Resection of non-regional lymph node metastasis in patients with colorectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 664-664
Author(s):  
Christina Edwards Bailey ◽  
Kamran Idrees ◽  
Alexander A. Parikh
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Overall Survival ◽  
Regional Lymph Node ◽  
Tumor Resection ◽  
Regional Lymph Nodes ◽  
Term Survival ◽  
Specific Patient ◽  
Rank Analysis

664 Background: Approximately 20% of patients with colorectal cancer (CRC) present with metastatic disease-most commonly to the liver or lungs. Successful resection of these metastatic foci leads to significant long-term survival. Less commonly, patients present with isolated metastasis to non-regional lymph nodes (NRLN) and little is known regarding the role of resection in these patients. The primary aim of this study is to evaluate the outcomes of patients with CRC who undergo resection of NRLN metastasis. Methods: A retrospective cohort study of patients diagnosed with CRC and NRLN metastasis was performed using the Surveillance, Epidemiology, and End Results database (2004-2012). Demographic and clinical factors were compared for patients who underwent resection of NRLN metastasis and those who had not. Kaplan-Meier and log-rank analysis was used for survival analysis. Logistic regression analysis was used to assess factors associated with resection of NRLN metastasis. Results: A total of 22,848 patients presented with metastatic CRC and underwent primary tumor resection. Of these, 786 (3.4%) presented with isolated NRLN metastasis and 78 (9.9%) underwent NRLN resection. Patients who underwent resection were more likely to be male, have rectal cancers, and poorly or undifferentiated grade tumors. Median overall survival (OS) was significantly improved for patients who underwent resection compared to those who did not (36 vs. 28 months, p = 0.036). In patients with colon cancer (N = 602), median OS was 33 vs. 21 months (p = 0.042) for those who underwent resection compared to those who did not, whereas in patients with rectal cancer (N = 184), the median OS was 45 vs. 38 months (p = 0.977), respectively. In multivariate analysis, rectal cancer (OR 1.84, 95% CI 1.08 to 3.13) and poorly or undifferentiated grade tumors (OR 1.64, 95% CI 1.01 to 2.66) were associated with increased resection of NRLN. Conclusions: Resection of NRLN metastasis in patients with CRC is associated with an overall survival benefit, particularly among patients with colon cancer. Further studies are needed to identify which specific patient subgroups would best benefit from this resection strategy.

scholarly journals Treatment of tumor thrombus in the superior mesenteric vein due to advanced colon cancer with complete surgical resection and chemotherapy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yoshitsugu Yanagida ◽  
Takahiro Amano ◽  
Ryuji Akai ◽  
Akira Toyoshima ◽  
Jotaro Kobayashi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Tumor Thrombus ◽  
Superior Mesenteric Vein ◽  
Tumor Resection ◽  
Term Survival ◽  
Mesenteric Vein ◽  
Advanced Colon Cancer ◽  
Complete Surgical Resection

Abstract Background Tumor thrombus in the superior mesenteric vein secondary to colon cancer is rare. We report a case of tumor thrombus in the superior mesenteric vein and liver metastasis due to advanced colon cancer that was treated with chemotherapy and complete surgical resection. Case presentation A 72-year-old man after transverse colectomy with lymph node dissection for advanced colon cancer was diagnosed with tumor thrombus in the superior mesenteric vein and liver metastasis. He underwent adjuvant chemotherapy and had complete surgical tumor resection involving tumor thrombectomy and hepatectomy. There has been no recurrence at 36 months after surgery. Conclusion Herein, we report a rare case of tumor thrombus in the superior mesenteric vein related to advanced colon cancer. The combination of chemotherapy and complete surgical tumor resection may provide long-term survival.

Comparison of Treatment, Cost, and Survival in Patients With Metastatic Colorectal Cancer in Western Washington, United States, and British Columbia, Canada

2020 ◽  
Vol 16 (5) ◽  
pp. e425-e432 ◽  
Author(s):  
Todd A. Yezefski ◽  
Dan Le ◽  
Leo Chen ◽  
Caroline H. Speers ◽  
Shasank Chennupati ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
British Columbia ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Systemic Therapy ◽  
Survival Data ◽  
De Novo ◽  
Tumor Resection ◽  
Care Utilization ◽  
Western Washington

PURPOSE: Few studies have directly compared health care utilization, costs, and outcomes between patients treated in the US multipayer health system and Canada’s single-payer system. Using cancer registry and claims data, we assessed treatment types, costs, and survival for patients with metastatic colorectal cancer (mCRC) in Western Washington State (WW) and British Columbia (BC). MATERIALS AND METHODS: Patients age ≥ 18 years diagnosed with mCRC in 2010 and later were identified from the BC Cancer database and a regional database linking WW SEER to claims from Medicare and two large commercial insurers. Demographics, treatment characteristics, costs of systemic therapy, and survival data were obtained from these databases and compared between the two regions. RESULTS: A total of 1,592 patients from BC and 901 from WW were included in the study. Median age was similar (BC, 66 years; WW, 63 years), but patients in BC were more likely to be male (57.1% v 51.2%; P ≤ .01) and to have de novo metastatic disease (61.0% v 38.3%; P ≤ .01). The use of radiation therapy was similar between regions (BC, 31.2%; WW, 33.9%; P = .18), but primary tumor resection was more common in BC (74.1% v 66.3%; P ≤ .01) as was hepatic metastasectomy (12.4% v 2.3%; P ≤ .01). Similar percentages of patients received systemic therapy (BC, 68.8%; WW, 67.1%; P = .40), but costs were significantly higher for first-line systemic therapy in WW ($6,226 v $15,792 per patient per month; P ≤ .01). Median overall survival was similar (BC, 16.9 months; WW, 18 months). CONCLUSION: Cost of systemic therapy for mCRC was significantly higher for patients in WW than in BC, but this did not translate to a difference in overall survival.

scholarly journals Single-Cell Analysis Reveals Characterization of Infiltrating T Cells in Moderately Differentiated Colorectal Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Xi Yang ◽  
Quan Qi ◽  
Yuefen Pan ◽  
Qing Zhou ◽  
Yinhang Wu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
T Cells ◽  
T Cell ◽  
Single Cell ◽  
Peripheral Blood ◽  
Strong Correlation ◽  
Tumor Tissue ◽  
Cell Populations

ObjectiveThis study aimed to characterize the tumor-infiltrating T cells in moderately differentiated colorectal cancer.MethodsUsing single-cell RNA sequencing data of isolated 1632 T cells from tumor tissue and 1252 T cells from the peripheral blood of CRC patients, unsupervised clustering analysis was performed to identify functionally distinct T cell populations, followed by correlations and ligand-receptor interactions across cell types. Finally, differential analysis of the tumor-infiltrating T cells between colon cancer and rectal cancer were carried out.ResultsA total of eight distinct T cell populations were identified from tumor tissue. Tumor-Treg showed a strong correlation with Th17 cells. CD8+TRM was positively correlated with CD8+IEL. Seven distinct T cell populations were identified from peripheral blood. There was a strong correlation between CD4+TN and CD4+blood-TCM. Colon cancer and rectal cancer showed differences in the composition of tumor-infiltrating T cell populations. Tumor-infiltrating CD8+IEL cells were found in rectal cancer but not in colon cancer, while CD8+ TN cells were found in the peripheral blood of colon cancer but not in that of rectal cancer. A larger number of tumor-infiltrating CD8+ Tex (88.94%) cells were found in the colon cancer than in the rectal cancer (11.06%). The T cells of the colon and rectal cancers showed changes in gene expression pattern.ConclusionsWe characterized the T cell populations in the CRC tumor tissue and peripheral blood.

scholarly journals Subsite-Specific Dietary Risk Factors for Colorectal Cancer: A Review of Cohort Studies

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Anette Hjartåker ◽  
Bjarte Aagnes ◽  
Trude Eid Robsahm ◽  
Hilde Langseth ◽  
Freddie Bray ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cohort Studies ◽  
Distal Colon ◽  
Proximal Colon ◽  
Risk Estimates ◽  
Specific Risk ◽  
Dietary Components

Objective. A shift in the total incidence from left- to right-sided colon cancer has been reported and raises the question as to whether lifestyle risk factors are responsible for the changing subsite distribution of colon cancer. The present study provides a review of the subsite-specific risk estimates for the dietary components presently regarded as convincing or probable risk factors for colorectal cancer: red meat, processed meat, fiber, garlic, milk, calcium, and alcohol.Methods. Studies were identified by searching PubMed through October 8, 2012 and by reviewing reference lists. Thirty-two prospective cohort studies are included, and the estimates are compared by sex for each risk factor.Results. For alcohol, there seems to be a stronger association with rectal cancer than with colon cancer, and for meat a somewhat stronger association with distal colon and rectal cancer, relative to proximal colon cancer. For fiber, milk, and calcium, there were only minor differences in relative risk across subsites. No statement could be given regarding garlic. Overall, many of the subsite-specific risk estimates were nonsignificant, irrespective of exposure.Conclusion. For some dietary components the associations with risk of cancer of the rectum and distal colon appear stronger than for proximal colon, but not for all.

scholarly journals Clinicopathological Factors Influencing Lymph Node Yield in Colorectal Cancer: A Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Elena Orsenigo ◽  
Giulia Gasparini ◽  
Michele Carlucci
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Rank Test ◽  
Lymph Node Yield ◽  
Log Rank Test ◽  
Lymph Node Retrieval

Many colorectal resections do not meet the minimum of 12 lymph nodes (LNs) recommended by the American Joint Committee on Cancer for accurate staging of colorectal cancer. The aim of this study was to investigate factors affecting the number of the adequate nodal yield in colorectal specimens subject to routine pathological assessment. We have retrospectively analysed the data of 2319 curatively resected colorectal cancer patients in San Raffaele Scientific Institute, Milan, between 1993 and 2017 (1259 colon cancer patients and 675 rectal cancer patients plus 385 rectal cancer patients who underwent neoadjuvant therapy). The factors influencing lymph node retrieval were subjected to uni- and multivariate analyses. Moreover, a survival analysis was carried out to verify the prognostic implications of nodal counts. The mean number of evaluated nodes was 24.08±11.4, 20.34±11.8, and 15.33±9.64 in surgically treated right-sided colon cancer, left-sided colon cancer, and rectal tumors, respectively. More than 12 lymph nodes were reported in surgical specimens in 1094 (86.9%) cases in the colon cohort and in 425 (63%) cases in the rectal cohort, and patients who underwent neoadjuvant chemoradiation were analysed separately. On univariate analysis of the colon cancer group, higher LNs counts were associated with female sex, right colon cancer, emergency surgery, pT3-T4 diseases, higher tumor size, and resected specimen length. On multivariate analysis right colon tumors, larger mean size of tumor, length of specimen, pT3-T4 disease, and female sex were found to significantly affect lymph node retrieval. Colon cancer patients with 12 or more lymph nodes removed had a significantly better long-term survival than those with 11 or fewer nodes (P=0.002, log-rank test). Rectal cancer patients with 12 or more lymph nodes removed approached but did not reach a statistically different survival (P=0.055, log-rank test). Multiple tumor and patients’ factors are associated with lymph node yield, but only the removal of at least 12 lymph nodes will reliably determine lymph node status.

Genetic epidemiology of colorectal cancer and associated cancers

Mutagenesis ◽  
2019 ◽  
Vol 35 (3) ◽  
pp. 207-219
Author(s):  
Hongyao Yu ◽  
Kari Hemminki
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Familial Risk ◽  
Shared Environment ◽  
Relative Risks ◽  
Swedish Family ◽  
Rectal Cancers ◽  
Common Risk Factors ◽  
Double Primary Cancers

Abstract We review here data on familial risk in colorectal cancer (CRC) generated from the Swedish Family-Cancer Database, the largest resource of its kind in the world. Although the concordant familial risk for CRC (i.e. CRC risk in families of CRC patients) has been reasonably well established, the studies on discordant familial risks (i.e. CRC risk in families with any other cancers) are rare. Because different cancers could be caused by shared genetic susceptibility or shared environment, data of associations of discordant cancers may provide useful information for identifying common risk factors. In analyses between any of 33 discordant cancers relative risks (RRs) for discordant cancers were estimated in families with increasing numbers of probands with CRC; in the reverse analyses, RRs for CRC were estimated in families with increasing numbers of probands with discordant cancers. In separate analyses, hereditary non-polyposis colorectal cancer (HNPCC) families were excluded from the study, based on HNPCC related double primary cancers, to assess the residual familial RRs. We further reviewed familial risks of colon and rectal cancers separately in search for distinct discordant associations. The reviewed data suggested that colon cancer was associated with a higher familial risk for CRC compared to rectal cancer. The previous data had reported associations of CRC with melanoma, thyroid and eye cancers. Nervous system cancer was only associated with colon cancer, and lung cancer only associated with rectal cancer. The reviewed data on discordant association may provide guidance to gene identification and may help genetic counseling.

scholarly journals Clinicopathological and molecular differences in colorectal cancer according to location

2019 ◽  
Vol 34 (1) ◽  
pp. 47-53 ◽  
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.

scholarly journals The Role of Primary Tumor Resection in Colorectal Cancer Patients with Asymptomatic, Synchronous, Unresectable Metastasis: A Multicenter Randomized Controlled Trial

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2306
Author(s):  
Eun Jung Park ◽  
Jeong-Heum Baek ◽  
Gyu-Seog Choi ◽  
Won Cheol Park ◽  
Chang Sik Yu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Complication Rate ◽  
Primary Tumor ◽  
Controlled Trial ◽  
Tumor Resection ◽  
Related Complication ◽  
Cancer Specific Survival ◽  
Randomized Controlled ◽  
Unresectable Metastases

We aimed to assess the survival benefits of primary tumor resection (PTR) followed by chemotherapy in patients with asymptomatic stage IV colorectal cancer with asymptomatic, synchronous, unresectable metastases compared to those of upfront chemotherapy alone. This was an open-label, prospective, randomized controlled trial (ClnicalTrials.gov Identifier: NCT01978249). From May 2013 to April 2016, 48 patients (PTR, n = 26; upfront chemotherapy, n = 22) diagnosed with asymptomatic colorectal cancer with unresectable metastases in 12 tertiary hospitals were randomized (1:1). The primary endpoint was two-year overall survival. The secondary endpoints were primary tumor-related complications, PTR-related complications, and rate of conversion to resectable status. The two-year cancer-specific survival was significantly higher in the PTR group than in the upfront chemotherapy group (72.3% vs. 47.1%; p = 0.049). However, the two-year overall survival rate was not significantly different between the PTR and upfront chemotherapy groups (69.5% vs. 44.8%, p = 0.058). The primary tumor-related complication rate was 22.7%. The PTR-related complication rate was 19.2%, with a major complication rate of 3.8%. The rates of conversion to resectable status were 15.3% and 18.2% in the PTR and upfront chemotherapy groups. While PTR followed by chemotherapy resulted in better two-year cancer-specific survival than upfront chemotherapy, the improvement in the two-year overall survival was not significant.

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