scholarly journals Nomogram based on homogeneous and heterogeneous associated factors for predicting distant metastases in patients with colorectal cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tianwen Luo ◽  
Yutong Wang ◽  
Xuefeng Shan ◽  
Ye Bai ◽  
Chun Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Lung Metastases ◽  
Roc Curves ◽  
Distant Metastases ◽  
Good Prediction ◽  
Operating Characteristics ◽  
Good Prediction Performance ◽  
Different Types ◽  
Associated Risk Factors

Abstract Background The identification of the homogeneous and heterogeneous risk factors for different types of metastases in colorectal cancer (CRC) may shed light on the aetiology and help individualize prophylactic treatment. The present study characterized the incidence differences and identified the homogeneous and heterogeneous risk factors associated with distant metastases in CRC. Methods CRC patients registered in the SEER database between 2010 and 2016 were included in this study. Logistic regression was used to analyse homogeneous and heterogeneous risk factors for the occurrence of different types of metastases. Nomograms were constructed to predict the risk for developing metastases, and the performance was quantitatively assessed using the receiver operating characteristics (ROC) curve and calibration curve. Results A total of 204,595 eligible CRC patients were included in our study, and 17.07% of them had distant metastases. The overall incidences of liver metastases, lung metastases, bone metastases, and brain metastases were 15.34%, 5.22%, 1.26%, and 0.29%, respectively. The incidence of distant metastases differed by age, gender, and the original CRC sites. Poorly differentiated grade, more lymphatic metastasis, higher carcinoembryonic antigen (CEA), and different metastatic organs were all positively associated with four patterns of metastases. In contrast, age, sex, race, insurance status, position, and T stage were heterogeneously associated with metastases. The calibration and ROC curves exhibited good performance for predicting distant metastases. Conclusions The incidence of distant metastases in CRC exhibited distinct differences, and the patients had homogeneous and heterogeneous associated risk factors. Although limited risk factors were included in the present study, the established nomogram showed good prediction performance.

scholarly journals Role of Color Doppler Imaging in Early Diagnosis and Prediction of Progression in Glaucoma

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Fatima Jimenez-Aragon ◽  
Elena Garcia-Martin ◽  
Raquel Larrosa-Lopez ◽  
Jose M. Artigas-Martín ◽  
Pilar Seral-Moral ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Color Doppler ◽  
Resistive Index ◽  
Color Doppler Imaging ◽  
Roc Curves ◽  
Doppler Imaging ◽  
Operating Characteristics ◽  
Diastolic Velocity ◽  
Retinal Artery

This longitudinal and prospective study analyzes the ability of orbital blood flow measured by color Doppler imaging (CDI) to predict glaucoma progression in patients with glaucoma risk factors. Patients with normal perimetry but having glaucoma risk factors and patients in the initial phase of glaucoma were prospectively included in the study and divided, after a five-year follow-up, into two groups: “Progression” and “No Progression” based on the changes in the Moorfields regression analysis (MRA) classification of Heidelberg retina tomograph (HRT). An orbital CDI was performed in all patients and the parameters obtained were correlated with changes in HRT. A logistic discrimination function (LDF) was calculated for ophthalmic artery (OA) and central retinal artery (CRA) parameters. Receiver operating characteristics curves (ROC) were used to assess the usefulness of LDFs to predict glaucomatous progression. A total of 71 eyes were included. End-diastolic velocity, time-averaged velocity, and resistive index in the OA and CRA were significantly different (P<0.05) between the Progression and No Progression groups. The area under the ROC curves calculated for both LDFs was of 0.695 (OA) and 0.624 (CRA). More studies are needed to evaluate the ability of CDI to perform early diagnosis and to predict progression in glaucoma in eyes.

scholarly journals Study of risk factors among stroke patients in a tertiary hospital of Northern India

2017 ◽  
Vol 4 (2) ◽  
pp. 446
Author(s):  
Amit Kumar ◽  
Onkar Nath Rai
Keyword(s):  
Risk Factors ◽  
Tertiary Hospital ◽  
Stroke Incidence ◽  
Medical College ◽  
Northern India ◽  
Different Types ◽  
History Of ◽  
Chest X Ray ◽  
Associated Risk Factors

Background: Stroke is one of the leading causes of death and disability worldwide. The aim of the study was to find out the incidence of different types of strokes and the associated risk factors and to establish the role of different investigations in patients of stroke.Methods: The study dealt with 100 patients of stroke who were admitted to B. R. D. Medical College, Gorakhpur, India. Each patient was analyzed in detail about clinical presentation and the investigations were aimed to establish the pathologic type of stroke and estimation of risk factors.Results: Stroke incidence was more in males (Male: Female= 1.43:1). Maximum incidence of stroke was in 6th decade (32%) followed by 7th decade (30%). Among modifiable risk factors, history of hypertension was the commonest (51%) followed by smoking (36% patients) exclusively, found in males. Hemiparesis was the most common presentation (95%) followed by altered sensorium (55%). Chest X-ray was abnormal in 16% patients, abnormal ECG was found in 27% patients and abnormal lipid values were found in 54 patients.Conclusions: Apart from control of hypertension and diabetes, abnormal lipid profile remains an important modifiable risk factor for stroke.

Adjunctive local therapy in metastatic colorectal cancer in an unselected cohort: Improved patient-survival in comparison to systemic therapies.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4096-4096
Author(s):  
Jan Schroeder ◽  
Evrim Tasci ◽  
Claus Nolte-Ernsting ◽  
Peter Michels ◽  
Natalie Wetzel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Lung Metastases ◽  
Local Therapy ◽  
Distant Metastases ◽  
Reference Population ◽  
Systemic Treatments ◽  
Radiofrequency Therapy ◽  
Study Population ◽  
Prospective Longitudinal

4096 Background: Patients with distant metastases in colorectal cancer have a poor prognosis and a low overall survival (OS). In addition to systemic treatments and irradiation, the tumor burden can be reduced by loco-regional therapeutics, including microwave ablation (MWA), radiofrequency therapy (RFA) and trans-arterial chemoembolization (TACE) available. To evaluate the benefit of such local therapies, we compared OS of a single-centre study population to a reference population of patients who underwent no loco-regional treatment within the German Tumor Registry Colorectal Cancer (TKK). Methods: The study population consists of a cohort of 51 patients (n = 51) treated loco-regionally in addition to systemic therapy. The patients were recruited in a single cancer centre in Mülheim, Germany during the years 2006 to 2015. A reference population of 788 patients was chosen from a prospective, longitudinal registry of the TKK. Time to event data analysis included the estimation of Kaplan-Meier cumulative survival probabilities and hazard ratios (HR) with corresponding 95% confidence intervals (95% CI) from Cox proportional hazards regression. Results: The median OS was 31.3 months (95% CI 26.8 - 41.6) in the study population, as compared to the reference population, where it was 21.9 months (95% CI 20.1 – 24.6). Patients with liver and lung metastases in the study population had an OS of 41.6 months (95% CI 30.5 – 78.2), the corresponding patients from the reference population 21.7 months (95% CI 16.7 – 24.6). Furthermore, patients in the reference group had a 1.79-fold death-rate, as compared to patients treated with additional loco-regional therapy (HR = 2.02; 95% CI: 1.29-3.16). Conclusions: Additional treatment with loco-regional therapies of distant metastases in patients with metastatic colorectal cancer appears to be associated with improved OS by nearly 10 months compared to systemic treatments only. [Table: see text]

scholarly journals Risk of Pharmacological or Hospital Treatment for Depression in Patients with Colorectal Cancer–Associations with Pre-Cancer Lifestyle, Comorbidity and Clinical Factors

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1979
Author(s):  
Trille Kristina Kjaer ◽  
Ida Rask Moustsen-Helms ◽  
Vanna Albieri ◽  
Signe Benzon Larsen ◽  
Thea Helene Degett ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Cox Regression ◽  
Disease Stage ◽  
Health Study ◽  
Hospital Treatment ◽  
Cancer Group ◽  
Increased Risk ◽  
Associated Risk Factors

We investigated the risk of depression in colorectal cancer (CRC) patients and associated risk factors. The 1324 patients with CRC and 6620 matched cancer-free participants from the Diet, Cancer and Health study were followed for up to 16 years for either a first hospitalization for depression or antidepressant prescription after diagnosis of CRC cancer or study entry date. Information on the outcome and covariates was retrieved from the Danish Colorectal Cancer Group database, the national health registries and questionnaires. Cumulative incidence of depression was estimated, and Cox regression models were used to evaluate the association between risk factors and depression incidence. During follow-up, 191 (14.4%) patients with CRC and 175 (2.6%) cancer-free comparison persons experienced depression. After adjustments, in the first year after cancer diagnosis, patients with CRC had a 12-fold higher hazard compared with the cancer-free population (HR, 12.01; 95% CI, 7.89–18.28). The risk decreased during follow-up but remained significantly elevated with an HR of 2.65 (95% CI, 1.61–4.36) after five years. Identified risk factors were presence of comorbidities, advanced disease stage and use of radiotherapy, while life style factors (pre-cancer or at diagnosis) and chemotherapy did not seem to contribute to the increased risk.

Mortality after emergency treatment of colorectal cancer and associated risk factors—a nationwide cohort study

2018 ◽  
Vol 34 (1) ◽  
pp. 85-95 ◽  
Author(s):  
Thea Helene Degett ◽  
Susanne Oksbjerg Dalton ◽  
Jane Christensen ◽  
Jes Søgaard ◽  
Lene Hjerrild Iversen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Cohort Study ◽  
Emergency Treatment ◽  
Associated Risk Factors

Retrospective study to elucidate a K-ras phenotype in patients with colorectal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 462-462
Author(s):  
I. Garrido-Laguna ◽  
F. Janku ◽  
G. S. Falchook ◽  
A. Naing ◽  
S. Fu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Median Survival ◽  
Lung Metastases ◽  
Significant Prognostic Factor ◽  
Ras Mutations ◽  
Activating Mutations ◽  
Pathological Characteristics ◽  
Different Types ◽  
And Gender ◽  
Metastatic Sites

462 Background: Activating mutations of the K-ras oncogene in colorectal cancer (CRC) are associated with resistance to EGFR antibodies and poor prognosis. Clinical and pathological characteristics associated with K-ras mutations have not been systematically analyzed. Methods: Patients with CRC referred to the phase I program for targeted therapy were analyzed for K-ras mutations using PCR-based DNA sequencing. Patients with mutant K-ras were matched with wild-type (wt) K-ras controls. Multiple clinical and pathological characteristics were analyzed to determine, whether there is a phenotype associated with K-ras mutations. Results: A total of 107 patients with CRC were identified; 58 with K-ras mutations; and 49 with wt K-ras. Patients with K-ras mutations compared with wt K-Ras had more frequently lung metastases (80% vs. 57%, p = 0.013). There was a trend towards higher number of metastatic sites in K-ras mutant patients compared with wt K-ras (3.16 vs. 2.69; p = 0.07). There were no associations between K-ras mutations and gender, age at diagnosis, liver metastases, peritoneal metastases, and lymphatic involvement. The median time from diagnosis to development of metastatic disease was similar in K-ras mutant and K-ras wt patients (194 vs. 196 weeks, p = 0.43). The median survival from diagnosis was also similar in K-ras mutant and K-ras wt patients (254 vs. 223 weeks, p = 0.32). There was no difference in the median survival from diagnosis in patients with different types of K-ras mutations (codon 12, codon 13, and codon 61). Dukes staging was the only statistically significant prognostic factor on multivariate analysis (p < 0.05). Conclusions: K-ras mutations in CRC in comparison with wt K-ras were associated with more frequent lung metastases. K-ras mutations did not impact survival. No significant financial relationships to disclose.

scholarly journals Abundant intratumoral fibrosis prevents lymphocyte infiltration into peritoneal metastases of colorectal cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255049
Author(s):  
En Wang ◽  
Masatsune Shibutani ◽  
Hisashi Nagahara ◽  
Tatsunari Fukuoka ◽  
Yasuhito Iseki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Immunohistochemical Staining ◽  
Lung Metastases ◽  
Treatment Resistance ◽  
Tumor Infiltrating Lymphocytes ◽  
Distant Metastases ◽  
Collagen Fibers ◽  
Peritoneal Metastases ◽  
Cancer Associated Fibroblasts ◽  
Primary Tumors

Background Tumor-infiltrating lymphocytes (TILs) have been reported to reflect the anti-tumor immune status. However, recent investigations have demonstrated that intratumoral fibrosis is important as a factor affecting the infiltration of TILs. This study investigated the organ specificities of TIL infiltration and intratumoral fibrosis in primary colorectal cancer and distant metastases, as well as the relationship between the distribution of TILs and intratumoral fibrosis. Methods Patients who underwent resection of primary tumors or distant metastases for colorectal cancer with distant metastases were enrolled. We evaluated the TIL infiltration by immunohistochemical staining with CD3&CD8 and intratumoral fibrosis by immunohistochemical staining with α-SMA positive cancer-associated fibroblasts and Masson’s trichrome staining against collagen fibers. The "ImageJ" was used to evaluate fibrosis, and the density of TILs in the dense and sparse areas of fibrosis was calculated. The Immunoscore (IS) was obtained based on the density of CD3+/CD8+TILs in the tumor center and invasive margin of the primary tumor. Results The degree of CD3+/CD8+TIL infiltration in peritoneal metastases was significantly lower than that in liver and lung metastases. The area ratio of α-SMA positive cancer-associated fibroblasts and collagen fibers in peritoneal metastases was significantly higher than that of liver and lung metastases. Furthermore, the density of TILs in the high-fibrosis area was significantly lower than that in the low-fibrosis area. In the high-IS group of primary tumors, the degree of TIL infiltration in distant metastases was significantly higher than that in the low-IS group. Conclusion The infiltration of T lymphocytes into tumors is prevented in peritoneal metastases of colorectal cancer due to the high intratumoral fibrosis, which may lead to treatment resistance and a poor prognosis.

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