Survival after Curative Resection for Stage I Colorectal Mucinous Adenocarcinoma

Abstract Background: The prognostic value of the mucinous adenocarcinoma histotype on the early stages especially for stage I colorectal cancer (CRC) is still unclear. This study determined the clinicopathologic characteristics and long-term outcome of stage I colorectal mucinous adenocarcinomas (MAC). Methods: Among the total of 503 patients with stage I CRC (56 having MAC and 447 having non-MAC) who underwent radical resection, the correlation between clinicopathological factors and MAC was analyzed. Multivariate analysis was performed to determine whether mucinous histotype itself was an independent prognostic impact in stage I patients. Results: MACs were observed more frequently located in the colon than rectum (p=0.046), more frequently displayed the microsatellite instability (MSI) phenotype (p=0.023) and had a greater frequency of T2 stage (p=0.001). The rate of recurrence was 13.5% and the cancer-specific mortality was 4.3% among all stage I CRC patients. There was no difference in disease-free survival and overall survival between MACs and non-MACs. On multivariate analysis, older age (p=0.030，hazard ratio: 2.62), rectal cancer (p=0.025, hazard ratio: 5.42), lymphovascular invasion (LVI) (p<0.001, hazard ratio: 9.74), and microsatellite stability (MSS) phenotypes (p=0.023, hazard ratio: 4.21) were independently associated to poor survival of stage I CRC. A high carcinoembryonic antigen (CEA) level (p=0.031, hazard ratio: 1.95), rectal cancer (p=0.045, hazard ratio: 1.64), LVI (p=0.002, hazard ratio: 3.95) and MSS phenotypes (p=0.012, hazard ratio: 2.98) were independently related to short disease-free survival of stage I CRC.Conclusions: Compared with non-MAC, MAC patients had more T2 patients and more MSI phenotypes in stage I CRC at presentation, but the mucinous histology is not a significant predictor of recurrence and prognosis in stage I CRC.

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Survival after Curative Resection for Stage I Colorectal Mucinous Adenocarcinoma

10.21203/rs.3.rs-21102/v1 ◽

2020 ◽

Author(s):

Liang Huang ◽

Shuangling Luo ◽

Sicong Lai ◽

Yonghua Cai ◽

Zhanzhen Liu ◽

...

Keyword(s):

Multivariate Analysis ◽

Mucinous Adenocarcinoma ◽

Disease Free Survival ◽

Stage I ◽

Prognostic Impact ◽

Clinicopathologic Characteristics ◽

Term Outcome ◽

Long Term Outcome ◽

Free Survival ◽

Disease Free

Abstract Background : The prognostic value of the mucinous adenocarcinoma histotype on the early stages especially for stage I colorectal cancer (CRC) is still unclear. This study determined the clinicopathologic characteristics and long-term outcome of stage I colorectal mucinous adenocarcinomas (MAC).Methods : Among the total of 503 patients with stage I CRC (56 having MAC and 447 having non-MAC) who underwent radical resection, the correlation between clinicopathological factors and MAC was analyzed. Multivariate analysis was performed to determine whether mucinous histotype itself was an independent prognostic impact in stage I patients.Results : MACs were observed more frequently located in the colon than rectum ( p =0.046), more frequently displayed the microsatellite instability (MSI) phenotype ( p =0.023) and had a greater frequency of T2 stage ( p =0.001). The rate of recurrence was 13.5% and the cancer-specific mortality was 4.3% among all stage I CRC patients. There was no difference in disease-free survival and overall survival between MACs and non-MACs. On multivariate analysis, older age ( p =0.030), rectal cancer ( p =0.025), lymphovascular invasion (LVI) ( p <0.001), and microsatellite stability (MSS) phenotypes ( p =0.023) were independently associated to poor survival of stage I CRC. A high carcinoembryonic antigen (CEA) level ( p =0.031), LVI ( p =0.002) and MSS phenotypes ( p =0.012) were independently related to short disease-free survival of stage I CRC.Conclusions : Compared with non-MAC, MAC patients had more T2 patients and more MSI phenotypes in stage I CRC at presentation, but the mucinous histology is not a significant predictor of recurrence and prognosis in stage I CRC.

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Number of lymph nodes recovered as an independent prognostic factor in predicting outcome in patients with pathologically node-negative rectal cancer following preoperative chemo/radiotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.606 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 606-606 ◽

Cited By ~ 4

Author(s):

Sree Lakshmi Rodda ◽

Amandeep Singh Dhadda ◽

Peter D. Dickinson ◽

Abed M Zaitoun ◽

Eric M Bessell

Keyword(s):

Rectal Cancer ◽

Multivariate Analysis ◽

Lymph Nodes ◽

Locally Advanced ◽

Disease Free Survival ◽

Advanced Rectal Cancer ◽

Locally Advanced Rectal Cancer ◽

Free Survival ◽

Node Negative ◽

Disease Free

606 Background: To determine the importance of number of lymph nodes recovered on outcome in pathological node negative rectal cancer patients who had received chemo/radiotherapy prior to surgery. Methods: We retrospectively analysed data from 262 patients with locally advanced rectal cancer who received pre-operative chemo/radiotherapy at Castle Hill Hospital, Cottingham and Nottingham University Hospital between 2001 and 2008. Patients were treated with CT planned radiotherapy to a dose of 45-50 Gy in 25 fractions with concurrent fluoropyrimidine chemotherapy. Surgery was normally performed at an interval of 6-8 weeks. There were 152 patients who were found to be pathologically node negative for further analysis. Median follow-up was 51.5 months Patients were grouped into < 10 nodes recovered or > 10 nodes recovered. Disease free survival (DFS) and overall survival (OS) was assessed using Log rank test. Multivariate analysis was performed using Cox-regression analysis. Results: Of the 152 patients analysed, 67.1 % (n=102 ) had fewer than 10 nodes recovered and 32.8% (n=50) had greater than 10 nodes recovered. The median number of nodes recovered was 7 (range 0-39). There was a improvement in 5 year DFS and OS in group who had more than 10 nodes recovered compared to group with less than 10 nodes recovered ( DFS at 5yrs :86.5% vs. 61.5%, p=0.01, OS at 5 yrs : 77.8% vs. 67.4% , P =0.059). On multivariate analysis pathological T-stage , circumferential resection margin (CRM) status and number of lymph nodes recovered were found to be independent predictors of disease free survival (p=0.002). Conclusions: The number of lymph nodes retrieved following surgery for locally advanced rectal cancer patients following chemo/radiotherapy is an independent prognostic factor in pathologically node negative patients. This may need to be considered when making subsequent adjuvant chemotherapy decisions.

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Prognostic Impact of the Number of Peritumoral Alveolar Macrophages in Patients With Stage I Lung Adenocarcinoma

10.21203/rs.3.rs-844311/v1 ◽

2021 ◽

Author(s):

Osamu Noritake ◽

Keiju Aokage ◽

Ayako Suzuki ◽

Kenta Tane ◽

Tomohiro Miyoshi ◽

...

Keyword(s):

Gene Expression ◽

Lung Adenocarcinoma ◽

Alveolar Macrophages ◽

Expression Profiles ◽

Disease Free Survival ◽

Stage I ◽

Strong Impact ◽

Prognostic Impact ◽

Free Survival ◽

Disease Free

Abstract Purpose:Intratumoral macrophages are reportedly involved in tumor progression in non-small cell lung cancer; however, little is known about the prognostic impact and function of alveolar macrophages (AMs). This study aims to investigate the prognostic impact of the number of peritumoral AMs in patients with stage I lung adenocarcinoma.Methods:We investigated 514 patients with pathological stage I lung adenocarcinoma who underwent complete resection with lobectomy or pneumonectomy. The number of peritumoral AMs were counted, and patients were classified into two groups based on the number of peritumoral AMs. Using the Cancer Genome Atlas (TCGA) database of stage I lung adenocarcinoma, we compared gene expression profiles of high and low peritumoral AM contents.Results:The median number of peritumoral AMs per alveolar space was 15.5. Patients with a high peritumoral AM content had significantly shorter disease-free survival and overall survival than patients with a low peritumoral AM content (both p < 0.01). In the multivariate analyses, a higher number of peritumoral AMs was an independent prognostic factor (p = 0.02). The analysis of TCGA database revealed that patients with a high peritumoral AM content had shorter disease-free survival than those with a low peritumoral AM content (p = 0.04). Gene expression analysis of TCGA stage I lung adenocarcinoma revealed enrichment of biological processes, such as chemotaxis and epithelial proliferation, in patients with a high peritumoral AM content.Conclusion:The number of peritumoral AMs had a strong impact on disease-free survival in patients with stage I lung adenocarcinoma.

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C-Reactive Protein As a Marker of Melanoma Progression

Journal of Clinical Oncology ◽

10.1200/jco.2014.58.0209 ◽

2015 ◽

Vol 33 (12) ◽

pp. 1389-1396 ◽

Cited By ~ 39

Author(s):

Shenying Fang ◽

Yuling Wang ◽

Dawen Sui ◽

Huey Liu ◽

Merrick I. Ross ◽

...

Keyword(s):

Disease Free Survival ◽

Hazard Ratio ◽

Stage I ◽

C Reactive Protein ◽

Free Survival ◽

Reactive Protein ◽

Unit Increase ◽

The Relationship ◽

Disease Free ◽

Combined Data

Purpose To investigate the association between blood levels of C-reactive protein (CRP) in patients with melanoma and overall survival (OS), melanoma-specific survival (MSS), and disease-free survival. Patients and Methods Two independent sets of plasma samples from a total of 1,144 patients with melanoma (587 initial and 557 confirmatory) were available for CRP determination. Kaplan-Meier method and Cox regression were used to evaluate the relationship between CRP and clinical outcome. Among 115 patients who underwent sequential blood draws, we evaluated the relationship between change in disease status and change in CRP using nonparametric tests. Results Elevated CRP level was associated with poorer OS and MSS in the initial, confirmatory, and combined data sets (combined data set: OS hazard ratio, 1.44 per unit increase of logarithmic CRP; 95% CI, 1.30 to 1.59; P < .001; MSS hazard ratio, 1.51 per unit increase of logarithmic CRP; 95% CI, 1.36 to 1.68; P < .001). These findings persisted after multivariable adjustment. As compared with CRP < 10 mg/L, CRP ≥ 10 mg/L conferred poorer OS in patients with any-stage, stage I/II, or stage III/IV disease and poorer disease-free survival in those with stage I/II disease. In patients who underwent sequential evaluation of CRP, an association was identified between an increase in CRP and melanoma disease progression. Conclusion CRP is an independent prognostic marker in patients with melanoma. CRP measurement should be considered for incorporation into prospective studies of outcome in patients with melanoma and clinical trials of systemic therapies for those with melanoma.

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Prognostic impact of preoperative immunonutritional status in rectal mucinous adenocarcinoma

Future Oncology ◽

10.2217/fon-2019-0793 ◽

2020 ◽

Author(s):

Yanwu Sun ◽

Zhekun Huang ◽

Huiming Lin ◽

Pan Chi

Keyword(s):

Overall Survival ◽

Mucinous Adenocarcinoma ◽

Anal Verge ◽

Disease Free Survival ◽

Prognostic Nutritional Index ◽

Prognostic Impact ◽

Free Survival ◽

Ptnm Stage ◽

The Impact ◽

Disease Free

Aim: To explore the impact of preoperative the albumin-to-globulin ratio (AGR) and the prognostic nutritional index (PNI) on prognosis in rectal mucinous adenocarcinoma (MAC). Methods: A total of 128 patients were included. Results: According to the X-tile analysis, cutoff values of AGR and PNI were 1.1 and 43.8. Preoperative AGR (p = 0.041), preoperative PNI (p = 0.036) and pTNM stage (p = 0.003) were independently associated with overall survival in rectal MAC patients. Distance from the anal verge (p = 0.005), preoperative AGR (p = 0.021), preoperative PNI (p = 0.007) and pTNM stage (p < 0.001) were significantly associated with disease-free survival in rectal MAC patients. Nomograms for overall survival and disease-free survival were developed (C-index: 0.739 and 0.764). Conclusion: Preoperative AGR and PNI can act as effective predictors for survival for rectal MAC patients.

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Improved Survival Outcome and Access to Cancer Screening from Hemorrhoid in Patients with Rectal Cancer

Gastroenterology Research and Practice ◽

10.1155/2020/5045142 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Qi Zou ◽

Donglin Ren ◽

Xiaolin Wang ◽

Liangliang Bai ◽

Guannan Tang ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Screening ◽

Disease Free Survival ◽

Stage I ◽

Concordance Index ◽

Free Survival ◽

Hazard Ratios ◽

Primary Endpoints ◽

The Impact ◽

Disease Free

Background. The interventions for hemorrhoid increase access to rectal cancer screening and thus might reduce cancer death. We aimed to examine the impact of hemorrhoid on survival outcomes in rectal cancer. Methods. We identified 510 patients with stage I to III rectal cancer from a prospectively collected database. Patients were divided into hemorrhoid and non-hemorrhoid group. The primary endpoints were disease-free survival (DFS) and overall survival (OS). Results. Hemorrhoid group had significantly more stage I-II diseases in comparison to nonhemorrhoid group (71.1% vs. 55.9%, P = 0.049 ). The hemorrhoid group had significantly better DFS and OS compared to nonhemorrhoid group, the hazard ratios (HRs) of which were 0.39 (95% CI 0.17-0.88, P = 0.018 ) and 0.33 (95% CI 0.12-0.92, P = 0.034 ), respectively. Multivariate analysis revealed that hemorrhoid was independently associated with DFS [adjusted HR 0.43 (95% CI 0.17-0.95, P = 0.045 )]. A nomogram for predicting DFS outcome was generated based on hemorrhoid history, with a concordance index of 0.71 (95% CI 0.66-0.75, P < 0.001 ). Conclusions. There may exist a screening effect and survival benefit from hemorrhoid in rectal cancer, which supports the significance of rectal cancer screening in lowering its mortality.

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