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Liu B, Zhang ZX, Nie XY, Sun WL, Yan YJ, Fu WH. Clinical outcome and prognostic factors of T4N0M0 colon cancer after R0 resection: A retrospective study. World J Gastrointest Oncol 2024; 16:1869-1877. [PMID: 38764842 PMCID: PMC11099430 DOI: 10.4251/wjgo.v16.i5.1869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/14/2024] [Accepted: 03/28/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Paradoxically, patients with T4N0M0 (stage II, no lymph node metastasis) colon cancer have a worse prognosis than those with T2N1-2M0 (stage III). However, no previous report has addressed this issue. AIM To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these patients. METHODS Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021, of which 112 patients were assigned to the training cohort, and the remaining 88 patients were assigned to the validation cohort. Differences between the training and validation groups were analyzed. The training cohort was subjected to multivariate analysis to select prognostic risk factors for T4N0M0 colon cancer, followed by the construction of a nomogram model. RESULTS The 3-year overall survival (OS) rates were 86.2% and 74.4% for the training and validation cohorts, respectively. Enterostomy (P = 0.000), T stage (P = 0.001), right hemicolon (P = 0.025), irregular review (P = 0.040), and carbohydrate antigen 199 (CA199) (P = 0.011) were independent risk factors of OS in patients with T4N0M0 colon cancer. A nomogram model with good concordance and accuracy was constructed. CONCLUSION Enterostomy, T stage, right hemicolon, irregular review, and CA199 were independent risk factors for OS in patients with T4N0M0 colon cancer. The nomogram model exhibited good agreement and accuracy.
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Affiliation(s)
- Bang Liu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Zhao-Xiong Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Xin-Yang Nie
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Wei-Lin Sun
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Yong-Jia Yan
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Wei-Hua Fu
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China
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Oncological impact of vascular invasion in colon cancer might differ depending on tumor sidedness. JOURNAL OF MINIMALLY INVASIVE SURGERY 2022; 25:53-62. [PMID: 35821690 PMCID: PMC9218406 DOI: 10.7602/jmis.2022.25.2.53] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 12/16/2022]
Abstract
Purpose Vascular invasion is a well-known independent prognostic factor in colon cancer and tumor sidedness is also being considered a prognostic factor. The aim of this study was to compare the oncological impact of vascular invasion depending on the tumor location in stages I to III colon cancer. Methods A retrospective analysis was performed using data from patients who underwent curative resection between 2004 and 2015. Patients were divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) groups according to the tumor location. Disease-free survival (DFS) and overall survival (OS) were compared between the RCC and LCC groups, depending on the presence of vascular invasion. Results A total of 793 patients were included, of which 304 (38.3%) had RCC and 489 (61.7%) had LCC. DFS and OS did not differ significantly between the RCC and LCC groups. Vascular invasion was a poor prognostic factor for DFS in both RCC (hazard ratio [HR], 2.291; 95% confidence interval [CI], 1.186–4.425; p = 0.010) and LCC (HR, 1.848; 95% CI, 1.139–2.998; p = 0.011). Additionally, it was associated with significantly worse OS in the RCC (HR, 3.503; 95% CI, 1.681–7.300; p < 0.001), but not in the LCC group (HR, 1.676; 95% CI, 0.885–3.175; p = 0.109). Multivariate analysis revealed that vascular invasion was independently poor prognostic factor for OS in the RCC (HR, 3.186; 95% CI, 1.391–7.300; p = 0.006). Conclusion This study demonstrated that RCC with vascular invasion had worse OS than LCC with vascular invasion.
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Minciuna CE, Tanase M, Manuc TE, Tudor S, Herlea V, Dragomir MP, Calin GA, Vasilescu C. The seen and the unseen: Molecular classification and image based-analysis of gastrointestinal cancers. Comput Struct Biotechnol J 2022; 20:5065-5075. [PMID: 36187924 PMCID: PMC9489806 DOI: 10.1016/j.csbj.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/07/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Gastrointestinal cancers account for 22.5% of cancer related deaths worldwide and represent circa 20% of all cancers. In the last decades, we have witnessed a shift from histology-based to molecular-based classifications using genomic, epigenomic, and transcriptomic data. The molecular based classification revealed new prognostic markers and may aid the therapy selection. Because of the high-costs to perform a molecular classification, in recent years immunohistochemistry-based surrogate classification were developed which permit the stratification of patients, and in parallel multiple groups developed hematoxylin and eosin whole slide image analysis for sub-classifying these entities. Hence, we are witnessing a return to an image-based classification with the purpose to infer hidden information from routine histology images that would permit to detect the patients that respond to specific therapies and would be able to predict their outcome. In this review paper, we will discuss the current histological, molecular, and immunohistochemical classifications of the most common gastrointestinal cancers, gastric adenocarcinoma, and colorectal adenocarcinoma, and will present key aspects for developing a new artificial intelligence aided image-based classification of these malignancies.
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Sugiura K, Seo Y, Aoki H, Onishi Y, Nishi Y, Kishida N, Tanaka M, Ito Y, Tokura H, Takahashi T. Bridge to Surgery for Obstructing Colonic Cancer: A Comparison between Right- and Left-sided Lesions. JOURNAL OF THE ANUS RECTUM AND COLON 2021; 5:34-39. [PMID: 33537498 PMCID: PMC7843137 DOI: 10.23922/jarc.2020-046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023]
Abstract
Objectives: Few studies have compared management and outcomes of bridge to surgery (BTS) for obstructive colonic cancer according to the location of the tumor. Additional information is needed about this procedure's characteristics and short-term and long-term outcomes. We aimed to compare patient and tumor characteristics, and outcomes of BTS for obstructive right-sided versus left-sided colonic cancers. Methods: This was a retrospective, single center, cohort study. The study cohort comprised 149 patients, including 48 with right-sided and 101 with left-sided obstructive colonic cancers, who were treated with BTS between January 2007 and December 2017. Data on medical history, investigations, treatments, and prognosis were collected from an electronic database of a single hospital. The primary end points were overall (OS) and disease-free (DFS) survival and short-term surgical outcomes. Results: Significantly more patients with right-sided cancers had postoperative complications (29.2% vs. 14.9%, p = 0.039). Additionally, postoperative chemotherapy was administered to a marginally significantly greater proportion of patients with left-sided cancers (29.2% vs 45.5%, p = 0.057). The long-term outcomes were comparable between the two groups (the 5-year OS rates were 67.6% and 80.9% [p = 0.117] and the 5-year DFS rates were 62.2% and 58.6% [p = 0.671]). Multivariate analyses using all studied variables showed that lymphovascular invasion, advanced T stage, and adjuvant chemotherapy were independent poor prognostic factors. Conclusions: The long-term outcome was not different between the right- and left-sided groups. In a BTS setting, postoperative complications may reduce the compliance of adjuvant chemotherapy in right-sided cancers and affect long-term outcomes.
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Affiliation(s)
- Kiyoaki Sugiura
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Yuki Seo
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Hikaru Aoki
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Yoshihiko Onishi
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Yusuke Nishi
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Norihiro Kishida
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Motomu Tanaka
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Yasuhiro Ito
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Hideyuki Tokura
- Department of Surgery, Ashikaga Red Cross Hospital, Ashikaga, Japan
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You K, Park HC, Park SC, Sohn DK, Oh JH, Lee DW, Park SS, Kang SB, Heo SC, Kim MJ, Park KJ. Laparoscopic approach for T4 colon cancer can be associated with poor prognosis in right-sided T4b tumours. Eur J Surg Oncol 2021; 47:1645-1650. [PMID: 33500180 DOI: 10.1016/j.ejso.2021.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/21/2020] [Accepted: 01/14/2021] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Although recent studies have demonstrated the safety of laparoscopic surgery in T4 colon cancer, some patients could have poor prognosis. In this study, we aimed to analyse the risk factors affecting oncologic outcome of laparoscopic surgery. MATERIALS AND METHODS Among the 1033 T4 colon cancer patients collected from a multicentre database (2004-2017), 584 patients (458 T4a and 126 T4b) underwent laparoscopic approach for radical surgery. Risk factors associated with 3-year disease-free survival (DFS) and overall survival (OS) were evaluated through multivariate analysis. In addition, subgroups were classified using a combination of risk factors, and the survival rate was evaluated. RESULTS During this period, 188 (32.2%) had recurrence, and 151 (25.9%) died. In the multivariate analysis for oncologic outcome, elevated carcinoembryonic antigen level (hazard ratio [HR] 1.37) and absence of adjuvant chemotherapy (HR 1.60) were associated with poor DFS. T4b (HR 1.56, 1.46), right-sided location (HR 1.52, 1.42), and open conversion (HR 2.70, 2.12) were independently associated with both poor DFS and OS. When four subgroups were analysed through the combination of tumour location and T stage, the DFS and OS rates were significantly lower in patients with right-sided T4b cancer than in other groups (log-rank p < 0.001). CONCLUSION Right-sided T4b colon cancer for laparoscopic surgery may lead to poor oncologic outcome. This approach could be a caution in suspected cases preoperatively.
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Affiliation(s)
- Kiho You
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Hyoung-Chul Park
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea.
| | - Sung Chan Park
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Dong-Won Lee
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sung-Sil Park
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sung-Bum Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Chul Heo
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Jung Kim
- Department of Surgery, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Pedrazzani C, Turri G, Park SY, Hida K, Fukui Y, Crippa J, Ferrari G, Origi M, Spolverato G, Zuin M, Bae SU, Baek SK, Costanzi A, Maggioni D, Son GM, Scala A, Rockall T, Guglielmi A, Choi GS, Larson DW. Clinical-Pathologic Characteristics and Long-term Outcomes of Left Flexure Colonic Cancer: A Retrospective Analysis of an International Multicenter Cohort. Dis Colon Rectum 2020; 63:1593-1601. [PMID: 33149021 DOI: 10.1097/dcr.0000000000001785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Colorectal cancer seldom presents at the splenic flexure. Small series on left flexure tumors reported a high occurrence of negative prognostic factors called into question as causes of poor prognosis. However, because of the small number of cases, no definite conclusions can be drawn. OBJECTIVE The aim of this study was to compare clinical-pathologic characteristics and short- and long-term outcomes of left flexure tumors with other colonic locations. DESIGN This was a retrospective analysis of consecutive patients who underwent surgery for tumors at the splenic flexure. Each tumor was paired in a 1 to 1 fashion with a right-sided and sigmoid tumor. SETTINGS The study was conducted in 10 international centers. PATIENTS A total of 641 patients with left flexure tumors were included in the study. MAIN OUTCOME MEASURES Overall survival and cancer-specific survival were measured. RESULTS Left flexure tumors presented more frequently with stenosis (30.5%; p < 0.001), with lesions infiltrating beyond the serosa (21.9%; p = 0.001) and with a high rate of mucinous histology (8.8%; p = 0.001). Looking at long-term prognosis, no differences were observed among the 3 groups, both considering overall and cancer-specific survival. However, left flexure tumors recurred more frequently as peritoneal carcinomatosis (20.6%; p < 0.001). LIMITATIONS This study was limited because of its retrospective nature. CONCLUSIONS Although left flexure tumors display several negative prognostic factors, they are not characterized by a worse prognosis compared with other colon cancer locations. See Video Abstract at http://links.lww.com/DCR/B395. CARACTERÍSTICAS CLÍNICO-PATOLÓGICAS Y RESULTADOS A LARGO PLAZO DEL CÁNCER DE COLON DE ÁNGULO IZQUIERDO: UN ANÁLISIS RETROSPECTIVO DE UNA COHORTE MULTICÉNTRICA INTERNACIONAL: El cáncer colorrectal rara vez se presenta en el ángulo esplénico. Pequeñas series sobre tumores de ángulo izquierdo informaron una alta incidencia de factores pronósticos negativos cuestionados como causas de mal pronóstico. Sin embargo, debido al pequeño número de casos, no se pueden sacar conclusiones definitivas.El objetivo de este estudio fue comparar las características clínico-patológicas, los resultados a corto y largo plazo de los tumores de ángulo izquierdo con otras ubicaciones de colon.Análisis retrospectivo de pacientes consecutivos que se sometieron a cirugía por tumores en el ángulo esplénico. Cada tumor se emparejó de forma individual con un tumor del lado derecho y sigmoide.El estudio se realizó en 10 centros internacionales.Se incluyeron en el estudio un total de 641 pacientes con tumores del ángulo izquierdo.Supervivencia general y específica del cáncerLos tumores de ángulo izquierda se presentaron con mayor frecuencia con estenosis (30.5%, p <0.001), con lesiones infiltradas más allá de la serosa (21.9%, p = 0.001), y con una alta tasa de histología mucinosa (8.8%, p = 0.001). En cuanto al pronóstico a largo plazo, no se observaron diferencias entre los tres grupos, considerando la supervivencia general y específica del cáncer. Sin embargo, los tumores de ángulo izquierdo recurrieron con mayor frecuencia como carcinomatosis peritoneal (20,6%; p <0,001).Este estudio fue limitado debido a su naturaleza retrospectiva.Aunque los tumores de ángulo izquierdo muestran varios factores pronósticos negativos, no se caracterizan por un peor pronóstico en comparación con otras ubicaciones de cáncer de colon. Consulte Video Resumen en http://links.lww.com/DCR/B395.
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Affiliation(s)
- Corrado Pedrazzani
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, University of Verona, Verona, Italy
| | - Giulia Turri
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, University of Verona, Verona, Italy
| | - Soo Yeun Park
- Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Koya Hida
- Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yudai Fukui
- Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Jacopo Crippa
- Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Giovanni Ferrari
- Department of General Surgery, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Origi
- Department of General Surgery, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Gaya Spolverato
- First Surgical Clinic Section, Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Matteo Zuin
- First Surgical Clinic Section, Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Sung Uk Bae
- Division of Colorectal Surgery, Department of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, Korea
| | - Seong Kyu Baek
- Division of Colorectal Surgery, Department of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, Korea
| | - Andrea Costanzi
- General Surgery Unit, San Leopoldo Mandic Hospital Merate, ASST Lecco, Italy
| | - Dario Maggioni
- General Surgery Unit, San Leopoldo Mandic Hospital Merate, ASST Lecco, Italy
| | - Gyung Mo Son
- Department of Surgery, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Yangsan, Korea
| | - Andrea Scala
- Department of Colorectal and Minimal Access Surgery, Royal Surrey National Health Service Foundation Trust, Guildford, United Kingdom
| | - Timothy Rockall
- Department of Colorectal and Minimal Access Surgery, Royal Surrey National Health Service Foundation Trust, Guildford, United Kingdom
| | - Alfredo Guglielmi
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology, and Pediatrics, University of Verona, Verona, Italy
| | - Gyu Seog Choi
- Colorectal Cancer Center, Kyungpook National University Medical Center, School of Medicine, Kyungpook National University, Daegu, Korea
| | - David W Larson
- Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
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Odeny TA, Farha N, Hildebrandand H, Allen J, Vazquez W, Martinez M, Paluri RK, Kasi A. Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer. J Clin Med 2020; 9:jcm9123848. [PMID: 33260810 PMCID: PMC7760538 DOI: 10.3390/jcm9123848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Thomas A. Odeny
- Department of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA;
| | - Nicole Farha
- Department of Medicine, University of Kansas Medical School, Kansas City, KS 66160, USA; (N.F.); (H.H.); (J.A.); (W.V.); (M.M.)
| | - Hannah Hildebrandand
- Department of Medicine, University of Kansas Medical School, Kansas City, KS 66160, USA; (N.F.); (H.H.); (J.A.); (W.V.); (M.M.)
| | - Jessica Allen
- Department of Medicine, University of Kansas Medical School, Kansas City, KS 66160, USA; (N.F.); (H.H.); (J.A.); (W.V.); (M.M.)
| | - Wilfred Vazquez
- Department of Medicine, University of Kansas Medical School, Kansas City, KS 66160, USA; (N.F.); (H.H.); (J.A.); (W.V.); (M.M.)
| | - Maximillian Martinez
- Department of Medicine, University of Kansas Medical School, Kansas City, KS 66160, USA; (N.F.); (H.H.); (J.A.); (W.V.); (M.M.)
| | - Ravi Kumar Paluri
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA;
| | - Anup Kasi
- Department of Medicine, Division of Medical Oncology, University of Kansas Cancer Center, 2650 Shawnee Mission Pkwy, Fairway, KS 66205, USA
- Correspondence: ; Tel.: +1-913-588-1227
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Inhibitory Effects of Apigenin on Tumor Carcinogenesis by Altering the Gut Microbiota. Mediators Inflamm 2020; 2020:7141970. [PMID: 33082711 PMCID: PMC7559228 DOI: 10.1155/2020/7141970] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/11/2020] [Accepted: 09/19/2020] [Indexed: 12/17/2022] Open
Abstract
The flavonoid apigenin is common to many plants. Although the responsible mechanisms have yet to be elucidated, apigenin demonstrates tumor suppression in vitro and in vivo. This study uses an azoxymethane (AOM)/dextran sodium sulfate- (DSS-) induced colon cancer mouse model to investigate apigenin's potential mechanism of action exerted through its effects upon gut microbiota. The size and quantity of tumors were reduced significantly in the apigenin treatment group. Using 16S rRNA high-throughput sequencing of fecal samples, the composition of gut microbiota was significantly affected by apigenin. Further experiments in which gut microbiota were reduced and feces were transplanted provided further evidence of apigenin-modulated gut microbiota exerting antitumor effects. Apigenin was unable to reduce the number or size of tumors when gut microbiota were depleted. Moreover, tumor inhibition effects were initiated following the transplant of feces from mice treated with apigenin. Our findings suggest that the effect of apigenin on the composition of gut microbiota can suppress tumors.
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He Y, Zhang L, Tan F, Wang LF, Liu DH, Wang RJ, Yin XZ. MiR-153-5p promotes sensibility of colorectal cancer cells to oxaliplatin via targeting Bcl-2-mediated autophagy pathway. Biosci Biotechnol Biochem 2020; 84:1645-1651. [PMID: 32380907 DOI: 10.1080/09168451.2020.1760784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Oxaliplatin (L-OHP) is one of the effective chemotherapeutic drugs for colorectal cancer (CRC). Further investigation into the molecular mechanism of chemoresistance could improve outcomes for patients with colorectal cancer. Recently, microRNAs have been reported as a key in drug resistance of tumors. In this study, we aimed to investigate the effects of miR-153-5p in L-OHP-resistant CRC cells, and its underlying mechanism. Downregulation of miR-153-5p was observed in CRC cells, while upregulation of miR-153-5p enhances the chemosensitivity of CRC/L-OHP cells. The autophagy of CRC/L-OHP cells was markedly increased after exposure to L-OHP but abolished by the upregulation of miR-153-5p. Dual-luciferase reporter assays validated that Bcl-2 was a direct target of miR-153-5p. In conclusion, our data suggested that miR-153-5p was a mediator of cisplatin resistance in colorectal cancer by affecting Bcl-2-mediated autophagy, indicating a new therapeutic target for CRC treatment.
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Affiliation(s)
- Yong He
- Intravenous drugs dispensing center, Ganzhou People's Hospital , Ganzhou, Jiangxi, China
| | - Ling Zhang
- Department of Pharmacy, The FirstPeople's Hospital of Xiantao , Xiantao, Hubei Province, China
| | - Fei Tan
- Intravenous drugs dispensing center, Ganzhou People's Hospital , Ganzhou, Jiangxi, China
| | - Li-Fang Wang
- Intravenous drugs dispensing center, Ganzhou People's Hospital , Ganzhou, Jiangxi, China
| | - De-Hui Liu
- Intravenous drugs dispensing center, Ganzhou People's Hospital , Ganzhou, Jiangxi, China
| | - Rong-Juan Wang
- Intravenous drugs dispensing center, Ganzhou People's Hospital , Ganzhou, Jiangxi, China
| | - Xiong-Zhang Yin
- Department of Pharmacy, Tongji Hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology , Wuhan, Hubei Province, China
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Rastogi YR, Saini AK, Thakur VK, Saini RV. New Insights into Molecular Links Between Microbiota and Gastrointestinal Cancers: A Literature Review. Int J Mol Sci 2020; 21:E3212. [PMID: 32370077 PMCID: PMC7246717 DOI: 10.3390/ijms21093212] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/20/2022] Open
Abstract
Despite decades of exhaustive research on cancer, questions about cancer initiation, development, recurrence, and metastasis have still not been completely answered. One of the reasons is the plethora of factors acting simultaneously in a tumour microenvironment, of which not all have garnered attention. One such factor that has long remained understudied and has only recently received due attention is the host microbiota. Our sheer-sized microbiota exists in a state of symbiosis with the body and exerts significant impact on our body's physiology, ranging from immune-system development and regulation to neurological and cognitive development. The presence of our microbiota is integral to our development, but a change in its composition (microbiota dysbiosis) can often lead to adverse effects, increasing the propensity of serious diseases like cancers. In the present review, we discuss environmental and genetic factors that cause changes in microbiota composition, disposing of the host towards cancer, and the molecular mechanisms (such as β-catenin signalling) and biochemical pathways (like the generation of oncogenic metabolites like N-nitrosamines and hydrogen sulphide) that the microbiota uses to initiate or accelerate cancers, with emphasis on gastrointestinal cancers. Moreover, we discuss how microbiota can adversely influence the success of colorectal-cancer chemotherapy, and its role in tumour metastasis. We also attempted to resolve conflicting results obtained for the butyrate effect on tumour suppression in the colon, often referred to as the 'butyrate paradox'. In addition, we suggest the development of microbiota-based biomarkers for early cancer diagnosis, and a few target molecules of which the inhibition can increase the overall chances of cancer cure.
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Affiliation(s)
- Yash Raj Rastogi
- School of Bioengineering and Food Technology, Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh 173229, India;
| | - Adesh K. Saini
- Faculty of Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh 173229, India;
| | - Vijay Kumar Thakur
- Biorefining and Advanced Materials Research Centre, Scotland’s Rural College (SRUC), Kings Buildings, Edinburgh, EH9 3JG, UK
| | - Reena V. Saini
- School of Biotechnology, Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Solan, Himachal Pradesh 173229, India
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11
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Farajihaye Qazvini F, Samadi N, Saffari M, Emami-Razavi AN, Shirkoohi R. Fibroblast growth factor-10 and epithelial-mesenchymal transition in colorectal cancer. EXCLI JOURNAL 2019; 18:530-539. [PMID: 31611737 PMCID: PMC6785779 DOI: 10.17179/excli2018-1784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 07/10/2019] [Indexed: 12/12/2022]
Abstract
As an inducer of epithelial-mesenchymal transition (EMT), fibroblast growth factor-10 (FGF-10) has a role in cell proliferation and differentiation in the embryo in addition to invasion and metastasis during carcinogenesis. In this study, we aimed to investigate the FGF-10 gene expression in tumor tissues based on the pathological feature of tumor related to EMT and metastasis. 62 tumors were obtained from 62 colorectal cancer patients during surgery. The pathological characteristics of the patients were carefully collected and classified by Iran National Tumor Bank. To quantify FGF-10 gene expression, RNA extraction, reverse transcription-PCR and real-time PCR were respectively performed. In addition, three colorectal cancer cell lines including LS174T, SW-948 and SW-480 were collected and cultured for further molecular analysis. Consequently, FGF-10 gene expression showed increased expression level in LS174T and SW-948 while it displayed decreased level in SW-480. Considering the tumor samples, we found an upregulation of FGF-10 gene expression in 52.1 % of all tumors in stage III and only in 9.09 % of all tumors in stage I. Also, there were an upregulation of FGF-10 gene expression in 50 % of all positive lymph invasion patients. Besides, FGF-10 gene upregulation was observed in 50 % of all tumors with a size larger than 5 cm (P value < 0.05) and 69 % of all tumors located in the colon (P value < 0.05). To our knowledge, this is the first time that FGF-10 expression is reported based on pathological features of colorectal cancer.
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Affiliation(s)
- Fatemeh Farajihaye Qazvini
- Department of Clinical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Group of Genetics, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nasser Samadi
- Department of Clinical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojtaba Saffari
- Group of Genetics, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Amir Nader Emami-Razavi
- Iran National Tumor Bank, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shirkoohi
- Group of Genetics, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
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12
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Mege D, Manceau G, Beyer L, Bridoux V, Lakkis Z, Venara A, Voron T, de'Angelis N, Abdalla S, Sielezneff I, Karoui M. Right-sided vs. left-sided obstructing colonic cancer: results of a multicenter study of the French Surgical Association in 2325 patients and literature review. Int J Colorectal Dis 2019; 34:1021-1032. [PMID: 30941568 DOI: 10.1007/s00384-019-03286-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Few studies compared management and outcomes of obstructing colonic cancer (OCC), according to the tumor site. Our aim was to compare patient and tumor characteristics, postoperative and pathological results, and oncological outcomes after emergency management of right-sided vs. left-sided OCC. METHODS A national cohort study including all consecutive patients managed for OCC from 2000 to 2015 in French surgical centers members of the French National Surgical Association (AFC). RESULTS During the study period, 2325 patients with OCC were divided in right-sided (n = 819, 35%) and left-sided (n = 1506, 65%) locations. Patients with right-sided OCC were older, more frequently females, and associated with comorbidities, history of cancer, or previous laparotomy. Surgical management was more frequently performed for right-sided than left-sided OCC (99 vs. 96%, p < 0.0001). Tumor resection was more frequently performed in right-sided OCC (95 vs. 90%, p < 0.0001). Among the resected patients, primary anastomosis was more frequently performed in case of right-sided OCC (86 vs. 62%, p < 0.0001). Definitive stoma rate was lower in right-sided location (17 vs. 46%, p < 0.0001). There was no significant difference between locations in terms of cumulative morbidity, anastomotic leak, unplanned reoperation, and mortality. Five-year overall and disease-free survival rates were significantly lower in right-sided OCC (43 and 36%) than in left-sided OCC (53 and 46%, p < 0.0001 and p = 0.001, respectively). CONCLUSIONS Although patients with right-sided OCC are frailer than left-sided OCC, tumor resection and anastomosis are more frequently performed, without difference in surgical results. However, right-sided OCC is associated with worse prognosis than distal location.
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Affiliation(s)
- Diane Mege
- Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - Gilles Manceau
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Department of Digestive and Hepatopancreato-Biliary Surgery, Pitié Salpêtrière University Hospital, 47-83 Bd de l'Hôpital, 75651, Paris Cedex 13, France
| | - Laura Beyer
- North University Hospital, Marseille, France
| | | | | | | | - Thibault Voron
- Saint Antoine University Hospital, Sorbonne University, Paris, France
| | | | - Solafah Abdalla
- Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicetre, France
| | - Igor Sielezneff
- Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille, Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - Mehdi Karoui
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Department of Digestive and Hepatopancreato-Biliary Surgery, Pitié Salpêtrière University Hospital, 47-83 Bd de l'Hôpital, 75651, Paris Cedex 13, France.
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13
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Yan Q, Zhang K, Guo K, Liu S, Wasan HS, Jin H, Yuan L, Feng G, Shen F, Shen M, Ma S, Ruan S. Value of tumor size as a prognostic factor in metastatic colorectal cancer patients after chemotherapy: a population-based study. Future Oncol 2019; 15:1745-1758. [PMID: 31038364 DOI: 10.2217/fon-2018-0785] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: To evaluate the relationship between tumor size and survival in metastatic colorectal cancer (mCRC) patients who received chemotherapy. Materials & methods: SEER database was accessed for eligible patients. Multivariate Cox regression analysis was performed to compare the effect of tumor size on overall survival (OS) and CRC-specific survival (CCSS). Results: Tumor size ≥5 cm was an independent risk factor for OS and CCSS in mCRC patients treated with chemotherapy. Tumor size <5 cm did not show a survival advantage in patients whose primary tumor site was rectosigmoid junction, while tumor size ≥5 cm was associated with poor OS and CCSS in left-and right-sided colorectal cancer. Conclusion: Tumor size ≥5 cm was associated with poor prognosis after receiving chemotherapy treatment and a risk factor for survival of mCRC.
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Affiliation(s)
- Qingying Yan
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Kai Zhang
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China.,Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 110065, USA
| | - Kaibo Guo
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Shan Liu
- Department of Assessment Center, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, PR China
| | - Harpreet S Wasan
- Department of Cancer Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, W12 0HS, UK
| | - Huimin Jin
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Li Yuan
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Guan Feng
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Fengfei Shen
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Minhe Shen
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, PR China
| | - Shenglin Ma
- Department of Oncology, The Forth Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Shanming Ruan
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310006, PR China.,Department of Oncology, The Forth Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
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14
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Feng J, Ma J, Liu S, Wang J, Chen Y. A noncoding RNA LINC00504 interacts with c-Myc to regulate tumor metabolism in colon cancer. J Cell Biochem 2019; 120:14725-14734. [PMID: 30998289 DOI: 10.1002/jcb.28733] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/25/2019] [Accepted: 01/30/2019] [Indexed: 12/24/2022]
Abstract
Accumulating evidence has shown a critical role of long-non-coding RNAs (lncRNAs) during multiple tumor progression. However, the potential functions of LINC00504 in colon cancer as well as its mechanisms remain obscure. By lncRNA profiling, we identified LINC00504 as a novel oncogenic lncRNA in colon cancer. The lncRNA LINC00504 was markedly upregulated in colon cancer cell lines and specimens. LINC00504 increases viability and migration of colon cells in vitro. Furthermore, LINC00504 also enhances colon cancer xenograft tumors in vivo. We noted that LINC00504 regulates metabolism at a transcriptional level which influences multiple metabolic pathways, such as glucose metabolism, pentose phosphate pathway, and tricarboxylic acid cycle. Mechanistic study showed that LINC00504 could interact with c-Myc to promote chromatin recruitment of c-Myc and enhance its transactivation activity. Collectively, our results showed that LINC00504 serves as an important transcriptional regulator for c-Myc in colon cancer cells. LINC00504 can reprogram central metabolism in colon cancer cells implying that LINC00504 may serve as a potential target for therapeutic intervention.
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Affiliation(s)
- Jinfeng Feng
- Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, China
| | - Jun Ma
- Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, China
| | - Shaoqun Liu
- Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, China
| | - Jianfa Wang
- Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, China
| | - Yi Chen
- Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, China
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15
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Hsu YL, Lin CC, Jiang JK, Lin HH, Lan YT, Wang HS, Yang SH, Chen WS, Lin TC, Lin JK, Lin PC, Chang SC. Clinicopathological and molecular differences in colorectal cancer according to location. Int J Biol Markers 2019; 34:47-53. [PMID: 30854932 DOI: 10.1177/1724600818807164] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE The incidence, pathogenesis, molecular pathways, and outcomes of colorectal cancer vary depending on the location of the tumor. This study aimed to compare the difference in tumor characteristics and the outcome between right-sided colon cancer and left-sided colorectal cancer (LCRC). MATERIALS AND METHODS A total of 1503 patients with colorectal cancer who underwent surgery at the Taipei Veterans General Hospital between 2000 and 2010 were enrolled in this study. Right-sided colon cancer was defined as cancers in the cecum, ascending colon, and transverse colon, while LCRC was defined as cancers in the splenic flexure colon, descending colon, sigmoid colon, and rectum. The endpoint was overall survival. The mutations were detected via polymerase chain reaction and MASS array. The prognostic value was determined using the log-rank test and the Cox regression analysis. RESULTS A total of 407 and 1096 cases were classified as right-sided colon cancer and LCRC, respectively. Compared to patients with LCRC, those with right-sided colon cancer had more mucinous type cancer (7.4% vs. 3.5%), poorly differentiated tumor (11.5% vs. 3.6%), and advanced tumor-node-metastasis stage. The risk for peritoneal tumor seeding was higher in the right-sided colon cancer group (12.8% vs. 5.7%). Overall survival was better in LCRC than in right-sided colon cancer ( P=0.036). CONCLUSIONS In our study, right-sided colon cancer had a more advanced tumor stage, a higher risk of peritoneal metastasis, and a poorer outcome than LCRC. Moreover, right-sided colon cancer had more gene mutations in BRAF, KRAS, SMAD4, TGF-β, PIK3CA, PTEN, AKT1, and high microsatellite instability.
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Affiliation(s)
- Yu-Lun Hsu
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Chun-Chi Lin
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Jeng-Kai Jiang
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Hung-Hsin Lin
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Yuan-Tzu Lan
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Huann-Sheng Wang
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Shung-Haur Yang
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Wei-Shone Chen
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Tzu-Chen Lin
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Jen-Kou Lin
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
| | - Pei-Ching Lin
- 3 Department of Clinical Pathology, Yang-Ming Branch, Taipei City Hospital, Taiwan.,4 Department of Health and Welfare, University of Taipei, Taiwan
| | - Shih-Ching Chang
- 1 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,2 National Yang-Ming University, School of Medicine, Taipei, Taiwan
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16
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Sakin A, Arici S, Secmeler S, Can O, Geredeli C, Yasar N, Demir C, Demir OG, Cihan S. Prognostic significance of primary tumor localization in stage II and III colon cancer. World J Gastrointest Oncol 2018; 10:410-420. [PMID: 30487952 PMCID: PMC6247106 DOI: 10.4251/wjgo.v10.i11.410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/14/2018] [Accepted: 10/17/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage II-III colon cancer.
METHODS This retrospective study included 942 patients with stage II and III colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC).
RESULTS The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage II and III disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage II; P = 0.547 and P = 0.481, respectively; stage III; P = 0.976 and P = 0.978, respectively). In patients with stage II and III disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage II; P = 0.381 and P = 0.947, respectively; stage III; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 ± 6.2 mo) and LCC (34 ± 4.9 mo) cases was eight months (P = 0.092).
CONCLUSION Our study showed no association of tumor localization with either DFS or OS in patients with stage II or III colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.
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Affiliation(s)
- Abdullah Sakin
- Department of Medical Oncology, Yuzuncu Yil University Medical School, Van 65090, Turkey
| | - Serdar Arici
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Saban Secmeler
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Orcun Can
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Nurgul Yasar
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Cumhur Demir
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Osman Gokhan Demir
- Department of Medical Oncology, Acıbadem University, Istanbul 34396, Turkey
| | - Sener Cihan
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
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17
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Park JH, Park HC, Park SC, Sohn DK, Oh JH, Kang SB, Heo SC, Kim MJ, Park JW, Jeong SY, Park KJ. Laparoscopic approach for left-sided T4 colon cancer is a safe and feasible procedure, compared to open surgery. Surg Endosc 2018; 33:2843-2849. [PMID: 30413928 DOI: 10.1007/s00464-018-6579-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/02/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND A laparoscopic approach can be attempted for pathologic T4 (pT4) colon cancer. Our aim was to evaluate the clinico-oncologic outcomes following laparoscopic versus open surgery for right and left-sided pT4 colon cancer. METHODS From a multicentric collaborative database, we enrolled 245 patients with right-sided colon cancer (RCC, 128 laparoscopy and 117 open) and 338 with left-sided colon cancer (LCC, 176 laparoscopy and 162 open). All patients underwent intended curative surgery for histologically proven T4 adenocarcinoma, between 2004 and 2013. The primary end-point of our analysis was the oncologic outcome, including the 5-year disease-free survival (5 year-DFS) and the 5-year overall survival (5 year-OS). The secondary end-points included the R0 resection rate and postoperative complications. RESULTS Our study group included 224 T4N0 and 359 T4N+ tumors. The median follow-up was 53 months. For patients with RCC, the rate of postoperative morbidities was lower for the laparoscopy than that for the open surgery group (12.5 vs. 22.2%, p = 0.044). There was no difference in the R0 resection rate (94.5 vs. 96.6%, p = 0.425) between the groups. The 5 year-DFS and 5 year-OS rates were lower for the laparoscopy than that in the open group (48.9% vs. 59.2%, p = 0.093; 60.0% vs. 70.0%, p = 0.284, respectively), but this difference was not statistically significant. Among patients with LCC, there were no differences in the rate of postoperative complication and R0 resection (15.3 vs. 21.0%, p = 0.307; 96.0 vs. 95.7%, p = 0.875, respectively). Both groups had comparable 5 year-DFS and 5 year-OS rates (62.7% vs. 61.1%, p = 0.552; 72.0% vs. 71.8%, p = 0.611, respectively). CONCLUSIONS Laparoscopic surgery appears to be a safe procedure for patients with pT4 LCC, but requires careful consideration for patients with pT4 RCC.
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Affiliation(s)
- Jung Ho Park
- Department of Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyoung-Chul Park
- Department of Surgery, Hallym University College of Medicine, Anyang, South Korea. .,Center for Colorectal Cancer, National Cancer Center, 323 Ilsan-Ro, Ilsan Dong-Gu, Goyang, 10408, South Korea.
| | - Sung Chan Park
- Center for Colorectal Cancer, National Cancer Center, 323 Ilsan-Ro, Ilsan Dong-Gu, Goyang, 10408, South Korea
| | - Dae Kyung Sohn
- Center for Colorectal Cancer, National Cancer Center, 323 Ilsan-Ro, Ilsan Dong-Gu, Goyang, 10408, South Korea
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center, 323 Ilsan-Ro, Ilsan Dong-Gu, Goyang, 10408, South Korea
| | - Sung-Bum Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Chul Heo
- Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Min Jung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Won Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea
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Siotos C, McColl M, Psoter K, Gilmore RC, Sebai ME, Broderick KP, Jacobs LK, Irwin S, Rosson GD, Habibi M. Tumor Site and Breast Cancer Prognosis. Clin Breast Cancer 2018; 18:e1045-e1052. [DOI: 10.1016/j.clbc.2018.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
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19
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Weiner AA, Gui B, Newman NB, Nosher JL, Yousseff F, Lu SE, Foltz GM, Carpizo D, Lowenthal J, Zuckerman DA, Benson B, Olsen JR, Jabbour SK, Parikh PJ. Predictors of Survival after Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases. J Vasc Interv Radiol 2018; 29:1094-1100. [PMID: 29754852 PMCID: PMC10905616 DOI: 10.1016/j.jvir.2018.02.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 02/14/2018] [Accepted: 02/17/2018] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To identify clinical parameters that are prognostic for improved overall survival (OS) after yttrium-90 radioembolization (RE) in patients with liver metastases from colorectal cancer (CRC). MATERIALS AND METHODS A total of 131 patients who underwent RE for liver metastases from CRC, treated at 2 academic centers, were reviewed. Twenty-one baseline pretreatment clinical factors were analyzed in relation to OS by the Kaplan-Meier method along with log-rank tests and univariate and multivariate Cox regression analyses. RESULTS The median OS from first RE procedure was 10.7 months (95% confidence interval [CI], 9.4-12.7 months). Several pretreatment factors, including lower carcinoembryonic antigen (CEA; ≤20 ng/mL), lower aspartate transaminase (AST; ≤40 IU/L), neutrophil-lymphocyte ratio (NLR) <5, and absence of extrahepatic disease at baseline were associated with significantly improved OS after RE, compared with high CEA (>20 ng/mL), high AST (>40 IU/L), NLR ≥5, and extrahepatic metastases (P values of <.001, <.001, .0001, and .04, respectively). On multivariate analysis, higher CEA, higher AST, NLR ≥5, extrahepatic disease, and larger volume of liver metastases remained independently associated with risk of death (hazard ratios of 1.63, 2.06, 2.22, 1.48, and 1.02, respectively). CONCLUSIONS The prognosis of patients with metastases from CRC is impacted by a complex set of clinical parameters. This analysis of pretreatment factors identified lower AST, lower CEA, lower NLR, and lower tumor burden (intra- or extrahepatic) to be independently associated with higher survival after hepatic RE. Optimal selection of patients with CRC liver metastases may improve survival rates after administration of yttrium-90.
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Affiliation(s)
- Ashley A Weiner
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Bin Gui
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Neil B Newman
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - John L Nosher
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Fady Yousseff
- Department of Radiation Oncology, Washington University School of Medicine, 660 South Euclid Ave, St Louis, Missouri 63110
| | - Shou-En Lu
- Rutgers School of Public Health, New Brunswick, New Jersey
| | - Gretchen M Foltz
- Department of Radiology, Washington University School of Medicine, 660 South Euclid Ave, St Louis, Missouri 63110
| | - Darren Carpizo
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Jonathan Lowenthal
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Darryl A Zuckerman
- Department of Radiology, Washington University School of Medicine, 660 South Euclid Ave, St Louis, Missouri 63110
| | - Ben Benson
- Department of Radiology, Jacobi Medical Center, Bronx, New York
| | - Jeffrey R Olsen
- Department of Radiation Oncology, University of Colorado, Denver, Colorado
| | - Salma K Jabbour
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Parag J Parikh
- Department of Radiation Oncology, Washington University School of Medicine, 660 South Euclid Ave, St Louis, Missouri 63110.
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20
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Marques MC, C Ribeiro HS, Costa WL, de Jesus VHF, de Macedo MP, Diniz AL, Godoy AL, Farias IC, Aguiar S, Riechelmann RSP, S Begnami MDF, Coimbra FJF. Is primary sidedness a prognostic factor in patients with resected colon cancer liver metastases (CLM)? J Surg Oncol 2018; 117:858-863. [PMID: 29611198 DOI: 10.1002/jso.25048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/21/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Recent studies have suggested that sidedness of origin from colorectal adenocarcinomas is a predictor of survival, however the impact of this factor in patients with resected colon cancer liver metastases (CLM) is not clear. So, in this study, we compared clinic and pathologic characteristics and long-term survival of patients with resected CLM according to the primary tumor location. METHODS This is a retrospective analyzes of a prospective database. Patients with resected CLM from 1998 to 2012 were included. Right colon included tumors from cecum to middle transverse colon, and left colon included tumors from splenic flexure to sigmoid. RESULTS One hundred fifty-one patients were included, 27 right colon and 124 left colon. In the latter group, there were more patients with synchronous disease (67.7 × 6.2%, P = 0.026) and a higher CEA (22.0 × 11.7 ng/mL, P = 0.001). However, K-Ras mutation was more frequent in right sided tumors (75.0 × 24.1%, P = 0.001). There was no difference in long term survival in both groups in this series even when adjusted for the confounding variables. CONCLUSION Sidedness do not seem to be a predictor of long term survival in patients with resected colon cancer liver metastases.
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Affiliation(s)
- Márcio C Marques
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Héber S C Ribeiro
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wílson L Costa
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | - Mariana P de Macedo
- Anatomic Pathology Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Alessandro L Diniz
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - André L Godoy
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Igor C Farias
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Samuel Aguiar
- Pelvic Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Felipe J F Coimbra
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
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21
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Aoyama T, Kashiwabara K, Oba K, Honda M, Sadahiro S, Hamada C, Maeda H, Mayanagi S, Kanda M, Sakamoto J, Saji S, Yoshikawa T. Clinical impact of tumor location on the colon cancer survival and recurrence: analyses of pooled data from three large phase III randomized clinical trials. Cancer Med 2017; 6:2523-2530. [PMID: 28948714 PMCID: PMC5673952 DOI: 10.1002/cam4.1208] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 12/25/2022] Open
Abstract
The aim of the present study was to determine whether or not the overall survival (OS) and disease-free survival (DFS) were affected by the tumor location in patients who underwent curative resection for colon cancer in a pooled analysis of three large phase III studies performed in Japan. In total, 4029 patients were included in the present study. Patients were classified as having right-side colon cancer (RC) if the primary tumor was located in the cecum, ascending colon, hepatic flexure or transverse colon, and left-side colon cancer (LCC) if the tumor site was within the splenic flexure, descending colon, sigmoid colon or recto sigmoid junction. The risk factors for the OS and DFS were analyzed. In the present study, 1449 patients were RC, and 2580 were LCC. The OS rates at 3 and 5 years after surgery were 87.6% and 81.6% in the RC group and 91.5% and 84.5% in the LCC group, respectively. Uni- and multivariate analyses showed that RRC increased the risk of death by 19.7% (adjusted hazard ratio = 1.197; 95% confidence interval, 1.020-1.408; P = 0.0272). In contrast, the DFS was similar between the two locations. The present study confirmed that the tumor location was a risk factor for the OS in patients who underwent curative treatment for colon cancer. Tumor location may, therefore, need to be considered a stratification factor in future phase III trials of colon cancer.
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Affiliation(s)
- Toru Aoyama
- Department of Surgery, Yokohama City University, Yokohama, Japan
| | | | - Koji Oba
- Department of Biostatistics, The University of Tokyo, Tokyo, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | | | - Chikuma Hamada
- Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi, Japan
| | - Shuhei Mayanagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Junichi Sakamoto
- Tokai Central Hospital, Kakamigahara, Japan.,Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan
| | - Shigetoyo Saji
- Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan
| | - Takaki Yoshikawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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