Implementation of an electronic surveillance database for patients with colorectal cancer.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 231-231
Author(s):  
Yan Li ◽  
Michael Rizzo ◽  
Pamela Kim Washington ◽  
Olakunle Ajayi ◽  
Matthew Dixon
Keyword(s):  
Colorectal Cancer ◽  
Tnm Classification ◽  
Cancer Staging ◽  
Physician Assistants ◽  
Data Repository ◽  
Electronic Surveillance ◽  
National Guidelines ◽  
Recurrence Rates ◽  
Nccn Guidelines ◽  
Surveillance Database

231 Background: An electronic surveillance database was created to monitor patients for five years following curative treatment for colorectal cancer. The database serves as an alert system and data repository for imaging, serology, and colonoscopy surveillance tests preloaded for each patient in accordance with NCCN guidelines based upon TNM cancer staging. Methods: The chiefs of Surgery and Oncology defined end-user specifications for the Filemaker Pro database. Key features include preloaded tests based upon NCCN guidelines, expected date of completion, and exam results. The database also tracks tests overdue or ordered but not yet obtained. A new workflow consisting of a monthly report of new colorectal cases from Pathology and a meeting of surgical and oncology physicians and physician assistants to review the report, update the database with new patients, and identify patients due for follow-up was established. Results: 250 cases are currently being monitored. By 2019, the database is poised to be the largest in Kaiser Permanente (KP) dedicated to active surveillance following colorectal cancer treatment. Conclusions: In addition to ensuring that individual patients obtain surveillance tests at the intervals based upon national guidelines for each TNM classification, the database can also be used to assess surveillance results and recurrence rates. The database format has also proven invaluable for other services. The Thoracic service recently created a database modeled after colorectal surveillance to begin tracking lung cancer patients. Beginning in 2016, the colorectal database became a Regional KP initiative and will be incorporated into HealthConnect (electronic medical record).

scholarly journals PRE- AND POSTOPERATIVE IMAGING METHODS IN COLORECTAL CANCER

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Gleim Dias de SOUZA ◽  
Luciana Rodrigues Queiroz SOUZA ◽  
Ronaldo Mafia CUENCA ◽  
Vinícius Martins VILELA ◽  
Bruno Eduardo de Morais SANTOS ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tnm Classification ◽  
Great Majority ◽  
Cancer Staging ◽  
Screening Tools ◽  
Screening Tests ◽  
Surgical Evaluation ◽  
Pre Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
American Society

ABSTRACT Introduction: Among the screening tests for colorectal cancer, colonoscopy is currently considered the most sensitive and specific technique. However, computed tomography colonography (CTC), magnetic resonance imaging (MRI), and transrectal ultrasonography have gained significant ground in the clinical practice of pre-treatment, screening and, more recently, post-treatment and surgical evaluation. Objective: To demonstrate the high accuracy of CT and MRI for pre and postoperative colorectal cancer staging. Methods: Search and analysis of articles in Pubmed, Scielo, Capes Periodicals and American College of Radiology with headings “colorectal cancer” and “colonography”. Weew selected 30 articles that contained radiological descriptions, management or statistical data related to this type of neoplasia. The criteria for radiological diagnosis were the American College of Radiology. Results : The great majority of patients with this subgroup of neoplasia is submitted to surgical procedures with the objective of cure or relief, except those with clinical contraindication. CTC colonography is not the most commonly used technique for screening; however, it is widely used for treatment planning, assessment of the abdomen for local complications or presence of metastasis, and post-surgical evaluation. MRI colonography is an alternative diagnostic method to CT, recommended by the American Society of Gastrointestinal Endoscopy. Although there are still no major studies on the use of MRI for screening, the high resolution examination has now shown good results for the American Joint Committee on Cancer TNM classification. Conclusion: MRI and CT represent the best means for colorectal neoplasm staging. The use of these methods as screening tools becomes beneficial to decrease complications and discomfort related to colonoscopy.

scholarly journals Beyond Microsatellite Instability: Evolving Strategies Integrating Immunotherapy for Microsatellite Stable Colorectal Cancer

2021 ◽  
Vol 22 (8) ◽  
Author(s):  
Federica Pecci ◽  
Luca Cantini ◽  
Alessandro Bittoni ◽  
Edoardo Lenci ◽  
Alessio Lupi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Cancer Progression ◽  
Checkpoint Inhibitors ◽  
Tnm Classification ◽  
Standard Of Care ◽  
First Line Therapy ◽  
Combination Strategies ◽  
The Impact

Opinion statementAdvanced colorectal cancer (CRC) is a heterogeneous disease, characterized by several subtypes with distinctive genetic and epigenetic patterns. During the last years, immune checkpoint inhibitors (ICIs) have revamped the standard of care of several tumors such as non-small cell lung cancer and melanoma, highlighting the role of immune cells in tumor microenvironment (TME) and their impact on cancer progression and treatment efficacy. An “immunoscore,” based on the percentage of two lymphocyte populations both at tumor core and invasive margin, has been shown to improve prediction of treatment outcome when added to UICC-TNM classification. To date, pembrolizumab, an anti-programmed death protein 1 (PD1) inhibitor, has gained approval as first-line therapy for mismatch-repair-deficient (dMMR) and microsatellite instability-high (MSI-H) advanced CRC. On the other hand, no reports of efficacy have been presented in mismatch-repair-proficient (pMMR) and microsatellite instability-low (MSI-L) or microsatellite stable (MSS) CRC. This group includes roughly 95% of all advanced CRC, and standard chemotherapy, in addition to anti-EGFR or anti-angiogenesis drugs, still represents first treatment choice. Hopefully, deeper understanding of CRC immune landscape and of the impact of specific genetic and epigenetic alterations on tumor immunogenicity might lead to the development of new drug combination strategies to overcome ICIs resistance in pMMR CRC, thus paving the way for immunotherapy even in this subgroup.

scholarly journals The IASLC Lung Cancer Staging Project: The New Database to Inform the Eighth Edition of the TNM Classification of Lung Cancer

2014 ◽  
Vol 9 (11) ◽  
pp. 1618-1624 ◽  
Author(s):  
Ramón Rami-Porta ◽  
Vanessa Bolejack ◽  
Dorothy J. Giroux ◽  
Kari Chansky ◽  
John Crowley ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Tnm Classification ◽  
Cancer Staging ◽  
Eighth Edition

scholarly journals A data-driven approach to a chemotherapy recommendation model based on deep learning for patients with colorectal cancer in Korea

2020 ◽  
Author(s):  
Jin-Hyeok Park ◽  
Jeong-Heum Baek ◽  
Sun Jin Sym ◽  
KangYoon Lee ◽  
Youngho Lee
Keyword(s):  
Colorectal Cancer ◽  
Deep Learning ◽  
Decision Support ◽  
Cancer Treatment ◽  
Clinical Decision Support ◽  
Treatment Guidelines ◽  
Treatment Protocol ◽  
Clinical Decision ◽  
Actual Data ◽  
Nccn Guidelines

Abstract Background: Clinical Decision Support Systems (CDSSs) have recently attracted attention as a method for minimizing medical errors. Existing CDSSs are limited in that they do not reflect actual data. To overcome this limitation, we propose a CDSS based on deep learning. Methods: We propose the Colorectal Cancer Chemotherapy Recommender (C3R), which is a deep learning-based chemotherapy recommendation model. Our model improves on existing CDSSs in which data-based decision making is not well supported. C3R is configured to study the clinical data collected at the Gachon Gil Medical Center and to recommend appropriate chemotherapy based on the data. To validate the model, we compared the treatment concordance rate with the National Comprehensive Cancer Network (NCCN) Guidelines, a representative set of cancer treatment guidelines, and with the results of the Gachon Gil Medical Center’s Colorectal Cancer Treatment Protocol (GCCTP). Results: For the CR3 model, the treatment concordance rates with the NCCN guidelines were 70.5% for Top-1 Accuracy and 84% for Top-2 Accuracy. The treatment concordance rates with the GCCTP were 57.9% for Top-1 Accuracy and 77.8% for Top-2 Accuracy. Conclusions: This model is significant, i.e., it is the first colon cancer treatment clinical decision support system in Korea that reflects actual data. In the future, if sufficient data can be secured through cooperation among multiple organizations, more reliable results can be obtained.

scholarly journals Multiple factors influence compliance with colorectal cancer staging recommendations: an exploratory study

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Anna R Gagliardi ◽  
Frances C Wright ◽  
Mahmoud A Khalifa ◽  
Andrew J Smith
Keyword(s):  
Colorectal Cancer ◽  
Exploratory Study ◽  
Cancer Staging ◽  
Multiple Factors

Adjuvant and Neoadjuvant Management of Colorectal Cancer

2020 ◽  
Author(s):  
Christina E Bailey ◽  
Eduardo Vilar ◽  
Y. Nancy You
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Significant Proportion ◽  
Operative Management ◽  
The United States ◽  
Current Evidence ◽  
Recurrence Rates ◽  
Curative Intent ◽  
Colon And Rectal Cancer

Colorectal cancer (CRC) is the third most common and lethal cancer in men and women in the United States. At presentation, a significant proportion of patients with CRC are able to undergo resection with curative intent, but up to 50% of these patients will develop recurrent disease. Fortunately, recurrence rates for both colon and rectal cancer have improved with the introduction of multimodality therapies, which include chemotherapy, chemoradiation therapy, and radiation therapy. These therapies are adjuncts to surgery and can be administered before (i.e. neoadjuvant) or after (i.e. adjuvant) surgery. This review summarizes the current evidence for the use of adjuvant and neoadjuvant therapies in colon and rectal cancer. This review contains 2 figures, 7 tables, and 77 references. Keywords: Colon cancer, rectal cancer, neoadjuvant therapy, adjuvant therapy, total neoadjuvant therapy, induction chemotherapy in rectal cancer, chemoradiation, organ preservation, non-operative management

Outcomes of level of ligation of inferior mesenteric artery in colorectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Pavan Kumar Jonnada ◽  
Monish Karunakaran ◽  
Dayakar Rao
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Anastomotic Leak ◽  
Mesenteric Artery ◽  
Fixed Effects ◽  
Inferior Mesenteric Artery ◽  
Meta Analysis ◽  
High Ligation ◽  
Recurrence Rates ◽  
Low Ligation

The level of ligation of the inferior mesenteric artery (IMA) is a critical factor that can influence outcomes. The aim of this meta-analysis was to compare outcomes following high or low ligation of IMA. A systematic search was performed for relevant articles published between 2000 and 2020. Meta-analysis was performed using fixed-effects or random-effects models; 31 studies were included. Results show significantly lower rates of anastomotic leak, postoperative morbidity and urinary dysfunction with low ligation compared with high ligation. Though recurrence rates were similar, 5-year overall survival was longer in the low ligation group. Low ligation of IMA decreases anastomotic leak rates and overall morbidity. Addition of IMA nodal clearance to low ligation appears to improve overall survival in colorectal cancer.

Colorectal Cancer

2018 ◽  
Author(s):  
Cathy Eng
Keyword(s):  
Colorectal Cancer ◽  
Staging System ◽  
Occult Blood ◽  
Cancer Staging ◽  
The United States ◽  
Tnm Staging ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Screening And Surveillance ◽  
Staging Systems

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.

Sign in / Sign up

Export Citation Format

Share Document