1/ IKZF1 CRC blood test, strengthening the validity of this blood test for CRC screening and monitoring in the general population. [Table: see text]

Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer

1999 ◽  
Vol 50 (3) ◽  
pp. 329-333 ◽  
Author(s):  
Ayako Ishiguro ◽  
Yoshiharu Uno ◽  
Yoh Ishiguro ◽  
Akihiro Munakata ◽  
Takayuki Morita
Keyword(s):  
Colorectal Cancer ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion

scholarly journals Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

2020 ◽  
Author(s):  
Chunyan Zeng ◽  
Dandan Xiong ◽  
Fei Cheng ◽  
Qingtian Luo ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multicenter Study ◽  
Tumor Size ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion ◽  
Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

scholarly journals Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

2020 ◽  
Author(s):  
Chunyan Zeng ◽  
Dandan Xiong ◽  
Fei Cheng ◽  
Qingtian Luo ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multicenter Study ◽  
Tumor Size ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion ◽  
Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathological analysis. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

SP1.1.5Association between prior screening involvement and presentation and outcomes in patients with colorectal cancer

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Afnan Mshihadani ◽  
Allan M Golder ◽  
David Mansouri ◽  
Donald C McMillan ◽  
Paul G Horgan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Adverse Outcomes ◽  
Tnm Stage ◽  
Screening Tests ◽  
Disease Stage ◽  
Emergency Presentation ◽  
Screening Participation ◽  
Co Morbidity ◽  
Bowel Cancer Screening

Abstract Aims Population bowel cancer screening (BCS) is well established, however many patients still present acutely or with advanced disease. Within a cohort of patients with colorectal cancer (CRC), this study aimed to analyse the relationship between prior engagement with the screening programme and mode of presentation, disease stage and survival. Methods All patients diagnosed with CRC from 2011-2014 in West of Scotland were identified from a regional database and linked into the Bowel Screening dataset for screening participation within two years preceding diagnosis. Results 6551 patients were diagnosed with CRC, 19% (n = 1217) through screening. 39% of patients were not invited for screening and 29% of patients did not respond to invite. Non-response to invite was associated with male sex, increasing age, socioeconomic deprivation, co-morbidity and smoking (all p < 0.001). 13% had previously returned negative screening tests. Negative screening was associated with female sex, anaemia, right sided, poorly differentiated and EMVI positive tumours, and screening with gFOBT versus FIT (all p ≤ 0.001).  2% did not undergo further investigation of a positive test, and <1% had a negative colonoscopy. Participation in screening was associated with reduced emergency presentations (8%vs22%), lower TNM Stage, and improved 3-year CSS (88%vs74%) and OS (85%vs69%) (all p < 0.001). Conclusion Most new cases of CRC are diagnosed outwith the screening programme, predominantly due to non-invite/failure to respond to invite. This has a significant association with adverse outcomes including emergency presentation, advanced TNM stage and poorer survival. Further work is required to increase screening uptake and widen access to BCS.

scholarly journals Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

2020 ◽  
Author(s):  
Chunyan Zeng ◽  
Dandan Xiong ◽  
Fei Cheng ◽  
Qingtian Luo ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multicenter Study ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Univariate Analysis ◽  
Early Colorectal Cancer ◽  
Base Line ◽  
Depth Of Invasion ◽  
Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors for LNM and the effectiveness of postoperative chemotherapy in patients with ECC.MethodsWe retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January, 2007 and October, 2018. The correlations between LNM and gender, age, tumor size, tumor location, endoscopic morphology, Pathology, depth of invasion and tumor budding (TB), were estimated directly based on postoperative pathology results. We also observed the overall survivals (OS) and recurrences between ECC patients with and without LNM after the base-line being matched.Results There were 473 ECC patients observed, 288 patients of them were enrolled, 17 patients had LNM (5.90%). Univariate analysis revealed that tumor size, pathology, lympho-vascular invasion were associated with LNM in ECC (P = 0.026, 0.000, 0.000, respectively), and multivariate logistic regression confirmed that tumor size, pathology, lympho-vascular invasion were risk factors for LNM (P = 0.021, 0.023, 0.001, respectively). There were no significant differences for the OS and recurrence between the ECC patients with and without LNM whose base-lines were matched (P = 0.158,0.346, respectively), neither no significant difference between chemotherapy and no chemotherapy ECC patients without LNM after surgery (P = 0.729,0.052).Conclusion Tumor size, pathology, lympho-vascular invasion were risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve the overall survival and recurrence in patients with LNM, but no necessary for the ECC patients without LNM.

scholarly journals Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

2020 ◽  
Author(s):  
Chunyan Zeng ◽  
Dandan Xiong ◽  
Fei Cheng ◽  
Qingtian Luo ◽  
Qiang Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Multicenter Study ◽  
Tumor Size ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Early Colorectal Cancer ◽  
Depth Of Invasion ◽  
Significant Difference

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathology results. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

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