EP.TU.313Colorectal cancer follow up: Can CT Colonography replace Colonoscopy?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Samantha Jolliffe ◽  
Feidhilm McGivney ◽  
Mei Chin ◽  
Kawan Shalli
Keyword(s):  
Colorectal Cancer ◽  
Ct Colonography ◽  
Cost Effective ◽  
Health Board ◽  
Low Grade ◽  
Detection Rates ◽  
Colorectal Cancer Resection ◽  
Significant Difference ◽  
One Year ◽  
Age Range

Abstract Aims Current guidelines recommend surveillance colonoscopy at one year following Colorectal Cancer Resection (CCR), yearly CT chest, abdomen and pelvis, CEA, and colonoscopy in 3 years. Previous studies showed no significant difference between CTC and colonoscopy detection rates of colorectal cancer or polyps >6mm. A review of abnormalities detected on surveillance colonoscopies one year following CCR. If the incidence is low CT Colonography (CTC) would be an alternative to colonoscopy and, when performed simultaneously with surveillance CT chest would be cost-effective, and help in the selective use of colonoscopy. Methods A retrospective analysis of one-year surveillance colonoscopies following CCR in 2016 at a health board with three different sites. Normal colonoscopy criteria included: no polyps, no tumour, and no abnormality at the anastomosis. Subtotal colectomy, panproctocolectomies and incomplete colonoscopies were excluded. Results 111 surveillance colonoscopies were performed one-year post CCR. Age range 30-87 years (39 patients were above 75). Ninety scopes were normal (81.1%). Eight identified only hyperplastic polyps (7.2%); indirectly making over 88% of surveillance colonoscopies unremarkable. Detected abnormalities: nine low-grade adenomas (8.1%), one anastomotic recurrence (0.9%), and only three new cancers (2.7%). There were no complications related to the procedure. Each colonoscopy costs £996 at this health board, CTC is significantly cheaper. Conclusion New cancer or recurrence post-CCR detected at one-year colonoscopy is very low; therefore, CTC would be ideal alternative surveillance. Adding it to CT Chest would significantly reduce the number of hospital attendances per patient, which is more cost-effective and reduces risk.

scholarly journals Current Tissue Molecular Markers in Colorectal Cancer: A Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Gaia Peluso ◽  
Paola Incollingo ◽  
Armando Calogero ◽  
Vincenzo Tammaro ◽  
Niccolò Rupealta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Molecular Markers ◽  
Ct Colonography ◽  
Precancerous Lesions ◽  
Therapeutic Process ◽  
Cost Effective ◽  
Screening Tests ◽  
Endoscopic Evaluation ◽  
The World

Background. Colorectal cancer (CRC) is one of the most spread neoplasia types all around the world, especially in western areas. It evolves from precancerous lesions and adenomatous polyps, through successive genetic and epigenetic mutations. Numerous risk factors intervene in its development and they are either environmental or genetic.Aim of the Review. Alongside common screening techniques, such as fecal screening tests, endoscopic evaluation, and CT-colonography, we have identified the most important and useful biomarkers and we have analyzed their role in the diagnosis, prevention, and prognosis of CRC.Conclusion. Biomarkers can become an important tool in the diagnostic and therapeutic process for CRC. But further studies are needed to identify a noninvasive, cost-effective, and highly sensible and specific screening test for their detection and to standardize their use in clinical practice.

The disproportionate effect of perioperative complications on mortality within one year after colorectal cancer resection in octogenarians

2015 ◽  
Vol 221 (4) ◽  
pp. e6-e7 ◽  
Author(s):  
Leonardo C. Duraes ◽  
Luca Stocchi ◽  
David W. Dietz ◽  
Matthew F. Kalady ◽  
Hermann P. Kessler ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Perioperative Complications ◽  
Cancer Resection ◽  
Colorectal Cancer Resection ◽  
One Year

A Randomized Prospective Study of the Cost -Effectiveness of the Conventional Spike, O-Set, and Uvxd Techniques in Continuous Ambulatory Peritoneal Dialysis

1994 ◽  
Vol 14 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Ignatius K.P. Cheng ◽  
Ching-Ying Chan ◽  
Suk-Wai Cheng ◽  
Joana F.M. Poon ◽  
Yu-Lian Ji ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cost Effectiveness ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cost Effective ◽  
Training Time ◽  
Outpatient Visits ◽  
Significant Difference ◽  
Hospital Stays ◽  
One Year ◽  
The Cost

Objective To compare the clinical outcome and cost-effectiveness of three techniques for continuous ambulatory peritoneal dialysis (CAPD): the conventional spike technique (C), the O-set (0), and UVXD (U, ultraviolet irradiation connection box). Design A randomized and prospective comparison of three CAPD techniques. Setting A tertiary referral and a satellite dialysis center.. Patients: One hundred patients with end-stage renal failure between 10 and 70 years of age, with good handeye coordination and not anticipated to receive a living related transplant within 6 months. Interventions Patients were randomized by referral to a table of random numbers to perform one of the three CAPD techniques. Main Outcome Measures Training time, details of peritonitis and exit-site infection (ESI) including the costs of antibiotic treatment, outpatient visits, hospital stays, technique, and patient survival were analyzed after a minimum follow-up period of one year. Results There were 38, 31, and 31 patients in groups C, 0, and U, respectively, and the total observation periods were 838,802, and 745 patient-months, respectively. The peritonitis rates for C, 0, and U were 21.5, 30.8, and 29.8 patient-months/episode, respectively. The corresponding ESI rates were 16.4,14.9, and 24 patient-months/ episode, respectively. When the time from the commencement of CAPD to the first infection was expressed using the Kaplan-Meier life table analysis, 39.5%, 67.7%, and 61.3% of patients in Groups C, 0, and U were free from peritonitis at one year (p = 0.088). The corresponding figures for ESI were 52.6%, 48.4%, and 61.3% (p = 0.35). There was no significant difference in technique survival in the three treatment groups. An analysis of the costs related to the use of antibiotics, outpatient visits, and hospital stays necessary for the treatment of peritonitis and ESI and those related to training time, additional equipment, and consumables required for the three CAPD techniques showed that, overall, the cost in 0 was the lowest, followed by U and C (U.S. $158, $170, and $179 per patient-month, respectively). Conclusion It was concluded that the O-set is a more cost-effective CAPD technique than UVXD, while both are more cost-effective than the conventional spike technique.

Evaluation of the necessity of primary tumor resection for synchronous metastatic colorectal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 592-592
Author(s):  
Yuji Miyamoto ◽  
Yasuo Sakamoto ◽  
Satoshi Ida ◽  
Masayuki Watanabe ◽  
Hideo Baba
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
University Hospital ◽  
Primary Tumor Resection ◽  
Colorectal Cancer Resection ◽  
Significant Difference ◽  
Group 5 ◽  
Colorectal Cancer Patients

592 Background: Recent advances in chemotherapy have improved survival in patients with metastatic colorectal cancer. Resection of primary tumor for patients with metastatic colorectal cancer remains controversial. Primary tumor with obstruction or bleeding may be recommended to resection pior to chemotherapy. In contrast, it should be considered potential complications associated with resection of primary tumor and disadvantage of the delay in chemotherapy. Here, we evaluate the needs of primary tumor resection for colorectal cancer patients with synchronous metastases. Methods: A retrospective analysis of patients with synchronous metastatic colorectal cancer treated at Kumamoto University Hospital between April, 2005 and December, 2009 was performed. We compared the survival of resected patients and non-resected patients. Results: 104 patients were identified. Sixty-four and 40 patients were included in the resected group and the non-resected group respectively. The mean follow-up time was 16.1 months. Median age was 61.9 and 64.3 years respectively. The non-resected group was more likely to have right-sided tumors (resected: 28%, non-resected: 43%). The number of patient with metastatic disease limited to the liver was similar in both group(resected: 48%, non-resected: 50%). In the resected group, 12 patients (18%) developed postoperative complications. In the nonresected group, 5 patients (12.5%) required creation of a diverting colostomy during the course of their treatment due to obstruction, and 2 patients (5%) required emergency surgical treatment for intestinal perforation due to the primary tumor. No significant difference in survival was observed between the groups, (logrank P=0.33). Median survival period was not significantly different (resected: 27.3 months, non-resected: 21.5 months, P=0.43). Conclusions: We concluded that it was not necessary to resect the primary lesion in patients with synchronous metastatic colorectal cancer when obstruction or bleeding was not found in primary lesions.

Characteristics of colorectal cancer in patients younger than 40 years compared to older patients.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 371-371
Author(s):  
Mohamed E. Salem ◽  
Monica Arun ◽  
Greg Dyson ◽  
Chadi Saad ◽  
Cassra Arbabi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rates ◽  
Age Groups ◽  
Cancer Center ◽  
Tumor Characteristics ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Poorly Differentiated ◽  
One Year ◽  
The Right

371 Background: The incidence of colorectal cancer (CRC) in younger patients (pts) is increasing. There is limited data on tumor characteristics and treatment outcome in this population. Methods: Patients with CRC treated at the Karmanos Cancer Center from 2005 to 2011 were studied. Younger (≤40 years) and older (>40 years) groups from a predominantly inner city population were compared for patient and tumor characteristics, treatment patterns, and survivals. T-tests and Fisher’s exact tests were used to determine statistical differences between age groups while the Kaplan-Meier method was used to estimate survival. Results: 42 pts were ≤ 40 (range, 17-40 years) and 96 pts were > 40 (range, 42-88 years). Mean ages for the groups were 33 and 60 years, respectively. There was no statistically significant difference in the distribution of race, gender, stage or KRAS mutation status between the two groups; however, older pts had a higher mean body mass index compared to younger pts (28 versus 23, p<0.001). Older pts were more likely to have a right colon primary (OR = 7.5, p = 0.04), while younger pts had higher likelihood of having sigmoid primary (OR = 3.4, p = 0.002) and worse grade (poorly differentiated) tumors (OR = 8.3, p <0.001). There were no significant differences between metastatic status or sites of metastases between the two groups. Significantly more young pts underwent surgery than older pts (92% versus 62%, p = 0.005). FOLFOX plus bevacizumab was the most commonly used first line treatment for both groups. The median survival estimates were 16.9 (8.1-23.9) and 17.1 months (13.3-31.0) for the younger and older pts, respectively. Importantly, the one-year survival rates were similar for both groups: 41% for both (p = 1). On the multivariate analysis, whether pts had a primary in the right or sigmoid colon was the only independent predictor of survival. Conclusions: Younger pts with colon cancer were diagnosed at a similar stage of the disease as older pts, but more likely to have poorly differentiated tumors. Younger pts were more likely to receive surgical interventions; however, both groups had equivalent one-year survivals. These results support the need for further prospective investigation in a larger population.

Influence of Breastfeeding on The Early Aged Children’s Health and Ql Indicators

2021 ◽  
Author(s):  
Marina Ararat Mardiyan ◽  
Siranush Ashot Mkrtchyan ◽  
Razmik Ashot Dunamalyan ◽  
Karine Hrant Simonyan ◽  
Hayk Vachagan Harutyunyan
Keyword(s):  
Quality Of Life ◽  
Cost Effective ◽  
Health Condition ◽  
Significant Difference ◽  
One Year ◽  
Duration Of Breastfeeding ◽  
The Cost ◽  
Effective Public Health ◽  
The Given

Abstract Background: Promotion and coverage of breastfeeding are considered to be the cost-effective public health measures in terms of Healthcare System. The aim of the research is to assess an influence of breastfeeding on infants’ health and quality of life (QL) parameters.Methods: This observational prospective study included 1790 newborns selected from Yerevan State Medical University’s Polyclinics (“Mouratsan” (sample=746) and “Heratsi” ” (sample=1044)). Data collection took a period between January 2016 and December 2017. Evaluation of children’s quality of life was performed with the help of the validated and adapted QUALIN questionnaire. The data related to child’s health condition were collected from the “Child Development History” cards available at the polyclinics of the investigated area.Results: Among 1770 one year old children 1681 were ever breastfed, 1224 (69.1%) were exclusively breastfed up to 3 months, the median duration of breastfeeding was 6 -7 months, 45% ≥ 6 months, 15% ≥ 1 year. There is a significant difference between the QL scores of the ever breastfed and the never breastfed subgroups. Duration of the breastfeeding also have an influence on QL scores.Conclusions: The given study’s results confirm that breastfeeding among the early aged Armenian children is of great importance in their health, influencing on quality of life and morbidity rates.

scholarly journals Gross-total resection of temporal low grade gliomas is a critically important factor in achieving seizure-freedom

2015 ◽  
Vol 73 (11) ◽  
pp. 924-928 ◽  
Author(s):  
Lucas Crociati Meguins ◽  
Rodrigo Antônio Rocha da Cruz Adry ◽  
Sebastião Carlos da Silva Júnior ◽  
Carlos Umberto Pereira ◽  
Jean Gonçalves de Oliveira ◽  
...  
Keyword(s):  
Intractable Epilepsy ◽  
Gross Total Resection ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Low Grade ◽  
Total Resection ◽  
Low Grade Gliomas ◽  
Significant Difference ◽  
The Mean ◽  
One Year

Objective To present a surgical series of patients with low grade temporal gliomas causing intractable epilepsy, focusing on long-term seizure outcome.Method A retrospective study was conducted with patients with temporal low-grade gliomas (LGG).Results Sixty five patients with were operated in our institution. Males were more affected than females and the mean age at surgery was 32.3 ± 8.4 (9-68 years). The mean age at seizure onset was 25.7 ± 9.2 (11-66 years). Seizure outcome was classified according with Engel classification. After one year of follow up, forty two patients (64.6%) were Engel I; seventeen (26.2%) Engel II; four (6.2%) Engel III and two (3.1%) Engel IV. Statistically significant difference in seizure outcome was obtained when comparing the extension of resection. Engel I was observed in 39 patients (69.6%) with total resection and in only 3 (33.3%) patients with partial resection.Conclusion Gross-total resection of temporal LGGs is a critically important factor in achieving seizure-freedom.

CT Colonography after Colorectal Cancer Resection: A One-Stop Assessment of Metachronous Mucosal Lesions, Local Recurrence, and Distant Metastases

Radiology ◽  
2011 ◽  
Vol 260 (1) ◽  
pp. 302-303 ◽  
Author(s):  
L. Max Almond ◽  
Sarah Snelling ◽  
Sarit Badiani ◽  
Douglas M. Bowley ◽  
Sharad S. Karandikar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Local Recurrence ◽  
Ct Colonography ◽  
Distant Metastases ◽  
Cancer Resection ◽  
Colorectal Cancer Resection ◽  
One Stop ◽  
Mucosal Lesions
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