Treatment strategy for obstructive colorectal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 741-741
Author(s):  
Shiro Iwagami ◽  
Nobutomo Miyanari ◽  
Tatsuo Kubota ◽  
Yousuke Nakao ◽  
Takanobu Yamao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Perioperative Complications ◽  
Tumor Resection ◽  
Treatment Strategies ◽  
Stage Iv ◽  
Two Stage ◽  
Obstructive Colorectal Cancer ◽  
One Stage ◽  
Number Of Patients ◽  
Resection And Anastomosis

741 Background: The number of patients with colorectal cancer has been increasing in all over the world. Approximately 10 percent of CRC is complicated by obstructive symptoms at the time of their diagnosis. Obstructive colorectal cancer (OCRC) could be a fatal because of perforation peritonitis or sepsis, and it is necessary to immediate treatment. The aim of this study was to explore the treatment strategies for patients with OCRC. Methods: Between April 2008 and December 2014, six hundred seventy two patients underwent surgery in out institute. The numbers of OCRC were 82 cases (12.2%). We evaluated the feasibility and effectiveness of our treatments for OCRC. Results: Treatment strategies were adopted according to the location of CRC. For patients with right-sided OCRC, we performed one-stage surgery. They underwent primary tumor resection and anastomosis at the same time. For left-sided OCRC, patients were treated by two-stage surgery. At first, they were managed by decompression of their colon with colostomy or transanal ileus tube, and then, underwent colectomy. The cases of right-side OCRC were 23 cases, and all of them underwent one-stage surgery. We could find no cases of anastomotic leakage in these cases. The cases of left-side OCRC were 59 cases, and 50 patients (86%) of them were treated two-stage surgery. Stage IV OCRC patients tended to undergo colostomy only. Conclusions: One-stage surgery was feasible for patients with right-sided OCRC. For left-sided OCRC cases, two-stage surgery was effective to prevent perioperative complications.

The impact of the COVID-19 pandemic on stage at diagnosis of breast and colorectal cancers.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6501-6501
Author(s):  
Jade Zhou ◽  
Shelly Kane ◽  
Celia Ramsey ◽  
Melody Ann Akhondzadeh ◽  
Ananya Banerjee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Late Stage ◽  
Stage Iv ◽  
Stage I ◽  
Screening Programs ◽  
Stage Distribution ◽  
Number Of Patients ◽  
The Impact

6501 Background: Effective cancer screening leads to a substantial increase in the detection of earlier stages of cancer, while decreasing the incidence of later stage cancer diagnoses. Timely screening programs are critical in reducing cancer-related mortality in both breast and colorectal cancer by detecting tumors at an early, curable stage. The COVID-19 pandemic resulted in the postponement or cancellation of many screening procedures, due to both patient fears of exposures within the healthcare system as well as the cancellation of some elective procedures. We sought to identify how the COVID-19 pandemic has impacted the incidence of early and late stage breast and colorectal cancer diagnoses at our institution. Methods: We examined staging for all patients presenting to UCSD at first presentation for a new diagnosis of malignancy or second opinion in 2019 and 2020. Treating clinicians determined the stage at presentation for all patients using an AJCC staging module (8th edition) in the electronic medical record (Epic). We compared stage distribution at presentation in 2019 vs 2020, both for cancers overall and for colorectal and breast cancer, because these cancers are frequently detected by screening. Results: Total numbers of new patient visits for malignancy were similar in 2019 and 2020 (1894 vs 1915 pts), and stage distribution for all cancer patients was similar (stage I 32% in 2019 vs 29% in 2020; stage IV 26% in both 2019 and 2020). For patients with breast cancer, we saw a lower number of patients presenting with stage I disease (64% in 2019 vs 51% in 2020) and a higher number presenting with stage IV (2% vs 6%). Similar findings were seen in colorectal cancer (stage I: 22% vs 16%; stage IV: 6% vs 18%). Conclusions: Since the COVID-19 pandemic, there has been an increase in incidence of late stage presentation of colorectal and breast cancer, corresponding with a decrease in early stage presentation of these cancers at our institution. Cancer screening is integral to cancer prevention and control, specifically in colorectal and breast cancers which are often detected by screening, and the disruption of screening services has had a significant impact on our patients. We plan to continue following these numbers closely, and will present data from the first half of 2021 as it becomes available.

A Novel Derivation Predicting Survival After Primary Tumor Resection in Stage IV Colorectal Cancer

2017 ◽  
Vol 60 (9) ◽  
pp. 895-904 ◽  
Author(s):  
Winson Jianhong Tan ◽  
Sreemanee Raaj Dorajoo ◽  
Madeline Yen Min Chee ◽  
Wah Siew Tan ◽  
Fung Joon Foo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer

scholarly journals Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis

2013 ◽  
Vol 18 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Walter Y Tsang ◽  
Argyrios Ziogas ◽  
Bruce S. Lin ◽  
Tara E. Seery ◽  
William Karnes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Analysis ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer

Quantification of p16 methylation in serum DNA as a new diagnostic tool for colorectal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10050-10050
Author(s):  
G. Nakayama
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Tool ◽  
Screening Program ◽  
Diagnostic Technique ◽  
Stage Iv ◽  
Venous Invasion ◽  
Tumor Stage ◽  
Serum Samples ◽  
Number Of Patients ◽  
Serum Dna

10050 Background: The incidence of colorectal cancer (CRC), one of the commonest malignancies worldwide, is still increasing. Despite advances in the diagnostic procedure, a large number of patients with CRC still presents with advanced disease. More sensitive and efficient diagnostic technique would make an impact on the prognosis of CRC patients through improving their compliance to the screening program, hence allowing earlier detection of the disease. To test the hypothesis that p16 methylation may serve as a marker for the diagnosis of CRC, we quantified the methylation levels of p16 in the serum DNA of CRC patients. Methods: Fresh specimens of 168 CRC and corresponding noncancerous tissues were obtained surgically at the Department of Surgery II, Nagoya University Graduate School of Medicine, together with the corresponding serum samples obtained 1 week prior to surgery. We defined the p16 methylation rate (p16 MR, in %) as follows: CM/(CM + CU) × 100%. CM is the concentration of methylated p16 sequences and CU is the concentration of unmethylated p16 sequences measured by quantitative methylation-specific PCR (Q-MSP) after bisulfite conversion. The relationship between the p16 MR and clinicopathologic findings were evaluated. Results: Aberrant p16 promoter methylation was found in 59% (99 of 168) of surgically resected CRC tissues. None of the corresponding normal tissues had methylated p16 sequences. 37% (37 of 99) serum samples of the CRC patients with tumoral p16 methylation had the same alterations. p16 MRs of 99 serum samples with tumoral p16 methylation were 0 to 68.9 (mean was 5.43±11.01). p16 MRs were significantly correlated with lymph node metastasis (P=0.001), lymphatic invasion (P=0.001) and venous invasion (P=0.020) of CRCs. p16 MRs increased significantly with tumor stage [stage I : 0.94 ± 1.68, stage II : 2.33 ± 5.19, stage III : 8.49 ± 14.22, stage IV : 10.03 ± 14.27 (P = 0.021)]. Moreover, the survival of patients with low p16 MR was significantly superior to those with high p16 MR (P=0.006). Conclusions: These results suggest that quantification of p16 methylation in the serum DNA might be a novel diagnostic tool and a prognostic factor for CRC. No significant financial relationships to disclose.

scholarly journals ALGORITHM OF SURGICAL CARE IN COMPLICATED COLORECTAL CANCER

2019 ◽  
Vol 18 (1) ◽  
pp. 66-73 ◽  
Author(s):  
A. V. Shabunin ◽  
Z. A. Bagateliya
Keyword(s):  
Colorectal Cancer ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Colonic Obstruction ◽  
Postoperative Mortality ◽  
Surgical Care ◽  
Two Stage ◽  
Elective Resection ◽  
One Stage ◽  
Malignant Colonic Obstruction

AIM: to standardize surgical care for the malignant colonic obstruction. PATIENTS AND METHODS: the retrospective cohort study included 797 patients with complicated colorectal cancer. Malignant colonic obstruction was diagnosed in 572 patients: 247 of them were treated in 2011-2013 (I group); 325 - in 2014-2017 (II). Urgent bowel resection was performed more often in I group (one-stage treatment), fecal diversion or stent- in II (two-stage treatment). Seventy-seven patients with tumor bleeding were included as well: 62 of them were treated conservatively or underwent endoscopic coagulation or arterial embolization (III group); 15 patients - underwent urgent bowel resection (IV). All of 148 patients with bowel perforation were underwent urgent surgery: resection was performed in 115 patients (V), suturing the perforation site-in 15 (VI), extraperitoneal drainage of the abscess - in18 (VII). Elective bowel resection was performed in 241 patients (186 - from I-II group, 40 - from III, 15 - from VI-VII) after 0.1-6 months. The comparative analysis of the early and late results of one- and two-stage treatment was carried out with assessment of the 3-year cumulative survival. RESULTS: postoperative mortality was significantly lower in elective resection groups compared with urgent resection groups: 3.6% vs 29.2% (II vs I); 5.0% vs 20.0% (III vs IV); 0.0% vs 35,7% (VI-VII vs V). The survival rate was higher in elective resection groups than in urgent ones: 0.809 vs 0.680 (II vs I), 0.8882vs 0.3571 (III vs IV), 0.8615 vs 0.4257 (VI-VII vs V). CONCLUSION: multi-stage approach for complicated colorectal cancer is more effective than one-stage.

Use and findings of K-ras in colorectal cancer (CRC) testing in administrative and electronic medical records (EMR) data from 2005 through 2010.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14146-e14146
Author(s):  
Satish Valluri ◽  
Sean D Sullivan ◽  
Scott David Ramsey ◽  
Charles Kreilick ◽  
Susan H Foltz Boklage ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Decision Making ◽  
Stage Iv ◽  
Second Line ◽  
Wild Type ◽  
First Line ◽  
Number Of Patients ◽  
Third Line ◽  
Line Of Therapy ◽  
The Impact

e14146 Background: The use of K-ras testing in clinical decision-making has grown over the past few years. The objective of this study was to evaluate, in a real world context, the trends and diagnostic findings of K-ras testing using managed care and EMR data. Methods: The Georgia Cancer Specialists Database EMR (2005-2010) and administrative data from the MarketScan and IMPACT database(s) was used to select patients with newly diagnosed colorectal cancer (CRC). We looked for trends in use of K-ras in relation to timing of chemotherapy administration. The EMR data provided information on k-ras mutation type. Results: In MarketScan, of the 23,548 patients with a diagnosis of CRC, 1,730 (7.3%) patients had a test ordered for K-ras between 2005 and 2010. The number of patients receiving K-ras increased with line of therapy: first line 336 patients (8.2%) of 4,098 treated, second line 455 patients (15.2%) of 2,984 treated, and third line 529 patients (33%) of 1,603 treated. We found similar results using the IMPACT database: 2,256 (7.8%) CRC patients had a test ordered for K-ras between 2005 and 2010. K-ras testing increased with line of therapy: first line 244 patients (7.8%), second line 510 (14.6%), and third line 650 patients (33.1%). EMR lab results from stage IV disease (n=349) consisted of 15% mutated type, 60% unknown and 25% wild type. For confirmed test results wild type represented 62.5% and mutated type 37.5%. Conclusions: Over the last six years, use of K-ras testing has increased in use in patients with CRC. The increase has occurred in later lines of therapy. The timing occurring late in therapy may limit the use of agents specific for this test.

Surgical Treatment of Colorectal Cancer Liver Metastases

2012 ◽  
pp. 209-212
Author(s):  
Steven A. Curley
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Treatment Strategies ◽  
Stage Iv ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Colorectal Cancer Liver Metastases ◽  
Stage Iv Colorectal Cancer ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Overview: Treatment strategies for patients with stage IV colorectal cancer have changed markedly in the last decade. Patients with colorectal cancer metastases to the liver have always been a fascinating group to consider biologically and for local-regional treatment strategies. In the late 1980s through the 1990s, resection was performed for a select subset of patients who had resectable disease. However, a high proportion of patients had bilobar unresectable disease and were treated with either 5-fluorouracil–based systemic chemotherapy or implanted hepatic arterial infusion pumps. The advent of the new millennium was associated with the availability of several new cytotoxic and biologic agents active in colorectal cancer. These agents have completely changed the approach to the treatment of patients with colorectal cancer liver metastases and thus have increased the complexity of the decision-making process for treatment of these patients.

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