Clinicopathological features and survival of colorectal cancer patients younger than 50 years: a retrospective comparative study

Abstract Background Colorectal cancer (CRC) is a disease of old age, but its incidence has been rising among younger population compared to older ones. Nevertheless, there is a controversy over survival of younger patients compared to the older ones. Therefore, in the current study, we investigated the clinicopathological features and survival of the younger (< 50 years) versus older (≥ 50 years) CRC patients. Results The younger and older groups consisted of 39.4% and 60.6% of patients, respectively. Both age groups were comparable regarding the symptom presentation and duration, and pre-operative carcinoembryonic antigen (CEA). The younger patients were diagnosed with a higher proportion of poorly differentiated (14.7% vs. 8.3%; p < 0.001) and more advanced tumors (53.2% vs. 45.9%; p = 0.266). The rectum tumor site was significantly more common among the younger patients (p = 0.021). The overall survival (OS) (p = 0.278), the cancer-specific survival (CSS) (p = 0.233), and the disease-free survival (DFS) (p = 0.497) did not differ significantly between the two groups. Based on Cox regression model, elevated pre-operative CEA level (HR = 1.41; 95%CI of 1.01–1.97), advanced tumor stage (6.06; 95%CI of 3.03–12.15), and poorly differentiated tumor (HR = 1.69; 95%CI of 1.05–2.71) were associated with decreased survival. Conclusions The younger patients did not have poor prognosis compared to the older ones despite having an advanced tumor stage and a poor tumor differentiation.

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Clinicopathological and molecular differences in colorectal cancer according to location

The International Journal of Biological Markers ◽

10.1177/1724600818807164 ◽

2019 ◽

Vol 34 (1) ◽

pp. 47-53 ◽

Cited By ~ 5

Author(s):

Yu-Lun Hsu ◽

Chun-Chi Lin ◽

Jeng-Kai Jiang ◽

Hung-Hsin Lin ◽

Yuan-Tzu Lan ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Overall Survival ◽

Cox Regression ◽

Rank Test ◽

Advanced Tumor Stage ◽

Tumor Seeding ◽

Cox Regression Analysis ◽

Advanced Tumor ◽

Tumor Node Metastasis Stage

Purpose: The incidence, pathogenesis, molecular pathways, and outcomes of colorectal cancer vary depending on the location of the tumor. This study aimed to compare the difference in tumor characteristics and the outcome between right-sided colon cancer and left-sided colorectal cancer (LCRC). Materials and methods: A total of 1503 patients with colorectal cancer who underwent surgery at the Taipei Veterans General Hospital between 2000 and 2010 were enrolled in this study. Right-sided colon cancer was defined as cancers in the cecum, ascending colon, and transverse colon, while LCRC was defined as cancers in the splenic flexure colon, descending colon, sigmoid colon, and rectum. The endpoint was overall survival. The mutations were detected via polymerase chain reaction and MASS array. The prognostic value was determined using the log-rank test and the Cox regression analysis. Results: A total of 407 and 1096 cases were classified as right-sided colon cancer and LCRC, respectively. Compared to patients with LCRC, those with right-sided colon cancer had more mucinous type cancer (7.4% vs. 3.5%), poorly differentiated tumor (11.5% vs. 3.6%), and advanced tumor-node-metastasis stage. The risk for peritoneal tumor seeding was higher in the right-sided colon cancer group (12.8% vs. 5.7%). Overall survival was better in LCRC than in right-sided colon cancer ( P=0.036). Conclusions: In our study, right-sided colon cancer had a more advanced tumor stage, a higher risk of peritoneal metastasis, and a poorer outcome than LCRC. Moreover, right-sided colon cancer had more gene mutations in BRAF, KRAS, SMAD4, TGF-β, PIK3CA, PTEN, AKT1, and high microsatellite instability.

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Prognostic Significance of Preoperative and Postoperative Complement C3 Depletion in Gastric Cancer: A Three-Year Survival Investigation

BioMed Research International ◽

10.1155/2017/2161840 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Jinning Ye ◽

Yufeng Ren ◽

Jianhui Chen ◽

Wu Song ◽

Chuangqi Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Significance ◽

Hospital Costs ◽

Disease Free Survival ◽

Tumor Stage ◽

Complement C3 ◽

Advanced Tumor Stage ◽

Advanced Tumor ◽

Prolonged Hospital

Objectives. The role of complement system in predicting prognosis of gastric cancer (GC) remains obscured. This study aims to explore the incidence of complement C3 depletion and associated outcomes in GC patients. Methods. between August 2013 and December 2013, 106 patients with gastric adenocarcinoma were prospectively analyzed. Plasma levels of complement C3 and C4 were detected at baseline, one day before surgery, and postoperative day 3, respectively. Patients with low C3 levels (<0.75 mg/mL) were considered as having complement depletion (CD), while others with normal C3 levels were included as control. The 3-year overall survival (OS), disease-free survival (DFS), and other outcomes were compared between both groups, with the CD incidence explored meanwhile. Results. The CD incidence was 28.3% before surgery but increased to 37.7% after surgery. Preoperative CD was related to prolonged hospital stay (22.7 versus 19.2 day, P=0.032) and increased postoperative complications (33.3% versus 14.5%, P=0.030) and hospital costs (P=0.013). Besides, postoperative C3 depletion was significantly associated with decreased 3-year OS (P=0.022) and DFS (P=0.003). Moreover, postoperative C3 depletion and advanced tumor stage were independent predictive factors of poor prognosis. Conclusions. Complement C3 depletion occurring in gastric cancer was associated with poor short-term and long-term outcomes.

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Characteristics of Colorectal Cancer in Young Patients at an Urban County Hospital

The American Surgeon ◽

10.1177/000313480807401019 ◽

2008 ◽

Vol 74 (10) ◽

pp. 973-976 ◽

Cited By ~ 6

Author(s):

Benjamin Karsten ◽

Justin Kim ◽

Justin King ◽

Ravin R. Kumar

Keyword(s):

Colorectal Cancer ◽

Young Patients ◽

Ethnically Diverse ◽

Tumor Grade ◽

Tumor Stage ◽

Young Group ◽

Advanced Tumor Stage ◽

Young Population ◽

Aggressive Approach ◽

Advanced Tumor

Colorectal cancer (CRC) is a disease primarily affecting an older population. The incidence of CRC in young patients has been rising. The purpose of this study was to evaluate the characteristics of CRC in an ethnically diverse, young population. Two groups of patients with CRC (40 years old or younger and 60 years old or older) treated from 1998 to 2005 were retrospectively evaluated. Forty-one young patients with CRC were identified. Hispanics constituted 51 per cent of the young population. Forty-four per cent of the lesions were right-sided in the young group compared with 21 per cent in the older group (P = 0.004). Advanced tumor stage (T3 and T4) was noted in 87.8 per cent of the young and 63 per cent of the older patients (P = 0.002; OR, 4.08). Poorly differentiated tumor grade was more common in young patients (P = 0.003) as well as mucinous/signet ring characteristics (P = 0.005). Young patients had an increased likelihood of a family history (P = 0.0001). Operative intervention and survival were similar for the two groups. Our study confirms, in an ethnically diverse young population, that CRC tends to be advanced stage, aggressive, and frequently nonoperable at the time of diagnosis. It is important for physicians to recognize the poor outcome of CRC in a younger population and consider an aggressive approach to diagnosis and early treatment.

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Overexpression of BUB1B, CCNA2, CDC20, and CDK1 in tumor tissues predicts poor survival in pancreatic ductal adenocarcinoma

Bioscience Reports ◽

10.1042/bsr20182306 ◽

2019 ◽

Vol 39 (2) ◽

Cited By ~ 11

Author(s):

Shu Dong ◽

Fei Huang ◽

Hao Zhang ◽

Qiwen Chen

Keyword(s):

Pancreatic Ductal Adenocarcinoma ◽

Tumor Development ◽

Disease Free Survival ◽

Tumor Stage ◽

Gene Expression Omnibus ◽

Ductal Adenocarcinoma ◽

Advanced Tumor Stage ◽

Kaplan Meier ◽

Advanced Tumor ◽

Tumor Tissues

AbstractOverexpressed genes in tumors usually contributed to aggressiveness in pancreatic ductal adenocarcinoma (PDAC). Using Gene Expression Omnibus (GEO) profiles including GSE46234, GSE71989, and GSE107610, we detected overexpressed genes in tumors with R program, which were enriched by Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene ontology (GO), and Reactome pathway databases. Then, we performed a survival analysis of enriched genes based on TCGA profile. Our results revealed that high BUB1B, CCNA2, CDC20, and CDK1 expression in tumors was significantly associated with worse overall survival (OS) (Log rank P=0.00338, P=0.0447, P=0.00965, and P=0.00479, respectively), which was validated using a Kaplan–Meier plotter with a median cutoff (Log rank P=0.028, P=0.0035, P=0.039, and P=0.0033, respectively). Moreover, overexpression of BUB1B, CCNA2, CDC20, and CDK1 in tumor tissues was significantly associated with disease-free survival (DFS) in PDAC patients (Log rank P=0.00565, P=0.0357, P=0.00104, and P=0.00121, respectively). BUB1B, CCNA2, CDC20, and CDK1 were significantly overexpressed in deceased PDAC patients (all P<0.01) and in patients with recurrence/disease progression (all P<0.05). In addition, PDAC patients with neoplasms of histologic grade G3-4 had significantly higher BUB1B, CCNA2 and CDC20 levels (all P<0.05). In conclusion, the up-regulation of BUB1B, CCNA2, CDC20, CDK1, and WEE1 in tumor tissues are associated with worse OS and DFS in PDAC and is correlated with advanced tumor stage and tumor development.

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Colon Cancer Survival Is Associated With Decreasing Ratio of Metastatic to Examined Lymph Nodes

Journal of Clinical Oncology ◽

10.1200/jco.2005.02.8852 ◽

2005 ◽

Vol 23 (34) ◽

pp. 8706-8712 ◽

Cited By ~ 333

Author(s):

Adam C. Berger ◽

Elin R. Sigurdson ◽

Thomas LeVoyer ◽

Alexandra Hanlon ◽

Robert J. Mayer ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Cancer Survival ◽

Regional Lymph Node ◽

Disease Free Survival ◽

Tumor Stage ◽

The United States ◽

Cancer Specific Survival ◽

End Points ◽

The Impact

Purpose Colorectal cancer is the second leading cause of cancer deaths in the United States, with poor survival predicted by regional lymph node (LN) metastasis. The impact of LN ratio (LNR) on survival is unknown in this disease. Patients and Methods We analyzed data from Intergroup trial 0089 of adjuvant chemotherapy for stage II and III patients with colon cancer, in which all patients received fluorouracil-based therapy. Survival was similar for all arms of the study, allowing us to evaluate all patients together. End points included overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Multivariate analyses were performed on all patients and on groups according to LNR quartiles (LNR: < 0.05, 0.05 to 0.19, 0.2 to 0.39, and 0.4 to 1.0). Covariates included in the models were age, sex, tumor stage, grade, histology, number of positive LNs, number of LNs removed, and LNR. Results The median age was 63.7 years, and the median number of LNs removed was 11. In the multivariate analysis, LNR was a significant factor for OS, DFS, and CSS in patients with 10 to 15 LN and more than 15 LN removed but not for patients with less than 10 LN removed. Using quartiles, LNR maintained its significance for all three end points when patients were grouped by node status. Conclusion After curative resection for colorectal cancer, the LNR is an important prognostic factor and should be used in stratification schemes for future clinical trials investigating adjuvant treatments.

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Overexpressed Proteins in HCC Cell-Derived Exosomes, CCT8, and Cofilin-1 Are Potential Biomarkers for Patients with HCC

Diagnostics ◽

10.3390/diagnostics11071221 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1221

Author(s):

Hyo Jung Cho ◽

Geum Ok Baek ◽

Moon Gyeong Yoon ◽

Hye Ri Ahn ◽

Ju A Son ◽

...

Keyword(s):

Area Under The Curve ◽

Disease Free Survival ◽

Tumor Stage ◽

Serum Markers ◽

Advanced Tumor Stage ◽

Protein Markers ◽

Poor Overall Survival ◽

Advanced Tumor ◽

Normal Hepatocyte ◽

Potential Biomarkers

Protein markers of hepatocellular carcinoma (HCC)-derived exosomes (HEX) have not yet been fully evaluated. Here, we identified novel protein contents of HEX and their clinical significance as biomarkers. Exosomes were isolated from human HCC cell lines and an immortalized normal hepatocyte cell line. Proteomic analyses revealed 15 markedly overexpressed proteins in HEX. The clinical relevance of the 15 proteins was analyzed in public RNA-sequencing datasets, and 6 proteins were selected as candidate of potential biomarkers. Serum CCT8 and CFL1 were markedly overexpressed in test cohort (n = 8). In the validation cohort (n = 224), the area under the curve (AUC) of serum CCT8 and CFL1 for HCC diagnosis was calculated as 0.698 and 0.677, respectively, whereas that of serum alpha-fetoprotein (AFP) was 0.628. The combination of three serum markers (CCT8, CFL1, and AFP) demonstrated the highest AUC for HCC diagnosis. (AUC = 0.838, 95% confidence interval = 0.773–0.876) Furthermore, higher serum CCT8 and CFL1 concentrations were significantly associated with the presence of vascular invasion, advanced tumor stage, poor disease-free survival, and poor overall survival. Cofilin-1 and CCT8, enriched proteins in HEX, were identified as potential diagnostic and prognostic serum biomarkers for HCC patients.

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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Younger Patients with Peritoneal Metastasis from Colorectal Cancer

10.21203/rs.3.rs-956314/v1 ◽

2021 ◽

Author(s):

Haipeng Chen ◽

Sicheng Zhou ◽

Yujuan Jiang ◽

Zhaoxu Zheng ◽

Zheng Liu ◽

...

Keyword(s):

Colorectal Cancer ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Peritoneal Metastasis ◽

Older Patients ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Cox Regression ◽

Young Patients ◽

Cancer Specific Survival ◽

Younger Patients

Abstract Background Currently, few studies have evaluated effectiveness of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in young patients with peritoneal metastasis (PM) of colorectal cancer (CRC) origin.Method Clinicopathological characteristics, perioperative data and survival outcomes in young patients, defined as being 50 years or less (n=23), performing CRS+HIPEC between June 2017 to June 2019 were reviewed and compared with older patients, defined as aged over 50 years (n=47).Results Compared with older patients, young patients were more likely to present with PM at the time of diagnosis (78.3% vs 51.1%, P=0.029) and exhibit a mucinous and signet-ring histology (60.9% vs 29.8%, P=0.013). The cancer-specific survival (CSS) after CRS+HIPEC in two groups are similar. On multivariate Cox regression, rectal origin (HR, 2.51, 95%CI, 1.11-5.67; P=0.027) and mucinous/signet adenocarcinoma (HR, 2.20, 95%CI, 1.02-4.74; P=0.044) were independent risk factors for poor CSS.Conclusion Younger patients (aged ≤50 years) with PM of CRC origin presented more often with synchronous PM than older patients. Although tend to exhibit a aggressive nature, they derive similar benefit from CRS+HIPEC as older patients.

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Hsa_circ_0062682 Promotes Serine Metabolism and Tumor Growth in Colorectal Cancer by Regulating the miR-940/PHGDH Axis

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.770006 ◽

2021 ◽

Vol 9 ◽

Author(s):

Shengbai Sun ◽

Chaoqun Li ◽

Kaisa Cui ◽

Bingxin Liu ◽

Mingyue Zhou ◽

...

Keyword(s):

Colorectal Cancer ◽

Tumor Growth ◽

Tumor Stage ◽

Inhibitory Effect ◽

Circular Rnas ◽

Advanced Tumor Stage ◽

Advanced Tumor ◽

Serine Metabolism

Colorectal cancer (CRC) is one of the most common malignancies globally. Increasing evidence indicates that circular RNAs (circRNAs) play a pivotal role in various cancers. The present study focused on exploring the role of a functionally unknown circRNA, hsa_circ_0062682 (circ_0062682), in CRC. By online analyses and experimental validations, we showed that circ_0062682 expression was aberrantly increased in CRC tissues compared with paired normal tissues. Increased expression of circ_0062682 in CRC notably correlated with a poor prognosis and advanced tumor stage. Functional experiments showed that circ_0062682 knockdown reduced CRC growth both in vitro and in vivo. Mechanistically, we revealed that circ_0062682 could sponge miR-940 and identified D-3-phosphoglycerate dehydrogenase (PHGDH), a key oxidoreductase involved in serine biosynthesis, as a novel target of miR-940. Silencing miR-940 expression could mimic the inhibitory effect of circ_0062682 knockdown on CRC proliferation. The expression of PHGDH was downregulated in circ_0062682-depleted or miR-940 overexpressing CRC cells at both the mRNA and protein levels. Circ_0062682 knockdown suppressed CRC growth by decreasing PHGDH expression and serine production via miR-940. Taken together, these data demonstrate, for the first time, that circ_0062682 promotes serine metabolism and tumor growth in CRC by regulating the miR-940/PHGDH axis, suggesting circ_0062682 as a potential novel therapeutic target for CRC.

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Clinicopathological Significance of Long Non-Coding RNA GHET1 in Human Cancers: A Meta-Analysis

Current Pharmaceutical Biotechnology ◽

10.2174/1389201021999200727163238 ◽

2020 ◽

Vol 21 (14) ◽

pp. 1422-1432

Author(s):

Arash Poursheikhani ◽

Negin Nokhandani ◽

Hassan Yousefi ◽

Dorsa M. Rad ◽

Amirhossein Sahebkar

Keyword(s):

Human Cancer ◽

Meta Analysis ◽

Public Health Problem ◽

Tumor Stage ◽

Clinicopathological Characteristics ◽

Positive Lymph Node ◽

Clinicopathological Features ◽

Advanced Tumor Stage ◽

Human Cancers ◽

Advanced Tumor

Introduction: Cancer is considered as the main public health problem and the second leading cause of morbidity and mortality worldwide. Numerous environmental-lifestyle related risk factors account for around one-third of cancer deaths. Recently, the key role of lncRNAs has been widely investigated in a variety of disorders, including cancer. The lncRNA GHET1 has been considered as an essential oncogenic lncRNA in many types of human cancers. Clinical investigations indicated that expression of lncRNA GHET1 is correlated with clinicopathological characteristics in cancer. This metaanalysis investigated the correlation between the lncRNA GHET1 expression and clinicopathological features in different types of cancers. Materials and methods: Comprehensive literature searches in PubMed, Scopus, and Web of Knowledge were conducted up to April 11, 2019. Sixteen studies were included in this meta-analysis. All statistical analyses were conducted using Stata software, version 12.0. Results: The pooled OR and 95%CIs of the sixteen relevant studies showed that over expression of lncRNA GHET1 was associated with tumor-size ≥5 cm (OR= 2.51, 95% CI: 1.89-3.33, p=0.00, I2=38.30%), positive lymph node metastasis (OR= 2.83, 95% CI: 1.78-4.52, p=0.00, I2=45.60%), advanced tumor stage (OR= 3.92, 95% CI: 2.97-5.19, p=0.00, I2=0.00%), positive distant metastasis (OR= 5.74, 95% CI: 2.58-12.77, p=0.00, I2=0.00%), advanced tumor status (OR= 2.97, 95% CI: 1.40- 6.29, p=0.01, I2=34.70%), and positive vascular invasion (OR= 2.69, 95% CI: 1.61-4.50, p=0.00, I2=29.20%). Conclusion: Taken together, the current study demonstrated that overexpression of lncRNA GHET1 is significantly associated with clinicopathological features in human cancers. Our results suggested that lncRNA GHET1 can be utilized as a prognostic biomarker in human cancer.

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Enhancing the Landscape of Colorectal Cancer Using Targeted Deep Sequencing

10.20944/preprints202009.0483.v1 ◽

2020 ◽

Author(s):

Chul Seung Lee ◽

In Hye Song ◽

Ahwon Lee ◽

Jun Kang ◽

Yoon Suk Lee ◽

...

Keyword(s):

Colorectal Cancer ◽

Poor Prognosis ◽

Cox Regression ◽

Disease Free Survival ◽

Tumor Stage ◽

Underlying Disease ◽

Clinicopathological Characteristics ◽

Oncologic Outcomes ◽

Cox Regression Analysis ◽

Targeted Next Generation Sequencing

Targeted next-generation sequencing (NGS) technology detects specific mutations that can provide treatment opportunities for colorectal cancer (CRC) patients. We included 145 CRC patients who underwent surgery. We analyzed the mutation frequencies of common actionable genes and their association with clinicopathological characteristics and oncologic outcomes using targeted NGS. Approximately 97.9% (142) of patients showed somatic mutations. Frequent mutations were observed in TP53 (70%), KRAS (49%), and APC (47%). TP53 mutations were significantly linked to higher overall stage (p=0.038) and lower disease-free survival (DFS) (p=0.039). ATM mutation was significantly associated with higher tumor stage (p=0.012) and shorter overall survival (OS) (p=0.041). Stage 3 and 4 patients with ATM mutations (p=0.023) had shorter OS, and FBXW7 mutation was significantly associated with shorter DFS (p=0.002). In multivariate Cox regression analysis, ATM mutation was an independent biomarker for poor prognosis of OS (p=0.022). TP53 and FBXW7 mutations are independent biomarkers for poor prognosis of DFS (p=0.042 and 0.030, respectively). A comprehensive analysis of the molecular markers for CRC can provide insights into the mechanisms underlying disease progression and help optimize a personalized therapy.

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