scholarly journals Therapeutic Characteristics, Chemotherapy-Related Toxicities and Survivorship in Colorectal Cancer Patients

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Zineb Aoullay ◽  
Meriem Slaoui ◽  
Rachid Razine ◽  
Abdelouahed Er-Raki ◽  
Bouchra Meddah ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rates ◽  
P Value ◽  
Major Health Problem ◽  
Major Health ◽  
Lung Cancers ◽  
Kaplan Meier ◽  
Colorectal Cancer Patients ◽  
Grade Iii ◽  
Chi2 Test

BACKGROUND: Colorectal Cancer (CRC) is a major health problem around the globe. In Morocco, the disease ranks third after breast and lung cancers. This study is the first in Morocco to investigate epidemiological, clinical and therapeutic features while exhaustively describing toxic side-effects to chemotherapy of CRC and studying the 3-years survivorship.METHODS: This is a descriptive and analytical retrospective study of about 290 patients with CRC enrolled during the period of January-December 2013. Statistical analysis was performed to correlate clinicopathological data with chemotherapy toxicity and survivorship in patients, by Chi2 test. Overall Survival (OS) rate has been calculated by the Kaplan-Meier method and compared using Log-rank test.RESULTS: Fifty-five percent had a tumor localized in rectum, and 42,8% in colon. Mean age of these patients at diagnosis was 56,16 ±14,6. incidence rate of adverse events (grade I to IV) was 85,6%. Diarrhea was the predominant toxicity (4.6%) occurring at a high grade (grade III-IV). The 3-years OS rate of patients with CRC was 71%. OS decreased by age, and patients with age subgroup between 40 to 59 years had a better OS than the other age subgroups (60 to 79 years and >80 years) with a p-value of 0.0001. Occurence of toxicity (all grades and types) was linked to a higher survival rates compared to the group who had no toxicity noticed (p-value of 0.001).CONCLUSION: Our study shows that patients who had a polychemotherapy had a better OS than those who had monotherapy (p-value of 0.002). 

scholarly journals Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer

2020 ◽  
Vol 9 (12) ◽  
pp. 3848
Author(s):  
Thomas A. Odeny ◽  
Nicole Farha ◽  
Hannah Hildebrandand ◽  
Jessica Allen ◽  
Wilfred Vazquez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Medical Center ◽  
Survival Rates ◽  
Tumor Location ◽  
P Value ◽  
Inter Quartile Range ◽  
Quartile Range ◽  
Kaplan Meier ◽  
The University

There are differences in the incidence, clinical presentation, molecular pathogenesis, and outcome of colorectal cancer (CRC) based on tumor location. Emerging research suggests that the perioperative carcinoembryonic antigen (CEA) ratio (post-op/pre-op CEA) is a prognostic factor for CRC patients. We aimed to determine the association between CEA ratio, tumor location, and overall survival (OS) among patients with CRC. We analyzed 427 patients who underwent resection for CRC at the University of Kansas Medical Center. After excluding those without pre- or post-operative CEA data, 207 patients were classified as either high (≥0.5) or low (<0.5) ratio. Primary outcomes were as follows: (1) OS stratified by CEA ratio; (2) OS stratified by tumor location; (3) OS stratified by tumor location among those with CEA elevation > 5 ng/mL at the time of recurrence. The Kaplan–Meier method was used to estimate survival rates. The median age was 62 years (inter-quartile range 51–71), 55% were male, 41% were smokers, 71% had left-sided tumors, the median pre-operative CEA was 3.1 ng/mL (inter-quartile range (IQR) 1.5–9.7), and 57% had a CEA ratio ≥0.5. The OS rates were 65.1% and 86.3% in patients with high versus low CEA ratios, respectively (log-rank p-value = 0.045). The OS rates were 64.4% and 77.3% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.5). Among patients with CEA levels greater than 5 at the time of recurrence, the OS rates were 42.9% and 43.4% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.7). There was a significantly higher survival among patients with low CEA ratios than among those with high CEA ratios. There was no difference in OS between left- versus right-sided tumors. Among patients with CEA elevation > 5 ng/mL at the time of recurrence, there was no difference in OS between left versus right-sided tumors. These findings warrant validation in a larger cohort as our sample size was limited.

Incidence, morbidity and 5-year survival of colorectal cancer patients in the Kujawsko-Pomorskie voivodship in 2005-2011, based on data from the National Health Fund

2018 ◽  
Vol 90 (3) ◽  
pp. 1-5
Author(s):  
Andrzej Nowicki ◽  
Sylwia Dahms
Keyword(s):  
Colorectal Cancer ◽  
National Health ◽  
Survival Rates ◽  
Epidemiological Data ◽  
Probability Of Survival ◽  
Health Fund ◽  
National Health Fund ◽  
Kaplan Meier ◽  
Colorectal Cancer Patients ◽  
Epidemiological Situation

Introduction: The incidence, morbidity and 5-year survival rates illustrate the epidemiological situation of colorectal cancer and assess the effectiveness of the treatment. In Poland, the National Health Fund is the payer of benefits. The data related to morbidity, incidence, and 5-year survival may be supplementary to the epidemiological data of the National Cancer Registry. Objective: Analysis of benefits granted by NHF in Bydgoszcz to persons with diagnosed colorectal cancer in 2006-2011 including the assessment of incidence, morbidity and 5-year survival of the population in the Kujawsko-Pomorskie province. Material and methods: The study analyzed the benefits recorded in the database of the National Health Fund in Bydgoszcz in 2006-2011 given to patients with colorectal cancer. The Kaplan-Meier method and the gambling rate were used to determine the probability of survival. Results: In 2006-2011 men were offered 10.1% more benefits than women. The most frequent benefits were colorectal cancer (48.9%), rectal cancer (43.8%) and esophageal cancer (7.2%). In total, 50410 benefits were provided. Despite the increase in the number of women in the population, 388 more men died than women. The probability of survival was 46.8 %% and 42.6% for men and women, respectively, and 41.8%, 44.2% and 48.9% for colon cancer, esophageal and rectal folds, respectively. Conclusions: In the Kujawsko-Pomorskie province during the period of 2006-2011 the number of diagnosed colorectal cancers increased as did the overall number of benefits provided.There was also a downward trend for the total number of benefits granted in relation to the trend of the increase in the number of new diagnosed cases. Incidence and morbidity rates were variable, gradually increasing in subsequent years and amounted to 59/100000 and 67/100000, 355/100000 and 408/100000 in 2010 and 2011, respectively. The probability of 5-year survival was 45.2%. Diagnosis of a disease in patients above 69 years of age increased the likelihood of death.

scholarly journals Soluble SIGLEC5: A New Prognosis Marker in Colorectal Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3896
Author(s):  
Karla Montalbán-Hernández ◽  
Ramón Cantero-Cid ◽  
Roberto Lozano-Rodríguez ◽  
Alejandro Pascual-Iglesias ◽  
José Avendaño-Ortiz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Operating Characteristic ◽  
Prognostic Markers ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Significant Heterogeneity ◽  
Kaplan Meier ◽  
Prognosis Marker ◽  
Colorectal Cancer Patients ◽  
Healthy Participants

Colorectal cancer (CRC) is the second most deadly and third most commonly diagnosed cancer worldwide. There is significant heterogeneity among patients with CRC, which hinders the search for a standard approach for the detection of this disease. Therefore, the identification of robust prognostic markers for patients with CRC represents an urgent clinical need. In search of such biomarkers, a total of 114 patients with colorectal cancer and 67 healthy participants were studied. Soluble SIGLEC5 (sSIGLEC5) levels were higher in plasma from patients with CRC compared with healthy volunteers. Additionally, sSIGLEC5 levels were higher in exitus than in survivors, and the receiver operating characteristic curve analysis revealed sSIGLEC5 to be an exitus predictor (area under the curve 0.853; cut-off > 412.6 ng/mL) in these patients. A Kaplan–Meier analysis showed that patients with high levels of sSIGLEC5 had significantly shorter overall survival (hazard ratio 15.68; 95% CI 4.571–53.81; p ≤ 0.0001) than those with lower sSIGLEC5 levels. Our study suggests that sSIGLEC5 is a soluble prognosis marker and exitus predictor in CRC.

scholarly journals Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3592
Author(s):  
Chong-Chi Chiu ◽  
Chung-Han Ho ◽  
Chao-Ming Hung ◽  
Chien-Ming Chao ◽  
Chih-Cheng Lai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Survival Rates ◽  
Normal Weight ◽  
P Value ◽  
Administrative Claims ◽  
The Impact

It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients’ long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan–Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53–1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43–1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50–24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00–29.99 kg/m2), class I obesity (30.00–34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.

Tolerance, survival and adherence to treatment with methotrexate in patients with rheumatoid arthritis

2019 ◽  
pp. 13-17
Author(s):  
J.M. Sevillano Gutierrez ◽  
D. Capelusnik ◽  
E.E. Schneeberger ◽  
G. Citera
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Descriptive Statistics ◽  
P Value ◽  
Multiple Logistic Regression ◽  
Adherence To Treatment ◽  
Exact Test ◽  
Cumulative Survival ◽  
Kaplan Meier ◽  
Chi2 Test

Background: Methotrexate (MTX) is the most frequently used medication in patients with Rheumatoid Arthritis (RA). However, several authors have questioned its success due to the presence of adverse events and the lack of adherence. Objectives: to determine cumulative survival of MTX, frequency and type of adverse events and causes of discontinuation in patients with RA. Methods: consecutive patients 18 years and older with a diagnosis of RA (ACR/EULAR 2010 criteria), who had begun treatment with MTX during their disease were included. Sociodemographic, clinical and therapeutic data were collected. Date of initiation and suspension of MTX, route of administration, concomitant treatments, consumption of coffee and tobacco, presence of adverse events (AE) were all consigned. Adherence was evaluated using the Compliance Questionnaire Rheumatology questionnaire 5-item summary version (CQR5). Statistical analysis: descriptive statistics. Chi2 test or Fisher’s exact test; Survival of treatment by Kaplan-Meier and log Rank. Multiple logistic regression. A p value <0.05 was considered significant.

scholarly journals Cancer in Africa: Is It a Genetic or Environmental Health Problem?

2020 ◽  
Vol 10 ◽  
Author(s):  
Abeer A. Bahnassy ◽  
Mona S. Abdellateif ◽  
Abdel-Rahman N. Zekri
Keyword(s):  
Health Problem ◽  
African Ancestry ◽  
Survival Rates ◽  
Mortality Rates ◽  
Sociocultural Factors ◽  
Major Health Problem ◽  
Major Health ◽  
Incidence And Mortality ◽  
Environmental Health Problem ◽  
African Patients

Patients of African ancestry have the poorest outcome and the shortest survival rates from cancer globally. This could be attributed to many variables including racial, biological, socioeconomic and sociocultural factors (either single, multiple or combined), which may be responsible for this major health problem. We sought to assess the most common types of cancer that endanger the health of the African people, and tried to investigate the real differences between African and other Non-African patients regarding incidence, prevalence and mortality rates of different cancers. Therefore, identifying the underlying aetiological causes responsible for the increased incidence and mortality rates of African patients will allow for changing the current plans, to make optimized modalities for proper screening, diagnosis and treatment for those African patients, in order to improve their survival and outcomes.

scholarly journals The prognostic role of tissue TLR2 and TLR4 in colorectal cancer

2020 ◽  
Vol 477 (5) ◽  
pp. 705-715
Author(s):  
Ines Beilmann-Lehtonen ◽  
Camilla Böckelman ◽  
Harri Mustonen ◽  
Selja Koskensalo ◽  
Jaana Hagström ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factor ◽  
Distant Metastases ◽  
University Hospital ◽  
Rank Test ◽  
Pathogen Invasion ◽  
Kaplan Meier ◽  
Node Positive Disease ◽  
Colorectal Cancer Patients ◽  
Dukes C

Abstract Colorectal cancer (CRC), the second most common cancer globally, resulted in 881,000 deaths in 2018. Toll-like receptors (TLRs) are crucial to detecting pathogen invasion and inducing the host’s immune response. This study aimed to explore the prognostic value of TLR2 and TLR4 tumor expressions in colorectal cancer patients. We studied the immunohistochemical expressions of TLR2 and TLR4 using tissue microarray specimens from 825 patients undergoing surgery in the Department of Surgery, Helsinki University Hospital, between 1982 and 2002. We assessed the relationships between TLR2 and TLR4 expressions and clinicopathological variables and patient survival. We generated survival curves using the Kaplan-Meier method, determining significance with the log-rank test. Among patients with lymph node–positive disease and no distant metastases (Dukes C), a strong TLR2 immunoactivity associated with a better prognosis (p < 0.001). Among patients with local Dukes B disease, a strong TLR4 immunoactivity associated with a worse disease-specific survival (DSS; p = 0.017). In the multivariate survival analysis, moderate TLR4 immunoactivity compared with strong TLR4 immunoactivity (hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.49–0.89, p = 0.007) served as an independent prognostic factor. In the multivariate analysis for the Dukes subgroups, moderate TLR2 immunoactivity (HR 2.63, 95% CI 1.56–4.44, p < 0.001) compared with strong TLR2 immunoactivity served as an independent negative prognostic factor in the Dukes C subgroup. TLR2 and TLR4 might be new prognostic factors to indicate which CRC patients require adjuvant therapy and which could spare from an unnecessary follow-up, but further investigations are needed.

Long-term maintenance capecitabine and celecoxib improved clinical outcomes by targeting colorectal cancer micrometastasis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14513-14513
Author(s):  
M. Zhang ◽  
S. Curley ◽  
C. Ng ◽  
B. Kurland ◽  
S. Krishnan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Stage Iv ◽  
Complete Response ◽  
Kaplan Meier ◽  
Stage Iv Disease ◽  
Disease Site ◽  
Colorectal Cancer Patients

14513 Background: Role of mainteance therapy after achieving complete response (CR) remain undefined for patients with metasatic colorectal cancer. We studied prognostic and treatment factors including maintenance capecitabine and celecoxib (XCEL) in all 19 unresectable metastatic colorectal cancer patients (pts) who had CR from the prior XCEL study. Methods: Event charts are used to summarize the timeline of the various treatments. Kaplan-Meier survival estimates and univariate log-rank tests were used to evaluate RFS and OS as time from CR. Prognostic and treatment factors included: tumor size, metastasis number (9 solitary disease), site (13 being extrahepatic), stage on diagnosis (stage II versus III/IV), disease free interval prior to stage IV disease, surgery (5 R0, 3 R1–2 resections), lactate dehydrogenase levels, first-line irinotecan chemotherapy, radiation (9 pts ≥ 45 Gy, 3 Pts < 45 Gy), and maintenance XCEL (duration 0–50.3 months). Results: Nine of 19 patients experienced recurrence (median 13 months after CR), and 4 died during the follow-up period (median 31 months after CR). The 2-year RFS for the unresected and R1–2 resected patients was 71% versus 20% for the R0 resected patients (p = 0.07). This paradoxical RFS pattern corresponded to a RFS advantage for maintenance XCEL (p = 0.002), but not any other prognostic or treatment factors. All relapses occurred in situ following discontinuation of XCEL except for the surgical cases. Patients undergoing maintenance XCEL also benefited in OS (p = 0.04). The median OS from XCEL and from onset of metastasis reached 51.9 months (95% CI, 45 months- not reached [NR]) and 73.3 months (95% CI, NR-NR months) respectively. Conclusions: Maintenance XCEL targets colorectal micrometastases and produces a paradoxical RFS and OS advantage among the high-risk unresected/R1–2 resected patients than R0 resected patients. Prospective studies are warranted to validate roles of maintenance XCEL in the treatment of colorectal micrometastases. No significant financial relationships to disclose.

Feasibility of the combination chemotherapy with 5-fluorouracil and oxaliplatin in metastatic gastric or colorectal cancer patients more than age of 80.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 136-136
Author(s):  
Kyu-Hyoung Lim ◽  
Hui-Young Lee ◽  
Sung Bae Park ◽  
Seo-Young Song
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Combination Chemotherapy ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Salvage Chemotherapy ◽  
Significant Difference ◽  
Colorectal Cancer Patients

136 Background: The combination chemotherapy of 5-fluorouracil (5-FU) and Oxaliplatin is usually used in gastric cancer (GC) and colorectal cancer (CRC). The safety and efficacy of the combination chemotherapy in patients over 80-years old has not been established yet. The purpose of this study was to assess the clinical outcomes and tolerability in the combination with 5-FU, leucovorin and oxaliplatin as first-line treatment in extremely elderly patients with GC or CRC. Methods: Eligibility included: 1) more than 80-years old, 2) metastatic gastric or colorectal cancer 3) chemotherapy-naive, 4) ECOG PS 0-1, 5) adequate organ function. Patients received the combination chemotherapy of 5-FU, leucovorin and oxaliplatin. Response evaluation was done every 8 weeks with RECIST criteria and toxicity was evaluated with NCI-CTCAE. Results: Between Sep 2008 and Nov 2014, 28 patients were reviewed and composed of equal numbers of GC and CRC. The median age was 82.2 years (80.0-85.6yrs) in GC and 81.1 years (80.0-89.3) in CRC, respectively. Total administrated cycles were 89 with median cycles of 5 in GC and 112 with median cycles of 11 in CRC. The median progression-free survival (PFS) and overall survival (OS) in GC were 5.4 months and 6.6 months, as compared with 7.3 months and 8.1 months, respectively. There were no significant difference in PFS (p = 0.94) and OS (p = 0.28) between GC and CRC. Overall survival rates at 1 year were 35.7% and 42.9%, respectively. After disease progression, salvage chemotherapy in GC and CRC was administrated in 1 and 7 patients, respectively. Common grade 3/4 hematology toxicities in both group were neutropenia, anemia. Frequent non-hematological toxicities were anorexia (60%), neuropathy (40%) and mucositis (25%), which were grade 1/2. Conclusions: The combination chemotherapy of 5-fluorouracil (5-FU) and Oxaliplatin has limited effect on improvement of OS in metastatic gastric or colorectal cancer patients more than age of 80. Further studies on the role of chemotherapy in these extremely elderly patients are needed.

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