scholarly journals The effect of individual-level factors in survival prognosis for colorectal cancer in Malaysia

2019 ◽  
Vol 6 (6) ◽  
pp. 2313 ◽  
Author(s):  
Anis K. Ghazali ◽  
Thomas J. Keegan ◽  
Mohd R. Abu Hassan ◽  
Benjamin M. Taylor
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Individual Characteristics ◽  
Treatment Modalities ◽  
Cancer Site ◽  
Survival Prognosis ◽  
Individual Level ◽  
Risk Of Death ◽  
Colorectal Cancer Patients

Background: In Malaysia, colorectal cancer is the second most common type of cancer for both sexes, represents 10.2% of total cancer cases in Malaysia. This study aims to identify the effect of individual-level factors on survival prognosis for patients with colorectal cancer in Malaysia.Methods: The study involved 4412 of colorectal cancer patients in Malaysia with histologically verified primary colorectal cancer, diagnosed between 2008 and 2013 (ICD-10, C18-C20), recorded in the database of National Cancer Patient Registry- Colorectal Cancer (NCPR-CC) Malaysia. We investigated the effect of individual characteristics such as age, gender, education as well as clinical characteristics such as cancer staging, cancer site and treatment modalities on survival prognosis after a diagnosis of colorectal cancer using a Cox regression survival model.Results: Patients diagnosed at stage IV had an almost 6-fold greater risk of dying from colorectal cancer than those with stage I. Age, third-degree education, poor tumour differentiation, the presence of distant metastases and receiving ‘other’ treatments were the other factors that increased the risk of death for colorectal cancer patients in Malaysian population.Conclusions: Our analysis revealed that the severity of the disease lead to poor prognosis in colorectal cancer in the population after adjusting for other individual characteristics. Health education programs targeting high risk group and emphasizing the importance of early detection of cancer as well as knowledge on the importance of cancer treatment should be implemented. Formulation of a better screening program needs to be extended so that it is a genuinely national program.

Expression of a CD44 variant containing exons 8 to 10 is a useful independent factor for the prediction of prognosis in colorectal cancer patients.

1996 ◽  
Vol 14 (4) ◽  
pp. 1122-1127 ◽  
Author(s):  
A Yamaguchi ◽  
T Urano ◽  
T Goi ◽  
M Saito ◽  
K Takeuchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Hematogenous Metastasis ◽  
High Recurrence Rate ◽  
Positive Staining ◽  
Cd44 Variant ◽  
Risk Of Death ◽  
Colorectal Cancer Patients

PURPOSE To determine the expression of the CD44 variant containing a variant exon 8 to 10 product (CD44v8-10) in colorectal cancer and to evaluate its prognostic value. MATERIALS AND METHODS CD44v8-10 was studied in resected tumors and normal mucosae obtained from 215 colorectal cancer patients (118 colon cancer and 97 rectal cancer). The expression of CD44v8-10 was analyzed immunohistochemically using the anti-CD44v8-10 monoclonal antibody (mAb) 44-1V. RESULTS One hundred of 215 cancer tissues expressed CD44v8-10. Positive staining was intense mainly on the cell membranes. There was no significant correlation between expression of CD44v8-10 and histologic type, primary tumor, lymphatic invasion, venous invasion, or peritoneal invasion. There were significant correlations between CD44v8-10 immunoreactivity and both lymph node and hematogenous metastasis. Patients with CD44v8-10-positive tumors had a greater relative risk of death compared with those whose tumors were CD44v8-10-negative. Among 169 patients who underwent curative resection, CD44v8-10 expression correlated with a high recurrence rate. The 5- and 10-year survival rates were 90.3% of patients with CD44v8-10-negative tumors, and 72.1% and 58.0% of those with CD44v8-10-positive tumors, respectively; these differences between the two groups of patients were significant (P < .01). In multivariate analysis using the Cox regression model, CD44v8-10 expression emerged as an independent prognostic indicator. CONCLUSION The results suggest that CD44v8-10 plays a role in metastasis of colorectal cancer, and tha CD44v8-10 expression may be a biologic marker of prognostic significance.

scholarly journals A nomogram based on pretreatment levels of serum bilirubin and total bile acid levels predicts survival in colorectal cancer patients

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinghao Cao ◽  
Shenghe Deng ◽  
Lizhao Yan ◽  
Junnan Gu ◽  
Jia Yang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Bile Acid ◽  
Bile Acids ◽  
Cancer Patients ◽  
Serum Bilirubin ◽  
Cox Regression ◽  
Total Bile Acid ◽  
Cox Regression Analysis ◽  
Colorectal Cancer Patients

Abstract Background Serum bilirubin and total bile acid (TBA) levels have been reported to be strongly associated with the risk and prognosis of certain cancers. Here, we aimed to investigate the effects of pretreatment levels of serum bilirubin and bile acids on the prognosis of patients with colorectal cancer (CRC). Methods A retrospective cohort of 1474 patients with CRC who underwent surgical resection between January 2015 and December 2017 was included in the study. Survival analysis was used to evaluate the predictive value of pretreatment levels of bilirubin and bile acids. X-Tile software was used to identify optimal cut-off values for total bilirubin (TBIL), direct bilirubin (DBIL) and TBA in terms of overall survival (OS) and disease-free survival (DFS). Results DBIL, TBIL, and TBA were validated as significant prognostic factors by univariate Cox regression analysis for both 3-year OS and DFS. Multivariate Cox regression analyses confirmed that high DBIL, TBIL and TBA levels were independent prognostic factors for both OS (HR: 0.435, 95% CI: 0.299–0.637, P < 0.001; HR: 0.436, 95% CI: 0.329–0.578, P < 0.001; HR: 0.206, 95% CI: 0.124–0.341, P < 0.001, respectively) and DFS (HR: 0.583, 95% CI: 0.391–0.871, P = 0.008; HR:0.437,95% CI: 0.292–0.655, P <0.001; HR: 0.634, 95% CI: 0.465–0.865, P = 0.004, respectively). In addition, nomograms for OS and DFS were established according to all significant factors, and the c-indexes were 0.819 (95% CI: 0.806–0.832) and 0.835 (95% CI: 0.822–0.849), respectively. Conclusions TBIL, DBIL and TBA levels are independent prognostic factors in colorectal cancer patients. The nomograms based on OS and DFS can be used as a practical model for evaluating the prognosis of CRC patients.

Can red cell distribution width and hemoglobin level variations be utilized to predict the prognosis of Stage III operative colorectal cancer patients with adjuvant chemotherapy treatment?

2020 ◽  
Author(s):  
Jie Li ◽  
Yuan-Yi Rui ◽  
Bo Song ◽  
Ke Zhang ◽  
Bo Yi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Cox Regression ◽  
Stage Iii ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Cox Regression Analysis ◽  
Colorectal Cancer Patients

Abstract Background: The aim of this study was to find that if the red cell distribution width (RDW) or hemoglobin (Hb) level variations had prognostic value in stage III colorectal cancer patients treated with operation and adjuvant chemotherapy. Methods: One hundred and twenty-two patients were included in this retrospective study. All were diagnosed and re-staged as stage III colorectal cancer in Sichuan Cancer Hospital according to the AJCC Cancer Staging Manual, 8 th edition, 2018. The patients received R0 resection before adjuvant chemotherapy. The baseline information, routine blood examination data, pathological outcome and prognostic stature was retracted from the database. Receiver operating characteristic (ROC) curve analysis was utilized to determine the cut-off value, while the survival analyses were performed with Kaplan-Meier curve, the log-rank test and the Cox regression analysis. Results: The chemotherapy-associated hemoglobin change (change between the pre- and post-chemotherapy hemoglobin levels) was identified to be associated with the metastasis (P=0.030). The optimal cut-off point was calculated to be -9.5 by the ROC curve of the hemoglobin change, while the area under the curve was 0.648 (95% CI: 0.524-0.772). The results showed that patients with larger hemoglobin decrease had significantly worse disease free survival (DFS) than those with smaller decrease (P=0.020). Factors associated with DFS in uni-variate COX regression analysis were the number of harvested lymph nodes (P=0.040) and the perineural invasion (P=0.020). The peri-chemotherapy change of hemoglobin level was estimated to have significant effect on patient survival (P=0.010). Conclusions: We concluded that chemotherapy-associated Hb change (change between the pre- and post-chemotherapy) was a DFS prognostic factor for the stage III colorectal cancer patients who underwent operation and adjuvant chemotherapy.

scholarly journals Chronic Diseases among Older Cancer Survivors

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Laura Deckx ◽  
Marjan van den Akker ◽  
Job Metsemakers ◽  
André Knottnerus ◽  
François Schellevis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Chronic Diseases ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Older Cancer Patients ◽  
After Cancer ◽  
Colorectal Cancer Patients

Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (≥60years) with older non-cancer patients.Material and Methods. Each cancer patient (n=3835, mean age 72) was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis) and longitudinally (incidence after diagnosis) for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis.Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37) and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44), which were significantly more frequent (P<0.01) among older cancer compared to non-cancer patients.Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice.

scholarly journals Effect of Chemotherapy and Radiotherapy on Cognitive Function in Colorectal Cancer: Evidence from National Representative Longitudinal Database

2021 ◽  
Author(s):  
Kwanghyun Kim ◽  
Chang Woo Kim ◽  
Aesun Shin ◽  
Hyunseok Kang ◽  
Sun Jae Jung
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Cox Regression ◽  
Chemotherapy Agent ◽  
Colon And Rectal Cancer ◽  
Colorectal Cancer Patients ◽  
Chemotherapy Agents

Background: We aimed to assess the risk of chemotherapy- and radiotherapy-related cognitive impairment in colorectal cancer patients. Methods: We randomly selected 40% of colorectal cancer patients from Korean National Health Insurance Database (NHID), 2004-2018 (N=148,848). Patients with one or more ICD-10 diagnostic codes for dementia or mild cognitive impairment was defined as cognitive impairment cases. Patients who were aged 18 or younger, diagnosed with cognitive impairment before colorectal cancer (N=8,225) and did not receive primary resection (N=45,320) were excluded. The effects of each chemotherapy agent on cognitive impairment were estimated. We additionally estimated the effect of radiotherapy in rectal cancer patients. Time-dependent competing risk Cox regression was conducted to estimate overall and age-specific hazard ratios (HR) separately for colon and rectal cancer. Results: In colon cancer, capecitabine and irinotecan was associated with higher cognitive im-pairment, while 5-fluorouracil was not. In rectal cancer, no chemotherapy agents increased the risk of cognitive impairment, nor did radiotherapy. Hazardous association of irinotecan was estimated larger in elderly patients compared with younger counterparts. Conclusion: Heterogeneous associations between various chemotherapy agents and cognitive impairment were observed. Elderly patients were more vulnerable to possible adverse cognitive effects. Radiotherapy did not increase the risk of cognitive impairment.

scholarly journals Prognosis analysis of patients with resectable T4 colorectal cancer

2020 ◽  
Author(s):  
Wei Chen ◽  
Jun-Wen Ye ◽  
Xiao-ping Tan ◽  
Yan Zhang ◽  
Jing-Lin Liang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Independent Factor ◽  
Node Metastasis ◽  
Colorectal Cancer Patients

Abstract Objective: To observe the factors related to survival and prognosis of patients with resectable stage T4 colorectal cancer. Methods : 148 patients with resectable stage T4 colorectal cancer who underwent surgery in the first Affiliated Hospital of Sun Yat-sen University between August, 1994 and December, 2005 were retrospectively analyzed. Univariate and multivariate analyses of associations between clinicopathological variables and survival were analyzed using the Cox regression model. Results: At the end of December of 2010 or death, the 5-year and 10 years OS rates were 49.0% and 32.2% respectively, the median OS was 25 months. The disease free survival rates (DFS) at 5 and 10 years were 44.2% and 30.3% respectively. In univariate analysis, patients with postoperative pathology lymph node metastasis was associated with the prognosis of patients with OS (all P< 0.01), postoperative adjuvant therapy failed to improve OS and DFS (P>0.05). Postoperative pathology lymph node metastasis was associated with DFS too (all P< 0.01). In multivariate analysis, postoperative pathology lymph node metastasis was independent factor affected OS and DFS in colorectal cancer patients. Conclusion: Postoperative prognosis of T4 colorectal cancer patients is poor, postoperative pathology lymph node positive was an independent factor affect OS and DFS.

Abstract 45: MACC1 expression and KRas13 mutation for improved survival prognosis of colorectal cancer patients

2014 ◽  
Author(s):  
Katharina Ilm ◽  
Wolfgang Kemmner ◽  
Gudrun Koch ◽  
Pia Herrmann ◽  
Marc Osterland ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Survival Prognosis ◽  
Colorectal Cancer Patients

Identifying Stage III Colorectal Cancer Patients: The Influence of the Patient, Surgeon, and Pathologist

2007 ◽  
Vol 25 (18) ◽  
pp. 2573-2579 ◽  
Author(s):  
Eva Judith Ann Morris ◽  
Nicola Joanne Maughan ◽  
David Forman ◽  
Philip Quirke
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Older Patients ◽  
Binary Logistic Regression ◽  
Stage Iii ◽  
Cancer Site ◽  
Data Sets ◽  
Quality Of Surgery ◽  
Nodal Yield ◽  
Colorectal Cancer Patients

Purpose Nodal yields from resected colorectal cancers vary greatly. This study sought to determine what patient, tumor, and management factors influence the number of nodes retrieved and to determine if the extent of lymphadenectomy affects stage allocation and influences survival. Patients and Methods Retrospective study of the nodal yields of 7,062 surgically resected colorectal cancer patients for whom colorectal pathology minimum data sets had been collected. The percentage of patients diagnosed as stage III was compared across nodal yield categories. A threshold for an adequate lymphadenectomy was defined as retrieval of 12 nodes. Binary logistic regression was used to determine factors associated with obtaining an adequate lymphadenectomy. Results Median nodal yields increased over the study period from 7 (interquartile range [IQR], 4 to 11) in 1995 to 13 (IQR 8 to 19) in 2003. There was no difference in yield by cancer site or sex, but yields were lower in older patients. Yields increased with increasing local invasion and stage of tumor. The percentage of patients diagnosed as stage III increased as yields increased. Five-year survival was lower in those patients who did not have an adequate lymphadenectomy. Adequate lymphadenectomy was significantly more likely in patients with advanced tumors and when the surgery and pathology was undertaken by a specialist. Older patients were significantly less likely to receive an adequate lymphadenectomy. Conclusion Variations in nodal yield are due to idiosyncratic patient and tumor characteristics and differences in the quality of surgery and pathology undertaken. Adequate lymphadenectomy is essential to ensure correct stage allocation and optimal survival.

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