Association of colon adenocarcinoma in situ in polyp with subsequent colon cancer: A population-based retrospective study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15605-e15605
Author(s):  
Shuai Wang ◽  
Apoorva Jayarangaiah ◽  
Anahat Kaur ◽  
Tarek N. Elrafei ◽  
Lewis Steinberg ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Villous Adenoma ◽  
Population Based ◽  
Hepatic Flexure ◽  
Excess Risk ◽  
Adenocarcinoma In Situ ◽  
Population Difference ◽  
Colon Cancers ◽  
Descending Colon

e15605 Background: Adenocarcinoma in situ (pTis) of the colon is defined as malignant cells confined within epithelium or mucosa. Since pTis is not invasive, polypectomy alone is usually adequate, especially if resection margins are cancer-free. We performed a population-based study to investigate the association of intrapolyp pTis and subsequent colon cancer. Methods: We queried the SEER database (1975-2017) for patients with pTis in adenoma. We further filtered patients with subsequent colon cancers. Standard incidence ratios (SIRs) were used to evaluate the excess risk of developing subsequent colon cancers comparing to the general population. Difference between patients who did or did not develop colon cancer were analyzed using Chi-square test. Results: A total of 15164 patients with pTis were identified. Among them, 736 (4.85%) patients developed subsequent colon cancer. Age ≥70 years, pTis in villous adenoma, polyp in hepatic flexure, splenic flexure, transverse colon, descending colon, and diagnosis year before 2000 were associated with increased risk of developing subsequent colon malignancy (all p< 0.05). Polypectomy comparing to colectomy (total, subtotal or partial) is associated with a higher rate of developing subsequent colon cancers ( p < 0.05). In patients with intrapolyp pTis, observation/expectation (O/E) of developing colon cancers are elevated to 4.76, 1.84, 1.66, and 1.28 within one year, 1-5 year, 5-10 year, and after ten years, respectively (all p< 0.05). O/E for the male and female is 1.80 and 1.63 (both p< 0.05); for the white and black is 1.64 and 2.21(both p< 0.05). Conclusions: Subsequent colon cancers developed in 4.85% of pTis patients. Excess risk of developing subsequent colon cancers is highest in the first year, and declines with time but persists beyond ten years. Male and black have the highest excess risk. Factors like older age, villous adenoma, location from hepatic flexure to descending colon, and polypectomy are associated with developing subsequent colon cancers.

scholarly journals Age-related inequalities in colon cancer treatment persist over time: a population-based analysis

2018 ◽  
Vol 73 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Louise Hayes ◽  
Lynne Forrest ◽  
Jean Adams ◽  
Mira Hidajat ◽  
Yoav Ben-Shlomo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Treatment ◽  
Treatment Decision ◽  
Population Based ◽  
Surgical Patients ◽  
Area Deprivation ◽  
Treatment Decision Making ◽  
Colon Cancers ◽  
Age Related ◽  
Over Time

BackgroundOlder people experience poorer outcomes from colon cancer. We examined if treatment for colon cancer was related to age and if inequalities changed over time.MethodsData from the UK population-based Northern and Yorkshire Cancer Registry on 31 910 incident colon cancers (ICD10 C18) diagnosed between 1999–2010 were obtained. Likelihood of receipt of: (1) cancer-directed surgery, (2) chemotherapy in surgical patients, (3) chemotherapy in non-surgical patients by age, adjusting for sex, area deprivation, cancer stage, comorbidity and period of diagnosis, was examined.ResultsAge-related inequalities in treatment exist after adjustment for confounding factors. Patients aged 60– 69, 70–79 and 80+ years were significantly less likely to receive surgery than those aged <60 years (multivariable ORs (95% CI) 0.84(0.74 to 0.95), 0.54(0.48 to 0.61) and 0.19(0.17 to 0.21), respectively). Age-related differences in receipt of surgery and adjuvant chemotherapy (but not chemotherapy in non-surgical patients) narrowed over time for the ’younger old’ (aged <80 years) but did not diminish for the oldest patients.ConclusionsAge inequality in treatment of colon cancer remains after adjustment for confounders, suggesting age remains a major factor in treatment decisions. Research is needed to better understand the cancer treatment decision-making process, and how to influence this, for older patients.

scholarly journals A case of urachal villous adenoma with high grade dysplasia focally bordering on adenocarcinoma in situ

2018 ◽  
Vol 16 ◽  
pp. 25-28
Author(s):  
Sriharsha Talluri ◽  
Waleed Eisa ◽  
Renee Frank ◽  
Heinric Williams
Keyword(s):  
Villous Adenoma ◽  
High Grade Dysplasia ◽  
Adenocarcinoma In Situ ◽  
High Grade

scholarly journals Colon cancer in malrotated gut: A case report

2021 ◽  
pp. 386-387
Author(s):  
Arnab Gupta ◽  
Subrata Kumar Sahu ◽  
Samir Bhattacharya ◽  
Sudip Haldar
Keyword(s):  
Colon Cancer ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Vascular Anomaly ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
Colon Cancers ◽  
Mesenteric Vessels ◽  
Well Differentiated

Malrotation of the gut is a rare congenital anomaly that mostly presents in the 1st month of life. Very rarely, it is found during adulthood either as an asymptomatic incidental finding or at autopsy. Presenting in adulthood with colon cancers is extremely rare. Here, we present the case of a middle-aged male patient with unexplained anemia which on investigation was found to have adenocarcinoma at the hepatic flexure of the colon. The staging computed tomography scan of the abdomen showed the growth at the hepatic flexure with malrotation of the gut. During the laparoscopic assessment, the cecum and ascending colon were found on the left side, and hence, a formal midline incision was made. Cecum was found on the left of the midline along with Ladd’s band. Extended right hemicolectomy was performed, dividing the Ladd’s band, taking care of the anomalous position of superior mesenteric vessels. The post-operative period was uneventful. Histopathological examination revealed this to be well-differentiated adenocarcinoma (pT3N1b). He thereafter received adjuvant chemotherapy and remains well after 5 years of follow-up. Presentation of malrotation of the gut in adulthood is seen in only 10–15% of cases as an incidental finding or at autopsy. Cancers in the colon in these patients are extremely rare. The treatment for colon cancer remains the same although one has to be careful about the vascular anomaly during the resection.

Microsatellite instability and adjuvant chemotherapy in stage II colon cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 767-767
Author(s):  
Julie L. Koenig ◽  
Albert Y. Lin ◽  
Erqi L. Pollom ◽  
Daniel Tandel Chang
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Microsatellite Instability ◽  
Univariate Analysis ◽  
Population Based ◽  
Stage Ii ◽  
Chi Square ◽  
Colon Cancers ◽  
Multiple Characteristics ◽  
Stage Ii Colon Cancer

767 Background: Randomized control trials and population-based studies have not demonstrated a definitive benefit for adjuvant chemotherapy in stage II colon cancers. Tumor side and microsatellite instability (MSI) have been proposed as prognostic and predictive factors, but there is little consensus about their utility. Previous studies have been limited by the availability of MSI data. Because microsatellite stability (MSS) is associated with worse prognosis and higher risk of metastases, we hypothesized patients with MSS would have increased benefit from chemotherapy. Methods: Using the National Cancer Database, we preformed a retrospective cohort study of patients with resected stage II colon cancer diagnosed 2006-2013. Patient and disease characteristics were compared with chi-square tests. Survival was evaluated with Cox proportional hazard models. Results: We identified 59,475 patients with stage II colon cancer. 11.4% of patients had known MSI status (n = 6,763) of which 88% had MSS (n = 5,953) and 12% had MSI (n = 810). Patients with MSS were more likely to receive chemotherapy (28.2% vs 19.9%, p < 0.001) and have left-sided tumors (38.8% vs 16.7%, p < 0.001). MSI (adjusted hazard ratio [HR] 0.64, 95% confidence interval [CI] 0.48-0.87; p = 0.003) and receipt of chemotherapy (HR 0.54, 95% CI 0.42-0.69; p < 0.001) were associated with better survival after controlling for multiple characteristics including tumor side. Although left-sided tumors had better survival on univariate analysis (HR 0.91, 95% CI 0.88-0.94; p < 0.001), side was not an independent predictor of survival after controlling for MSI and other characteristics (HR 1.01, 95% CI 0.86-1.20; p = 0.860). Among patients with MSS, chemotherapy remained associated with improved survival (HR 0.54, 95% CI 0.43-0.70; p < 0.001) and this benefit did not vary by tumor side (interaction p = 0.380). There was no interaction between MSI status and chemotherapy (p = 0.139), but we observed less of a survival benefit for chemotherapy in patients with MSI (HR 0.81, 95% CI 0.38-1.75; p = 0.595). Conclusions: Our data suggest a benefit for adjuvant chemotherapy in stage II colon cancer even after adjusting for MSI status. However, tumor side was not prognostic after controlling for MSI status.

scholarly journals Synchronous and Metachronous Colon Cancers in Patients with Gastric Cancer: Report of 2 Cases

2016 ◽  
Vol 9 (3) ◽  
pp. 752-759
Author(s):  
Byoung Jo Suh
Keyword(s):  
Gastric Cancer ◽  
Anal Verge ◽  
Cancer Case ◽  
Adenocarcinoma In Situ ◽  
Colon Cancers ◽  
Laparoscopically Assisted Distal Gastrectomy ◽  
Well Differentiated ◽  
Pathological Report

Colorectal cancer is the most common synchronous or metachronous cancer in patients with gastric cancer. I report two cases of synchronous and metachronous colon cancer with gastric cancer. Case 1: A 70-year-old man was admitted to our hospital for the treatment of gastric cancer, which had been diagnosed during esophagogastroduodenoscopy (EGD) screening. The recommended preoperative testing was colonofiberscopy (CFS). The CFS revealed a 3-cm ulcerofungating mass, located 20 cm from the anal verge. The pathological report showed a well-differentiated adenocarcinoma. Consequently, we performed radical total gastrectomy and low anterior resection simultaneously. There was no recurrence during the 40-month follow-up of this individual on an out-patient basis. Case 2: A 71-year-old man who was treated with laparoscopically assisted distal gastrectomy (LADG) due to early gastric cancer underwent regular follow-up examination with EGD and abdominopelvic computed tomography. A CFS performed 5 years after the LADG revealed a polypoid mass in the sigmoid colon. The pathological report showed a villous adenoma with adenocarcinoma in situ. The patient underwent a colonofiberscopic mucosectomy. At 36 months after the endoscopic mucosectomy, the patient remained free of recurrence.

scholarly journals Cervical Adenocarcinoma in Situ in the United States: Results from Population-based Laboratory Surveillance, 2008–2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S68-S69
Author(s):  
Angela Ahlquist Cleveland ◽  
Michelle L Johnson ◽  
Julia W Gargano ◽  
Ina U Park ◽  
Marie R Griffin ◽  
...  
Keyword(s):  
United States ◽  
Squamous Cell ◽  
Hpv Vaccination ◽  
The United States ◽  
Population Based ◽  
Screening Methods ◽  
Adenocarcinoma In Situ ◽  
Hpv Typing ◽  
Hpv Types

Abstract Background Cervical cancer screening methods are more effective for detection of squamous cell carcinoma precursor lesions (cervical intraepithelial neoplasia; CIN2 and 3) than for less-common adenocarcinoma precursors (adenocarcinoma in situ; AIS). Primary prevention through human papillomavirus (HPV) vaccination is expected to impact both CIN and AIS, although less data exist about the HPV types associated with AIS. We analyzed HPV types detected in AIS and CIN identified through population-based surveillance. Methods The Centers for Disease Control and Prevention and partners conduct surveillance for CIN2, CIN3, and AIS (CIN2+) among women aged ≥18 years in five locations in the United States. Specimen blocks for women aged 18–39 are sent to CDC for HPV typing using L1 consensus PCR. We analyzed cases with AIS only, AIS with CIN2 or 3 (AIS+CIN), and CIN3 only, the highest grade squamous cell precursor. We used chi-square tests to compare HPV types by histology. Types evaluated were HPV16 and 18 (high-risk (HR) types targeted by all HPV vaccines), 5 additional HR types targeted by the 9-valent vaccine (31/33/45/52/58; “additional 9vHPV”), and 7 other HR non-vaccine types (35/39/51/56/59/66/68). Results Between 2008 and 2014, 18,394 women were diagnosed with CIN2+. Of those, 517 (2.8%) had AIS (283 AIS only, 234 AIS+CIN) and 5,766 (31%) had CIN3 only. Median ages at diagnosis for AIS, AIS+CIN, and CIN3 were 37, 32, and 31 years, respectively. HPV typing results were available for 89 AIS, 99 AIS+CIN, and 2,923 CIN3 cases; HPV was detected in nearly all specimens (99% AIS, 100% AIS+CIN, 98% CIN3), and 21% of positive specimens had &gt;1 HPV type identified. HPV16 (AIS: 51%, AIS+CIN: 64%, CIN3: 59%; p ≤ 0.001) and HPV18 (AIS: 39%, AIS+CIN: 31%, CIN3: 5%; P ≤ 0.001) were most common. Additional 9vHPV types (AIS: 3%, AIS+CIN: 12%, CIN3: 26%; P ≤ 0.001), and HR non-vaccine types (AIS: 6%, AIS+CIN2+: 2%, CIN3+: 9%; P ≤ 0.001) were detected less frequently. Conclusion HPV types differed by histology, with AIS having a greater proportion of HPV 18 and a lower proportion of additional 9vHPV and HR non-vaccine types. This report on the largest sample of genotyped AIS cases to date provides data for vaccine impact monitoring, and suggests a high opportunity for vaccine prevention of AIS. Disclosures M. R. Griffin, MedImmune: Grant Investigator, Grant recipient

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