TREATMENT RESULTS OF PATIENTS WITH COMPLICATED COLORECTAL CANCER IN ORDINARY HOSPITAL AND HOSPITAL ON REGIONAL LEVEL

The article analyzed the results of surgical treatment of 1098 patients with urgent complications of colon cancer (acute intestinal obstruction, enterorrhagia, perforation, perifocal inflammation) in patients from Smolensk and Smolensk Region at the period from 2001 to 2013. The volume of surgical intervention depended on the age of patients, terms of hospital admission from the moment of complication development, common condition of patients, presence of severe accompanying pathology, localization of malignant tumor, presence of locally advanced process, regional metastasis, kind of urgent complication.

Download Full-text

TREATMENT OF PATIENTS WITH COMPLICATIONS OF COLON CANCER IN CONDITIONS OF MULTIFIELD GERONTOLOGICAL HOSPITAL

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2016-175-3-73-78 ◽

2016 ◽

Vol 175 (3) ◽

pp. 73-78

Author(s):

N. I. Glushkov ◽

T. L. Gorshenin

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Locally Advanced ◽

Acute Intestinal Obstruction ◽

Maximal Level ◽

Treatment Results ◽

Advanced Tumor ◽

Tumor Perforation ◽

Cancer Complications ◽

Locally Advanced Tumor

The article analyzes treatment results of 482 patients of elderly and senile age with complicated colon cancer forms who were in the hospital for war veterans at the period from 2008 to 2014. The more frequent complication of colon cancer was an acute intestinal obstruction (76,8%). Peritumorous inflammation with abscess formation was noted in 13,5% cases, hemorrhage - in 5,6% tumor perforation - in 4,1% cases. The operations were performed by conventional methods and using endovideosurgical technologies in case of complication of colon cancer. Laparoscopic operations had less volume of intraoperative hemorrhage, lower rate of postoperative complications and reduction of the level of postoperative lethality. The rate of lethality was 31,18% after conventional operations and it consisted of 1,81% after laparoscopic surgery. Total postoperative lethality was 24,5%. The maximal level of postoperative lethality was noted in cases of colon cancer complications and it had an ultimate rate (100%) in cases of perforation of locally advanced tumor.

Download Full-text

Comparison of Treatment Outcomes between Right- and Left-sided Colorectal Adenocarcinoma after Adjuvant Chemotherapy

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2021.6.4.389-395 ◽

2021 ◽

Vol 6 (4) ◽

pp. 389-395

Author(s):

Dean Marvin Potato Pizarro ◽

Carlos Dy ◽

Mel Valerie` Cruz- Ordinario ◽

Cyrielle Marie Atutubo

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Adjuvant Chemotherapy ◽

Colorectal Adenocarcinoma ◽

Locally Advanced ◽

Survival Outcomes ◽

Metastatic Setting ◽

Significant Difference ◽

Disease Free ◽

Tumor Laterality

Objective: The survival outcomes of patients with metastatic colorectal adenocarcinoma based on tumor laterality has already been established based on large-scale retrospective studies. As for the non-metastatic disease, the data is much more conflicting. Local data in this population is also scarce. In this study, we determined the difference in survival of right-sided versus left-sided colorectal cancer patients after surgery and adjuvant chemotherapy. Patients and Methods: This retrospective study analyzed a total of 124 patients who were diagnosed with early to locally advanced (stage I to IVA) colorectal adenocarcinoma and underwent definitive surgery and adjuvant systemic treatment per physician’s preference. The patients were stratified according to the primary tumor laterality: Right-Sided Colon cancer (RCC) and Left-sided Colon cancer (LCC). The primary outcome being investigated is the disease-free survival (DFS) at 3 years and 5 years. Secondary outcomes are overall survival (OS) at 3 years and 5 years, and site of disease recurrence across laterality.Results: The findings did not show a significant difference in the 3-year and 5-year DFS between RCC and LCC after surgery and adjuvant chemotherapy (3-year DFS: 50.0% in the RCC group and 54.3% in the LCC group; P=.671; 5-year DFS: 36.7% in the RCC group and 36.2% in the LCC group, P=.474). The OS difference was also not significant at 3 years and 5 years (3-year OS: 68.8% in the RCC group and 73.9% in the LCC group, P=.572; 5-year OS: 31.3% in the RCC group and 26.1% in the LCC group, P=.474). The overall recurrence rate was not significantly different in both groups (65.6% in the RCC group and 66.3% in the LCC group; P=.944). Majority of the recurrences were at a distant site in both groups (61.1% in the RCC group and 69.6% in the LCC group; P=.501) and the most common were in the lungs, and liver. Conclusion: The survival outcome of non-metastatic colorectal adenocarcinoma was not significantly different between RCC and LCC after surgery and adjuvant chemotherapy. The outcome was also similar after stratification of the population into early and locally advanced disease. More diverse clinical characteristics other than tumor location may be prognostic of disease-free and survival outcomes in the non-metastatic setting of colorectal cancer. Further studies with a larger sample size are needed to validate the correlation of survival to the specific stage and anatomic location.

Download Full-text

The main contributor to the upswing of survival in locally advanced colorectal cancer: an analysis of the SEER database

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819862154 ◽

2019 ◽

Vol 12 ◽

pp. 175628481986215 ◽

Cited By ~ 7

Author(s):

Yuqiang Li ◽

Lilan Zhao ◽

Cenap Güngör ◽

Fengbo Tan ◽

Zhongyi Zhou ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Regression Model ◽

Advanced Colorectal Cancer ◽

Cox Regression ◽

Locally Advanced ◽

Seer Database ◽

Cox Regression Model ◽

Main Contributor ◽

Locally Advanced Colorectal Cancer

Background: There is no conclusion about the most important contributor to the upswing of locally advanced colorectal cancer (LACRC) survival. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database was extracted to identify colorectal adenocarcinoma cancer patients at stage II and III diagnosed in the two periods 1989–1990 and 2009–2010. The statistical methods included Pearson’s chi-squared test, log-rank test, Cox regression model and propensity score matching. Results: The Cox regression model showed that hazard ratio (HR) of non-surgery dropped from 11.529 to 3.469 in right colon cancer (RCC), 5.214 to 2.652 in left colon cancer (LCC) and 3.275 to 3.269 in rectal cancer (RC) from 1989–1990 to 2009–2010. The 95% confidence intervals (CIs) for surgical resection in 2009–2010 were narrower than those in 1989–1990. HR became greater in LACRC without chemotherapy (from 1.337 to 1.779 in RCC, 1.269 to 2.017 in LCC, 1.317 to 1.811 in RC). There was no overlapping about the 95% CI of chemotherapy between the two groups. The progress of surgery was not linked to the improvement of overall survival (OS) of RCC ( p = 0.303) and RC ( p = 0.660). Chemotherapy had a significant association with OS of all colorectal cancer (CRC) patients ( p = 0.017 in RCC; p = 0.006 in LCC; p = 0.001 in RC). Conclusions: Advancements in chemotherapy regimen were the main contributor to the upswing of CRC survival. The improvements in surgery had a limited effect on improvements in CRC survival.

Download Full-text

Influence of palliative surgical resection on overall survival in patients with Advanced Colorectal Cancer: A retrospective single institutional study

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.13532 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 13532-13532

Author(s):

M. S. Kaufman ◽

N. Radhakrishnan ◽

R. Roy ◽

A. Thomas ◽

G. Gecelter ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Surgical Resection ◽

Surgical Intervention ◽

Performance Status ◽

Locally Advanced ◽

Median Number ◽

Positive Influence ◽

Study Results ◽

C 30

13532 Background: The role of palliative surgical resection in patients presenting with locally advanced or metastatic colorectal cancer (CRC) is unclear. Resection is often limited to symptomatic management of bleeding, obstruction, perforation or for relief of pain, in patients with an adequate performance status and an expected life span of over several weeks. An exploratory analysis to evaluate the influence of a palliative surgical resection on survival outcome in patients with advanced CRC is reported. Methods: A retrospective review of medical records of all patients diagnosed with advanced CRC at our institution between the years 1998–2003 was undertaken. Tumor registry data were reviewed to identify age, gender, modalities of therapy (i.e. surgery (S), chemotherapy (C), radiation), and overall survival. IRB approval was obtained for this study. Results: 185 patients were identified. Mean age was 67 years (range 30–99). M: F ratio was 1:1. 62% of patients (115/185) underwent a palliative surgical intervention. Mean survival of patients who underwent S and those that did not undergo S was 27.7 months (mo) and 8.7 mo respectively (p<0.0001). 48% of patients (79/185) underwent systemic C. Mean survival of patients who received C + S, and patients who received C alone was 39 mo and 17.3 mo respectively (p<0.0004). 51% of patients who underwent S, received C; 30% of patients who did not undergo S, received C. Chemotherapy data were available on 46 of 79 patients. Patients treated with S + C, and C without S, received a median of 9 mo and 6 mo of therapy respectively. The median number of regimens used were similar in both. Conclusions: These exploratory data suggest a positive influence of a palliative resection performed during the disease course of patients with advanced CRC. The increased frequency of utilization and the more prolonged duration of C in the surgically treated patients may in part contribute to this improved survival . This may also be reflective of performance status at the time of diagnosis. Future trials enrolling patients with advanced CRC should prospectively stratify for surgical intervention to further clarify the influence of this modality on the outcome of systemic therapy in this disease. No significant financial relationships to disclose.

Download Full-text

ONCOLOGICAL OPERATIONS IN EMERGENCY SURGERY (CLINICAL CASE)

Sibirskij medicinskij vestnik ◽

10.31549/2541-8289-2021-2-29-33 ◽

2021 ◽

pp. 29-33

Author(s):

K.V. Atamanov ◽

◽

V.E. Voitsitsky ◽

O.A. Tkachuk ◽

V.A. Lebedeva ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Postoperative Complications ◽

Intestinal Obstruction ◽

Clinical Case ◽

Positive Outcome ◽

Acute Intestinal Obstruction ◽

Major Surgery ◽

Number Of Patients ◽

Combined Interventions

The increase in the incidence of colorectal cancer cannot go unnoticed. The number of patients with its complications in general surgical hospitals is growing steadily. The main ones include acute intestinal obstruction, bleeding, tumor destruction with paracancerous abscess formation or perforation. This limits the possibilities of carrying out the radical treatment of oncoproctological patients significantly, and reduces the number of resection interventions considerably. The incidence of postoperative complications in emergency patients is statistically higher than after elective surgeries. The most fatal is the failure of the enterocolonic anastomosis, usually requiring relaparotomy and often colostomy. With regional tumors, combined interventions are necessary, a prerequisite for which is the availability of trained specialists. The article presents a clinical case of performing a major surgery with a positive outcome for complicated colon cancer in a hospital on duty.

Download Full-text

Genetic testing and surgeon decision

Acta chirurgica iugoslavica ◽

10.2298/aci0402057g ◽

2004 ◽

Vol 51 (2) ◽

pp. 57-60

Author(s):

G. Guanti

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Monoclonal Antibodies ◽

Genetic Testing ◽

Clinical Outcome ◽

Locally Advanced ◽

Genetic Alterations ◽

Advanced Colon Cancer ◽

Therapeutic Decisions ◽

Staging Systems

Colorectal cancer is a highly treatable and often curable disease when localized to the bowel. Traditional pathological staging systems have been useful in predicting the outcome of colorectal cancer, but is now evident that colorectal cancer is heterogeneous and its natural story strongly correlates with genetic alterations that occur during progression from adenoma to carcinoma to metastatic disease. The goal of many studies is to define a marker, or set of markers, on which therapeutic decisions could be made with greater precision for given individuals. In investigations in which at least 100 patients with locally advanced colon cancer have been studied, those in which monoclonal antibodies to p53 (PAB 1801/DO-7/D0-1) were used have generally demonstrated that mutant or overexpression of p53 is associated with a worse clinical outcome.

Download Full-text

POSTOPERATIVE COMPLICATIONS OF COMBINED SURGERIES IN PATIENTS WITH DISSEMINATED FORMS OF COLON CANCER

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2017-176-2-86-94 ◽

2017 ◽

Vol 176 (2) ◽

pp. 86-94

Author(s):

N. A. Maistrenko ◽

A. A. Khvatov ◽

A. A. Sazonov

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Advanced Colorectal Cancer ◽

Surgical Complication ◽

Locally Advanced ◽

Combined Operations ◽

Somatic Status ◽

Locally Advanced Colorectal Cancer ◽

Careful Assessment ◽

Reliable Increase

OBJECTIVE. The authors investigated the peculiarities and character of complications in gerontological patients with disseminated forms of colon cancer after combined and extended operative interventions. MATERIALS AND METHODS. A retrospective analysis of treatment results of 154 patients was made. The single-stage combined operations were performed on 32 patients of the first group with IV stage of colon cancer. The operation included removing of primary tumor and liver metastases. Combined and extended operative interventions were carried out on 122 patients of the second group with locally-advanced colorectal cancer (T3-4N1-3M0). The patients of both groups were divided into 2 subgroups according to the age: subgroup A - over 60 years of age, subgroup B - younger than 60. Comparison of parameters of postoperative period was made separately in each group between subgroups. RESULTS. There weren’t noted any reliable increase in rate of surgical complication in patients of elderly and senile age with disseminated forms of colon cancer after combined operations. These operations accompanied by high risk of development of functionally-somatic complications as a rule connected with decompensation of concurrent pathology. CONCLUSIONS. The authors recommend to make the careful assessment of general somatic status of gerontological patients with disseminated forms of colorectal cancer and apply the multidiscipline approach in order to balance on time the concurrent pathology after combined operations.

Download Full-text

Disparities in stage at presentation and treatment of colorectal cancer among Hispanic and non-Hispanic white patients.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.433 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 433-433 ◽

Cited By ~ 1

Author(s):

Rodrigo Rodriguez ◽

Melissa Gonzalez ◽

Bridget N. Fahy ◽

Anita Kinney ◽

Ashwani Rajput

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Colon Cancer ◽

Locally Advanced ◽

Incidence Rates ◽

Cancer Center ◽

Advanced Stage ◽

Stage Of Disease ◽

Nccn Guidelines ◽

Significant Difference

433 Background: Although incidence rates for colorectal cancer (CRC) for Hispanics are similar to non-Hispanic whites (NHW) in New Mexico, the cause-specific mortality is higher among the Hispanic population. Hispanics have also been shown to be less likely to be current with colorectal cancer screening guidelines as compared to NHW. The purpose of this study was to determine if there was a difference between Hispanics and NHW in stage at presentation and if the care provided was concordant with NCCN guidelines at our NCI designated cancer center. Methods: A prospective data base of all patients who presented with colorectal cancer between June 2009 and July 2013 was queried. A total of 197 patients were identified. Data was extracted that included: demographics, stage of CRC at first diagnosis, treatments given, and pathology results. Frequencies of stage at presentation and NCCN guideline concordance (meeting the 12 lymph node metric, receipt of adjuvant therapy for stage III disease and radiation therapy for locally advanced rectal cancer) were recorded. Results: The Table shows the results. There were 107 (55%) males. There was not a statistical difference in the stage of presentation for Hispanics and NHW for patients with colon cancer. Hispanic patients with rectal cancer, however, presented with more advanced stage of disease as compared to NHW (p<0.05). There was no statistically significant difference in concordance with NCCN guidelines for the three metrics analyzed. Conclusions: Hispanics and NHW with colon cancer presented with similar stage of disease and were concordant with NCCN guideline metrics. Hispanics with rectal cancer, however, presented at a more advanced stage of disease as compare to NHW patients. The reason for this disparity remains to be elucidated. Future studies to include outreach, education, screening and molecular profiling of these disparate populations are planned. [Table: see text]

Download Full-text