Caution Is Required Before Recommending Routine Carcinoembryonic Antigen and Imaging Follow-Up for Patients With Early-Stage Colon Cancer

2009 ◽  
Vol 27 (36) ◽  
pp. e279-e280 ◽  
Author(s):  
Michael Chao ◽  
Peter Gibbs
Keyword(s):  
Colon Cancer ◽  
Carcinoembryonic Antigen ◽  
Early Stage ◽  
Early Stage Colon Cancer

Comparative clinical efficacy of adjuvant chemotherapy regimens in randomized controlled trials (RCTs) of early-stage colon cancer: Systematic review and meta-analysis.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 498-498
Author(s):  
J. Cassidy ◽  
H. Schmoll ◽  
E. Chu ◽  
N. Hawkins ◽  
I. Tatt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Assessment Tool ◽  
Early Stage ◽  
Meta Analysis ◽  
Group Analysis ◽  
Significant Difference ◽  
Early Stage Colon Cancer

498 Background: A systematic review was conducted to identify RCTs of adjuvant chemotherapy regimens for early-stage colon cancer and a network meta-analysis performed to compare efficacy of oxaliplatin/fluoropyrimidine regimens. Methods: A systematic review identified RCTs recruiting adult patients with early-stage (adjuvant) stage II/III colon cancer. Outcome measures included hazard ratios for DFS and OS. Only publications in English were considered. Study quality was assessed using the Cochrane Collaboration “risk of bias” assessment tool. A single reviewer screened abstracts/titles using predefined selection criteria, with critical appraisal and data extraction conducted independently by two reviewers. A Bayesian network meta-analysis was used to estimate comparative efficacy of adjuvant chemotherapy across RCTs. Results: 56 articles describing 40 trials were selected, of which six reported data on regimens accepted as current standard of care (capecitabine/X-ACT, XELOX/NO16968, FOLFOX/MOSAIC, FLOX/C-07) or common comparators: bolus 5FU/LV and LV5FU2 (C-96-1, PETACC-2). Statistical assessment of heterogeneity was not possible due to the limited study network. Baseline characteristics were similar across trials with the exception of three trials recruiting only stage III patients; sub-group analysis on these trials was not possible due to lack of common comparators. There was no significant difference in DFS at a median follow-up of 3-years (or closest reported analysis) for XELOX vs. FLOX (HR=0.99, 95% CI 0.80–1.22) or FOLFOX (HR=1.00, 95% CI 0.72–1.41). There was also no significant difference in OS at a median follow-up of at least 5 years. Taken as a class, oxaliplatin-containing regimens (XELOX, FOLFOX, FLOX) improved DFS vs. non-oxaliplatin-containing regimens (HR=0.80, 95% CI 0.73–0.87). This result was confirmed for OS. Conclusions: Despite the limited number of available trials, the results of these analyses demonstrate a clear benefit of incorporating oxaliplatin into combination regimens for early-stage colon cancer. XELOX, FOLFOX and FLOX appear to be equivalent in terms of efficacy in this setting. [Table: see text]

scholarly journals Management of patients with early-stage colon cancer: guidelines of the Italian Medical Oncology Association

ESMO Open ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e001001
Author(s):  
Lisa Salvatore ◽  
Marco Imperatori ◽  
Ermenegildo Arnoldi ◽  
Carlo Carnaghi ◽  
Stefano Cordio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Diagnosis ◽  
Medical Oncology ◽  
Radical Surgery ◽  
Early Stage ◽  
Colorectal Cancers ◽  
Early Stage Colon Cancer ◽  
Cancer Guidelines

About 75% of colorectal cancers are diagnosed as early stage, in which radical surgery is achievable. In the last decade, in Italy, the overall incidence of colorectal cancer has remained stable, while mortality gradually decreased, which is attributable to early diagnosis and improved medical, surgical and locoregional treatments. The Italian Medical Oncology Association formulated guidelines to manage early-stage colon cancer, including screening, diagnosis, treatment and follow-up, which we herein present.

Global clinical experience with adjuvant oxaliplatin/5-fluorouracil (5-FU)-based chemotherapy for colon cancer: Outcomes of the ACCElox registry.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14624-e14624
Author(s):  
Young Suk Park ◽  
Jiafu Ji ◽  
John Raymond Zalcberg ◽  
Mostafa M. Elserafy ◽  
Antonio C. Buzaid
Keyword(s):  
Colon Cancer ◽  
Clinical Practice ◽  
Early Stage ◽  
Sensory Neuropathy ◽  
Post Treatment ◽  
Stage Ii ◽  
Early Stage Colon Cancer ◽  
Stage Ii Colon Cancer ◽  
Practice Methods

e14624 Background: The ACCElox registry assessed the therapeutic management of early stage colon cancer with oxaliplatin/5-FU-based regimen and duration of adjuvant chemotherapy in current clinical practice. Methods: Newly diagnosed patients (N=1,548) with stage II or III colon cancer, who had undergone complete resection of the primary tumor and treated with at least one dose of "oxaliplatin" were enrolled in this prospective observational study (Feb-2006–Jul-2008) and followed up till 36 months post-treatment. Results: 72.7% and 27.3% of the patients were diagnosed with stage III and stage II colon cancer, respectively. 1,152 (74.4%) patients completed the prescribed chemotherapy. The most frequent causes of discontinuation were refusal (9.0%), adverse events (AEs) (8.1%) or relapse/recurrence of disease (3.6%). Overall, 1,512 (97.6%) patients received at least one cycle of oxaliplatin regimen. Treatment delay occurred in 1,013 patients (67%), mainly attributed to AEs (40.9%) and personal inconvenience (35.5%). During the 3-year follow-up period disease relapse/recurrence occurred in 285 (18.4%) patients with similar rates in the three groups (FOLFOX: 18.1%, FLOX: 19%, and XELOX: 18.6%). Overall number of deaths reported at the end of 3- year study period was 72 (4.7%). Majority of AEs reported during treatment were of grade 1–2 and the most common ones were neutropenia (63.9%), thrombocytopenia (23.3%), diarrhea (9.7%), sensory neuropathy (4.5%) and infection (2.6%). Sensory neuropathy was the most frequent AEs reported at 6 and 12 months of post-treatment follow-up. Conclusions: A majority of the patients completed the prescribed oxaliplatin/5-FU regimen. No unexpected AEs were reported. Our results confirm the favorable benefit/risk profile of oxaliplatin/5-FU based regimens in clinical practice. [caption]Distribution and treatment outcomes.[caption] Clinical trial information: NCT01310972. [Table: see text]

scholarly journals Nivolumab, ipilimumab and COX2-inhibition in early stage colon cancer

2017 ◽  
Vol 28 ◽  
pp. v207
Author(s):  
M. Chalabi ◽  
M. Van Leerdam ◽  
A. Aalbers ◽  
J. Van den Berg ◽  
G. Beets ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Early Stage ◽  
Early Stage Colon Cancer

scholarly journals Early stage colon cancer

2013 ◽  
Vol 19 (46) ◽  
pp. 8468 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Colon Cancer ◽  
Early Stage ◽  
Early Stage Colon Cancer

scholarly journals The Predictive and Prognostic Value of Sex in Early-Stage Colon Cancer: A Pooled Analysis of 33,345 Patients from the ACCENT Database

2013 ◽  
Vol 12 (3) ◽  
pp. 179-187 ◽  
Author(s):  
Winson Y. Cheung ◽  
Qian Shi ◽  
Michael O'Connell ◽  
James Cassidy ◽  
Charles D. Blanke ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Prognostic Value ◽  
Early Stage ◽  
Pooled Analysis ◽  
Early Stage Colon Cancer ◽  
Predictive And Prognostic Value

scholarly journals Simultaneous Assessment of the Efficacy and Toxicity of Marine Mollusc–Derived Brominated Indoles in an In Vivo Model for Early Stage Colon Cancer

2017 ◽  
Vol 17 (2) ◽  
pp. 248-262 ◽  
Author(s):  
Babak Esmaeelian ◽  
Kirsten Benkendorff ◽  
Richard K. Le Leu ◽  
Catherine A. Abbott
Keyword(s):  
Colon Cancer ◽  
Natural Products ◽  
Liver Toxicity ◽  
Early Stage ◽  
Blood Biochemistry ◽  
In Vivo Model ◽  
Liver Histopathology ◽  
Genotoxic Carcinogens ◽  
Early Stage Colon Cancer

The acute apoptotic response to genotoxic carcinogens animal model has been extensively used to assess the ability of drugs and natural products like dietary components to promote apoptosis in the colon and protect against colorectal cancer (CRC). This work aimed to use this model to identify the main chemopreventative agent in extracts from an Australian mollusc Dicathais orbita, while simultaneously providing information on their potential in vivo toxicity. After 2 weeks of daily oral gavage with bioactive extracts and purified brominated indoles, mice were injected with the chemical carcinogen azoxymethane (AOM; 10 mg/kg) and then killed 6 hours later. Efficacy was evaluated using immunohistochemical and hematoxylin staining, and toxicity was assessed via hematology, blood biochemistry, and liver histopathology. Comparison of saline- and AOM-injected controls revealed that potential toxic side effects can be interpreted from blood biochemistry and hematology using this short-term model, although AOM negatively affected the ability to detect histopathological effects in the liver. Purified 6-bromoisatin was identified as the main cancer preventive agent in the Muricidae extract, significantly enhancing apoptosis and reducing cell proliferation in the colonic crypts at 0.05 mg/g. There was no evidence of liver toxicity associated with 6-bromoisatin, whereas 0.1 mg/g of the brominated indole tyrindoleninone led to elevated aspartate aminotransferase levels and a reduction in red blood cells. As tyrindoleninone is converted to 6-bromoisatin by oxidation, this information will assist in the optimization and quality control of a chemopreventative nutraceutical from Muricidae. In conclusion, preliminary data on in vivo safety can be simultaneously collected when testing the efficacy of new natural products, such as 6-bromoisatin from Muricidae molluscs for early stage prevention of colon cancer.

Sign in / Sign up

Export Citation Format

Share Document