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 Prevalence of pelvic floor symptoms in female patients attending the two-week wait clinic with suspected colorectal cancer

2016 ◽  
Vol 98 (6) ◽  
pp. 413-418 ◽  
Author(s):  
J Bennett ◽  
A Greenwood ◽  
P Durdey ◽  
D Glancy
Keyword(s):  
Colorectal Cancer ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Obstructed Defecation ◽  
Bowel Habit ◽  
Wexner Score ◽  
Exact Test ◽  
Female Patients ◽  
Presenting Symptoms ◽  
Pelvic Floor Symptoms

Introduction The aim of this study was to establish the prevalence of pelvic floor symptoms in women referred to a colorectal two-week wait (2WW) clinic with suspected colorectal cancer. Methods A questionnaire assessing faecal incontinence (FI) (Wexner score) and obstructed defecation syndrome (ODS) (Renzi score) was offered to 98 consecutive female patients attending a colorectal 2WW clinic at a single trust. Results Overall, 56 (57%) of the 98 patients had significant ODS and/or FI (scores >9/20), 33 (34%) had ODS and 40 (41%) had FI. Seventeen patients (17%) had both ODS and FI. Analysis of the 63 patients referred with a change in bowel habit (CIBH) showed 40 (63%) to be Renzi and/or Wexner positive compared with 16 (46%) of the 35 patients who presented without CIBH (p=0.095, Fisher’s exact test). Further analysis showed that 31 (78%) of the 40 patients with FI presented with CIBH compared with 32 (55%) of the 58 without FI (p=0.032). In terms of ODS, 23 (70%) of the 33 patients with ODS presented with CIBH compared with 40 (62%) of the 65 without ODS (p=0.506). Conclusions Over half of the female patients attending our colorectal 2WW clinic had significant pelvic floor dysfunction (FI/ODS), which may account for their symptoms (especially in the CIBH referral category). While it is important for malignancy to be excluded, many patients may benefit from investigation and management of their pelvic floor dysfunction as the cause for their presenting symptoms.

Contributive compared with subsidized insurance in colorectal cancer in the Colombian National Administrative Cancer Registry.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18136-e18136
Author(s):  
Robert Hsu ◽  
Paula Ramirez ◽  
Lizbeth Acuña ◽  
Gilberto Lopes
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Cancer Care ◽  
Nutritional Support ◽  
Early Stage ◽  
Care Delivery ◽  
Tnm Staging ◽  
Wait Times ◽  
Curative Surgery

e18136 Background: Colombia has gone to great lengths to provide nearly universal health care insurance for its patients, as 96.6% of its constituents now have health insurance as of 2014 compared to 23.5% in 1993. Most Colombians are associated with either contributive insurance (CI) in which employees and employers contribute to the insurance or subsidized insurance (SI) in which government funds cover the insurance cost. Colorectal cancer (CRC) has the 5th highest incidence of all malignancies in Colombia. This abstract aims to compare CRC care delivery metrics between CI and SI. Methods: We used the Colombian National Administrative Cancer Registry (NACR) data compiled from the Department of Health Ministry from January 2, 2016- January 1, 2017 consisting of 32 departments and 1122 municipalities. CRC cases were investigated by incidence, mortality, percentage of cases with early stage detection, stage I-III with curative surgery intent, nutritional support, and TNM staging, and days between suspicion to diagnosis, diagnosis to first treatment, neoadjuvant therapy to surgery, and surgery to adjuvant therapy. Results: There were 2605 new CRC cases in the NACR in 2017, with 1691 CI cases and 823 SI cases. There was a noticeably higher incidence in CI (7.2 new cases per 100,000 people) than in SI (3.7 new cases per 100,000), and a higher mortality rate (5.0 deaths per 100,000) in CI compared with SI cases (2.6 deaths per 100,000). There was a significant increase in average wait time for SI CRC cases from diagnosis to first treatment (77.7 days vs. 57.3 days, p = .027) and in average time to neoadjuvant therapy to surgery in CI cases (123.1 days vs. 92.5 days, p = .054) with longer but statistically insignificant wait times in SI cases in average time to adjuvant therapy (83.6 days vs. 73.9 days, p = .0168) and suspicion to diagnosis (56.1 days vs. 46.9 days, p = .811). Similar percentages of CI and SI cases had early stage detection (37.2% in SI vs. 34.3% in CI, p = 0.311), TNM staging (50.7% in CI vs. 49.3% in SI, p = 0.146), stage I-III cases with curative surgery intent (23.3% in CI vs. 21.8% in SI, p = 0.833), and nutritional support (10.5% in CI vs. 8.5% in SI, p = 0.942). Conclusions: The NACR represents a model for developing countries to improve cancer care delivery efficiently. As evidenced by higher incidence and mortality in CI cases and longer wait times before treatment in SI cases, there are differences in cancer care delivery between major modes of healthcare delivery in Colombia. More investigation needs to be done with a goal of streamlining cancer care delivery.

scholarly journals Phenotype-Genotype Correlation in Colorectal Cancer: A Real-Life Study

2021 ◽  
pp. 1-9
Author(s):  
Catarina Frias-Gomes ◽  
Ana Carla Sousa ◽  
Inês Rolim ◽  
Ana Raquel Henriques ◽  
Francisco Branco ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mismatch Repair ◽  
Early Stage ◽  
Small Sample Size ◽  
Real Life ◽  
Disease Free Survival ◽  
Small Sample ◽  
Stage I ◽  
Curative Surgery ◽  
Genetic Characteristics

<b><i>Background and Aims:</i></b> Colorectal cancer (CRC) is a heterogeneous disease with distinctive genetic pathways, such as chromosomal instability, microsatellite instability and methylator pathway. Our aim was to correlate clinical and genetic characteristics of CRC patients in order to understand clinical implications of tumour genotype. <b><i>Methods:</i></b> Single-institution retrospective cohort of patients who underwent curative surgery for CRC, from 2012 to 2014. <i>RAS</i> and <i>BRAF</i> mutations were evaluated with the real-time PCR technique Idylla®. Mismatch repair deficiency (dMMR) was characterized by absence of MLH1, MSH6, MSH2 and/or PMS2 expression, evaluated by tissue microarrays. Overall survival (OS) and disease-free survival (DFS) were assessed using survival analysis. <b><i>Results:</i></b> Overall, 242 patients were included (males 57.4%, age 69.3 ± 12.9 years; median follow-up 49 months). <i>RAS</i>-mutated tumours were associated with reduced DFS (<i>p</i> = 0.02) and OS (<i>p</i> = 0.045) in stage I–III CRC. <i>BRAF</i>-mutated tumours were more predominant in females and in the right colon, similarly to dMMR tumours. BRAF status did not influence OS (4 years)/DFS (3.5 years) in stage I–III disease. However, after relapse, length of survival was 3.5 months in <i>BRAF</i>-mutated tumours in contrast to 18.6 months in <i>BRAF</i> wild-type tumours (<i>p</i> = NS). No germline mutations in mismatch repair genes were so far identified in the patients with dMMR tumours. Molecular phenotype (<i>RAS, BRAF</i> and MMR) did not influence OS in metastatic patients. Our small sample size may be a limitation of the study. <b><i>Conclusion:</i></b> In our cohort, <i>RAS</i>-mutated tumours were associated with worse DFS and OS in early-stage CRC, whereas the remaining molecular variables had no prognostic influence.

scholarly journals Colorectal cancer in adolescents and young adults with Lynch syndrome: a Danish register-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053538
Author(s):  
Jon Ambæk Durhuus ◽  
Christina Therkildsen ◽  
Thomas Kallemose ◽  
Mef Nilbert
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Lynch Syndrome ◽  
Early Onset ◽  
Early Stage ◽  
Young Patients ◽  
Stage Distribution ◽  
Confounding Variables ◽  
Symptom Awareness ◽  
Cox Analysis

ObjectiveTo assess clinicopathological predictors and prognosis in early-onset colorectal cancer (CRC) in Lynch syndrome with comparison to patients diagnosed from age 40 and up.DesignNational, retrospective register-based case–control study.SettingDanish national hereditary CRC register.ParticipantsIndividuals with Lynch syndrome diagnosed with CRC from January 1950 to June 2020. The analysis was based on 215 early-onset CRCs diagnosed between 15 and 39 years of age and 574 CRCs diagnosed at age 40–88 years.Main outcome measuresClinical and histopathological characteristics and survival. Confounding variables were analysed by Cox analysis.Results27.2% of the tumours in the Danish Lynch syndrome cohort were diagnosed under age 40. Disease-predisposing alterations in MLH1 and MSH2 were overrepresented in the age 15–39 cohort compared with patients diagnosed over age 40. CRCs diagnosed under age 40 showed an adverse stage distribution with 36.2% stage III–IV tumours compared with 25.8% in the over age 40 group. However, young patients diagnosed with early-stage tumours did have a significantly better prognosis compared with early-stage tumours in the older age group.ConclusionsEarly-onset CRC in Lynch syndrome is primarily linked to alterations in MLH1 and MSH2 and displays an adverse stage distribution. These observations serve as a reminder of surveillance, symptom awareness and rapid diagnostic handling of CRC in young adults with Lynch syndrome.

Disease characteristics and treatment outcomes of young colorectal cancer patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 691-691 ◽  
Author(s):  
Hiral D. Parekh ◽  
Yu Wang ◽  
Wissam Hanayneh ◽  
Miles Cameron ◽  
Sanda Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Treatment Outcomes ◽  
Early Stage ◽  
Young Patients ◽  
Study Cohort ◽  
Chi Square ◽  
Perioperative Therapy ◽  
Cancer Specific Survival ◽  
Disease Characteristics ◽  
Cox Proportional Hazard Regression

691 Background: The incidence of colorectal cancer (CRC) in young patients (< 50 years) is increasing but little is known about disease characteristics and treatment outcomes in this patient population. Methods: CRC patients diagnosed at < 50 years of age (UF institutional registry 2000-2017) constituted the IRB approved study cohort. Statistical methods included descriptive statistics, uni-variable cox proportional hazard regression model, Pearson chi-square exact and Wilcoxon rank-sum test. Results: The median age at diagnosis was 45 years (range 17-50, n = 286) with 212 (74%) diagnosed between age 40-50. One third (35.7%) of patients had rectal primary and most common histology was adenocarcinoma (ACa, 84.6%) and 20% of those had poorly differentiated tumor. More than half of patients had an advanced primary (T3/T4, 65%) and 44% had lymph node positive disease. A trend towards increased delivery of perioperative therapy was seen in early staged disease. (See table) Patients who underwent curative resections had better hemoglobin (p = 0.005) and albumin levels (Alb, p < 0.001) and lower CEA level (p < 0.001). Factors associated poor survival were low alb levels ≤ 34 g/l, advanced primary tumor (T3/T4), nodal disease (N1/N2) and presence of diffuse metastasis. For stage 4 disease, the cancer-specific survival (CSS) at 1 year was 77.2%, 3-year CSS was 46.1% and 5-year CSS was 29%; survival was better (HR = 0.4; 95% CI 0.2-0.6, p < 0.001) among patients who underwent metastatectomy. Conclusions: Our data suggests that younger CRC patients were more likely to be managed in an aggressive manner with a higher proportion of early stage patients receiving perioperative therapy. A suggestion of an improved CSS was seen in advanced stage disease even with similar prognostic factors. Review of larger datasets are warranted. [Table: see text]

Prevalence of delay to seeking medical attention in patients with synovial sarcoma and association with inferior outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23556-e23556
Author(s):  
Tiffany Seto ◽  
Meena Song ◽  
Elisabeth Russell ◽  
Danny Sam ◽  
Minggui Pan
Keyword(s):  
Synovial Sarcoma ◽  
Metastatic Disease ◽  
Median Duration ◽  
Early Stage ◽  
Young Patients ◽  
Medical Attention ◽  
Early Stage Disease ◽  
Palpable Mass ◽  
Presenting Symptoms ◽  
Stage Disease

e23556 Background: Synovial sarcoma is an aggressive soft tissue sarcoma that predominantly affects young patients with high rate of relapse and mortality. Systemic study of patients’ presenting symptoms and possible delay of seeking medical attention is lacking. Methods: We retrospectively reviewed the electronic records of all patients diagnosed with synovial sarcoma from 2005 to 2016 within Kaiser Permanente Northern California to identify the pattern of presenting symptoms and its correlation with outcomes. Results: Of the 77 patients with synovial sarcoma, 64 had early stage disease and 13 had metastatic disease at diagnosis, with median age at diagnosis of 47 years. Anatomically, 48 patients had primary disease at the extremity, 12 trunk, and 17 visceral. Median duration of follow up is 40 months. The median time from symptom to first medical appointment (TTM) is 3 months (range 0.1 to 180 months). Nine out of 13 patients who presented with metastatic disease were visceral primary. For the 60 patients with an extremity/trunk primary, patients who presented with pain without a palpable mass had a median duration of TTM of 12 months, compared to the TTM of 3 months for patients who presented with a palpable mass. The relapse rate (RR) and disease-free survival (DFS) for patients with an extremity/trunk primary who presented with pain but without a palpable mass were significantly worse when compared to patients who presented with a palpable mass (RR 50% vs. 26.5%, and DFS 27 vs. 42.5 months, p < 0.005). TTM was inversely correlated with DFS for the 64 cases with early stage disease and for the 60 cases with extremity/trunk primary (p < 0.00000001). Of the 11 patients with a foot primary, a similar pattern of TTM and DFS was also observed. Conclusions: Patients with synovial sarcoma who presented with pain but without a palpable mass had longer TTM, worse DFS and higher RR compared to patients who presented with a palpable mass. Longer TTM was associated with worse DFS.

The Clinicopathologic Characteristics of Colorectal Cancer in Patients under 50 years of Age: Experience of an Oncology Center

2001 ◽  
Vol 87 (2) ◽  
pp. 74-77 ◽  
Author(s):  
Nazan Günel ◽  
Deniz Yamac ◽  
Zafer Akcali ◽  
Ferit Taneri ◽  
Mehmet Oguz
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Malignant Tumors ◽  
Familial Cancer ◽  
Young Patients ◽  
Clinicopathologic Characteristics ◽  
Old Patients ◽  
Presenting Symptoms ◽  
History Of ◽  
Oncology Center

Background/aim Colorectal cancer is seen mostly among patients older than 50 years of age. An aggressive behavior is a frequently cited as characteristic of colorectal cancer in young patients. The purpose of the present study was to reveal the clinicopathologic characteristics of colorectal cancer among patients under 50 years of age. Methods Two hundred and seventy-one patients with colorectal cancer admitted to our oncology center were evaluated, and clinicopathologic findings of the young and old patients were compared. Patient gender, site distribution, tumor stage classification, lymph node involvement, metastatic site, histologic classification, histologic differentiation, family history of malignant tumors, presenting symptoms and survival rates were compared. Results One hundred patients were 50 years of age or under. Clinical, histopathologic characteristics and overall survival of the two groups did not differ. A higher rate of familial cancer syndromes was detected among young patients. Conclusions The presentation and outcome of the disease in young patients do not differ from those of older patients. A significant family history of colorectal cancer in the young patients showed the need for screening whereas the outcome of metastatic disease was poor. In order to anticipate long survival, early detection and aggressive treatment is necessary.

Colorectal cancer in young patients: An institutional experience.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15140-e15140
Author(s):  
Wissam Hanayneh ◽  
Yu Wang ◽  
Thomas J. George ◽  
Miles Cameron ◽  
Sanda Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mutational Analysis ◽  
Early Stage ◽  
Young Patients ◽  
Braf V600e ◽  
Mismatch Repair Gene ◽  
Study Cohort ◽  
Common Mutation ◽  
Perioperative Therapy ◽  
Cancer Specific Survival

e15140 Background: The incidence of colorectal cancer (CRC) in young patients (<50 years) is increasing but little is known about disease characteristics and treatment outcomes in this patient population. Methods: CRC patients diagnosed at < 50 years of age (UF registry 2000-2017) constituted the IRB approved study cohort. Statistical methods included descriptive statistics, uni-variable cox proportional hazard regression model, Pearson chi-square exact and Wilcoxon rank-sum test. Results: Young CRC patients (n= 286) comprised 16% of total CRC patients (n= 1806) treated at our institution. (See Table for demographics and tumor characteristics). The median age at diagnosis was 45 years (range 17-50) with 74% diagnosed between age 40-50. One third (35.7%) of patients had rectal primary. DNA mismatch repair gene deficiencies (dMMR) and/or microsatellite instability (MSI) was tested in 60.1%; 10.5% had MSI-H or dMMR tumors and 11 of those had confirmed Lynch syndrome. Next generation sequencing (n= 71) or mutational analysis (n= 79) was performed. Most common mutation was exon 12 of K- ras (40.7%, n = 61) followed by TP53 (7.33%; n = 11) and PIK3CA (5.33%; n = 8). BRAF V600E was seen in 5 patients. Patients who underwent curative resections had better hemoglobin (p=0.005), albumin levels (p <0.001) and lower CEA level (p<0.001). Factors associated with poor survival were low albumin ≤34 g/l, advanced primary tumor (T3/T4), nodal disease (N1/N2) and presence of diffuse metastases. For stage 4 disease, the cancer-specific survival (CSS) at 1 year was 77.2%, 3-year CSS was 46.1% and 5-year CSS was 29%; survival was better (HR=0.4; 95% CI 0.2-0.6, p<0.001) among patients who underwent metastatectomy. Conclusions: Our results reveal that the most young CRC were 40-50 years age group with a female preponderance. Young CRC patients were more likely to be managed in an aggressive manner with a higher proportion of early stage patients receiving perioperative therapy. A suggestion of an improved CSS was seen in advanced stage disease even with similar prognostic factors. Review of larger data sets are warranted. [Table: see text]

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.

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