scholarly journals Influence of second or multiple tumours on the prognosis of patients with colorectal cancer

2012 ◽  
Vol 59 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Philipp Hildebrand ◽  
Janina Humke ◽  
Elisabeth Oevermann ◽  
Erik Schloericke ◽  
Conny Bürk ◽  
...  

Background: Colorectal cancer is one of the most common forms of cancer in the Western world. A wide variety of prognostic factors for colorectal cancer have been identified. There is, however, a paucity of literature addressing the influence of multiple primary carcinomas on prognosis. We conducted the present study in order to investigate the influence of second or multiple primary tumours on the prognosis of colorectal cancer patients. Patients and Methods: From 1992 to 2005, 1500 patients underwent surgery for colorectal cancer at the University Hospital of Luebeck. Of these, 276 patients (19%) had multiple primary malignant tumours. We performed statistical analyses only on patients who underwent surgery with curative intent in order to minimise additional prognostic factors. The patients were divided into groups according to the time of multiple primary tumour occurrence. Data were analyzed for various variables. Results: We did not detect any significant differences in survival either between the various groups or between patients with and without multiple primary tumours. Conclusion: The presence of multiple primary carcinomas is not an independent prognostic factor in patients with an index tumour of the colorectum. Multiple primary tumours are thus not necessarily associated with a poorer outcome and patients should receive curative intent surgery and appropriate follow-up care.

Author(s):  
Franz Xaver Singhartinger ◽  
Martin Varga ◽  
Tarkan Jäger ◽  
Adam Dinnewitzer ◽  
Oliver Koch ◽  
...  

Abstract Background Colorectal cancer (CRC) leads to metastatic disease in approximately 30% of patients. In patients with newly diagnosed CRC with both liver and lung metastases, curative resection is rarely possible. The aim of this study is to evaluate the overall (OS) and relapse-free survival (RFS) rates of these patients after resection with curative intent. Methods This study is a retrospective analysis of colorectal cancer patients (n=8, median age 54.3 years) with simultaneous liver and lung metastasis undergoing resection with curative intent between May 1st, 2002, to December 31st, 2016, at our institution. Results Colon was the primary tumour site in 2 patients and rectum in 6 patients. The median number of liver and lung metastases was 3 and 2, respectively. Patients received various treatment sequences individualized on tumour disease burden. R0 resection was achieved after all but one procedure. Two severe Clavien-Dindo grade IIIb complications were present. Median hospital stay was 9 (3–24) days per procedure. Tumour relapse was observed in all patients with median RFS of 9 (3–28) months and median OS of 40 (17–52) months. In 4 cases, where repeated resection of recurrent metastases (3 liver and 1 lung) was possible, the median OS was 43 months. Conclusion Our data suggests that patients seem to benefit from resection with curative intent, with tendency to prolonged OS and with acceptable complication rate. Tumour recurrence occurred in all patients. Repeated resection was beneficial and led to further prolonged OS.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Liu ◽  
Yao Xu ◽  
Guijun Xu ◽  
Vladimir P. Baklaushev ◽  
Vladimir P. Chekhonin ◽  
...  

Abstract Background Colorectal cancer (CRC) is a major cancer burden, and prognosis is determined by many demographic and clinicopathologic factors. The present study aimed to construct a prognostic nomogram for colorectal cancer patients with distant metastasis. Methods Colorectal cancer patients with distant metastasis diagnosed between 2010 and 2016 were selected from the Surveillance, Epidemiology, and End Results database. Cox proportional hazards regression was used to identify independent prognostic factors. A nomogram was constructed to predict survival, and validation was performed. Results A total of 7099 stage IV colorectal cancer patients were enrolled in the construction cohort. The median overall survival was 20.0 (95% CI 19.3–20.7) months. Age at diagnosis, marital status, race, primary tumour site, tumour grade, CEA level, T stage, N stage, presence of bone, brain, liver and lung metastasis, surgery for primary site and performance of chemotherapy were independent prognostic factors. The nomogram was constructed and the calibration curve showed satisfactory agreement. The C-index was 0.742 (95% CI 0.726–0.758). In the validation cohort (7098 patients), the nomogram showed satisfactory discrimination and calibration with a C-index of 0.746 (95% CI 0.730–0.762). Conclusion A series of factors associated with the survival of CRC patients with distant metastasis were found. Based on the identified factors, a nomogram was generated to predict the survival of stage IV colorectal cancer patients. The predictive model showed satisfactory discrimination and calibration, which can provide a reference for survival estimation and individualized treatment decisions.


2019 ◽  
Vol 18 (1) ◽  
pp. 30-35
Author(s):  
R. I. Rasulov ◽  
A. A. Yudin ◽  
G. I. Songolov

Background. The problem of the development of liver metastases in colorectal cancer patients previously treated with curative intent surgery remains little studied. Identification of significant factors affecting the occurrence of metachronous metastasis contributes to a more accurate prediction of recurrence in this group of patients. material and methods. In our study we analyzed the incidence of liver metastases and prognostic factors in 116 colorectal cancer patients previously treated with curative intent at Irkutsk Regional Cancer Center between 2006 and 2017. The patients received combined modality treatment including neoadjuvant radiotherapy or chemoradiotherapy for localized and locally advanced rectal cancer, radical surgery and adjuvant chemotherapy. After curative treatment, 96 patients had no evidence of distant liver metastases, and 20 patients developed distant metastases. results. The incidence of liver metastases was 17 %. In most patients, metastases occurred 16.5 months after completion of curative treatment, reaching peak incidence at 12–18 months. Prognostic factors of colorectal liver metastases in colorectal cancer patients previously treated with curative intent surgery were: the stage of the tumor, tumor growth in the parirectal/mesocolic fatty tissue, and no previous preoperative chemoradiotherapy and adjuvant chemotherapy. conclusion. For early detection of liver metastases, the carcinoembryonic antigen (CEA) measurements, contrast-enhanced abdominal multislice CT, and ultrasound-guided liver biopsy were recommended to perform every 3 months in the postoperative period.


Cancer ◽  
2010 ◽  
Vol 116 (12) ◽  
pp. 2913-2921 ◽  
Author(s):  
Patrizia Ferroni ◽  
Mario Roselli ◽  
Antonella Spila ◽  
Roberta D'Alessandro ◽  
Ilaria Portarena ◽  
...  

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinghao Cao ◽  
Shenghe Deng ◽  
Lizhao Yan ◽  
Junnan Gu ◽  
Jia Yang ◽  
...  

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.


2019 ◽  
Vol 09 (01) ◽  
pp. 42-50
Author(s):  
Camara Youssouf ◽  
Ba Hamidou Oumar ◽  
Sangare Ibrahima ◽  
Toure Karamba ◽  
Coulibaly Souleymane ◽  
...  

2020 ◽  
Author(s):  
Rosi Sicuro ◽  
Emanuele Tumino ◽  
Christian Lambiase ◽  
Domenica Mamone

Abstract BackgroundAmong the various causes of death, colorectal carcinoma represents the second highest cause in frequency both in men and in women. A colorectal cancer is diagnosed every 3.5 minutes and a person dies of colorectal cancer every 9 minutes. In 2018, in Italy were recorded around 51.000 new cases, with a mortality rate of over 18.000 deaths. There is clear evidence demonstrating that the identification and treatment of cancer at an early stage positively influence the reduction in mortality. Colonoscopy is the most effective technique used to identify and remove polyps, thus avoiding the costs related to surgical treatment and hospitalization.The purpose of this study is to evaluate the costs of the system Endotics for robotic colonoscopy as an alternative to conventional diagnostic colonoscopy performed under anaesthesia at the University Hospital of Pisa.MethodsThe cost analysis was developed according to the Budget Impact Analysis method application, an essential and complementary part of the Health Technology Assessment evaluation, which has the main purpose of assessing the financial sustainability of new health technology, estimating the consequences of its use and diffusion in a specific context characterized by the limited availability of resources. The observation period covered a time interval of 3 months, during which an average of 43 colonoscopic procedures per day was performed and mapped and a total of 23 colonoscopes were used. ResultsOverall, the work done has allowed identifying the cost of a conventional painless diagnostic colonoscopy performed in our institution which amounts to € 426.25. The valuation of the costs of the robotic colonoscopy amounted overall to € 441.25.ConclusionsThe ideal procedure to diagnose a colon disease should be safe, well-tolerated, possibly non-invasive, with high diagnostic accuracy and, not least, cost-effectiveness. The results of this study suggest that in the University Hospital of Pisa the costs related to robotic colonoscopy performed with the Endotics system are superimposable to those of conventional painless colonoscopy, reducing the overall risk associated with the colonoscopic procedure maintaining a high diagnostic accuracy with a greater tolerability by the patient, thus pushing the colonoscopy towards “the ideal procedure”.


2019 ◽  
Vol 30 (6) ◽  
pp. 1403-1409
Author(s):  
Luis García Onrubia ◽  
Gabriela Estefanía Pacheco-Callirgos ◽  
Alejandro Portero-Benito ◽  
Ciro García-Álvarez ◽  
Ester Carreño Salas ◽  
...  

Introduction: To report the spectrum and frequency of conjunctiva tumours in an ocular oncology unit analysing the clinical profile of benign, precancerous and malignant conjunctival lesions. Methods: A retrospective case series of 462 consecutive patients diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid from 1992 to 2017. Results: Among 462 consecutive patients, the tumour was classified as melanocytic in 252 (54.5%) and non-melanocytic in 210 (45.5). Two hundred forty-eight males (mean age 51.63 (SD = 23.20)) and 214 females (mean age 48.27 (SD = 21.77)) were included. Mean patient age at diagnosis was 50.07 years (range = 1-92 years). The majority of tumours were benign (n = 307 (66.5%)) followed by precancerous (n = 103 (22.3%)) and finally by malignant ones (n = 52 (11.3%)). Benign lesions were predominantly found in younger individuals rather than premalignant (p < 0.05) and malignant ones (p < 0.05). Most of the melanocytic lesions were benign (88.5%), most epithelial ones were precancerous (61.4%) and most lymphoid lesions were malignant (56.3%). Tumours involving one or four quadrants of the ocular surface usually were benign, unlike tumours involving three quadrants that were malignant (16 (48.5%) p < 0.05). The majority of benign lesions were detected on females (n = 163 (53.1%)) by routine examination (n = 178 (86.4%)). However, main complaint in malignant tumours was the growth of the lesion (n = 39 (76.5%)). Conclusion: Most of the conjunctival tumours were melanocytic, mostly benign, closely followed by those of epithelial origin, with a predominance of precancerous lesions. Melanocytic, epithelial and lymphoid tumours accounted for over 90% of cases. A trend was identified with benign lesions being found in younger female patients on routine examination.


Sign in / Sign up

Export Citation Format

Share Document