Colorectal Cancer in Northwestern Iran

Background. Colorectal cancer is the third most prevalent cancer worldwide, which is less common in the Middle East; its prevalence demonstrated to be 7 persons per 100,000 populations in Iran. In this study, we aimed to investigate the clinicopathologic features of CRC patients in West Azerbaijan province of Iran. Methods. In this crosssectional study, 546 patients who underwent surgical procedures with the pathologic diagnosis of colorectal cancer in both academic and private hospitals of Urmia were enrolled. Results. The mean age at diagnosis was 55.2 ± 11.5 years. 23% had an age lower than forty years old. Rectal bleeding (26%), abdominal pain (25%), and large bowel obstruction (23%) were three most common presenting symptoms. 26% of patients presented with acute abdomen. 95% of tumors were adenocarcinoma, 4% were lymphoma, and 1% was other rare tumors. Regarding the stage of cancer according to TNM staging system, 6% of patients were in stage I, followed by 37% in stage II, 33% in stage III, and 24% in stage IV. In 44.5% of patients, the tumor was located in rectum. Conclusion. In west Azerbaijan province of Iran, patients with colorectal cancer present in younger age and more advanced stages in comparison with the developed countries.

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The clinicopathological and survival analysis of urological mucosal melanoma: A single-center retrospective observational study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e21588 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e21588-e21588

Author(s):

Bixia Tang ◽

Xieqiao Yan ◽

Zhihong Chi ◽

Siming Li ◽

Chuanliang Cui ◽

...

Keyword(s):

Urinary Tract ◽

Regional Lymph Node ◽

Stage Iv ◽

Staging System ◽

Tnm Staging ◽

Mucosal Melanoma ◽

Future Research ◽

Molecular Characteristics ◽

Urethral Carcinoma ◽

Tnm Staging System

e21588 Background: Primary mucosal melanoma arising in the urinary tract is rare and poorly characterized. Methods: The records of patients with urological mucosal melanoma who presented to the department of Renal Cancer and Melanoma of Peking University Cancer Hospital between September, 2004 and April, 2019 were reviewed. Available clinicopathological and molecular characteristics were summarized, including pathological parameters, gene mutation, primary surgical intervention, systemic treatment and clinical course. The rates of local recurrence rate, loco-regional lymph node metastasis and distant metastasis were assessed. American Joint Committee on Cancer (AJCC) TNM Staging System for bladder cancer/renal pelvis and ureter cancer/urethral carcinoma (8th ed., 2017) were adopted for staging. Results: Fifty-eight patients were involved in the study with a median age of 62.5 years (range: 32-82). The anatomic sites of the primary urological mucosal melanomas were from the urethra (89.7%), bladder (6.9%), ureter (0%) and kidney (0%), and the left (4.4%) were from multiple loci. At initial diagnosis, 75.9% (n=44) were stage I/II disease, 1.7% (n=1) stage III, and 22.4% (n=13) stage IV. There was 3.4% incidence of CKIT mutation and 1.7% of BRAF mutation. After median follow-up of 22.6 mo, 31.4% (16/51) relapsed locally after organ-preserved surgery. 21.6% (11/51) and 39.2% (20/51) developed metastases to reginal lymph nodes and distance, respectively. The median relapse free survival and median overall survival were 12.2 (95%CI: 7.9-16.4) mo and 33.9 (95%CI: 19.2-48.6) mo, respectively. Univariate Cox analysis showed that TNM stage and systemic adjuvant therapy were the prognostic factors of OS, while no association was found with Breslow thickness, miotic rate, ulceration and gender. Conclusions: Urological mucosal melanoma predominantly arises from lower urinary tract with rare BRAF and CKIT mutation. AJCC TNM Staging System for urothelial carcinoma is proved practical for urothelial melanoma, which should be validated in larger population. Future research is required to identify adjuvant treatment approaches to improve disease outcomes.

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Colorectal Cancer

10.2310/fm.1181 ◽

2018 ◽

Author(s):

Cathy Eng

Keyword(s):

Colorectal Cancer ◽

Staging System ◽

Occult Blood ◽

Cancer Staging ◽

The United States ◽

Tnm Staging ◽

Screening Tests ◽

Fecal Occult Blood ◽

Screening And Surveillance ◽

Staging Systems

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.

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Prostaglandin E-Major Urinary Metabolite (PGE-MUM) as a Tumor Marker for Lung Adenocarcinoma

Cancers ◽

10.3390/cancers11060768 ◽

2019 ◽

Vol 11 (6) ◽

pp. 768 ◽

Cited By ~ 1

Author(s):

Hironori Kawamoto ◽

Hiromichi Hara ◽

Jun Araya ◽

Akihiro Ichikawa ◽

Yu Fujita ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Cancer Progression ◽

Stage Iv ◽

Staging System ◽

Tnm Staging ◽

Tumor Burden ◽

Urinary Metabolite ◽

Prostaglandin E ◽

Major Urinary Metabolite ◽

Embryonic Antigen

Background: Prostaglandin E2 (PGE2) is metabolized to prostaglandin E-major urinary metabolite (PGE-MUM). Enhanced cyclooxygenase-2 (COX-2) expression demonstrated in lung adenocarcinoma indicates increased PGE-MUM levels in patients with lung adenocarcinoma. Objectives: We aimed to elucidate the clinical usefulness of measuring PGE-MUM as an indicator of tumor burden in patients with lung adenocarcinoma. Methods: PGE-MUM was measured by a radioimmunoassay in control healthy volunteers (n = 124) and patients with lung adenocarcinoma (n = 54). Associations between PGE-MUM levels and clinical characteristics of the patients (including lung cancer stage and TNM factors (T: Tumor, N: Node, M: Metastasis) were examined. Results: PGE-MUM levels were significantly elevated in patients with lung adenocarcinoma. A PGE-MUM level of 14.9 μg/g∙Cr showed 70.4% sensitivity and 67.7% specificity for the diagnosis of lung adenocarcinoma. PGE-MUM levels tended to be positively correlated with cancer progression as determined by the TNM staging system. Advanced stage (stage III, stage IV, and recurrence) was significantly associated with high PGE-MUM levels by logistic regression analysis. No apparent correlation was demonstrated between PGE-MUM and carcinoma embryonic antigen (CEA) levels. Conclusions: PGE-MUM can be a promising biomarker reflecting the systemic tumor burden of lung adenocarcinoma.

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Establishment and validation of a novel nomogram incorporating clinicopathological parameters into the TNM staging system to predict prognosis for stage II colorectal cancer

Cancer Cell International ◽

10.1186/s12935-020-01382-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shaobo Mo ◽

Zheng Zhou ◽

Yaqi Li ◽

Xiang Hu ◽

Xiaoji Ma ◽

...

Keyword(s):

Colorectal Cancer ◽

Staging System ◽

Tnm Staging ◽

Stage Ii ◽

Clinicopathological Parameters ◽

Tnm Staging System ◽

Stage Ii Colorectal Cancer

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Accuracy of TNM staging system in prognostic stratification of stage IV digestive endocrine tumors.

Journal of Clinical Oncology ◽

10.1200/jco.2010.28.15_suppl.e14588 ◽

2010 ◽

Vol 28 (15_suppl) ◽

pp. e14588-e14588

Author(s):

E. Merola ◽

F. Panzuto ◽

M. Rinzivillo ◽

R. Valente ◽

C. Bestani ◽

...

Keyword(s):

Stage Iv ◽

Staging System ◽

Tnm Staging ◽

Endocrine Tumors ◽

Tnm Staging System ◽

Prognostic Stratification

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Early colorectal cancer detection on routine CT to improve patient's 5-year survival.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.593 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 593-593

Author(s):

Ricky Rodriguez ◽

Bryce Daniel Perkins ◽

Peter Yong Soo Park ◽

Phillip Koo ◽

Madappa N. Kundranda ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Nodes ◽

Staging System ◽

Tnm Staging ◽

Early Colorectal Cancer ◽

Wall Thickening ◽

Imaging Features ◽

Ascending Colon ◽

Abdominal Ct ◽

Diagnostic Ct

593 Background: Prognosis of colorectal cancer (CRC) is greatly influenced by stage at diagnosis. Early colorectal cancer can be subtle on CT scans showing only mild wall thickening, small polyps, or subtle lymph nodes. Identifying these lesions on CT performed for nonspecific symptoms can help identify interval CRC and improve patient outcome. The purpose of the present study is to classify missed CRC on abdominal CT by their imaging features and whether early identification can downstage CRC patients. Methods: A retrospective analysis was conducted of patients (pts) diagnosed with CRC. Data collection included age, gender, ECOG, KRAS mutation status, overall survival (OS). CT obtained prior to and at diagnosis were evaluated. Images were reviewed for multiple CT features including appearance of mass, mesenteric infiltration, abnormal draining lymph nodes, contrast enhancement relative to adjacent mucosa, and intralesional calcifications. Staging was evaluated using available CT scan and based on the TNM staging system for CRC. Results: The 41 pts with 51 prediagnostic CTs from 1/1/2012 - 12/31/2015 had mean age of 68 years (range:44-90 ) Mean ECOG status for the population was 1.46. 41% of the prediagnostic CTs had missed findings. 52 and 43 % of the missed findings were in the rectosigmoid and ascending colon respectively. Of the 15 missed masses, 9 appeared as asymmetric wall thickening, 3 as concentric wall thickening, and 3 as polyps. Of the 14 missed lymph node groups, 2 were excluded due to stability or nonrelated condition. The remaining lymph nodes were found in the associated draining station and averaged 3±1.2 mm in size. On average, the stage at prediagnostic CT was 3A and the diagnostic CT was 3C (p = 0.0015). Average time lapse between prediagnostic and diagnostic CT was 21 months (3-64 months). Conclusions: High percentage of CRC findings are missed on abdominal CT due to their subtle feature, with most misses in the rectosigmoid and ascending colon. A dedicated search can improve detection by specifically looking for polyps, wall thickening, and small lymph nodes in the draining station. Early detection of CRC can improve survival by lowering the stage from 3C to 3A, thus providing 36% improvement in 5-year survival.

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A modified TNM staging system for non-metastatic colorectal cancer based on nomogram analysis of SEER database

BMC Cancer ◽

10.1186/s12885-017-3796-1 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 9

Author(s):

Xiangxing Kong ◽

Jun Li ◽

Yibo Cai ◽

Yu Tian ◽

Shengqiang Chi ◽

...

Keyword(s):

Colorectal Cancer ◽

Metastatic Colorectal Cancer ◽

Staging System ◽

Tnm Staging ◽

Seer Database ◽

Tnm Staging System

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Urgent Need for a New Staging System in Advanced Colorectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2008.17.6453 ◽

2008 ◽

Vol 26 (29) ◽

pp. 4828-4833 ◽

Cited By ~ 93

Author(s):

Graeme J. Poston ◽

Joan Figueras ◽

Felice Giuliante ◽

Gennaro Nuzzo ◽

Alberto F. Sobrero ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Survival Rates ◽

Surgical Techniques ◽

Stage Iv ◽

Staging System ◽

Sequential Therapy ◽

Rapid Expansion ◽

Curative Surgery ◽

The Impact

Despite recent advances in the medical treatment of metastatic colorectal cancer (mCRC), which include irinotecan- and oxaliplatin-based first-line regimens, the concept of planned sequential therapy involving three active agents during the course of a patient's treatment and the increasing use of targeted monoclonal antibodies, 5-year survival rates for patients with advanced CRC remain unacceptably low. For patients with CRC liver metastases, liver resection remains the only chance of cure, with 5-year survival rates ranging from 25% to 40%. However, 80% to 85% of patients with stage IV CRC have liver disease which is considered unresectable at presentation. The rapid expansion in the use of improved combination chemotherapy regimens plus or minus biologics, to render initially unresectable metastases resectable has increased the percentage of patients eligible for potentially curative surgery. However, the current staging criteria for CRC patients with metastatic disease do not reflect these recent changes or the fact that there is also a large variation in the survival of patients with stage IV CRC. For example the survival for a patient with a solitary, resectable liver metastasis is better than that for a patient with stage III disease. A new staging system is therefore needed that acknowledges both the improvements that have been made in surgical techniques for resectable metastases and the impact of modern chemotherapy on rendering initially unresectable CRC liver metastases resectable, while at the same time distinguishing between patients with a chance of cure at presentation and those for whom only palliative treatment is possible.

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