The diagnostic yield of preoperative staging computed tomography of the thorax in colorectal cancer patients without hepatic metastases

Background: Late state colorectal cancer treatments have important side effects that should be avoided in patients where drug effectiveness is not adequate. PrediCTC is a new biomarkers blood test developed to determinate the chemotherapy response in unresectable metastatic colorectal cancer patients that could allow to obviate unnecessary treatments. Aim: To assess from the Spanish Societal Perspective the cost-utility of the test PrediCTC compared to the computed tomography in aim to evaluate chemotherapy treatment response in late stage colorectal cancer patients. Methods: Based on the results of Barbazán et al., a Markov model has been developed, in which the different lines and cycles that the colorectal patient can receive and how they can move between them according to the computed tomography or PrediCTC have been represented. The effectiveness has been expressed in quality adjusted life years (QALYs), avoiding adverse events. Results: Base case analysis shows savings in different types of costs for PrediCTC (per patient): €14.30 in those arise from adverse events, €22,345.73 in chemotherapy costs, €4849.61 in other direct costs, and €306.21 in indirect costs. Although computed tomography 12-week assessed patients gain 0.17 QALYs compared with PrediCTC. Conclusions: From the Spanish Societal Perspective, PrediCTC is not a cost-utility option but allows to identify earlier patients who are not benefiting from first-line chemotherapy avoiding unnecessary side effects and costs.

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Assessment of the Clinical Usefulness of Preoperative Computed Tomography in Colorectal Cancer Patients Who Received Unplanned Reoperation

Gastroenterology Research and Practice ◽

10.1155/2020/6062414 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Rui Wang ◽

Yi Gao ◽

Jia-Yi Li ◽

Zhong-Hui Wang ◽

Qin-qing Li ◽

...

Keyword(s):

Colorectal Cancer ◽

Computed Tomography ◽

Postoperative Complications ◽

Cancer Patients ◽

Ct Imaging ◽

Preoperative Imaging ◽

Imaging Evaluation ◽

Preoperative Ct ◽

Colorectal Cancer Patients ◽

Statistical Indicators

Background. In the unplanned reoperation of colorectal cancer patients, computed tomography (CT) is increasingly utilized to locate postoperative complications and previously unlocalized lesions. The purpose of this study is to explore the application of CT in the mortality and complications of the reoperation of colorectal cancer. Patients and Methods. We performed a retrospective review of collected data from the colorectal surgeries of 90 identified colorectal cancer patients who received an unplanned reoperation from 2010 to 2018. Patients were stratified according to those with preoperative CT imaging (CT group, n=36) and those without preoperative CT imaging (NCT group, n=54). Twenty-four statistical indicators of each patient were studied, including their preoperative risk, surgical characteristics, and postoperative outcomes, and satisfaction was evaluated. All data were statistically analysed for predicting postoperative complications by univariate and multivariate logistic regression analyses. Results. Ninety patients received an unplanned reoperation in the study, and 40% (36/90) of these patients underwent preoperative CT examination. Patients’ risk factors were similar between CT and NCT groups. Preoperative imaging was more commonly performed for reoperative new anastomosis + ileostomy but less common for reoperative Dixon’s procedure. The operative duration of the NCT group was longer (139 vs. 104 min, respectively, P=0.01). Preoperative NCT examination (OR 1.24; 95% CI=1.09‐1.42; P=0.01) was an independent predictor of postoperative complications. Importantly, three patients died after an unplanned reoperation for colorectal cancer, which occurred only in the NCT group (5.6% vs. 0.0%, P=0.01). Conclusion. The use of conventional preoperative CT optimizes the choice of the surgical site and the strategy of laparotomy, so as to reduce the length of operation. Preoperative imaging evaluation should be performed for patients undergoing repeat abdominal surgery.

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The Role of Big Endothelin-1 in Colorectal Cancer

The International Journal of Biological Markers ◽

10.1177/172460080201700407 ◽

2002 ◽

Vol 17 (4) ◽

pp. 268-274 ◽

Cited By ~ 5

Author(s):

C. Arun ◽

B. Swift ◽

K.E. Porter ◽

K.P. West ◽

N.J.M. London ◽

...

Keyword(s):

Colorectal Cancer ◽

Plasma Concentration ◽

Liver Metastases ◽

Cancer Cells ◽

Cancer Patients ◽

Hepatic Metastases ◽

Plasma Samples ◽

Median Score ◽

Endothelin 1 ◽

Colorectal Cancer Patients

Introduction Changes in liver blood flow caused by an unknown splanchnic vasoconstrictor have been noted in colorectal cancer patients with liver metastases. This prospective study was performed to assess whether plasma levels of big endothelin-1 (big ET-1) were raised in patients with colorectal cancer. Methods Plasma samples from peripheral vein of patients who underwent surgery for primary colorectal cancer (n=60) and those with known colorectal liver metastases (n=45) for a period of 15 months were taken prior to treatment and compared to age- and sex-matched controls (n=20). Plasma samples were analysed by using a single-step sandwich enzyme immunoassay. Immunohistochemistry and in situ hybridisation were also performed on tumour sections to investigate the expression of ET-1 by cancer cells. Results The median (range) plasma concentration of big ET-1 in controls was 2.1 pg/mL (1.2–13.4 pg/mL). The median (range) plasma concentration of big ET-1 in colorectal cancer patients with no overt hepatic metastases was 3.8 pg/mL (1.2–15.8 pg/mL), p=0.002, and the median (range) plasma concentration of big ET-1 in colorectal cancer patients with hepatic metastases was 5.2 pg/mL (1.7–30 pg/mL), p=0.0001; both were significantly elevated compared to the control group. A significant difference in immunostaining for big ET-1 was noted between paired normal colonic mucosa (median score-1) and tumour sections (median score-3), p=0.01. Conclusion This study has demonstrated elevated concentrations of big ET-1 in colorectal cancer patients, especially in those with hepatic metastases. Upregulation of ET activity in colorectal cancer could be inferred by the increased immunostaining of big ET-1 in cancer cells. Therefore, plasma big ET-1 levels should be evaluated as a potential tumour marker for the identification of hepatic metastases at an earlier stage.

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Chest Computed Tomography Screening in Colorectal Cancer Patients

World Journal of Surgery ◽

10.1007/s00268-008-9891-3 ◽

2009 ◽

Vol 33 (6) ◽

pp. 1325-1326 ◽

Cited By ~ 3

Author(s):

Carl Chartrand-Lefebvre ◽

Réal Lapointe ◽

Louise Samson ◽

Marie-Pierre Cordeau ◽

Julie Prenovault

Keyword(s):

Colorectal Cancer ◽

Computed Tomography ◽

Cancer Patients ◽

Chest Computed Tomography ◽

Colorectal Cancer Patients

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Comparison of Mangafodipir Trisodium- and Ferucarbotran-Enhanced MRI for Detection and Characterization of Hepatic Metastases in Colorectal Cancer Patients

American Journal of Roentgenology ◽

10.2214/ajr.04.1941 ◽

2006 ◽

Vol 186 (4) ◽

pp. 1059-1066 ◽

Cited By ~ 21

Author(s):

Hyoung Jung Kim ◽

Kyoung Won Kim ◽

Jae Ho Byun ◽

Hyung Jin Won ◽

Yong Moon Shin ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Hepatic Metastases ◽

Mangafodipir Trisodium ◽

Enhanced Mri ◽

Colorectal Cancer Patients

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Quality of life in colorectal cancer patients with hepatic arterial infusion (HAI) pumps

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19602 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19602-19602

Author(s):

V. C. Sun ◽

R. Nelson ◽

B. Wagman ◽

M. Carroll ◽

B. Lee ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Cancer Patients ◽

Assessment Tool ◽

Hepatic Metastases ◽

Hepatic Arterial Infusion ◽

Arterial Infusion ◽

Colorectal Cancer Patients ◽

The Impact

19602 Background: More than half of patients diagnosed with colorectal cancer will develop hepatic metastases. Most patients with hepatic metastases will recur within two years after resection. Hepatic arterial infusion (HAI) pumps deliver regional treatment. However, very few studies quantitatively explore the patient's experience of living with an HAI pump and how this experience impacts HAI-related quality of life (QOL). This study explored the impact of HAI pump treatment on patient's overall QOL within the specific domains of physical, psychological, social, and functional well-being. Methods: Twenty-five colorectal cancer patients treated with HAI pumps completed an HAI pump- specific QOL assessment tool at one data collection time point. The QOL assessment tool items were derived from the investigator's previous QOL research with this patient population [Blair et al., 2002, Annals of Surgical Oncology]. Demographic, disease and QOL data were summarized using descriptive statistics. Results: Of the 25 patients accrued, 32% were receiving treatments through their HAI pump and 68% were not. There were no significant difference in QOL between treatment status, gender, and age (<65 or = 65). Currently treated pump patients experienced more appetite changes (p=0.03), sleep changes (p=0.08), and more restrictions in traveling (p=0.08). Male patients had more concerns with lifting heavy items (p=0.05), while female patients had more concerns with isolation (p=0.17) and changes in the type of clothing worn (p=0.16). Younger patients had more concerns with vigorous activity (p=0.01), bending (p=0.08), and were more self-conscious of their appearance with the pump (p=0.01). Conclusions: Overall, in this study, colorectal cancer patients with HAI pumps reported good QOL and were satisfied with their overall treatment experience. Although there was no comparative statistical analysis performed in this study, several QOL concerns remain worrisome for patients. Defining these specific QOL concerns in HAI patients will enhance clinical understanding of their unique experience with this treatment modality and impact patient management. This will enable further development of educational tools and research to test interventions to support HAI patients and sustain their QOL. No significant financial relationships to disclose.

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