scholarly journals Factors associated with the survival of colorectal cancer in Mexico

2020 ◽  
Vol 18 (3) ◽  
pp. 315-324 ◽  
Author(s):  
Carlos Quezada-Gutiérrez ◽  
María Teresa Álvarez-Bañuelos ◽  
Jaime Morales-Romero ◽  
Clara Luz Sampieri ◽  
Raúl Enrique Guzmán-García ◽  
...  

Background/Aims: Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment.Methods: A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis.Results: Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (<i>P</i>= 0.026) and an advanced clinical stage of 22% (<i>P</i>< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (<i>P</i>= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1–54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2–4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1–2.9).Conclusions: Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16040-e16040
Author(s):  
Fernando Namuche ◽  
Claudio J. Flores

e16040 Background: The incidence of colorectal cancer (CRC) in Peru has increased in the last decades. But the use of monoclonal antibodies is restricted in our population because of insureance issues. Approximately 20% of patients with CRC already have metastases at diagnosis. There is a lack of data in the benefits of our population with the use of anti-VEGF and anti-EGFR that this study intents to fill. Methods: We retrospectively reviewed the electronic medical records of 58 patients with metastatic CRC, KRAS, NRAS and BRAF wild type from one specialized Peruvian cancer center between 2006 and 2017 Descriptive results for numeric variables were presented as means with standard deviation (SD) or medians with interquartile range (IQR), depending on their distributions; otherwise, we expressed the qualitative variables as numbers with percentages. The survival analysis was performed with Kaplan Meier method for PFS and OS, comparing the curves with Log Rank test. A multivariate analysis was performed using the Cox regression model with the statistically significant variables found in the univariate analysis. Results: There was 29 patients in the anti-EGFR arm, and 29 patients in the anti-VEGF arm. Patients that received first anti-EGFR and then anti-VEGF had better OS [HR, 0.87; 95% CI,0.019-0.811; p < 0.001] than patients that received first anti-VEGF and then anti-EGFR. Multpile Cox regressión analysis demonstrated that metastasectomy, debut with less thant 2 metastasis site, left side tumor, and histologic grade were associated with better OS. Conclusions: Patients with mCRC RAS and BRAF wild type that received anti-EGFR and then anti-VEGF had better OS than patients that received anti-VEGF and then anti-EGFR.


2020 ◽  
pp. 1286-1297
Author(s):  
Samvel Bardakhchyan ◽  
Sergo Mkhitaryan ◽  
Davit Zohrabyan ◽  
Liana Safaryan ◽  
Armen Avagyan ◽  
...  

PURPOSE In Armenia, colorectal cancer (CRC) is one of the most frequently diagnosed cancers. It is in the third place by incidence. The aim of this study was to evaluate treatment and outcomes of CRC in Armenia during the last 9 years. MATERIALS AND METHODS For this retrospective hospital-based study, we have collected data from two main oncology centers in Armenia: National Oncology Center and “Muratsan” Hospital of Yerevan State Medical University. The information about patients with CRC who were treated at these two centers between January 1, 2010 and July 1, 2018 was collected from the medical records. Log-rank test and Kaplan-Meier curves were used for survival analysis. Prognostic factors were identified by Cox regression. RESULTS A total of 602 patients with CRC were involved in the final analysis. Median follow-up time was 37 months (range, 3-207 months). A total of 8.6% of patients had stage I, 32.9% stage II, 38.0% stage III, and 17.6% stage IV cancer; for 2.7% patients, the stage was unknown. The main independent prognostic factors for overall survival (OS) were tumor stage, grade, and histology. Adjuvant chemotherapy has been shown to improve survival in stage II colon cancer and stage III rectal but not in stage II rectal cancer. Radiotherapy did not yield survival improvement in stage II or III rectal cancer. Three- and 5-year OS rates were 62.9% and 51.8% for all stages combined and 79.7% and 68.5% for stages I-II, 62.5% and 48.4% for stage III, and 24.4% and 17% for stage IV respectively. CONCLUSION As seen from our results, our survival rates are lower than those of the developed world. Additional research is needed to identify the underlying reasons and to improve patients’ treatment and outcomes in Armenia.


2021 ◽  
Author(s):  
Xuetong Rong ◽  
Haiyi Liu ◽  
Hongmei Yu ◽  
Jian Zhao ◽  
Jie Wang ◽  
...  

Abstract Objective: To evaluate the efficacy and safety of apatinib combined with FOLFIRI in the first-line treatment of advanced metastatic colorectal cancer (mCRC) and explore potential factors of efficacy. Methods: Twenty mCRC patients treated at Affiliated Cancer Hospital of Shanxi Medical University from March 2017 to March 2019 were included according to the enrolment criteria. They provided informed consent and were treated with apatinib combined with FOLFIRI according to the scheduled regimen until disease progression or unacceptable toxicity occurred. The primary endpoint was OS. The secondary endpoints included PFS, ORR, DCRand safety. OS and PFS were calculated using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were used to evaluate independent prognostic factors of OS and PFS. R was used to determine cut-off values for biochemical indicators. Forest maps were drawn for Cox univariate results and the relationships between NLR and ECOG, which were significant in univariate analysis, and OS were represented by Kaplan-Meier curves. Results: The median OS and PFS were 16.135 months (95% CI: 9.211–22.929) and 6 months (95% CI: 5.425–6.525). Multivariate Cox analysis showed that NLR and CEA were independent prognostic factors. The most common grade 3–4 adverse events were hypertension, diarrhoea, increased alkaline phosphatase, decreased leukocytes and decreased neutrophils. Conclusion: Apatinib combined with FOLFIRI for the first-line treatment of advanced unresectable mCRC showed good efficacy and safety. The baseline NLR was predictive of efficacy, and a low baseline NLR (HR: 0.2895, P=0.0084) was associated with improved OS.


2021 ◽  
Vol 27 (2) ◽  
pp. 69-78
Author(s):  
Ariffin Nasir ◽  
Norhaila Adenam ◽  
Surini Yusoff ◽  
Fahisham Taib ◽  
Norsarwany Mohamad

Introduction: Ewing Family Tumour (EFT) is a group of rare malignant and aggressive tumour, with a considerably improved prognosis. However, there is lack of study on the outcome of children with EFT in Malaysia. Objectives: The study aimed to evaluate the Overall Survival (OS) rate, Event Free Survival (EFS) rate and identify the prognostic factors that determined the EFT outcome at Hospital Universiti Sains Malaysia (USM). Methodology: A retrospective record review of children aged 0-18 years with EFT was done. Patients were identified from the registration data in the Oncology Unit and Record Office of Hospital USM. For patients with untraceable information or deceased, a letter was sent to State Registry to obtain the outcome of the patient. The association between demographics and patients’ clinical factors was determined using the Cox regression. Survival curves were estimated by the Kaplan-Meier method and were compared using the Log-rank test. Results: There were 51 patients identified but 29 of them were eligible for the study. The mean duration of follow-up was 21 months. The OS rate at 1, 2, 3 and 5 years were 62.1%, 44.8%, 30.2% and 21.6% respectively. The EFS rate at 1, 2, 3 and 5 years were 41.9%, 26.7%, 17.8% and 0% respectively. Multivariate Cox regression analysis showed that the presence of surgical intervention (p = 0.030) and major complications (p = 0.045) were the significant prognostic factors to the survival of EFT. Conclusion: The survival rate of EFT among our patients was comparable to other developing countries, with surgical intervention and the presence of major complications as independent prognostic factors.


2020 ◽  
Vol 57 (2) ◽  
pp. 172-177
Author(s):  
Samuel AGUIAR JUNIOR ◽  
Max Moura de OLIVEIRA ◽  
Diego Rodrigues Mendonça e SILVA ◽  
Celso Abdon Lopes de MELLO ◽  
Vinicius Fernando CALSAVARA ◽  
...  

ABSTRACT BACKGROUND: Hospital-based studies recently have shown increases in colorectal cancer survival, and better survival for women, young people, and patients diagnosed at an early disease stage. OBJECTIVE: To describe the overall survival and analyze the prognostic factors of patients treated for colorectal cancer at an oncology center. METHODS: The analysis included patients diagnosed with colon and rectal adenocarcinoma between 2000 and 2013 and identified in the Hospital Cancer Registry at A.C.Camargo Cancer Center. Overall 5-year survival was estimated using the Kaplan-Meier method, and prognostic factors were evaluated in a Cox regression model. Hazard ratios (HR) are reported with 95% confidence intervals (CI). RESULTS: Of 2,279 colorectal cancer cases analyzed, 58.4% were in the colon. The 5-year overall survival rate for colorectal cancer patients was 63.5% (65.6% and 60.6% for colonic and rectal malignancies, respectively). The risk of death was elevated for patients in the 50-74-year (HR=1.24, 95%CI =1.02-1.51) and ≥75-year (HR=3.02, 95%CI =2.42-3.78) age groups, for patients with rectal cancer (HR=1.37, 95%CI =1.11-1.69) and for those whose treatment was started >60 days after diagnosis (HR=1.22, 95%CI =1.04-1.43). The risk decreased for patients diagnosed in recent time periods (2005-2009 HR=0.76, 95%CI =0.63-0.91; 2010-2013 HR=0.69, 95%CI =0.57-0.83). CONCLUSION: Better survival of patients with colorectal cancer improves with early stage and started treatment within 60 days of diagnosis. Age over 70 years old was an independent factor predictive of a poor prognosis. The overall survival increased to all patients treated in the period 2000-2004 to 2010-2013.


2020 ◽  
Author(s):  
Feng Huang ◽  
Yuanfei Peng ◽  
Qing Ye ◽  
Jinhu Chen ◽  
Yangming Li ◽  
...  

Abstract Background: Genetic alterations play an important role in the progression of colorectal cancer (CRC). Identifying new biomarkers to assess the prognosis of patients with CRC is critical. Cartilage Intermediate Layer Protein 2 (CILP2) gene, screened from the TCGA database by bioinformatics, may be closely related to the progression of CRC. CILP2 was barely reported with clinical features of tumors.Materials and methods: Clinical information and RNA-seq data were derived from the TCGA colorectal carcinoma cohort. CILP2 expression at mRNA level was estimated by bioinformatical analysis of TCGA cases. Tissue microarray (TMA) was constructed containing paraffin-embedded 64 pairs of CRC and matched adjacent normal tissues. The expression at the protein level was detected in 64 pairs of CRC and matched adjacent normal tissues by immunohistochemical analysis. CILP2 expression level and its clinical value were estimated by bioinformatical analysis with linear and logistic regression. Survival analysis was performed between high and low groups of CILP2 expression by Cox regression analysis, and the P-value was calculated by the log-rank test. Kaplan-Meier curves were tested by the log-rank test.Results: CILP2 was statistically significantly higher expressed in the CRC tissues when compared with paired adjacent normal tissues in the TCGA cohort (P<0.001) and in the TMA cohort (P=0.001). Also, CILP2 high-expression was strongly correlated with T3/4 stage (P=0.001), N1/2/3 stage (P=0.005), M1 stage (P=0.048), and higher clinical stage (UICC 2010 stage) (P<0.001) in TCGA cohort, and also positively associated with T3/4 stage (P=0.022) and higher clinical stage (UICC 2010 stage) (P=0.03) in TMA cohort. Furthermore, CILP2 overexpression predicted poor prognosis and could be as an independent prognostic factor (P=0.003).Conclusion: We revealed that CILP2 is associated with advanced stages and could play a role as an independent predictor of poor survival in CRC.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4034-4034
Author(s):  
Gustavo Cartaxo de Lima Gössling ◽  
Fernando de Souza Pereira ◽  
Rafaela Kathrine da Silva ◽  
Leonardo de Brittes Andrade ◽  
Nicolas Peruzzo ◽  
...  

4034 Background: Indications for PM in pts with mCRC are often based on the presence of favorable prognostic factors. We aimed to analyze the prognostic factors and outcomes of pts treated with PM for mCRC. Methods: We retrospectively identified pts with mCRC who underwent PM with curative intent between Jan 1985 and Dec 2019 at Hospital de Clínicas de Porto Alegre. Demographics, clinicopathological features and previously described prognostic factors were collected. Univariate Cox regression was performed and followed by Kaplan-Meier (KM) curves with log-rank test when significant. Results: Fifty-eight pts underwent PM. Demographics are described in Table. Wedge resection was performed in 87.9% and margins were negative in 89.1%. Mean number of lesions was 2.4 ± 1.7, with the largest measuring 1.7 ± 0.9 cm. Two or more resections were performed in 36.2%, nodal sampling in 27.3%, and nodal disease was found in 5.2%.Thirty-day readmission rate was 5.2%. One pt had a Clavien-Dindo grade IIIb complication. RAS/RAF/MMR and CK20/CDX2 were available for 13.8% and 58.6% of the sample. Median PFS 14 months (m) (95% CI 10.4 - 17.5), median OS 58 m (95% CI 33.5 - 82.4) and 5-year survival 49.8%. Unfavorable prognostic factors for OS included disease-free interval (DFI) < 24 m (40 m, 95% CI 31.8 - 48.1 vs 85 m, 95% CI 75.7 -96.2; P < 0.005), synchronous presentation (33 m, 95% CI 23.9 - 42.0 vs 77 m, 95% CI 50.7 - 103.2; P < 0.001), largest lesion size ≥ 2cm (37 m, 95% CI 22.9 - 51.0 m vs 81 m, 95% CI - 33.7 - 128.2, P = 0.019) and lack of CK20 expression (19 m, 95% CI 12.1 - 27.2 vs. 83 m, 95% CI 46.9 - 119.0; P < 0.001). More than one lesion at presentation was prognostic for PFS (11 m, 95% CI 7.6 - 14.3 vs 23 m, 95% CI 0.1 - 59.2; P = 0.003) but not OS (P = 0.11). Grade was significant at Cox regression but showed no effect in further analysis. Neither CEA at baseline or relapse, resection margins, Charlson comorbidity index (CCI) or adjuvant chemotherapy were prognostic. Conclusions: Our results suggest a benefit for select pts and PM. Lack of CK20 expression may be associated with more aggressive disease and shorter OS. Additional molecular prognostic factors after PM should be further explored. [Table: see text]


2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
James Joseph Yahaya ◽  
Tonny Okecha ◽  
Michael Odida ◽  
Henry Wabinga

Background. Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients with prostate cancer in Uganda is poor. The aim of this study was to determine the 3-year overall survival rate of a cohort of patients with prostate cancer residing in Kyadondo County who were diagnosed from 2012 to 2014. The secondary objective was to correlate the overall survival with the clinicopathological prognostic factors. Materials and Methods. This was a retrospective cohort study which involved 136 patients who were diagnosed histologically with prostate cancer at the department of pathology between 2012 and 2014. The cases were registered at the Kampala cancer registry and followed up to 31st December 2017. Data analysis was done using STATA version 12.0. The Kaplan-Meir curves were used for analysis of the 3-year overall survival rate. Hazard ratio (HR) and Log-rank test at 95% confidence interval under Cox-regression model were used to evaluate the effect of the covariates on the 3-year overall survival rate. p<0.05 was considered statistically significant. Results. More than half of the cases, 55.9% (n=76) had Gleason score >8. Most of the patients, 67.7% (n=92) had advanced disease at diagnosis. The 3-year overall survival rate was 67.6% with median survival of 36.5 months and range of 0–65 months. Clinical stage of the patients (HR = 1.65, p=0.039), Gleason score (HR = 1.88, p=0.008), and lymphovascular invasion (HR = 0.37, p=0.002) were the independent predictors of the 3-year overall survival rate in this study. Conclusion. The 3-year overall survival of prostate cancer patients in Uganda is poor. Most of the patients with are diagnosed with advanced clinical stages (stage III and IV). The Gleason score, clinical stage and lymphovascular invasion can powerfully predict independently the overall survival of patients with prostate cancer. This implies that the Gleason score, clinical stage and lymphovascular invasion may be used to predict the overall survival of patients with prostate cancer even prior prostatectomy.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yifan Sun ◽  
Haihua Long ◽  
Lin Sun ◽  
Xiujuan Sun ◽  
Liping Pang ◽  
...  

Abstract Background Phosphoglucomutase (PGM), a key enzyme in the metabolism of glucose-1-phosphate and glucose-6-phosphate, has been found to be associated with proliferation, invasion, and metastasis of cancer. However, the expression and function of PGM5 in colorectal cancer (CRC) remains unknown. Methods We tested PGM5 mRNA and protein expression levels in 79 CRC tissue and their matched adjacent tissue samples by qRT-PCR and immunohistochemistry, respectively. Overall survival (OS) was estimated with the Kaplan–Meier method and compared between groups with the log-rank test. We performed multivariable Cox regression analyses to identify factors associated with CRC risk. The cell proliferation, migration and invasion abilities of CRC cells were detected by using CCK-8, Transwell migration and invasion assays, respectively. Results The PGM5 protein levels expression in CRC tissues were significantly lower than those in the adjacent tissues (t = 5.035, P < 0.001), and Kaplan–Meier analysis indicated that low PGM5 expression were significantly associated with poor overall survival (P = 0.0069). Univariate and multivariate analyses demonstrated that PGM5 was an independent risk factor for overall survival (hazard ratio = 0.3951, P = 0.014). PGM5 overexpression significantly inhibited the proliferation, invasion and migration abilities of CRC cells. On the contrary, knockdown of PGM5 promotes the invasion and migration of CRC cells. Conclusions PMG5 regulates proliferation, invasion, and migration in the CRC and decreased PGM5 is associated with poor prognosis. Therefore, PGM5 is a promising biomarker in CRC and decreased PGM5 may predict poor overall survival in patients with CRC.


2019 ◽  
Vol 39 (8) ◽  
Author(s):  
Jingfeng Zhang ◽  
Sifeng Hu ◽  
Yansen Li

Abstract Keratin 18 (KRT18) has been suggested to be overexpressed in most types of human tumor, but the expression pattern of KRT18 in colorectal cancer (CRC) remained unknown. In our research, KRT18 protein expression was markedly increased in CRC cancer tissues and cell lines compared with adjacent normal colorectal tissues and normal colonic epithelial cell line, respectively. Meanwhile, we observed high KRT18 expression was associated with advanced clinical stage, deep tumor invasion, lymph node metastasis, distant metastasis, poor differentiation and unfavorable prognosis in CRC patients. Multivariate Cox regression analysis showed high expression of KRT18 was an unfavorable independent predictor for overall survival in CRC patients. The in vitro studies indicated down-regulation of KRT18 expression depressed CRC cell viability, migration and invasion. In conclusion, KRT18 serves as an oncogenic role in CRC progression and may be a therapeutic target for promoting CRC patients’ prognosis.


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