scholarly journals Second isolated anastomotic recurrence after curative surgery for colorectal cancer

2017 ◽  
Vol 99 (2) ◽  
pp. e56-e57
Author(s):  
M Bailon-Cuadrado ◽  
JI Blanco-Alvarez ◽  
R Velasco-Lopez ◽  
M Rodriguez-Lopez
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Staple Line ◽  
Cancer Recurrence ◽  
Anastomotic Recurrence ◽  
Curative Surgery ◽  
Left Hemicolectomy ◽  
Stenotic Lesion ◽  
Anastomosis Site ◽  
One Year

Introduction The two mechanisms postulated for cancer recurrence at the anastomosis site (‘anastomotic recurrence’ (AR)) after curative surgery for colorectal cancer are: (i) intraluminal dissemination of viable cancer cells; (ii) metachronous carcinogenesis related with changes in the local milieu provoked by the materials employed to carry out the anastomosis. Case History We describe a 79-year-old female who underwent a left hemicolectomy due to a stenotic lesion shown on colonoscopy: an adenocarcinoma (pT3NO, G2). One year after surgery, control colonoscopy revealed an AR, so a new resection was carried out. Pathology showed it to be a recurrent adenocarcinoma over the staple line (pT3N0, G2). One year after the second surgical procedure, control colonoscopy evinced a new AR, resulting in a new resection. Pathology revealed a new AR. Conclusions This is only the second time that a second isolated AR after curative resection for colorectal cancer has been reported.

Resolution of Paraneoplastic Lumbosacral Plexopathy in a Patient With Stage III Rectal Cancer after Curative Resection

2021 ◽  
pp. 000313482110488
Author(s):  
Joseph J. Bengart ◽  
Konstantinos Chouliaras ◽  
Steven Nurkin
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Rectal Adenocarcinoma ◽  
Preoperative Treatment ◽  
Onconeural Antibodies ◽  
Atypical Symptoms ◽  
Lumbosacral Plexopathy ◽  
Progressive Muscle Weakness ◽  
One Year ◽  
High Index Of Suspicion

Paraneoplastic syndromes are rare but possible manifestations of colorectal cancer. We present THE CASE of a 51-year-old female diagnosed with cT3N2 rectal adenocarcinoma who developed back pain and progressive muscle weakness during preoperative treatment. She had a rapid worsening in mobility and was ultimately ambulating with a wheelchair, despite physical therapy and conservative treatments. Extensive laboratory workup including onconeural antibodies was negative and her lower extremity electromyogram was suggestive of a subacute demyelinating lumbosacral plexopathy. After multidisciplinary discussion, the decision was made to proceed with curative resection. She had significant improvement in her weakness following resection, suggesting a paraneoplastic etiology. One year after resection, she remains free of disease and is ambulating comfortably. Onconeural antibodies can be a helpful diagnostic tool, but their absence does not rule out paraneoplastic disease. A high index of suspicion is necessary when assessing patients with atypical symptoms, particularly with the rise of colorectal cancer in young adults.

scholarly journals Intensive Follow-Up After Curative Surgery for Colorectal Cancer

2017 ◽  
Vol 30 (9) ◽  
pp. 633 ◽  
Author(s):  
Rita Vale Rodrigues ◽  
João Pereira da Silva ◽  
Isadora Rosa ◽  
Isabel Santos ◽  
Nuno Pereira ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Curative Treatment ◽  
Rank Test ◽  
Surveillance Program ◽  
Curative Surgery ◽  
Cancer Antigen ◽  
Chi Square ◽  
Postoperative Surveillance

Introduction: The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence.Material and Methods: Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. Statistics: chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®).Results: We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9).Discussion: The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program.Conclusion: This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence.

Anastomotic Recurrence After Curative Resection for Colorectal Cancer

2016 ◽  
Vol 41 (1) ◽  
pp. 285-294 ◽  
Author(s):  
Won Beom Jung ◽  
Chang Sik Yu ◽  
Seok Byung Lim ◽  
In Ja Park ◽  
Yong Sik Yoon ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Anastomotic Recurrence

Nutritional status and outcomes of veterans undergoing curative surgery for colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18585-e18585
Author(s):  
Urvashi Mitbander ◽  
Timothy Frankel ◽  
Irina Y. Dobrosotskaya
Keyword(s):  
Colorectal Cancer ◽  
Weight Loss ◽  
Tertiary Care ◽  
Veterans Health ◽  
Health Administration ◽  
Significant Weight Loss ◽  
Curative Surgery ◽  
Curative Intent ◽  
Post Surgery ◽  
One Year

e18585 Background: Malnutrition is highly prevalent within the cancer population. Malnourishment has various negative surgical and oncologic impacts. The Veterans Health Administration (VHA) provides comprehensive care to patients in a single-payer system allowing for capture of peri-operative data and the opportunity for focused pre-operative (pre-op) interventions to improve outcomes. We sought to study the effect of pre-op weight and albumin on post-operative (post-op) complications in a contemporaneous group of veterans with colorectal cancer (CRC) at a tertiary care Veterans Affairs (VA) hospital. Methods: This is a retrospective review of 105 patients with colorectal malignancies treated with curative intent surgery at the VA Ann Arbor Healthcare System between January 2015 and January 2020. Patients with distant metastatic disease, neoadjuvant therapy, non-adenocarcinoma histology, or those receiving majority of care outside of the VHA were excluded. We examined BMI trends from one year prior to one year post surgery, rates of nutrition consults, and post-op complications defined as abnormal clinical developments such as, but not limited to, infection and delayed wound healing. Fisher’s exact test was used for analysis. Results: At time of CRC diagnosis, the mean age was 70.3 ± 9.1 and the median stage was T2N0. Surgical resections were 65% (n = 68) laparoscopic. Pre-op weight loss from 6 months prior to diagnosis to time of surgery was observed in the majority of patients (n = 47, 64%). Significant weight loss, defined as ≥3% weight reduction, was seen in 45% (n = 33) of patients. A quarter of patients were identified to have a low pre-op albumin of less than 3.5 (n = 25, 25%). Significant weight loss and low pre-op albumin were each independently associated with increased post-op complications (p < 0.01). Post-op weight loss was seen in 81% (n = 73) and 69% (n = 48) of patients at 30- and 60-days post-op, respectively, and was not associated with post-op complications. Inpatient post-op nutrition consultation was performed in 96% (n = 101) of patients; nutritional supplements were recommended in only 23% (n = 23) of cases. In patients with significant weight loss, pre-op nutrition evaluation was performed in 15% (n = 5) of cases and post-op outpatient nutrition follow up occurred in 18% (n = 6) of cases. Conclusions: 45% of patients had ≥3% weight loss 6 months prior to diagnosis of CRC and 25% of patients had low albumin levels. These led to greater post-operative complications. An intensive nutrition pre-habilitation program to address weight loss and low albumin prior to surgery for CRC is needed and may reduce associated complications.

scholarly journals A Comparative Study of Colorectal Cancer Based on Patient’s Age

2021 ◽  
Vol 63 (2) ◽  
pp. 70-73
Author(s):  
Nasir K. Dhahir ◽  
Aqeel Abbas Noaman
Keyword(s):  
Colorectal Cancer ◽  
Early Stage ◽  
Young Patients ◽  
Pathological Finding ◽  
Bowel Habit ◽  
Curative Surgery ◽  
Left Hemicolectomy ◽  
Presenting Symptoms ◽  
Bleeding Per Rectum ◽  
Frequent Site

Abstract: Background: The alteration of bowel habits, bleeding per-rectum and anemia were common features in both groups in this study, but in young patients there was a delay of 6 months between the presenting symptoms and the definitive diagnosis because the disease was not suspected and investigated in them. The most common site for the tumors in young patients was the rectum and in patients above the age of 40 years was the Sigmoid. The pathological finding showed that classification of the colorectal tumors in young patients appear moderately to poorly differentiated adenocarcinoma , this indicate a more malignant course of the disease in young patients. This study send a message to all clinicians that the incidence of colorectal cancer is increasing in young patients and therefore we should be alert when dealing with young patients presenting with abdominal pain, bleeding per-rectum and alteration of bowel habit to diagnose the disease at an early stage to undertake curative surgery . Aim of the study: To study the clinical coarse of colorectal cancer in age between (less than 40 to above 40), and the most frequent site and distribution, and the types of surgical intervention. Patients and methods: In the period between January 2012 to March 2013, 35 patients with colorectal cancer were treated at Al-Yarmouk Hospital,10 patients were below the age of 40 years ,( 5 Males and 5 Females ) with age ranging from 22-40 years , 25 patients were above the age of 40 years (12 males and13 females). Results:100% of patients less than 40 years presenting as anemia and 50% bleeding per rectum, while 88% of patients above 40 years with weakness and lethargy.30% of patients less 40years age, and 36% of patients above 40 years consider as an emergency cases, and others as elective cases. Surgical treatment involving 50% of patients less than 40 are right, left hemicolectomy and anterior resection, and in age of above 40 56% by left hemicolectomy. More common stages in young patents are  C and B  but in old  A ,B , C. Recommendations: Researchers recommend periodic screening by a doctor to diagnose the tumor early with the need to develop educational programs on early signs of colorectal cancer.

scholarly journals Comparing Survival and Recurrence in Curative Stage I to III Colorectal Cancer in Transfused and Nontransfused Patients

2014 ◽  
Vol 99 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Yumna Talukder ◽  
Andrew P. Stillwell ◽  
Simon K. Siu ◽  
Yik-Hong Ho
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Curative Resection ◽  
Cancer Recurrence ◽  
Stage I ◽  
Blood Transfusions ◽  
Cancer Resection ◽  
Colorectal Cancer Resection ◽  
Related Survival

Abstract Evidence of the association between blood transfusions and its impact on prognostic outcomes in patients who undergo curative resection of colorectal cancer remains controversial. The aim of this study was to determine whether receiving peri-operative blood transfusions during curative colorectal cancer resection affected overall survival, cancer-related survival, and cancer recurrence. This retrospective study was undertaken at The Royal Brisbane and Women's Hospital, Australia, between 1984 and 2004. The outcomes of 1370 patients undergoing curative colorectal cancer resection for TNM stage I to III were analyzed. Four hundred twenty three patients (30.9%) required transfusion and 947 patients (69.1%) did not. Peri-operative transfusion was associated with higher rates of cancer recurrence on multivariate analysis (P = 0.024, RR, 1.257, 95% CI, 1.03–1.53); however, it was not independently associated with poorer overall or cancer-related survival. Where the aim is curative resection, this study contributes to a body of evidence that blood transfusions may be associated with poorer outcomes.

Systemic coagulation reactivation in recurrence of colorectal cancer

2003 ◽  
Vol 89 (04) ◽  
pp. 726-734 ◽  
Author(s):  
Ole Thorlacius-Ussing ◽  
Lene Iversen
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Curative Resection ◽  
Cancer Recurrence ◽  
Coagulation Activation ◽  
Curative Intent ◽  
Soluble Fibrin ◽  
Coagulation Tests

SummaryAt time of diagnosis, most cancer patients present with laboratory evidence of systemic coagulation activation. After treatment with curative intent, these hemostatic alterations seemingly disappear as seen in colorectal cancer with regard to prothrombin fragment 1+2 (F1+2), thrombin-antithrombin complex (TAT), and soluble fibrin (SF).The aim of this study was to investigate whether coagulation activation recurs with cancer recurrence and to study whether preoperative coagulation tests have any prognostic value in colorectal cancer.Plasma F1+2, TAT, and SF levels were prospectively recorded from 113 patients followed after curative resection of colo-rectal cancer. The patients were seen in clinic after 3, 6, 12, and 18 months, and after 2, 3, 4, and 5 years.Coagulation reactivation was observed at the time of recurrence, as demonstrated by significantly increased plasma TAT and SF, along with a non-significant increase (P = 0.09) in F1+2.Preoperative values of F1+2,TAT, and SF did not show association with prognosis.

Serum p53 antibodies is a postoperative predictive biomarker after curative resection in colorectal cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14567-14567
Author(s):  
A. Takeda
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Curative Resection ◽  
Predictive Biomarker ◽  
Serum Samples ◽  
P53 Antibodies ◽  
Serum P53 Antibodies ◽  
One Year ◽  
Colorectal Cancer Patients ◽  
Serum P53

14567 Background: Because alternations of the p53 tumor suppressor gene are the most commonly observed and can occur early in the carcinogenic process, the accumulation of mutant p53 often leads to the production of p53 antibodies in the sera. The aim of this study is to evaluate the clinical usefullness as early detection marker and as a predictive biomarker of serum p53 antibodies in primary colorectal cancer. Methods: Serum samples are obtained before treatment and from time to time postoperatively and stored - 800C until assay. We employed the newly produced quantitative p53 antibodies ELISA Kit (MESACUP anti-p53 Test, MBL, Japan) to determine the presence of p53 antibodies in 311 patients with colorectal adenocarcinoma compared with the conventional two markers of CEA and CA19–9. Post operative clinical course and the long time survival were evaluated in sero-positive patients after resection. Results: The sensitivities of serum p53 antibodies, CEA and CA19–9 were 32.9%, 36.0% and 23.1%, almost equivalent to CEA and significantly higher than CA19–9. No obvious correlations were evident between the status of serum p53 antibodies and values of two markers, resulting in independent of the other markers. The sensitivity rate of CEA turned up as promotion of pathological stage, but the presence of serum p53 antibodies was more significantly associated with stage 0,I,II. One hundred-nine patients who showed preoperatively sero-positive patients were monitored for at least one year after resection. There was a significant correlation between operative curability and postoperative absence of serum p53 antibodies. Most of repeatedly positive patients treated as curative resection developed recurrence within one year in stageIIandIII. Repeatedly detected patients for serum p53 antibodies have a significantly poor prognosis compared with changed negative patients after curative resection in stageIIandIII. Conclusions: Serum p53 antibodies is easy and convenient, non- invasive, detectable many times and not necessary for surgical specimens for assay. Surveillance of p53 antibodies is rapid and readily facilitated test, which appears to be useful as a new tool for early diagnosis and as a postoperative predictive marker for colorectal cancer patients. No significant financial relationships to disclose.

scholarly journals Individualized Prediction of Stage I Colorectal Cancer Recurrence Using a Nomogram

2021 ◽  
Author(s):  
Aobo Zhuang ◽  
Dexiang Zhu ◽  
Qi Lin ◽  
Pingping Xu ◽  
Guodong He ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Recurrence Rate ◽  
Cox Regression ◽  
Radical Surgery ◽  
Cancer Recurrence ◽  
Stage I ◽  
Recurrence Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Preoperative Serum

Abstract Background Though the prognosis of stage l colorectal cancer (CRC) is suitable, some patients still recurrence and have a poor prognosis. Few prognostic risk models have been proposed. Therefore, we aimed to identify factors affecting the recurrence in patients with stage I CRC and develop a predictive nomogram. Methods The nomogram was based on a retrospective study on patients who underwent radical surgery for stage I CRC at Zhongshan Hospital (Shanghai, China) between August 2008 and December 2016. Predictive factors for recurrence were determined and a nomogram predicting recurrence-free survival was constructed based on Cox regression. This model was internally validated, and performance was evaluated through calibration plots. Results A total of 1,359 patients who underwent curative surgery for stage I CRC were enrolled. With the 62.0 months median follow-up time,71 (5.2%) experienced recurrence. The median time to recurrence was 24 months, 70% was diagnosed within three years after curative resection and 80% within 5 years. The 5-year cumulative recurrence rate was 5.0%, and the 10-year recurrence rate was 6.6%. In multivariate Cox analysis, age, preoperative serum CEA concentration, preoperative serum CA19-9 concentration, preoperative neutrophil-to-lymphocyte ratio, primary tumor location and lymphovascular invasion were the independent predictors of recurrence. A nomogram based on eight factors for recurrence-free survival was developed and internally validated. The concordance index of the nomogram was 0.716. Conclusions For stage I CRC, more than one in every twenty people may experience recurrence within 10 years after radical surgery. The nomogram we developed and internally validated might be helpfulhelpful in postoperative stage I CRC surveillance.

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