Impact of age on clinical and pathological features as well as outcome in Egyptian patients with colorectal cancer (CRC).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 600-600
Author(s):  
Noha Rashad ◽  
Arielle Lutterman Heeke ◽  
Hussein Mustafa Khaled ◽  
Nelly Ali El din ◽  
Gamal Abd El Motaal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Older Patients ◽  
Tumor Differentiation ◽  
Pathological Features ◽  
Primary Tumors ◽  
Molecular Features ◽  
Kaplan Meier ◽  
Egyptian Patients ◽  
Improved Outcome ◽  
Clinical And Pathological Features

600 Background: The incidence of early onset CRC is rising. Little is known about the clinicopathological differences between younger and older Egyptian (EGY) adults with CRC. Herein we explore these differences. Methods: A retrospective review of younger EGY adult (YA; ≤ 46 years) and older EGY adult (OA; > 65 years) patients (pts) with CRC was performed. T and Fisher’s exact tests were used for comparative analyses. Kaplan-Meier methodology estimated survival. Results: In total, 997 EGY pts with CRC were studied, including 443 YA (median age 35 years; range 15-46) and 153 OA pts (median 70 years range 65-84).There were no statistically significant differences with respect to gender, degree of tumor differentiation, extracolonic extension, stage at presentation, or patterns of metastasis between the two groups. YA pts had more rectal primaries compared with OA pts (49% vs. 31%, p < 0.001), whereas older pts had more colon primaries (69% vs. 51%, p < 0.001). Additionally YA pts had more left-sided tumors (78% vs. 62%, p < 0.001) compared with OA pts, whereas older pts had more right-sided tumors (32% vs. 17%, p < 0.001). YA pts were more likely to have mucin-producing tumors (40% vs. 23%, p = 0.003). Although there were no differences in the proportion of pts presenting with metastatic disease (28% [YA] vs. 32% [OA], p = 0.615), or the pattern of metastasis to the liver, lung, or peritoneum (40% vs. 50%, p = 0.288; 5% vs. 6%, p = 1.00, 16% vs. 17%, p = 1.00), YA were more likely to have CRC-related lymph node (LN) involvement (mean: 3.2 vs. 1.6, p = 0.006). There were no differences in PFS (Median: 12 months for YA vs. 13 months for OA) or OS (median: 76 months for YA vs. not reached for OA) between the two groups. However male YA pts had a better OS that female pts (median OS not reached in males, 72 months in females). Conclusions: Significant differences were evident between YA and OA pts with CRC, notably locations of primary tumors. Male had improved outcome compared to female YA patients. Additional evaluation of the molecular features of CRC in young and older patients in Egypt is warranted.

scholarly journals Clinical and pathological features in colorectal cancer associated to Lynch syndrome

2018 ◽  
Vol 29 ◽  
pp. v66
Author(s):  
O. Higuera ◽  
A. Rodriguez ◽  
N. Rodriguez-Salas ◽  
L. Ruiz-Giménez ◽  
A. Gallego ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lynch Syndrome ◽  
Pathological Features ◽  
Clinical And Pathological Features

Colorectal cancer characteristics and outcomes in patients less than age 50: A comparison of an urban university hospital with the NCI SEER database.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3621-3621 ◽  
Author(s):  
Edith P. Mitchell ◽  
Allan Topham ◽  
Pramila R. Anne ◽  
Scott Goldstein ◽  
Gerald Isenberg ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Older Patients ◽  
University Hospital ◽  
Data Sets ◽  
Seer Database ◽  
Pathological Features ◽  
Younger Patients ◽  
The Third ◽  
Colorectal Cancer Patients ◽  
Better Than

3621 Background: Cancer of the colon and rectum is the third most commonly occurring cancer, as well as the third leading cause of cancer deaths in American men and women. Colorectal cancer in younger patients is believed to have worse pathological features and prognosis than in older patients. The objective of this study was to assess pathological features and outcomes of CRC in patients less than age 50 using an institutional sample and comparing to the Surveillance, Epidemiology and End Results (SEER) database. Methods: Included in the study were a total of 4595 cases from the Tumor Registry at Thomas Jefferson University Hospital (TJUH) over a twenty year period from 1988 through 2007 and 290,338 cases from the Surveillance, Epidemiology and End Results (SEER) database from 1988 through 2004. Patients less than age 50 were compared to those age 50 and older. Results: Patients under age 50 with CRC presented with more advanced stage tumors in both data sets (<0.0001) , and had more poorly differentiated tumors than older patients (PTJUH=0.02754; PSEER<0.0001). Patients under 50 also had more mucinous/signet ring cell tumors with 12 percent to 8.1 percent in the TJUH data (p=0.002916) and 13.2 percent to 10.3 percent in the SEER data (p<0.0001), with younger males having the highest prevalence in both data sets. Younger patients had fewer proximal tumors than patients 50 and over, and a higher proportion of rectal tumors (p<0.001). Patients under age 50 were more likely to have positive nodes at all stages (PSEER <0.0001) relative to 50 and over, as well as more likely to develop peritoneal metastases (PTJUH=0.3507),, but less likely to have lung metastases PTJUH=0.05249) than older pts. Despite their poor pathologic features, patients under age 50 had better than or equal survival to those 50 and older. Conclusions: Colorectal cancer patients under age 50 presented with worse histological characteristics and metastasized much sooner, yet the younger patients had better than or equal survival to those ages 50 and older. Ongoing studies will assess differences in treatment and molecular features between younger and older colorectal cancer patients.

Clinicopathological, molecular features and prognosis of colorectal cancer with mucinous component

2020 ◽  
Author(s):  
Jianxia Li ◽  
Liu Yang ◽  
Fan Bai ◽  
Yue Cai ◽  
Jianwei Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariable Analysis ◽  
Clinicopathological Characteristics ◽  
Primary Tumors ◽  
Pik3ca Mutations ◽  
Dna Mismatch ◽  
Molecular Features ◽  
Mucinous Component ◽  
Repair Protein ◽  
Mismatch Repair Protein

Background: Colorectal cancer (CRC) with mucinous component is associated with distinct characteristics and controversial prognosis. Patients & methods: A total of 1800 CRC patients were retrospectively enrolled and grouped by the mucinous content of the primary tumors. The clinicopathological characteristics and overall survival rate were compared between groups. Results: Mucinous adenocarcinoma (MAC) and adenocarcinoma with mucinous component (AMC) had higher frequencies of DNA mismatch repair protein deficiency, KRAS, BRAF and PIK3CA mutations as compared to those of conventional adenocarcinoma (CAC). MAC had worse prognosis than CAC. However, MAC was not an independent prognostic factor in multivariable analysis. Conclusion: Molecular features of AMC and MAC were similar, which were different from those of CAC. Neither MAC nor AMC were independent prognostic factors for CRC.

scholarly journals PD-L1 expression in liver metastasis: its clinical significance and discordance with primary tumor in colorectal cancer

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Xiao-Li Wei ◽  
Xuan Luo ◽  
Hui Sheng ◽  
Yun Wang ◽  
Dong-Liang Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Checkpoint Inhibitors ◽  
Tissue Microarrays ◽  
Tumor Differentiation ◽  
Metastatic Tumors ◽  
Primary Tumors ◽  
Expression Cluster

Abstract Background The outcomes of immune checkpoint inhibitors in cancer patients with liver metastases are poor, which may be related to a different tumor microenvironment in liver metastases from primary tumors. This study was aimed to analyze PD-L1 expression and the immune microenvironment status in liver metastases and compare the differences of PD-L1 expression between primary tumors and liver metastases of colorectal cancer. Methods 74 cases of pathologically confirmed colorectal cancer with liver metastasis underwent resection from our hospital were included. Tissue microarrays were used for the interpretation of PD-L1 expression, cluster of differentiation 4 (CD4) and CD8 density by immunohistochemistry. We evaluated the disparity between primary tumor and liver metastasis in PD-L1 expression, CD4 and CD8 density and analyzed the factors associated with obvious PD-L1 disparity. Results The expression of PD-L1 was positively related to the density of CD4 and CD8 in liver metastases. The expression of PD-L1 in liver metastases was higher than in primary tumors in certain subgroups, including patients with concurrent liver metastases (n = 63, p = 0.05), patients receiving concurrent resection of primary and metastatic tumors (n = 56, p = 0.04). The two subgroups generally reflected those without inconsistent external influences, such as treatment and temporal factors, between primary tumors and liver metastases. In these subgroups, the intrinsic differences of microenvironment between primary tumors and liver metastases could be identified. Furthermore, tumor differentiation [moderate vs. poor: OR = 0.23, 95% CI: 0.03–0.99, p = 0.05)] were demonstrated to be associated with obvious discordance of PD-L1 expression between primary tumors and liver metastases. Conclusions The expression of PD-L1 in liver metastases was higher than in primary tumors in subgroups, reflecting intrinsic microenvironment differences between primary and metastatic tumors. Obvious discordance of PD-L1 expression between primary tumor and liver metastasis was significantly related to the tumor differentiation.

Abstract 17188: Calcific Degenerative Mitral Disease vs Myxomatous Degeneration: Crystallizing the Differences

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Gerald M Lawrie ◽  
Nan R Earle ◽  
Elizabeth A Earle
Keyword(s):  
Older Patients ◽  
Cox Regression ◽  
Ring Size ◽  
Posterior Leaflet ◽  
Anterior Leaflet ◽  
Kaplan Meier ◽  
Myxomatous Degeneration ◽  
Mitral Disease ◽  
Reconstructive Techniques ◽  
Clinical And Pathological Features

Introduction: Myxomatous (M) and other non-M, non-ischemic valve pathologies are often all classified as “degenerative mitral valve disease.” We have seen at TEE and surgery a subgroup of older patients with normal or reduced leaflet area, leaflet cholesterol deposition, annular fibrosis and calcification and thickened chordae - at most only two are ruptured. We classify these pts as “calcific degenerative (D).” Hypothesis: Pts with D have different outcomes and require different techniques than pts with M. Methods: Since 1994, D and M have been recorded prospectively and separately; 205 patients had D pathology, 654 had M. Results: D pts were more often female: 63% (130/205) vs. M, 32% (209/654) p<0.0001; older : 69.20±11.34 vs. 60.86±13.42 years, p<0.0001; had a lower preop EF: 55.97±12.82 vs. 61.80±9.10, p<0.0001; smaller preop annular AP diameter: 41.59±5.60 vs. 44.36±4.00, p<0.0001; more concurrent AVRs: 8.8% (18/205) vs. M: 3.5% (23/654) p=0.0038; had fewer posterior chordal replacements: 4.06±1.54 vs. 4.67±1.53, p=0.0016 and smaller ring sizes D: 28.22±3.06 vs. M: 30.72±2.86, p<0.0001. Periop mortality was higher in D: 3.9% (8/205) in D vs 1.2% (8/654) of M pts, p=0.0293. Late 10-yr survival (Kaplan-Meier) was D, 37.94%, and for M, 71.3%, p<0.0001. Late 10-yr freedom from reoperation (Kaplan-Meier) was for D, 95.6% and for M, 93.2%, p=0.375. Late 10-yr freedom from significant mitral regurgitation (MR) (Kaplan-Meier) was for D, 79.9%, and for M, 85.9%, p=0.269. Cox regression for predictors of mortality identified age (relative risk (RR) 1.078, p<0.0001), sex (RR 0.715, p=0.0320) preop EF (RR 0.985, p=0.0220), concomitant CAB (RR 1.614, p=0.0058), posterior leaflet repaired (RR 0.581, p=0.0058) or both posterior and anterior leaflet repaired (RR 0.500, p=0.0150), and leaflet calcification, (RR 1.734, p=0.0440); for predictors of reoperation, age (RR 0.971, p=0.048) and sex (RR 2.914, p=0.040); and for a predictor of late MR, annuloplasty ring size (RR 1.242, p=0.0094). Conclusions: These data confirmed that the D group had distinct clinical and pathological features which can be identified preoperatively and intraoperatively. Leaflet resection is not successful in these patients. Reconstructive techniques are preferred.

Osteosarcoma of the Myometrium Synchronous with Bilateral Papillary Cystadenocarcinoma of the Ovary and Papillary Adenocarcinoma of the Cervix

1988 ◽  
Vol 74 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Fulvio Basolo ◽  
Raffaele Pingitore ◽  
Angelo Gadducci
Keyword(s):  
Genital Tract ◽  
Rare Case ◽  
Female Genital Tract ◽  
Papillary Adenocarcinoma ◽  
Pathological Features ◽  
Primary Tumors ◽  
The World ◽  
Clinical And Pathological Features ◽  
Female Genital

We report an extremely rare case of a 60-year-old woman with myometrial osteosarcoma associated with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix. The uterine osteosarcoma is the seventh case reported in the world, while it is the second case of syncronous triple primary tumors of the upper female genital tract. Clinical and pathological features of previously reported cases of uterine osteosarcoma and triple primary neoplasias of the upper female genital tract are critically reviewed.

Bax Expression Decreases Significantly From Primary Tumor to Metastasis in Colorectal Cancer

2002 ◽  
Vol 20 (3) ◽  
pp. 811-816 ◽  
Author(s):  
Agneta Jansson ◽  
Xiao-Feng Sun
Keyword(s):  
Colorectal Cancer ◽  
Clinical Significance ◽  
Primary Tumor ◽  
Tumor Tissue ◽  
Colorectal Cancer Patient ◽  
Normal Mucosa ◽  
Tumor Differentiation ◽  
Clinicopathologic Characteristics ◽  
Primary Tumors ◽  
Histologic Types

PURPOSE: Bax is a proapoptotic member of the bcl-2 family. Previous studies about Bax have shown that the expression increases from normal to tumor tissue, but the clinical significance is contradictory. Our aims were to analyze the expression of Bax from normal mucosa to primary tumor and to metastases in colorectal cancer patient. We further investigated whether low Bax expression in the primary tumor or changed expression from normal mucosa to primary tumor and to metastases had biologic and clinical significance. PATIENTS AND METHODS: The study included 135 patients with primary colorectal adenocarcinoma, of whom 31 had metastases in the lymph nodes and 75 had normal mucosa. Immunohistochemistry, DNA sequencing, and microsatellite analysis were used to detect Bax expression, mutations, and microsatellite instability. RESULTS: The protein was observed in 132 of 135 tumors, all normal epithelial cells and metastases. The frequencies of weak expression were greater from well/moderately to poorly differentiated and to mucinous carcinomas. Bax expression was stronger from normal to tumor tissue, but subsequently decreased in metastases. The matched cases with lower expression in the metastases than in the primary tumor showed a more infiltrative growth pattern and more distal metastases. CONCLUSION: The association of Bax expression with tumor differentiation/histologic types and a decreased expression in the metastases, suggests that Bax expression may be involved in tumor differentiation/histologic types and metastatic progression. We also propose the novel notion that changed Bax expression in the metastases compared with the primary tumors might provide information to determine the clinicopathologic characteristics of the tumor.

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