scholarly journals Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location

2019 ◽  
Vol 8 (11) ◽  
pp. 1812 ◽  
Author(s):  
Jung-Soo Pyo ◽  
Young-Min Shin ◽  
Dong-Wook Kang
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Metastatic Lymph Node ◽  
Tumor Location ◽  
Prognostic Implication ◽  
Colon Cancers ◽  
Significant Difference ◽  
Node Ratio ◽  
Rectal Cancers ◽  
Location Methods

Background: The proportion of the number of involved lymph nodes (LNs) to the number of examined LNs—defined as metastatic LN ratio (mLNR)—has been considered as a prognostic parameter. This study aims to elucidate the prognostic implication of the mLNR in colorectal cancer (CRC) according to the tumor location. Methods: We evaluated the correlation between prognoses and the involved and examined LNs as well as mLNR according to the tumor location in 266 surgically resected human CRCs. Besides, to evaluate the optimal cutoff for high and low mLNRs, we investigated the correlation between mLNR and survival according to the various cutoffs. Results: LN metastasis was found in 146 cases (54.9%), and colon and rectal cancers were found in 116 (79.5%) and 30 (20.5%) of the cases, respectively. The mean mLNRs were significantly higher in rectal cancer than in colon cancer (0.38 ± 0.28 vs. 0.21 ± 0.24, P = 0.003). Besides this, the number of involved LNs in rectal cancer was significantly high compared to colon cancer (11.83 ± 10.92 vs. 6.37 ± 7.78, P = 0.014). However, there was no significant difference in the examined LNs between the rectal and colon cancers (31.90 ± 12.28 vs. 36.60 ± 18.11, P = 0.181). In colon cancer, a high mLNR was significantly correlated with worse survival for all cutoffs (0.1, 0.2, 0.3, and 0.4). However, rectal cancer only showed a significant correlation between high mLNR and worse survival in the subgroup with a cutoff of 0.2. Conclusions: Our results showed that high mLNR was significantly correlated with worse survival. The number of involved LNs and mLNRs were significantly higher in rectal cancer than in colon cancer. The cutoff of 0.2 can be useful for the differentiation of prognostic groups, regardless of tumor location.

Bevacizumab effectiveness and primary tumor location in metastatic colorectal cancer patients.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 683-683 ◽  
Author(s):  
Wen-zhuo He ◽  
Qiong Yang ◽  
Chang Jiang ◽  
Fang-xin Liao ◽  
Shou-sheng Liu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Tumor Location ◽  
First Line ◽  
Primary Tumor Location ◽  
Colon Cancers

683 Background: There is currently no consensus about whether bevacizumab effectiveness is associated with the primary tumor location of metastatic colorectal cancer (mCRC). The aim of this study was to assess whether the primary tumor location was a predictor for bevacizumab treatment. Methods: From 2004 to 2013, 740 patients with mCRC treated with oxaliplatin / 5-FU / leucovorin (mFOLFOX6) or irinotecan / 5-FU / leucovorin (FOLFIRI) (CT group) and 244 patients treated with bevacizumab plus mFOLFOX6 or FOLFIRI (CT + B group) as first-line setting were included from Sun yat-sen university cancer center. Right-side colon cancers included those occurring in the cecum, ascending colon or transverse colon. Left-side colon cancers included those from descending or sigmoid colon. The primary outcome was overall survival (OS). Kaplan-Meier curves with log-rank tests were used to detect difference. All statistical tests were two sided. Results: 222 right-side colon, 259 left-side colon and 259 rectal cancer patients were included in CT group while 78 right-side colon, 86 left-side colon and 80 rectal cancer patients were included in CT + B group. Patients in CT + B group had similar OS compare with CT group only when the primary tumor located at right-side colon (median OS was 19.6 months for CT + B group versus 19.5 months for CT group, P = 0.269). For left-side colon cancer, significantly longer OS were observed in CT + B than CT group (22.3 months versus 21.9 months, P = 0.014). For rectal cancer patients, those in CT + B group also had longer OS than CT group (25.9 months versus 21.1 months, P = 0.005). Conclusions: Our data suggested that patients with right-side colon cancer could not get survival benefit from the addition of bevacizumab to first-line chemotherapy. Further data from randomized trials are needed to test our hypothesis. [Table: see text]

scholarly journals Prognostic implication of metastatic lymph node ratio in node-positive rectal cancer

2011 ◽  
Vol 80 (4) ◽  
pp. 260
Author(s):  
Sang-Min Lee ◽  
Jong-Seok Shin ◽  
Hong-Jo Choi ◽  
Ki-Jae Park ◽  
Young-Hoon Roh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Ratio ◽  
Metastatic Lymph Node ◽  
Prognostic Implication ◽  
Node Positive ◽  
Metastatic Lymph ◽  
Node Ratio

Survival outcomes of left-sided versus right-sided colon cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 502-502 ◽  
Author(s):  
Jasmine Lizette Gowarty ◽  
Charis Durham ◽  
Lucas Wong ◽  
Wencong Chen
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Tumor Location ◽  
Independent Prognostic Factor ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Colon Cancers ◽  
Time To Recurrence ◽  
Significant Difference

502 Background: Right-sided colon cancers (RCC) are defined up to the splenic flexure where as left-sided colon cancers (LCC) involve the descending, sigmoid, and rectosigmoid regions. The landmark CALGB/SWOG 80405 study concluded that sidedness was an independent prognostic factor for survival in stage IV adenocarcinoma of the colon or rectum, with a poorer prognosis in RCC. This raises the question as to whether or not stage of malignancy plays a role. We performed a retrospective analysis on survival for stage I to IV colon cancer treated at our institution in order to assess if tumor location is an independent prognostic factor as described in previous studies. Methods: Primary site of cancer, sex, age at diagnosis, vital status, and year of diagnosis for stage I, II, III, and IV colon cancer was collected from our institution’s tumor registry from 2007 to 2017. The inclusion criteria included those diagnosed with stage I to IV colon cancer at 18 years of age and above. Exclusion criteria included a diagnosis of both RCC and LCC and patients under age 18. The median of overall survival and time to recurrence between LCC and RCC were compared using Wilcoxon Rank Sum Test with two-sided significance level at 0.05. Results: Time to overall survival and time to recurrence was shown to have no significant difference between RCC and LCC (p = 0.3398 and 0.9467, respectively). Cox proportional hazards model adjusted for age and sex also support the claim (p = 0.1725 and 0.0633). There was a statistically significant difference in age between the two groups with the older mean age seen in RCC (68 versus 62). The distribution of recurrence was statistically significant with a higher recurrence in RCC (p = 0.0105). Conclusions: Unlike CALGB/SWOG 80405, our analysis included the transverse colon as part of RCC and examined stage I to IV colon cancer to ultimately conclude that there was no significant difference in overall survival or time to recurrence. Our study suggests that tumor location is not an independent prognostic factor on survival for all stages of colon cancer. However, a higher suspicion for recurrence may be needed for those diagnosed with RCC. Future investigations involving molecular subtypes and mutations are needed to further clarify prognosis and tumor sidedness.

scholarly journals Elevated MUC5AC expression is associated with mismatch repair deficiency and proximal tumor location but not with cancer progression in colon cancer

2020 ◽  
Author(s):  
Sebastian Dwertmann Rico ◽  
Doris Höflmayer ◽  
Franziska Büscheck ◽  
David Dum ◽  
Andreas M. Luebke ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Mismatch Repair ◽  
Cancer Progression ◽  
Strong Association ◽  
Tumor Location ◽  
Colorectal Cancers ◽  
Mismatch Repair Deficiency ◽  
Repair Deficiency ◽  
Cancer Aggressiveness ◽  
Rectal Cancers

AbstractMucin 5AC (MUC5AC) is a secreted gel-forming mucin expressed by several epithelia. In the colon, MUC5AC is expressed in scattered normal epithelial cells but can be abundant in colorectal cancers. To clarify the relationship of MUC5AC expression with parameters of tumor aggressiveness and mismatch repair deficiency (dMMR) in colorectal cancer, a tissue microarray containing 1812 colorectal cancers was analyzed by immunohistochemistry. MUC5AC expression was found in 261 (15.7%) of 1,667 analyzable colorectal cancers. MUC5AC expression strongly depended on the tumor location and gradually decreased from proximal (27.4% of cecum cancers) to distal (10.6% of rectal cancers; p < 0.0001). MUC5AC expression was also strongly linked to dMMR. dMMR was found in 21.3% of 169 cancers with MUC5AC positivity but in only 4.6% of 1051 cancers without detectable MUC5AC expression (p < 0.0001). A multivariate analysis showed that dMMR status and tumor localization predicted MUC5AC expression independently (p < 0.0001 each). MUC5AC expression was unrelated to pT and pN status. This also applied to the subgroups of 1136 proficient MMR (pMMR) and of 84 dMMR cancers. The results of our study show a strong association of MUC5AC expression with proximal and dMMR colorectal cancers. However, MUC5AC expression is unrelated to colon cancer aggressiveness.

Genetic epidemiology of colorectal cancer and associated cancers

Mutagenesis ◽  
2019 ◽  
Vol 35 (3) ◽  
pp. 207-219
Author(s):  
Hongyao Yu ◽  
Kari Hemminki
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Familial Risk ◽  
Shared Environment ◽  
Relative Risks ◽  
Swedish Family ◽  
Rectal Cancers ◽  
Common Risk Factors ◽  
Double Primary Cancers

Abstract We review here data on familial risk in colorectal cancer (CRC) generated from the Swedish Family-Cancer Database, the largest resource of its kind in the world. Although the concordant familial risk for CRC (i.e. CRC risk in families of CRC patients) has been reasonably well established, the studies on discordant familial risks (i.e. CRC risk in families with any other cancers) are rare. Because different cancers could be caused by shared genetic susceptibility or shared environment, data of associations of discordant cancers may provide useful information for identifying common risk factors. In analyses between any of 33 discordant cancers relative risks (RRs) for discordant cancers were estimated in families with increasing numbers of probands with CRC; in the reverse analyses, RRs for CRC were estimated in families with increasing numbers of probands with discordant cancers. In separate analyses, hereditary non-polyposis colorectal cancer (HNPCC) families were excluded from the study, based on HNPCC related double primary cancers, to assess the residual familial RRs. We further reviewed familial risks of colon and rectal cancers separately in search for distinct discordant associations. The reviewed data suggested that colon cancer was associated with a higher familial risk for CRC compared to rectal cancer. The previous data had reported associations of CRC with melanoma, thyroid and eye cancers. Nervous system cancer was only associated with colon cancer, and lung cancer only associated with rectal cancer. The reviewed data on discordant association may provide guidance to gene identification and may help genetic counseling.

scholarly journals Prognostic Significance of Microvessel Density Determining by Endoglin in Stage II Rectal Carcinoma: A Retrospective Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Zeljko Martinovic ◽  
Drazen Kovac ◽  
Mia Martinovic
Keyword(s):  
Rectal Cancer ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Normal Mucosa ◽  
Tumor Location ◽  
Integrated System ◽  
Stage Ii ◽  
Rank Test ◽  
Adjacent Mucosa ◽  
Significant Difference

Background. The role of endoglin in the Dukes B rectal cancer is still unexplored. The aim of this study was to examine the expression of endoglin (CD105) in resected rectal cancer and to evaluate the relationship between microvessels density (MVD), clinicopathological factors, and survival rates.Methods. The study included 95 primary rectal adenocarcinomas, corresponding to 67 adjacent and 73 distant normal mucosa specimens from surgical resection samples. Tumor specimens were paraffin-embedded and immunohistochemical staining for the CD105 endothelial antigen was performed to count CD105-MVD. For exact measurement of the CD105-MVD used a computer-integrated system Alphelys Spot Browser 2 was used.Results. The intratumoral CD105-MVD was significantly higher compared with corresponding adjacent mucosa (P<0.0001) and distant mucosa specimens (P<0.0001). There was no significant difference in the CD105-MVD according to patients age, gender, tumor location, grade of differentiation, histological type, depth of tumor invasion, and tumor size. The overall survival rate was significantly higher in the low CD105-MVD group of patients than in the high CD105-MVD group of patients (log-rank test,P=0.0406).Conclusion. CD105-assessed MVD could help to identify patients with possibility of poor survival in the group of stage II RC.

Adjuvant chemotherapy with uracil-tegafur (UFT) for stage III colorectal cancer: Final results of randomized trials by the National Surgical Adjuvant Study of Colorectal Cancer (NSAS-CC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4049-4049 ◽  
Author(s):  
T. Hamaguchi ◽  
K. Shirao ◽  
Y. Moriya ◽  
S. Yoshida ◽  
S. Kodaira ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Hazard Ratio ◽  
Stage Iii ◽  
Control Group ◽  
Significant Difference ◽  
Resected Stage

4049 Background: In the latter 1990s, no consensus was reached as to whether adjuvant chemotherapy was standard treatment for completely resected stage III colorectal cancer in Japan. At that time, we started two randomized controlled trials to clarify the role of adjuvant chemotherapy of stage III colon and rectal cancer in the same time. Methods: Patients with completely resected stage III cancer of the colon or rectum (PS, 0 to 2; age, 20 to 75 years; no other adjuvant therapy) were eligible for these trials. Patients were registered within 6 weeks after surgery and were randomly assigned to receive surgery alone (control group) or surgery followed by treatment with UFT (400 mg/m2/day), given for 5 consecutive days per week for 1 year (UFT group). The target number of patients was 500 for colon cancer and 400 for rectal cancer (hazard ratio = 0.67, one-sided a= 0.05, β= 0.2). The primary endpoint was relapse-free survival (RFS), and the secondary end point was overall survival (OS). Results: Between October 1996 and April 2001, a total of 334 patients with colon cancer and 276 with rectal cancer were enrolled. Four ineligible patients were excluded; data from the remaining 332 patients with colon cancer and 274 with rectal cancer were analyzed. The patients’ characteristics were similar in the groups. Analysis of the results of follow-up until March 2006, at least 5 years after surgery in all patients (median follow-up period, 6.2 years), showed no significant difference in RFS or OS in colon cancer. In rectal cancer, however, RFS and OS were significantly better in the UFT group than in the control group. The only grade 4 toxicity was diarrhea, occurring in 1 patient with colon cancer and 1 patient with rectal cancer. Conclusions: Postoperative adjuvant chemotherapy with UFT is well tolerated and improved RFS and OS in patients with stage III rectal cancer. In colon cancer, the expected benefits were not obtained (hazard ratio = 0.67). [Table: see text] No significant financial relationships to disclose.

Can sidedness predict for survival in primary locoregional colon cancers?

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 584-584
Author(s):  
Weining Wang ◽  
Chin Jin Seo ◽  
Grace Hwei Ching Tan ◽  
Claramae Shulyn Chia ◽  
Khee Chee Soo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Rank Test ◽  
Rectosigmoid Junction ◽  
Colon Cancers ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact

584 Background: Right and left-sided colon cancers are embryonically distinct and present differently. Recently, there has been growing belief that sidedness could be independently associated with survival outcomes. This has important clinical implications regarding the prognostication, management and surveillance of colon cancer patients. Hence, we aim to investigate the impact of sidedness on survival in our patient population in this study. Methods: Patients who had primary treatment naïve colon cancer who underwent curative surgical resection in our institution from September 2002 to December 2010 were included in this study. Demographic and clinicopathological data was collected from electronic records and clinical charts. Tumours arising from the cecum, ascending colon, hepatic flexure and transverse colon were considered right-sided, while those arising from splenic flexure and descending colon were considered left-sided. Cancers of the rectosigmoid junction and rectum were excluded. Kaplan-Meier curves and log-rank test were used to compare overall, locoregional recurrence-free and distant recurrence-free survivals (OS, LRFS, DRFS respectively) between both groups. Multivariate analysis was performed using Cox regression proportional hazards. Results: 389 patients were included in this study. 238 had left-sided tumours while the remaining 151 had right-sided tumours. In our cohort, right-sided tumours were associated with older age and mucinous histology. Kaplan-Meier curves plotted showed improved LRFS in left-sided tumours (p = 0.04, median survival not reached) but no significant difference in OS and DRFS. On multivariate analysis, sidedness was also found to be an independent prognostic factor for LRFS but not OS and DRFS despite factoring in age, size of tumour, pT, pN and histology. Conclusions: Our study suggests that left-sided tumours in primary colon cancer are independently prognostic for improved locoregional survival as compared to the right-sided tumours, even after taking into account other known factors such as age, staging and histology.

Distance from the anal verge as an indirect measure to predict response to anti-EGFR therapy in left side metastatic colon cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15153-e15153
Author(s):  
Daniela Pezzutti DOMINGUES Armentano ◽  
Mariana Ribeiro Monteiro ◽  
Raphael Araujo ◽  
Renata Arakelian ◽  
Paula Freire Cardoso ◽  
...  
Keyword(s):  
Anal Verge ◽  
Tumor Location ◽  
Response To Therapy ◽  
Rank Test ◽  
Metastatic Colon Cancer ◽  
Indirect Measure ◽  
Colon Cancers ◽  
Significant Difference ◽  
Group A ◽  
Group B

e15153 Background: Right and left sided colon cancers (RC, LC) differ with respect to biology and response to therapy. Several retrospective analyses have assessed the clinical effect of epidermal growth fator receptor (EGFR) targeted agents in patients with metastatic CRC (mCRC) according to the primary tumor location. Differentiating only right from left. But can in the LC responses differ according to the distance from the anal verge (DAV)? Methods: Exploratory retrospective analyses was planned to evaluate if LC responses differ according to the DAV. LC was defined as tumors originating anywhere from the distal rectum to the left colic flexure (splenic flexure). DAV was describe in cm measured by previous to surgery or treatment, colonoscopy, CT or MRI. Patients were divided for analysis purposes in two groups: Group A (tumors above 12cm from de anal verge), Group B (tumors below 12cm from the anal verge). Results: We retrospectively evaluated 29 patients with left metastatic colorectal cancer treated with anti-EGFR therapy as part of their treatment at the Paulistano Hospital -São Paulo from 2011 to 2018. Median population age 51.8 years (48.5-62.3). Median DAV 14.5 (4.6-25 cm). Median follow-up 12.8 months. No significant difference on stable and partial response rate was detected (Group A 43.7% vs Gropup B 56.3%), p=0.211. Long-rank test with a median pFS 8,5 meses and a PFS at 6 months of 66.7 vs 78,8 (Group A and Group B respectively ), p=0.901. Two-year OS was 58.4 % in Group A and 100% in Group B, p=0.17. Conclusions: Although no significant diferences were detected, responses rates were numerically higher in patients with tumors located below 12 cm from the anal verge. Further studies are needed to evaluate the association between response and DAV.

Sign in / Sign up

Export Citation Format

Share Document