scholarly journals Trends and Clinical Outcomes in Young-onset Colorectal Cancer Patients

2020 ◽  
Vol 49 (11) ◽  
pp. 848-856 ◽  
Author(s):  
Serene SN Goh ◽  
Edith XL Loo ◽  
Daniel JK Lee
Keyword(s):  
Colorectal Cancer ◽  
Emergency Surgery ◽  
Elective Surgery ◽  
Stage Iv ◽  
Tertiary Hospital ◽  
Signet Ring Cell ◽  
Factors Affecting ◽  
Young Onset ◽  
Signet Ring ◽  
Colorectal Cancer Patients

Introduction: Young individuals with colorectal cancer (CRC) tend to be diagnosed at advanced stages and are not routinely included in screening programmes. This study describes the incidence, disease pattern and factors affecting overall survival in young- onset CRC. Methods: A retrospective study of young-onset CRC patients diagnosed between 2010 and 2017 in a tertiary hospital was conducted. Results: There were 99 patients, 69.7% had left-sided while 30.3% had right-sided CRC. The mean age was 43.3 years (43.3±5.0) and 62 patients (62.6%) were male. The incidence of young-onset CRC has been on the rise since 2014. Out of 99 patients, 65 (65.7%) underwent elective surgery, 30 (30.3%) underwent emergency surgery and the remainder 5 (4.0%) were palliated. The most common presenting complaints for patients who underwent elective surgery were abdominal pain, per-rectal bleeding and altered bowel habits. For patients who required emergency surgery, 20 (66.6%) presented with intestinal obstruction and 10 (33.3%) had intestinal perforation. There were 42 (42.4%) stage III CRC and 20 (20.2%) stage IV CRC. The most frequent metastatic site was the liver (20/20, 100%). Five patients had signet ring cells (5.1%) in their histology while 15 (15.2%) had mucinous features. The overall 5-year survival of young-onset CRC was 82.0%. Advanced overall stage (hazard ratio (HR) 6.1, CI 1.03–3.62) and signet ring histology (HR 34.2, CI 2.24–5.23) were associated with poor prognosis. Conclusion: Young-onset CRC tend to be left-sided with advanced presentations. However, their 5-year survival remains favourable as compared to the general population. Keywords: Colorectal screening in the young, early-onset colorectal cancer, signet ring cell colorectal cancer

scholarly journals Colorectal Signet Ring Cell Carcinoma in a Young Pregnant Woman

2020 ◽  
Vol 13 (1) ◽  
pp. 182-187
Author(s):  
Francisco Ibargüengoitia Ochoa ◽  
Gerardo Miranda Dévora ◽  
Leonardo Silva Lino ◽  
Cintia Sepulveda Rivera ◽  
Diego González Vázquez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cell Carcinoma ◽  
Stage Iv ◽  
Signet Ring Cell Carcinoma ◽  
Signet Ring Cell ◽  
High Morbidity ◽  
Cancer Stage ◽  
Signet Ring ◽  
Histologic Differentiation ◽  
Ring Cell

Colorectal cancer during pregnancy is one of the less common neoplasms with an incidence of 0.8 in 100,000 pregnancies. Primary colonic signet ring cell carcinoma is a weird variety, characterized by a poor histologic differentiation, with a high morbidity-mortality rate. The case of a 24-year-old patient with a 22-week-old pregnancy and colorectal cancer stage IV in palliative state is presented, with a devastating result. Early diagnosis represents a challenge because of the presentation form and the histologic aggressiveness of this disease. We suggest that colorectal cancer during pregnancy must be treated by a multidisciplinary team.

scholarly journals Preoperative C-reactive protein as a prognostic factor in stage IV colorectal cancer

2021 ◽  
Author(s):  
Hiroka Kondo ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Shintaro Ishikawa ◽  
Takatsugu Fujii ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rate ◽  
Stage Iv ◽  
Time Frame ◽  
Long Term Results ◽  
Factors Affecting ◽  
Lower Survival Rate ◽  
Reactive Protein ◽  
Stage Iv Colorectal Cancer ◽  
Colorectal Cancer Patients

Background A prognosis for stage IV colorectal cancer is generally poor. As a result, the development of an appropriate treatment strategy for each individual with this disease within a limited time frame is important. Few studies have been made of CRP in stage IV cases of colorectal cancer so it is unclear whether CRP is a useful prognostic marker for this disease. Thus, the purpose of this study was to clarify the relationship between the preoperative CRP level and the prognosis of stage IV colorectal cancer. Patients and methods Between April 2007 and December 2015, 384 patients with stage IV colorectal cancer who underwent primary resection were included. Patients were divided into high (HCG) and low (LCG) CRP groups based on a preoperative CRP cut-off value of ≥1.0 mg/dL. Postoperative short- and long-term results were examined retrospectively. Results The 5-year survival rate was 24.6% for HCG and 36.7% for LCG, indicating the survival rate for HCG was lower. The study was limited to patients who were unable to undergo R0 surgery. Preoperative CEA levels were higher in HCG while the postoperative chemotherapy induction rate was lower. HCG also showed a significantly lower survival rate than LCG. Multivariate analysis showed that CRP levels above 1.0 mg/dL, poorly differentiated histopathology, and the absence of chemotherapy were risk factors affecting overall survival. Conclusion These results suggest that the preoperative CRP level may be a useful biomarker for the prognosis of incurable stage IV colorectal cancer.

scholarly journals Intraoperative perfusion assessment of the proximal colon by a visual grading system for safe anastomosis after resection in left-sided colorectal cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyo Seon Ryu ◽  
Seok-Byung Lim ◽  
Eu-Tteum Choi ◽  
Inho Song ◽  
Jong Lyul Lee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Anastomosis ◽  
Proximal Colon ◽  
Grading System ◽  
Visual Grading ◽  
Old Patients ◽  
Factors Affecting ◽  
Poor Grade ◽  
Perfusion Assessment ◽  
Colorectal Cancer Patients

AbstractWe aimed to evaluate the clinical feasibility of a new visual grading system. We included 50 patients who underwent resection of primary colorectal cancer. Before anastomosis, the marginal vessel was cut and the perfusion status was assessed by a visual grading system. The visual grading system is comprised of five grades according to the bleeding from the marginal vessel and is categorized into 4 groups: good (grade A and B), moderate (grade C), poor (grade D) and none (grade E). Colorectal anastomosis was performed only in the good and moderate groups. We compared postoperative outcomes between the good and moderate groups and analysed the factors affecting the perfusion grade. Among the patients, 48% were grade A, 12% were grade B, and 40% were grade C. There was no anastomotic leakage. Only one patient with grade C showed ischemic colitis and needed reoperation. Age was the only factor correlated with perfusion grade in multivariate analysis (OR 1.080, 95% CI 1.006–1.159, p = 0.034). The perfusion grades were significantly different between > 65 and < 65 year-old patients (> 65, A 29.2% B 12.5% C 58.3% vs. < 65, A 65.4% B 11.5% C 23.1%, p = 0.006). Our intraoperative perfusion assessment that uses a cutting method and a visual grading system is simple and useful for performing a safe anastomosis after colorectal resection. If the perfusion grade is better than grade C, an anastomosis can be performed safely. Age was found to be an important factor affecting the perfusion grade.

These studies indicate that homologous blood transfusion affects the outcome of clinical diseases in both beneficial and adverse ways. Experimental situations are not suitable for randomized clinical trials - transfusions cannot be given to prevent the onset of diabetes or wound strength measured in man following receipt of homologous or autologous blood. These experimental observations indicate that the outcomes of numerous clinical diseases which have not been studied may be manipulated by the use of homologous blood or that transfusion should be avoided. Several studies indicate that changes in immune function following transfusion are permanent. The number of clinical phenomena associated with immune suppression and attributable to blood transfusion is unknown. SUMMARY Given the evidence presented here it would be foolish to suggest that transfusion of homologous blood has no immunologic consequences for the recipient. Blood transfusion is the oldest form of transplant - no one would argue that transplantation between unrelated individuals has no influience on the immune system. In organ transplantation the immunologic sequelae are permanent and there is evidence that the same is true following homologous blood transfusion. Lymphocytopenia is present one year following surgery for Crohn's disease if patients receive perioperative blood transfusion (43). Colorectal cancer patients transfused more than seven years prior to diagnosis have significantly reduced numbers of lymphocytes and lower natural killer cytotoxicity than colorectal cancer patients who have never been transfused (44). Transfusion of neonates causes suppression of lymphocyte reactivity which is still demonstrable 25 to 30 years later (45). There is evidence that transfusion at any time prior to elective surgery increases susceptibility to infectious complications (14) and otherwise healthy transfused individuals may be at increased risk of developing malignancies (46). All the longterm consequences of blood transfusion are not negative: Survival of transplants is prolonged by pretransplant transfusion and some women suffering from recurrent spontaneous abortion can deliver at term if previously transfused with their spouse's leukocytes. In the future we will be able to transfuse blood without causing immune perterbations and the consequent clinical phenomena. Studies presented here suggest that removal of donor leukocytes reduces the risk of infection and cancer recurrence. The technology has not reached the point of reducing the leukocyte number in transfused blood below 10^/unit. An alternative which is increasingly being utilized is autologous blood programs. Physicians are discovering that patients tolerate hemoglobin levels which were previously unacceptably low and many patients prefer being anemic over the risks of receiving homologous blood. Since transfusion is an identifier of high cost hospitalized patients, alternatives to routine blood use are being studied in hopes of safely reducing the costs of transfusion. REFERENCES 1. Jubert AV, Lee ET, Hersh EM, McBride CM. J Surg Res 15:399-403, 1973. 2. M 19 u4n ( s3t ) e3r4A6-M 35 , 2 W , i1n9c8h1u . rch RA, Keane RM, Shatney CH, Ernst CB, Nuidema GD. Ann Surg

1995 ◽  
pp. 300-300
Keyword(s):  
Colorectal Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Elective Surgery ◽  
Autologous Blood ◽  
Homologous Blood ◽  
Homologous Blood Transfusion ◽  
One Year ◽  
Colorectal Cancer Patients

Prognostic Significance of Peritoneal Metastasis in Stage IV Colorectal Cancer Patients With R0 Resection

2017 ◽  
Vol 60 (10) ◽  
pp. 1041-1049 ◽  
Author(s):  
Keiichi Arakawa ◽  
Kazushige Kawai ◽  
Soichiro Ishihara ◽  
Keisuke Hata ◽  
Hiroaki Nozawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Peritoneal Metastasis ◽  
Prognostic Significance ◽  
Stage Iv ◽  
R0 Resection ◽  
Stage Iv Colorectal Cancer ◽  
Colorectal Cancer Patients
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