scholarly journals Two Cases of Long-Term Survival of Advanced Colorectal Cancer with Synchronous Lung Metastases Treated with mFOLFOX6/XELOX + Bevacizumab

2018 ◽  
Vol 11 (2) ◽  
pp. 601-608 ◽  
Author(s):  
Yuta Ushida ◽  
Eiji Shinozaki ◽  
Keisho Chin ◽  
Mitsukuni Suenaga ◽  
Daisuke  Takahari ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lung Metastases ◽  
Rare Event ◽  
Ileocecal Resection ◽  
Term Survival ◽  
Desirable Outcome ◽  
Multiple Metastases ◽  
Cecum Cancer ◽  
Laparoscopic Ileocecal Resection ◽  
Disease Free

Background: Colorectal cancer (CRC) with lung metastases has an unfavorable prognosis. However, nowadays, even advanced CRC can have a favorable outcome in certain cases. A complete response (CR) is a rare event in advanced CRC with lung metastases. Herein, we report 2 rare cases of advanced CRC attaining a CR. Case Presentation: Case 1 was a 58-year-old man who underwent laparoscopic ileocecal resection for cecum cancer with multiple metastases to the lungs in 2011. We performed treatment with mFOLFOX6 and bevacizumab chemotherapy in August 2011. After 11 courses, computed tomography (CT) revealed a CR to chemotherapy in February 2012. He has remained disease-free for 5 years and 3 months. Case 2 was a 70-year-old woman who underwent laparoscopic ileocecal resection for cecum cancer in August 2010. Recurrence of multiple metastases to both lungs was detected in November 2010. We started treatment with XELOX and bevacizumab chemotherapy in January 2011. In January 2011, CT after 14 courses revealed disappearance of the lung lesions, thereby indicating a CR. She has remained disease-free for 5 years and 4 months. Conclusion: We encountered 2 patients with CRC with lung metastases who were treated with chemotherapy leading to a CR. Cases resulting in such a desirable outcome are extremely rare.

scholarly journals An Octogenarian Case of Sequential Laparoscopic Surgery for Synchronous Isolated Splenic Metastasis From Cancer of the Cecum

2021 ◽  
Vol 105 (1-3) ◽  
pp. 619-622
Author(s):  
Hideyuki Yokokawa ◽  
Rie Imaizumi ◽  
Yoshitomo Ito ◽  
Teppei Kono ◽  
Taro Koike ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Resection ◽  
Case Reports ◽  
Ileocecal Resection ◽  
Splenic Metastasis ◽  
Short Term ◽  
Case Presentation ◽  
Laparoscopic Ileocecal Resection ◽  
Disseminated Disease ◽  
Cecal Cancer

Introduction Because splenic metastasis from colorectal cancer is usually a result of metastasis from widely disseminated disease, cases with resectable isolated splenic metastasis are uncommon. Case presentation We report here a case of synchronous isolated splenic metastasis from cecal cancer that was treated with sequential laparoscopic splenectomy after short-term observation following laparoscopic ileocecal resection. Both postoperative courses were uneventful, allowing the patient to be discharged early. Two years have passed, without recurrence, since the second operation. Conclusions There are very few case reports on synchronous isolated splenic metastasis from colorectal cancer. Sequential laparoscopic resection might contribute to obtaining an uneventful postoperative course, especially in elderly patients such as ours.

Colorectal cancer ovarian metastases

2021 ◽  
pp. ijgc-2020-002328
Author(s):  
Lucas W Thornblade ◽  
Ernest Han ◽  
Yuman Fong
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Median Overall Survival ◽  
Disease Free Survival ◽  
Ovarian Metastasis ◽  
Term Survival ◽  
Ovarian Metastases ◽  
Risk Of Death ◽  
Significant Difference ◽  
Disease Free

ObjectiveOvarian metastases occur in 3%–5% of patients with colorectal cancer. The role of oophorectomy in that setting continues to be debated. We aimed to assess the survival of women treated with metastasectomy for ovarian metastasis.MethodsRetrospective cohort study of patients in the California Cancer Registry (2000–2012) with stage IV colorectal cancer and ovarian metastases. Pathology other than adenocarcinoma was excluded. Adjusted Cox-proportional hazard analysis was applied to assess the risk of death.ResultsA total of 756 patients with synchronous ovarian metastases and 516 patients with metachronous ovarian metastases form the basis of this analysis. Median follow-up for the synchronous cohort was 21 months (IQR: 8–36). Median overall survival was 23 months (IQR: 10–42). Estimated 5-year survival reached 17% and 10-year survival was 8%. There was a significant difference in unadjusted survival between patients with solitary ovarian metastasis (median overall survival: 51 months) compared with those who had both ovarian and extraovarian metastases (20 months) (log-rank test, P<0.0001). For patients with solitary ovarian metastases, the 5- and 10-year survival was 46% and 31%, respectively. Among patients with synchronous ovarian metastases, longer unadjusted survival was observed after oophorectomy (median overall survival: 24 months) compared with no oophorectomy (18 months, log-rank P=0.01). For patients with metachronous diagnoses of colorectal cancer ovarian metastasis, the median disease-free survival was 19 months. The median survival after resection of metachronous ovarian metastases was 25 months, with the survival directly related to the disease-free interval until metastasis. For patients with resected metachronous ovarian metastases, the 5- and 10-year post-metastasectomy survival was 14% and 5%, respectively.ConclusionsPatients with colorectal cancer ovarian metastasis have favorable long-term survival. Survival rates are higher if the tumor is isolated to the ovary or if metachronous to the primary cancer.

Treatment outcomes of patients (pts) with primary mediastinal germ cell tumors (PMGCT): The M. D. Anderson Cancer Center (MDACC) experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14538-14538
Author(s):  
A. J. Rodney ◽  
A. Siefker-Radtke ◽  
N. M. Tannir ◽  
S. Swisher ◽  
G. Walsh ◽  
...  
Keyword(s):  
Germ Cell ◽  
Poor Prognosis ◽  
Lung Metastases ◽  
Germ Cell Tumors ◽  
Phase Iii ◽  
Term Survival ◽  
Excellent Outcome ◽  
Undifferentiated Histology ◽  
Disease Free

14538 Background: PMGCT are uncommon germ cell malignancies. Mediastinal nonseminomatous germ cell tumors (NSGCT) have a poor prognosis, whereas pure seminoma (Sem) has a good or intermediate prognosis irrespective of mediastinal presentation. Methods: We retrospectively identified 19 male pts with PMGCT seen at MDACC between October 1998 and September 2004 from a clinical database. Pts with resectable NSGCT were offered surgery upon plateau of their chemotherapy response. Prior to referral, 1 pt had primary surgical resection without preoperative (preop) chemotherapy. Results: There were 14 pts with NSGCT and 5 with good prognosis Sem. The median age was 29.5 (20–60). Seven pts with NSGCT had mixed or undifferentiated histology, and the remainder had pure yolk sac (5 pts) or choriocarcinoma (2 pts). The estimated median survival (Kaplan-Meier) for all patients (Sem + NSGCT) was 21 months. All pts with Sem were alive and disease-free at last follow-up (median 12 months, range 7–34). All pts with Sem received 4 courses of etoposide and cisplatin (EP); one also received bleomycin (BEP); one received radiotherapy consolidation; none received surgery. Of the pts with NSGCT, 9 (64%) have died, including 1 who refused surgery. Five pts with NSGCT were alive at last follow-up and 3 (21%) were disease-free (15+, 27+ and 35+ months). Four pts with NSGCT (29%) reached beyond 2 years survival (27+, 28, 35+, and 63+ months) including 3 with lung metastases and one with elevated preop alpha-fetoprotein (28,022 ng/ml). Each of these pts received 6–10 courses of multiple-regimen preop chemotherapy, and 2 received initially 4 courses of BEP without marker normalization. Conclusions: Mediastinal Sem treated with 4 courses EP had an excellent outcome without surgery. Pts with mediastinal NSGCT had a 64% mortality rate despite aggressive treatment. Several pts with mediastinal NSGCT did achieve long-term survival following aggressive chemotherapy and surgery, even with lung metastases and failure to normalize markers. A phase III trial of BEP versus dose-dense chemotherapy for poor-prognosis NSGCT is now in progress at MDACC. No significant financial relationships to disclose.

Long-term survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy compared with hepatic resection for metastatic colorectal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 630-630 ◽  
Author(s):  
Aaron Udell Blackham ◽  
Greg B. Russell ◽  
John H. Stewart ◽  
Konstantinos Ioannis Votanopoulos ◽  
Edward Allen Levine ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Hepatic Resection ◽  
Metastatic Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Performance Status ◽  
Term Survival ◽  
Disease Free

630 Background: Surgical resection of peritoneal metastases (PM) from colorectal cancer has been reported to yield outcomes similar to liver resection for hepatic metastases (HM). However recent data suggests PM may have a worse prognosis than other metastatic sites. Methods: A review of metastatic colorectal cancer patients obtained from prospective databases (1992-2010) comparing liver resection for HM to cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for PM. Results: 181 patients underwent hepatic resection and 182 patients underwent CS/HIPEC with a median follow-up of 55 and 106 months respectively. A margin-negative resection was obtained in 168 (93%) hepatic resections, while 89 patients (49%) with PM had complete cytorection of all gross disease (R0/R1). A comparison of these two groups demonstrated significant differences in age, pre-operative chemotherapy and performance status. Disease-free median survival was 15.2 months after hepatic resection and 9.9 months after CS/ HIPEC (p=0.02). The 5-year overall survival (OS) for HM patients was 33% with a median OS of 45.0 months; while 5-year OS was 23% and median OS was 32.3 months for PM patients (p=0.02). In a proportional hazards regression model, performance status and pre-operative chemotherapy had no significant effect on survival, while increased age (p=0.02) and PM (p=0.03) were associated with decreased OS. Postoperative morbidity was 38% versus 51% (p=0.04) and mortality was 3.0% versus 2.3% (p=0.73) in the HM and PM groups, respectively. Conclusions: Disease-free survival and OS are worse for patients who received complete cytoreduction and CS/HIPEC for PM compared to margin-negative liver resection for HM suggesting a more aggressive tumor biology in PM.

Metastatic Osteosarcoma Presenting as a Small-Bowel Polyp

2000 ◽  
Vol 124 (11) ◽  
pp. 1682-1684
Author(s):  
Angel Panizo-Santos ◽  
Iosu Sola ◽  
María Dolores Lozano ◽  
Enrique de Alava ◽  
Javier Pardo
Keyword(s):  
Lung Metastases ◽  
Abdominal Mass ◽  
Rare Event ◽  
Term Survival ◽  
Metastatic Osteosarcoma ◽  
Entire Thickness ◽  
Unusual Phenomenon ◽  
History Of ◽  
The Right

Abstract Gastrointestinal metastases of osteosarcoma are an extraordinarily rare event and, as far as we can determine, have been reported previously only 5 times; these cases represent an unusual pattern of progression. We describe a 21-year-old man with an osteosarcoma of the right tibia that was removed 4 years previously. Two years later, the patient showed lung metastases. At his most recent presentation, he complained of abdominal pain, nausea, vomiting, and anorexia. Radiologic examination revealed an abdominal mass close to the jejunum and 3 nodules in the liver. One metastasis was an ulcerated and pedunculated polypoid mass located in the mucosa of the bowel, and the other involved the entire thickness of the jejunum. This unusual phenomenon represents an alteration in the natural history of osteosarcoma as a result of increased long-term survival.

scholarly journals SURGICAL OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH SYNCHRONOUS COLORECTAL LIVER METASTASES

2014 ◽  
Vol 51 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Rafael FONTANA ◽  
Paulo HERMAN ◽  
Vincenzo PUGLIESE ◽  
Marcos Vinicius PERINI ◽  
Fabricio Ferreira COELHO ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Disease Free

Context Colorectal cancer is the second most prevalent cancer worldwide, and the liver is the most common site of metastases. Surgical resection of colorectal liver metastases provides the sole possibility of cure and the best odds of long-term survival. Objectives To describe surgical outcomes and identify features associated with disease prognosis in patients submitted to synchronous colorectal cancer liver metastasis resection. Methods Retrospective study of 59 patients who underwent surgery for synchronous colorectal cancer liver metastasis. Actuarial survival and disease-free survival were assessed, depending on the prognostic variable of interest. Results Postoperative mortality and morbidity rates were 3.38% and 30.50% respectively. Five-year disease-free survival was estimated at 23.96%, and 5-year overall survival, at 38.45%. Carcinoembryonic antigen levels ≥50 ng/mL and presence of three or more liver metastasis were limiting factors for disease-free survival, but did not affect late survival. No patient with liver metastases and extrahepatic disease had disease-free interval longer than 20 months, but this had no significance or impact on long-term survival. None of the prognostic factors assessed had an impact on late survival, although no patients with more than three liver metastases survived beyond 40 months. Conclusions Although Carcinoembryonic antigen levels and number of metastases are prognostic factors that limit disease-free survival, they had no impact on 5-year survival and, therefore, should not determine exclusion from surgical treatment. Resection is the best treatment option for synchronous colorectal liver metastases, and even for patients with multiple metastases, large tumors and extrahepatic disease, it can provide long-term survival rates over 38%.

scholarly journals Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 900
Author(s):  
Sophie Müller ◽  
Franziska Köhler ◽  
Anne Hendricks ◽  
Carolin Kastner ◽  
Kevin Börner ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Brain Metastases ◽  
Lung Metastases ◽  
Meta Analysis ◽  
Blood Levels ◽  
Kras Mutations ◽  
Therapy Regimen ◽  
Multiple Metastases

Colorectal cancer (CRC) is the third most common malignancy worldwide. Most patients with metastatic CRC develop liver or lung metastases, while a minority suffer from brain metastases. There is little information available regarding the presentation, treatment, and overall survival of brain metastases (BM) from CRC. This systematic review and meta-analysis includes data collected from three major databases (PubMed, Cochrane, and Embase) based on the key words “brain”, “metastas*”, “tumor”, “colorectal”, “cancer”, and “malignancy”. In total, 1318 articles were identified in the search and 86 studies matched the inclusion criteria. The incidence of BM varied between 0.1% and 11.5%. Most patients developed metastases at other sites prior to developing BM. Lung metastases and KRAS mutations were described as risk factors for additional BM. Patients with BM suffered from various symptoms, but up to 96.8% of BM patients were asymptomatic at the time of BM diagnosis. Median survival time ranged from 2 to 9.6 months, and overall survival (OS) increased up to 41.1 months in patients on a multimodal therapy regimen. Several factors including age, blood levels of carcinoembryonic antigen (CEA), multiple metastases sites, number of brain lesions, and presence of the KRAS mutation were predictors of OS. For BM diagnosis, MRI was considered to be state of the art. Treatment consisted of a combination of surgery, radiation, or systemic treatment.

Non-surgical Treatments for Lung Metastases in Patients with soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA)

2020 ◽  
Vol 16 ◽  
Author(s):  
Cecilia Tetta ◽  
Maria Carpenzano ◽  
Areej Tawfiq J Algargoush ◽  
Marwah Algargoosh ◽  
Francesco Londero ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Stereotactic Body Radiation Therapy ◽  
Lung Metastases ◽  
Disease Free Interval ◽  
Stereotactic Body Radiation ◽  
Free Interval ◽  
Disease Free

Background: Radio-frequency ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two emerging therapies for lung metastases. Introduction: We performed a literature review to evaluate outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). Method: After selection, seven studies were included for each treatment encompassing a total of 424 patients: 218 in the SBRT group and 206 in the RFA group. Results: The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. : In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease-free interval from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. : Local control showed high percentage for both procedures. Conclusion: SBRT is recommended in patients unsuitable to surgery, in synchronous bilateral pulmonary metastases, in case of deep lesions and in patients receiving high-risk systemic therapies. RFA is indicated in case of a long disease-free interval, in oligometastatic disease, when only the lung is involved, in small size lesions far from large vessels. : Further large randomized studies are necessary to establish whether these treatments may also represent a reliable alternative to surgery.

scholarly journals 678 Addition of a single bacteria facilitates anti-tumor immunity and long-term survival in colorectal cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A717-A717
Author(s):  
Abigail Overacre-Delgoffe ◽  
Anthony Cillo ◽  
Hannah Bumgarner ◽  
Ansen Burr ◽  
Justin Tometich ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
T Cells ◽  
Tumor Immunity ◽  
Tumor Burden ◽  
Intestinal Microbiome ◽  
Tumor Control ◽  
Mesenteric Lymph Nodes ◽  
Term Survival ◽  
16S Sequencing ◽  
Tumor Bearing

BackgroundColorectal cancer remains one of the most common and deadliest cancers worldwide and effective therapies are lacking. While immunotherapy has revolutionized treatment for many cancers, the overwhelming majority of colorectal cancer patients are non-responsive and the 5-year survival rate for advanced disease is <20%. Immunotherapeutic response has been associated with select members of the microbiome in melanoma; however, the potential benefit in colorectal cancer and the underlying mechanisms remain unclear. We sought to determine how specific members of the intestinal microbiome affect anti-tumor immunity in colorectal cancer (CRC) in hopes of discovering novel treatments and revealing potential hurdles to current therapeutic response in CRC patients.MethodsWe utilized a carcinogen-induced mouse model of CRC and colonized half of the tumor-bearing mice with Helicobacter hepaticus (Hhep) 7 weeks post AOM. Tumor number was assessed 12 weeks post AOM. We isolated lymphocytes from the lamina propria, colonic epithelium, mesenteric lymph nodes, and tumor(s) to track the spatial and transcriptional Hhep-specific and endogenous immune responses during tumor progression through 5’ single cell RNAseq, flow cytometry, and immunofluorescence. In addition, we utilized 16S sequencing and FISH to track Hhep colonization, location within the colon, and its impact on the surrounding microbiome.ResultsWe have found that rational modification of the microbiome of colon tumor-bearing mice through addition of a single bacteria, Hhep, led to tumor control or clearance and a significant survival advantage. Colonization led to the expansion of the lymphatic network and development of numerous peri- or intra-tumoral tertiary lymphoid structures (TLS) composed of Hhep-specific CD4 T follicular helper cells (TFH) as well as the bacteria itself. This led to an overall ‘heating’ of the tumor, wherein we saw an increase of CD4 T cell infiltration to the tumor core as well as an increase in CD103+ type 1 DC (cDC1) recruitment through increased chemokines such as CCL5 and XCL1. Hhep-specific TFH were both necessary and sufficient to drive TLS formation, increased immune invasion, and anti-tumor immunity.ConclusionsWe have shown that addition of a single bacteria, Hhep, leads to a reduction in CRC tumor burden or clearance through lymphatic expansion, TLS formation, and remodeling of the tumor microenvironment, and that Hhep-specific T cells are required for tumor control. These studies suggest that rational modification of the microbiome and microbiome-specific T cells can positively impact anti-tumor immunity and may represent a unique immunotherapeutic target to turn resistant tumors into responsive tumors.

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