scholarly journals Improved Survival Outcome and Access to Cancer Screening from Hemorrhoid in Patients with Rectal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Qi Zou ◽  
Donglin Ren ◽  
Xiaolin Wang ◽  
Liangliang Bai ◽  
Guannan Tang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Screening ◽  
Disease Free Survival ◽  
Stage I ◽  
Concordance Index ◽  
Free Survival ◽  
Hazard Ratios ◽  
Primary Endpoints ◽  
The Impact ◽  
Disease Free

Background. The interventions for hemorrhoid increase access to rectal cancer screening and thus might reduce cancer death. We aimed to examine the impact of hemorrhoid on survival outcomes in rectal cancer. Methods. We identified 510 patients with stage I to III rectal cancer from a prospectively collected database. Patients were divided into hemorrhoid and non-hemorrhoid group. The primary endpoints were disease-free survival (DFS) and overall survival (OS). Results. Hemorrhoid group had significantly more stage I-II diseases in comparison to nonhemorrhoid group (71.1% vs. 55.9%, P = 0.049 ). The hemorrhoid group had significantly better DFS and OS compared to nonhemorrhoid group, the hazard ratios (HRs) of which were 0.39 (95% CI 0.17-0.88, P = 0.018 ) and 0.33 (95% CI 0.12-0.92, P = 0.034 ), respectively. Multivariate analysis revealed that hemorrhoid was independently associated with DFS [adjusted HR 0.43 (95% CI 0.17-0.95, P = 0.045 )]. A nomogram for predicting DFS outcome was generated based on hemorrhoid history, with a concordance index of 0.71 (95% CI 0.66-0.75, P < 0.001 ). Conclusions. There may exist a screening effect and survival benefit from hemorrhoid in rectal cancer, which supports the significance of rectal cancer screening in lowering its mortality.

scholarly journals Survival after Curative Resection for Stage I Colorectal Mucinous Adenocarcinoma

2020 ◽  
Author(s):  
Liang Huang ◽  
Shuangling Luo ◽  
Sicong Lai ◽  
Yonghua Cai ◽  
Zhanzhen Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Mucinous Adenocarcinoma ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
Stage I ◽  
Prognostic Impact ◽  
Long Term Outcome ◽  
Free Survival ◽  
Disease Free

Abstract Background: The prognostic value of the mucinous adenocarcinoma histotype on the early stages especially for stage I colorectal cancer (CRC) is still unclear. This study determined the clinicopathologic characteristics and long-term outcome of stage I colorectal mucinous adenocarcinomas (MAC). Methods: Among the total of 503 patients with stage I CRC (56 having MAC and 447 having non-MAC) who underwent radical resection, the correlation between clinicopathological factors and MAC was analyzed. Multivariate analysis was performed to determine whether mucinous histotype itself was an independent prognostic impact in stage I patients. Results: MACs were observed more frequently located in the colon than rectum (p=0.046), more frequently displayed the microsatellite instability (MSI) phenotype (p=0.023) and had a greater frequency of T2 stage (p=0.001). The rate of recurrence was 13.5% and the cancer-specific mortality was 4.3% among all stage I CRC patients. There was no difference in disease-free survival and overall survival between MACs and non-MACs. On multivariate analysis, older age (p=0.030，hazard ratio: 2.62), rectal cancer (p=0.025, hazard ratio: 5.42), lymphovascular invasion (LVI) (p<0.001, hazard ratio: 9.74), and microsatellite stability (MSS) phenotypes (p=0.023, hazard ratio: 4.21) were independently associated to poor survival of stage I CRC. A high carcinoembryonic antigen (CEA) level (p=0.031, hazard ratio: 1.95), rectal cancer (p=0.045, hazard ratio: 1.64), LVI (p=0.002, hazard ratio: 3.95) and MSS phenotypes (p=0.012, hazard ratio: 2.98) were independently related to short disease-free survival of stage I CRC.Conclusions: Compared with non-MAC, MAC patients had more T2 patients and more MSI phenotypes in stage I CRC at presentation, but the mucinous histology is not a significant predictor of recurrence and prognosis in stage I CRC.

scholarly journals Magnitude of the Age-Advancement Effect of Comorbidities in Colorectal Cancer Prognosis

2020 ◽  
Vol 18 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Daniel Boakye ◽  
Viola Walter ◽  
Lina Jansen ◽  
Uwe M. Martens ◽  
Jenny Chang-Claude ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Cancer Prognosis ◽  
Free Survival ◽  
Hazard Ratios ◽  
The Impact ◽  
Disease Free ◽  
Worse Prognosis

Background: Comorbidities and old age independently compromise prognosis of patients with colorectal cancer (CRC). The impact of comorbidities could thus be considered as conveying worse prognosis already at younger ages, but evidence is lacking on how much worsening of prognosis with age is advanced to younger ages in comorbid versus noncomorbid patients. We aimed to quantify, for the first time, the impact of comorbidities on CRC prognosis in “age advancement” of worse prognosis. Methods: A total of 4,602 patients aged ≥30 years who were diagnosed with CRC in 2003 through 2014 were recruited into a population-based study in the Rhine-Neckar region of Germany and observed over a median period of 5.1 years. Overall comorbidity was quantified using the Charlson comorbidity index (CCI). Hazard ratios and age advancement periods (AAPs) for comorbidities were calculated from multivariable Cox proportional hazards models for relevant survival outcomes. Results: Hazard ratios for CCI scores 1, 2, and ≥3 compared with CCI 0 were 1.25, 1.53, and 2.30 (P<.001) for overall survival and 1.20, 1.48, and 2.03 (P<.001) for disease-free survival, respectively. Corresponding AAP estimates for CCI scores 1, 2, and ≥3 were 5.0 (95% CI, 1.9–8.1), 9.7 (95% CI, 6.1–13.3), and 18.9 years (95% CI, 14.4–23.3) for overall survival and 5.5 (95% CI, 1.5–9.5), 11.7 (95% CI, 7.0–16.4), and 21.0 years (95% CI, 15.1–26.9) for disease-free survival. Particularly pronounced effects of comorbidity on CRC prognosis were observed in patients with stage I–III CRC. Conclusions: Comorbidities advance the commonly observed deterioration of prognosis with age by many years, meaning that at substantially younger ages, comorbid patients with CRC experience survival rates comparable to those of older patients without comorbidity. This first derivation of AAPs may enhance the empirical basis for treatment decisions in patients with comorbidities and highlight the need to incorporate comorbidities into prognostic nomograms for CRC.

scholarly journals Oxaliplatin Increases Disease-Free Survival in Rectal Cancer: A Single-Institution Experience

2016 ◽  
Vol 96 (2) ◽  
pp. E168-E169
Author(s):  
A. Roy ◽  
J.R. Olsen ◽  
R.J. Myerson ◽  
S. Markovina ◽  
T.A. DeWees ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Disease Free Survival ◽  
Single Institution ◽  
Free Survival ◽  
Disease Free

The Impact of Multiple Recurrences in Disease-Free Survival of Breast Cancer: An Extended Cox Model

2012 ◽  
Vol 98 (4) ◽  
pp. 428-433 ◽  
Author(s):  
Mahmood Reza Gohari ◽  
Reza Khodabakhshi ◽  
Javad Shahidi ◽  
Zeinab Moghadami Fard ◽  
Hossein Foadzi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Model ◽  
Disease Free Survival ◽  
Free Survival ◽  
Multiple Recurrences ◽  
The Impact ◽  
Disease Free ◽  
Extended Cox Model

scholarly journals Prognostic Value of Tumor-Stroma Ratio in Rectal Cancer: A Systematic Review and Meta-analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuzhou Zhu ◽  
Zechuan Jin ◽  
Yuran Qian ◽  
Yu Shen ◽  
Ziqiang Wang
Keyword(s):  
Rectal Cancer ◽  
Web Of Science ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Tumor Stroma ◽  
Pathologic Feature ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Risk Predictor ◽  
Disease Free

BackgroundTumor-stroma ratio (TSR) is a promising new prognostic predictor for patients with rectal cancer (RC). Although several studies focused on this pathologic feature, results from those studies were still inconsistent.MethodsThis research aimed to estimate the prognostic values of TSR for RC. A search of PubMed, EMBASE, and Web of Science was carried out. A meta-analysis was performed on disease-free survival, cancer-specific survival, and overall survival in patients with RC.ResultsThe literature search generated 1,072 possible studies, of which a total of 15 studies, involving a total of 5,408 patients, were eventually included in the meta-analysis. Thirteen of the 15 articles set the cutoff for the ratio of stroma at 50%, dividing patients into low-stroma and high-stroma groups. Low TSR (rich-stroma) was significantly associated with poorer survival outcome. (DFS: HR 1.54, 95% CI 1.32–1.79; OS: HR 1.52 95% CI 1.34–1.73; CSS: HR 2.05 95% CI 1.52–2.77).ConclusionPresent data support TSR to be a risk predictor for poor prognosis in RC patients.

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