Number of Lymph Nodes Examined and Associated Clinicopathologic Factors in Colorectal Carcinoma

2009 ◽  
Vol 133 (5) ◽  
pp. 781-786 ◽  
Author(s):  
Steven S. Shen ◽  
Bisong X. Haupt ◽  
Jae Y. Ro ◽  
Jijiang Zhu ◽  
H. Randoph Bailey ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Lymph Nodes ◽  
Medical Center ◽  
Tumor Location ◽  
Patient Age ◽  
Bowel Segment ◽  
Patient Âgé ◽  
Clinicopathologic Factors ◽  
Resected Bowel

Abstract Context.—Nodal metastasis is one of the most important prognostic factors in colorectal carcinoma. The number of lymph nodes recovered and examined in resection specimens has been recently shown to be critical for proper staging and is associated with survival. Objective.—To assess the clinicopathologic factors that may be associated with the number of lymph nodes harvested from surgical resections. Design.—Clinicopathologic factors of 434 consecutive cases of colorectal cancers treated by surgical resection from a single tertiary medical center were retrospectively reviewed and correlated with number of lymph nodes recovered. Results.—Our data show that patient age, tumor location, and length of resected bowel segment were associated with number of lymph nodes harvested in surgical resections of colorectal cancer. The average number of lymph nodes was 18.2 and 17.8 for patients younger than 50 years and aged 50 through 60 years, respectively, whereas it was 14.4, 15.1, and 14.9 for patients aged 61 through 70 years, 71 through 80 years, and 80 years and older, respectively. More lymph nodes were present in resection specimens of cecum/ascending colon and descending colon cancers than in those of transverse colon, sigmoid colon, and rectal cancers. There was a linear increase in number of lymph nodes examined with increasing length of bowel resection specimens. In multivariate regression analysis, the factors that remained independent predictors of removal of 12 or more lymph nodes from resection specimens were tumor location and length of resected bowel segment. Conclusions.—The number of lymph nodes obtained in resection specimens for colorectal cancer was significantly associated with the length of resected segments of bowel, patient age, and location of the tumor.

scholarly journals The methylation of SDC2 and TFPI2 defined three methylator phenotypes of colorectal cancer

2021 ◽  
Author(s):  
Lei Ruixue ◽  
Zhao Yanteng ◽  
Huang Kai ◽  
Wan Kangkang ◽  
Li Tingting ◽  
...  
Keyword(s):  
Gene Expression ◽  
Colorectal Cancer ◽  
Cpg Island ◽  
Methylation Status ◽  
Tumor Location ◽  
Functional Enrichment ◽  
Superior Performance ◽  
Regulation Of Transcription ◽  
Patient Age ◽  
Patient Âgé

Methylation-based noninvasive molecular diagnostics are easy and feasible tools for the early detection of colorectal cancer (CRC). However, many of them have the limitation of low sensitivity with some CRCs detection failed in clinical practice. In this study, the clinical and pathological characteristics, as well as molecular features of three methylator-groups, defined by the promoter methylation status of SDC2 and TFPI2, were investigated in order to improve the performance of CRC detection. The Illumina Infinium 450k Human DNA methylation data and clinical information of CRCs were collected from The Cancer Genome Atlas (TCGA) project and Gene Expression Omnibus (GEO) database. CRC samples were divided into three groups, HH (dual-positive), HL (single positive) and LL (dual-negative) according to the methylation status of SDC2 and TFPI2 promoters. Differences in age, tumor location, microsatellite instable status and differentially expressed genes (DEGs) were evaluated among the three groups and these findings were then confirmed in our inner CRC dataset. The combination of methylated SDC2 and TFPI2 showed a superior performance of distinguishing CRCs from normal controls than each alone. Samples of HL group were more often originated from left-side CRCs whereas very few of them were from right-side (P < 0.05). HH grouped CRCs showed a higher level of microsatellite instability and mutation load than other two groups (mean nonsynonymous mutations for HH/HL/LL: 10.55/3.91/7.02, P = 0.0055). All mutations of BRAF, one of the five typical CpG island methylator phenotype (CIMP) related genes, were found in HH group (HH/HL/LL: 51/0/0, P = 0.018). Also there was a significantly older patient age at the diagnosis in HH group. Gene expression analysis identified 37, 84 and 22 group-specific DEGs for HH, HL and LL, respectively. Functional enrichment analysis suggested that HH specific DEGs were mainly related to the regulation of transcription and other processes, while LL specific DEGs were enriched in the biological processes of extracellular matrix interaction and cell migration. The three defined mathylator groups showed great difference in tumor location, patient age, MSI and ECM biological process, which could facilitate the development of more effective biomarkers for CRC detection.

Factors predicting length of stay in patients hospitalized for acute parotitis

2020 ◽  
pp. jim-2020-001506
Author(s):  
Avinoam Markovich ◽  
Ohad Ronen
Keyword(s):  
Clinical Laboratory ◽  
Medical Center ◽  
White Cell Count ◽  
Acute Infection ◽  
Retrospective Chart Review ◽  
Significant Treatment ◽  
Patient Age ◽  
Factors Affecting ◽  
Patient Âgé ◽  
Length Of Hospitalization

Acute suppurative parotitis (ASP) is an acute infection of the parotid gland that necessitates hospitalization in some patients. The aim of this study was to evaluate clinical laboratory values including hydration, nutritional status, inflammatory markers and age, and to compare them with duration of hospitalization of patients with ASP. This is a retrospective chart review in a tertiary academic center. We investigated the factors affecting length of hospitalization in patients admitted to Galilee Medical Center with a diagnosis of ASP between 2010 and 2018. Of the 60 patients with ASP included in the study, 24 were male. The average age of patients was 60, ranging from 18 to 99. We found statistically significant correlations between length of hospitalization and patient age (r=0.3), C reactive protein (r=0.3), white cell count (WCC) at presentation (r=0.3), blood urea nitrogen to creatinine ratio (BUN:Cr) (r=0.2), and platelet levels at discharge (r=0.4). Examination of these factors on multivariate analysis found hospitalization duration was exclusively affected by patients’ level of dehydration as represented by BUN:Cr. Patient age, WCC levels at presentation, and platelet levels were not found to be statistically significant. Treatment and interventions should be planned accordingly.

scholarly journals Chart review of diagnostic methods, baseline characteristics and symptoms for European patients with pancreatic cancer

2021 ◽  
Vol 17 (15) ◽  
pp. 1843-1854
Author(s):  
Alfredo Carrato ◽  
Davide Melisi ◽  
Gerald Prager ◽  
Christoph B Westphalen ◽  
Anabel Ferreras ◽  
...  
Keyword(s):  
Chart Review ◽  
Diagnostic Technique ◽  
Tumor Location ◽  
Diagnostic Methods ◽  
Ductal Adenocarcinoma ◽  
Inclusion Criteria ◽  
First Line ◽  
Patient Age ◽  
Patient Âgé ◽  
Baseline Characteristics

Aim: To survey European physicians managing patients with metastatic pancreatic ductal adenocarcinoma (PDAC) and understand differences in baseline characteristics, diagnostic methods, symptoms and co-morbidities. Materials & methods: Patient record inclusion criteria were: ≥18 years old, metastatic PDAC diagnosis and completion of first-line treatment between July 2014 and January 2016. Records were grouped by patient age, gender and primary tumor location. Results: Records (n = 2565) were collected from nine countries. Baseline characteristics varied between subgroups. Computed tomography was the most frequently used diagnostic technique. Symptoms at diagnosis included abdominal and/or mid-back pain (72% of patients) and weight loss (61.5%). Co-morbidities varied with patient age. Conclusion: Greater awareness of symptoms, diagnostic methods and co-morbidities present at PDAC diagnosis may support better patient management decisions.

scholarly journals Many Neurology Readmissions Are Nonpreventable

2016 ◽  
Vol 7 (2) ◽  
pp. 61-69 ◽  
Author(s):  
Sidney T. Le ◽  
S. Andrew Josephson ◽  
Hans A. Puttgen ◽  
Lorrie Gibson ◽  
Elan L. Guterman ◽  
...  
Keyword(s):  
Length Of Stay ◽  
San Francisco ◽  
Chart Review ◽  
Medical Center ◽  
Hospital Readmissions ◽  
Johns Hopkins Hospital ◽  
Unplanned Readmission ◽  
Neurosurgical Procedures ◽  
Patient Age ◽  
Patient Âgé

Introduction: Reducing unplanned hospital readmissions has become a national focus due to the Centers for Medicare and Medicaid Services’ (CMS) penalties for hospitals with high rates. A first step in reducing unplanned readmission is to understand which patients are at high risk for readmission, which readmissions are planned, and how well planned readmissions are currently captured in comparison to patient-level chart review. Methods: We examined all 5455 inpatient neurology admissions over a 2-year period to University of California San Francisco Medical Center and Johns Hopkins Hospital via chart review. We collected information such as patient age, procedure codes, diagnosis codes, all-payer diagnosis-related group, observed length of stay (oLOS), and expected length of stay. We performed multivariate logistic modeling to determine predictors of readmission. Discharge summaries were reviewed for evidence that a subsequent readmission was planned. Results: A total of 353 (6.5%) discharges were readmitted within 30 days. Fifty-five (15.6%) of the 353 readmissions were planned, most often for a neurosurgical procedure (41.8%) or immunotherapy (23.6%). Only 8 of these readmissions would have been classified as planned using current CMS methodology. Patient age (odds ratio [OR] = 1.01 for each 10-year increase, P < .001) and estimated length of stay (OR = 1.04, P = .002) were associated with a greater likelihood of readmission, whereas index admission oLOS was not. Conclusions: Many neurologic readmissions are planned; however, these are often classified by current CMS methodology as unplanned and penalized accordingly. Modifications of the CMS lists for potentially planned neurological and neurosurgical procedures and for acute discharge neurologic diagnoses should be considered.

scholarly journals Colorectal cancer surgery remains effective with rising patient age

2014 ◽  
Vol 29 (8) ◽  
pp. 971-979 ◽  
Author(s):  
Ulrich Nitsche ◽  
Christoph Späth ◽  
Tara C. Müller ◽  
Matthias Maak ◽  
Klaus-Peter Janssen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Surgery ◽  
Patient Age ◽  
Colorectal Cancer Surgery ◽  
Patient Âgé

Modifiable factors that influence colorectal cancer lymph nodes sampling and examination

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4047-4047
Author(s):  
M. E. Valsecchi ◽  
J. Leighton ◽  
W. Tester
Keyword(s):  
Colorectal Cancer ◽  
Logistic Regression ◽  
Lymph Nodes ◽  
Medical Center ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
The United States ◽  
Routine Practice ◽  
Modifiable Factors ◽  
Multiple Variables

4047 Background: Colorectal cancer is the fourth most common malignancy in the United States. The single most important prognostic factor is lymph node involvement. Multiple guidelines recommend a minimum of 12 nodes should be sampled in order to insure accurate staging and treatment. However this standard of care requirement is not always achieved. The objective of this study is to identify potential modifiable factors that may explain this inadequacy between the optimal approach and routine practice. Methods: The medical charts of all patients treated for colorectal cancer stage I-III between 1999–2007 at Albert Einstein Medical Center were reviewed. The association between multiple variables and the presence of ≥12 lymph nodes reported were examined using logistic regression models. Results: A total of 337 patients were included; 173 (51%) had ≥12 lymph nodes retrieved with a mean of 12.7 (SD±7.6). Demographic characteristics: 78% older than 60 years old; 161 patients (47.8%) male; white (27%), black (67%) and other race (6%). Using a univariate analysis the following variables were statistically associated with ≥12 lymph nodes reported: Colon size (20.6±14.7 vs. 29.9±23.1 cm, P<.001); Mesocolon thickness (3.8±0.9 vs. 4.2±0.9 cm, P<.001); Tumor size (4.14±2.3 vs. 4.6±2.1, P=.03); Site of tumor (Right vs. Left, P<.001); Pathologist (P=.06); Pathologist's Assistant (P=.006); Type of surgery (Right or Sub-Total Colectomy vs. Others, P<.001), Individual Surgeon (P=.009). The results of the multivariate logistic regression analysis, adjusting for age, sex and race, are presented in the Table . Conclusions: This studied showed that multiple factors influence the number of lymph nodes sampled. The role of the surgeon, the pathologist and specially the pathologist's assistant are potentially improvable factors with appropriate education. [Table: see text] No significant financial relationships to disclose.

Implications of Familial Colorectal Cancer Risk Profiles and Microsatellite Instability Status

2009 ◽  
Vol 27 (13) ◽  
pp. 2238-2244 ◽  
Author(s):  
Steven J. Lubbe ◽  
Emily L. Webb ◽  
Ian P. Chandler ◽  
Richard S. Houlston
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Familial Aggregation ◽  
Absolute Risk ◽  
Familial Risk ◽  
Risk Groups ◽  
Familial Colorectal Cancer ◽  
Patient Age ◽  
Screening Programs ◽  
Patient Âgé

Purpose Estimating familial colorectal cancer (CRC) risk is clinically important in being able to discriminate between high- and low-risk groups. To quantify familial CRC risks associated with mismatch repair (MMR) deficient and microsatellite stable (MSS) tumors, we analyzed 2,941 population-based cases of CRC. Patients and Methods MMR status in CRCs was established by testing for microsatellite instability (MSI). MUTYH status was assigned by screening for Y165C and G382D variants. Age-specific relative and absolute CRC risks in first-degree relatives (FDRs) were calculated, and the most likely genetic models of familial aggregation were derived. Results CRC risks in FDRs were strongly associated with MSI status (MSI, standardized incidence ratio [SIR] = 4.28, 95% CI, 3.51 to 5.17; MSS, SIR = 1.91, 95% CI, 1.73 to 2.11), early-onset disease (MSI patient age < 55 years, SIR = 10.96, 95% CI, 8.32 to 14.17; MSS patient age < 55 years, SIR = 2.3, 95% CI, 1.88 to 2.85), and having more than one affected FDR (MSI, SIR = 10.00, 95% CI, 7.74 to 12.72; MSS, SIR = 2.78, 95% CI, 2.18 to 3.48). The familial aggregation of CRC associated with MSI cancer was parsimonious with dominant model conferring a high CRC risk at early ages. Approximately 69% of the excess familial risk in FDRs can be ascribed to MSS CRC, and although the pattern of familial risk supports recessive susceptibility in addition to MUTYH, the absolute risk of CRC is at best modest. Conclusion The results from this analysis should enable an individual's risk of CRC to be more accurately estimated, thus maximizing the value of screening programs. Results also have utility in the design of genetic analyses to identify novel disease alleles.

scholarly journals Demographic And Histopathological Characteristics Of Colorectal Polyps: A Descriptive Study Based On Samples Obtained From Symptomatic Patients

2016 ◽  
Vol 55 (2) ◽  
pp. 118-123
Author(s):  
Genta Cekodhima ◽  
Altin Cekodhima ◽  
Arben Beqiri ◽  
Mehdi Alimehmeti ◽  
Gerhard Sulo
Keyword(s):  
Colorectal Cancer ◽  
Histopathological Examination ◽  
Colorectal Polyps ◽  
Medium Size ◽  
Polyp Size ◽  
Patient Age ◽  
Patient Âgé ◽  
Potentially Malignant ◽  
Study Population ◽  
And Gender

Abstract Background Colorectal polyps (CP) are common among individuals older than 50 years. Some polyp types can precede colorectal cancer (CRC). This study aimed at describing histopathological characteristics of colorectal polyps in relation to age and gender among symptomatic patients referred for a colonoscopy examination during 2011-2014 in Tirana, Albania. Methods Study population included 267 individuals aged ≥ 20 years and diagnosed with ≥ 1 polyp during a colonoscopy examination. A total of 346 polyps were identified, excised and measured, and underwent histopathological examination. Results Adenomas accounted for 79.8% of all polyps and tubular type was the most frequent one (74.4%). The majority of polyps (42.5%) were small (<1 cm), 38.7% of a medium size (1-2 cm) and 18.8% large (>2 cm). Adenomas were larger than non-adenomatous polyps (p<0.01) There was no gender difference with regard to patient age (p=0.22) or polyp size (p=0.84) Adenomas were more frequent among men compared to women (p=0.02). Age was strongly related to polyp characteristics. The proportion of adenomas increased significantly with age (p<0.01). Within adenomas, the proportion of villous types - a precursor of colorectal cancer - increased remarkably with age (p=0.01). Older age was positively associated with potentially malignant adenomas (defined as adenomas > 1 cm and showing high-grade dysplasia) (p<0.01). Conclusion Adenomas accounted for the majority of polyps. Their morphology, size and malignant potential were related to patient age.

scholarly journals Correlation Between Programmed Cell Death Ligand1 (PD-L1) Expression and Clinical Parameters in Colorectal Carcinoma.

2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Zainab Waleed Aziz ◽  
Asmaa Mohammadsheet Mahmood ◽  
Zahraa Osama Yahiya ◽  
Wahda Mohammed Taib Al –Nuaimy
Keyword(s):  
Cell Death ◽  
Colorectal Carcinoma ◽  
Programmed Cell Death ◽  
Lymph Nodes ◽  
Tissue Microarray ◽  
Tissue Expression ◽  
Tumor Location ◽  
Lymphatic Invasion ◽  
Tnm Stage ◽  
Clinicopathologic Characteristics

Abstract     Objectives: Programmed Cell Death Ligand1 (PD-L1) tissue expression in CRC (colorectal cancer) displays conflicting results among various studies. We aimed to identify the rate of PD-L1 positivity in colorectal carcinoma, and it's immune infiltrating cells, their relationship with clinicopathologic parameters of patients, and to correlate the results with other studies.    Methods: PD-L1 antibody retrospectively analyzed immunohistochemically in tissue microarray blocks of 99 specimens with colonic and rectal carcinomas operated between January 2015 to December 2017. A comparison performed between PD-L1 expression  in tumor cells (TCs) as well as tumor-infiltrating immune cells (TIICs) for age, sex, histological differentiation, the primary tumor location, number of involved lymph nodes, angiolymphatic invasion, and TNM stage.   Results: Of the 99 patients, the median age was 54.5 (range: 18 to 83) years. Fourteen samples were PD-L1 positive in TCs, increased to 32%  in TIICs. A significant expression of PD-L1in TCs was correlated with medullary histology (p= 0.03), number of the involved lymph nodes (p= 0.02), distant metastasis (p= 0.001), and TNM stage (p= 0.0001). The PD-L1 status in TIICs was again connected with adverse clinical and pathological parameters.    Conclusions: The expression of PD-L1 in TCs and TIICs is associated significantly with advanced cancer or lymphatic invasion in patients who underwent surgery after a diagnosis of CRC. The research designates the significance of estimation of TCs and TIICs in correlation to clinicopathologic characteristics of patients a finding that could produce a piece of evidence for precise electing immunotherapy.       Keywords: Programmed cell death ligand1, colorectal carcinoma, Tissue microarray study, Immunohistochemistry.      

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