Arginase as a Useful Factor for the Diagnosis of Colorectal Cancer Liver Metastases

The present work is a continuation of studies on arginase as a marker in the diagnosis of colorectal cancer liver metastases (CRCLM). The purpose of the study was the evaluation of the arginase test in comparison with other colorectal cancer tests such as CEA, CA 19-9 and biochemical markers of liver function such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The studies were conducted on blood serum from 85 patients with CRCLM obtained one to two days before tumor resection. The control group comprised 140 healthy blood donors and 81 patients with various non-malignant gastrointestinal diseases. Raised arginase activity was observed in serum of 85% of CRCLM patients, whereas elevated levels of CEA and CA 19-9 were found in 63% and 42% of patients, respectively. The combination of CEA or CA 19-9 with the arginase assay improved their sensitivity, but the sensitivity of the combined parameters was not higher than that of the arginase test itself. AST and ALT activities were increased in about 30% of CRCLM patients. The specificity of the arginase test calculated for 221 control subjects was 76%. It can thus be concluded that the determination of serum arginase activity can be helpful in the diagnosis of patients with colorectal cancer liver metastases.

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The Use of Radiofrequency Thermal Ablation in Combine Treatment of Patients with Liver Bilobar Metastases from Colorectal Cancer

Science and Innovations in Medicine ◽

10.35693/2500-1388-2018-0-2-49-53 ◽

2018 ◽

Vol 3 (2) ◽

pp. 49-53

Author(s):

OI I Kaganov ◽

SV V Kozlov ◽

AE E Orlov ◽

NV V Blinov

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Combined Treatment ◽

Treatment Method ◽

Main Group ◽

Rank Test ◽

Control Group ◽

Metastatic Process ◽

Oncology Centre

Aim - determination of RFTA place in the combined treatment of bilobar liver metastatic process of colorectal cancer. Materials and methods. 176 patients with colorectal cancer with multiple (more than 4) bilobar liver metastases were included in the study after primary tumor removal. The research was held in Samara Regional Oncology Centre from 2001 to 2014. According to the treatment method patients were divided into two groups. Main group got the combined (chemotherapy + RFTA) treatment (98 patients). In control group only chemotherapy was applied to 78 patients. Results. One-, two- and three-year OS were 73.5%, 25.1%, 7.2% in the main group and 39.6%, 6.3%, 2.1% in the control group. With RFTA application we reached the 1.8% index of four-year survival in the main group, while three-year survival in the control group was only 2.1%. The OS median reached 18 months in the main group and 11 months in the control group, OS curves in two comparing groups were significantly different( log-rank test 3.77, р=0,000). Conclusion. Combination of RFTA with chemotherapy as the treatment of bilobar liver metastases of colorectal cancer, significantly improves the DFS and overall survival indexes, comparing to the group of patients who received only chemotherapy.

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Oral adjuvant chemotherapy using uracil-tegafur (UFT) with leucovorin (LV) after resection of colorectal cancer liver metastases: Long-term survival results of the phase III UFT/LV study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.672 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 672-672 ◽

Cited By ~ 3

Author(s):

Kiyoshi Hasegawa ◽

Akio Saiura ◽

Tadatoshi Takayama ◽

Shinichi Miyagawa ◽

Junji Yamamoto ◽

...

Keyword(s):

Colorectal Cancer ◽

Adjuvant Chemotherapy ◽

Liver Metastases ◽

Curative Resection ◽

Phase Iii ◽

Control Group ◽

Colorectal Cancer Liver Metastases ◽

The Impact ◽

Better Than

672 Background: Surgical resection has been accepted as the standard therapy for colorectal cancer liver metastases (CRLM), however, high recurrence incidence even after curative resection remains a severe problem. The 1st analysis of the UFT/LV trial showed that oral UFT/LV for 6 months significantly prolonged relapse-free survival (RFS) after resection for CRLM (Kobayashi A et al. ASCO 2014, Hasegawa K et al. PlosOne 2016 E-pub). To further evaluate the impact of the UFT/LV therapy on overall survival (OS), we performed the 2nd analysis under longer follow-up period, as have been scheduled by the protocol. Methods: Patients undergoing curative resection of CRLM were randomly assigned to either UFT/LV or surgery alone (control) group. In the UFT/LV group, 5 cycles of adjuvant UFT/LV (UFT 300mg/m2 and LV 75 mg/day for 28 days followed by 7 days rest in one cycle) were administered. Results: Between 2004 and 2010, a total of 180 patients were enrolled to this trial, among whom 3 patients were ineligible for analysis. Median follow-up of the 2nd analysis was 6 years. The 5y-OS rate in the UFT/LV group was 65.3%, which was slightly better than the control group (62.2%) without statistical significance. The hazard ratio for death in the UFT/LV relative to the control was 0.86 (95% confidence interval: 0.54-1.38, P = 0.54). The OS curves of the 2 groups were identical within 4 years after resection, however, the OS curve of the UFT/LV group seemed to go higher than the control group. The 5y-RFS rate in the UFT/LV group was 36.2%, which was significantly better than that in the control group (32.3%), as have been shown by the 1st analysis. Conclusions: The results of the 2nd analysis suggested that oral UFT/LV adjuvant chemotherapy might be also useful to prolong OS, as have been confirmed for RFS. This regimen can be recommended as an alternative choice after hepatic resection for CRLM. Clinical trial information: C000000013.

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Early Diagnosis of Liver Metastases from Colorectal Cancer through CT Radiomics and Formal Methods: A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm11010031 ◽

2021 ◽

Vol 11 (1) ◽

pp. 31

Author(s):

Aldo Rocca ◽

Maria Chiara Brunese ◽

Antonella Santone ◽

Pasquale Avella ◽

Paolo Bianco ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Formal Methods ◽

Liver Parenchyma ◽

Radiological Diagnosis ◽

Clinical Samples ◽

Control Group ◽

Colorectal Cancer Liver Metastases ◽

Intelligence Models ◽

Artificial Intelligence Models

Background: Liver metastases are a leading cause of cancer-associated deaths in patients affected by colorectal cancer (CRC). The multidisciplinary strategy to treat CRC is more effective when the radiological diagnosis is accurate and early. Despite the evolving technologies in radiological accuracy, the radiological diagnosis of Colorectal Cancer Liver Metastases (CRCLM) is still a key point. The aim of our study was to define a new patient representation different by Artificial Intelligence models, using Formal Methods (FMs), to help clinicians to predict the presence of liver metastasis when still undetectable using the standard protocols. Methods: We retrospectively reviewed from 2013 to 2020 the CT scan of nine patients affected by CRC who would develop liver lesions within 4 months and 8 years. Seven patients developed liver metastases after primary staging before any liver surgery, and two patients were enrolled after R0 liver resection. Twenty-one patients were enrolled as the case control group (CCG). Regions of Interest (ROIs) were identified through manual segmentation on the medical images including only liver parenchyma and eventual benign lesions, avoiding major vessels and biliary ducts. Our predictive model was built based on formally verified radiomic features. Results: The precision of our methods is 100%, scheduling patients as positive only if they will be affected by CRCLM, showing a 93.3% overall accuracy. Recall was 77.8%. Conclusion: FMs can provide an effective early detection of CRCLM before clinical diagnosis only through non-invasive radiomic features even in very heterogeneous and small clinical samples.

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