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Emile SH, Horesh N, Garoufalia Z, Dourado J, Rogers P, Salama E, Wexner SD. Accuracy of Clinical Staging of Localized Colon Cancer: A National Cancer Database Cohort Analysis. Ann Surg Oncol 2024; 31:6461-6469. [PMID: 39075244 DOI: 10.1245/s10434-024-15875-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND This study aimed to assess concordance between clinical and pathologic assessment of colon cancer. PATIENTS AND METHODS A retrospective cohort analysis of patients with stage I-III colon cancer in the National Cancer Database (2010-2019) was conducted. Concordance between clinical and pathologic assessment of colon cancer was calculated using Kappa coefficients and 95% confidence intervals (CIs). RESULTS A total of 125,473 patients (51.2% female; mean age 68.2 years) were included. There was moderate concordance between clinical and pathologic T stage (Kappa = 0.606, 95%CI: 0.602-0.609) and between clinical and pathologic N stage (Kappa = 0.506, 95%CI: 0.501-0.511). For right-sided colon cancer, there was moderate agreement between clinical and pathologic T stage (Kappa = 0.594, 95%CI: 0.589-0.599) and N stage (Kappa = 0.530, 95%CI: 0.523-0.537). For left-sided colon cancer, there was substantial agreement between clinical and pathologic T stage (Kappa = 0.624, 95%CI: 0.619-0.630) and moderate agreement between N stage (Kappa 0.472, 95%CI: 0.463-0.480). Sensitivity of clinical assessment of T and N stage ranged from 64.3% to 77.2% and 41.6% to 54.5%, respectively. Specificity ranged from 96.7% to 97.7% for T stage and 95.7% to 97.3% for N stage. CONCLUSIONS Clinical assessment of T and N stages of colon cancer had good diagnostic accuracy with moderate concordance with the final pathologic stage. While clinical assessment was highly specific with < 3% of patients being over-staged, it had modest sensitivity, especially for detection of nodal involvement. Diagnostic accuracy of clinical assessment of right and left colon cancers was similar, except for higher sensitivity and accuracy of assessment of nodal involvement in right than left colon cancers.
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Affiliation(s)
- Sameh Hany Emile
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
- General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospitals, Mansoura, Egypt
| | - Nir Horesh
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
- Department of Surgery and transplantation, Sheba Medical Center, Ramat-Gan, Israel
| | - Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Justin Dourado
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Peter Rogers
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Ebram Salama
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Steven D Wexner
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
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Dourado J, Rogers P, Emile S, Wignakumar A, Weiss B, Horesh N, Garoufalia Z, Aeschbacher P, Wexner S. Predictors of nodal positivity in clinically under-staged patients with colon cancer: A National Cancer Database study and proposal of a predictive scoring system. Am J Surg 2024; 235:115777. [PMID: 38834421 DOI: 10.1016/j.amjsurg.2024.115777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Colon cancer pathological and clinical staging may be disoncordant. This study assessed patients with colon cancer in whom the nodal status was clinically understaged. METHODS Patients with stage I-III clinical node-negative colon cancer from the National Cancer Database were included. Regression analyses were conducted to elucidate risk factors for clinical nodal understaging and a scoring system was developed to identify high-risk patients. RESULTS The study included 94,945 patients with 78.4 % of patients correctly staged and 21.6 % clinically understaged. The predictors of nodal positivity in clinically understaged patients were age <65 (OR 1.43), left-sided tumors (OR 1.41), elevated CEA (OR 2.03), moderately (OR 1.81) or poorly/undifferentiated tumors (OR 3.76), T1 tumors (OR 1.29), signet-ring cell histology (OR 2.26), and microsatellite-stable tumors (OR 1.4). CONCLUSION Patients with colon cancer and the above factors are more likely to have their nodal status clinically understaged. A scoring system has been developed to identify high-risk patients.
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Affiliation(s)
- Justin Dourado
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Peter Rogers
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Sameh Emile
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA; Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura, Egypt
| | - Anjelli Wignakumar
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Brett Weiss
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Nir Horesh
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA; Department of Surgery and Transplantation, Sheba Medical Center, Ramat-Gan, Israel
| | - Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA
| | - Pauline Aeschbacher
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Steven Wexner
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
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Wang B, Hu T, Shen R, Liu L, Qiao J, Zhang R, Zhang Z. A 18F-FDG PET/CT based radiomics nomogram for predicting disease-free survival in stage II/III colorectal adenocarcinoma. Abdom Radiol (NY) 2024:10.1007/s00261-024-04515-1. [PMID: 39096393 DOI: 10.1007/s00261-024-04515-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVES This study aimed to establish a clinical nomogram model based on a radiomics signatures derived from 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG PET/CT) and clinical parameters to predict disease-free survival (DFS) in patients with stage II/III colorectal adenocarcinoma. Understanding and predicting DFS in these patients is key to optimizing treatment strategies. METHODS A retrospective analysis included 332 cases from July 2011 to July 2021 at The Sixth Affiliated Hospital, Sun Yat-sen University, with PET/CT assessing radiomics features and clinicopathological features. Univariate Cox regression, the least absolute shrinkage and selection operator (LASSO) Cox, and multivariable Cox regression identified recurrence-related radiomics features. We used a weighted radiomics score (Rad-score) and independent risk factors to construct a nomogram. Evaluation involved time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). RESULTS The nomogram, incorporating Rad-score, pN, and pT demonstrated robust predictive ability for DFS in stage II/III colorectal adenocarcinoma. Training cohort areas under the curve (AUCs) were 0.78, 0.80, and 0.86 at 1, 2, and 3 years, respectively, and validation cohort AUCs were 0.79, 0.75, and 0.73. DCA and calibration curves affirmed the nomogram's clinical relevance. CONCLUSION The 18F-FDG PET/CT based radiomics nomogram, including Rad-score, pN, and pT, effectively predicted tumor recurrence in stage II/III colorectal adenocarcinoma, significantly enhancing prognostic stratification. Our findings highlight the potential of this nomogram as a guide for clinical decision making to improve patient outcomes.
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Affiliation(s)
- Bing Wang
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tianyuan Hu
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Rongfang Shen
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- The First People's Hospital of Xinjiang Kashgar Area, Kashgar, Xinjiang, China
| | - Lian Liu
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junwei Qiao
- The First People's Hospital of Xinjiang Kashgar Area, Kashgar, Xinjiang, China
| | - Rongqin Zhang
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Zhanwen Zhang
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Cao X, Wu B, Guo S, Zhong W, Zhang Z, Li H. Construction of prognostic nomogram based on the SEER database for esophageal cancer patients. Clinics (Sao Paulo) 2024; 79:100433. [PMID: 39079460 PMCID: PMC11334687 DOI: 10.1016/j.clinsp.2024.100433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/12/2024] [Indexed: 08/09/2024] Open
Abstract
Currently, the incidence of esophageal cancer continues to rise around the world. Because of its good early prognosis, it is of great significance to establish an effective model for predicting the survival of EC patients. The purpose of this study was to predict survival after diagnosis in Esophageal Cancer (EC) patients by constructing a valid clinical nomogram. In this study, 5037 EC patient samples diagnosed from 2010 to 2015 were screened by accessing the SEER database, and 8 independent prognostic factors were screened by various methods, and Cox multivariate regression was included to construct a prognostic model and nomogram for esophageal cancer. to estimate esophageal cancer recurrence and overall survival. Calibration of the nomogram predicted probabilities of 1-year, 3-year and 5-year survival probability, which were closely related to actual survival. In conclusion, this study validated that the column-line graphical model can be considered an individualized quantitative tool for predicting the prognosis of patients with EC in order to assist clinicians in making therapeutic decisions.
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Affiliation(s)
- Xiying Cao
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Department of Thoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, China.
| | - Bingqun Wu
- Department of Thoracic Surgery, Huaxin Hospital, First Hospital of Tsinghua University, Beijing, China
| | - Shaoming Guo
- Department of Thoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, China
| | - Weixiang Zhong
- Department of Thoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, China
| | - Zuxiong Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Balaban V, Mutyk M, Bondarenko N, Zolotukhin S, Sovpel O, Sovpel I, Zykov D, Rublevskiy I, Klochkov M, Prado AP, He M, Tsarkov P. Comparison of D2 vs D3 lymph node dissection for RIght COloN cancer (RICON): study protocol for an international multicenter open-label randomized controlled trial. Trials 2024; 25:438. [PMID: 38956698 PMCID: PMC11221103 DOI: 10.1186/s13063-024-08269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 06/18/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Colon cancer is a global health concern, ranking fifth in both new diagnoses and deaths among tumors worldwide. Surgical intervention remains the primary treatment for localized cases, with a historical evolution marked by a focus on short-term outcomes. While Japan pioneered radical tumor removal with a systematic categorization of lymph nodes (D1, D2, D3), the dissemination of Japanese practices to the West was delayed until 90th of last century. Discrepancies between Japanese D3 dissection and the CME with CVL principle persist, with variations in longitudinal margins and recommended procedures. Non-randomized trials indicate the superiority of D3 over D2, but a consensus is lacking. METHODS This prospective, international, multicenter, randomized controlled trial employs a two-arm, parallel-group, open-label design to rigorously compare the 5-year overall survival outcomes between D2 and D3 lymph node dissection in stage II-III right colon cancer. Building on prior studies, the trial aims to address existing knowledge gaps and provide a comprehensive evaluation of the outcomes associated with D3 dissection. The study population comprises patients with right colon cancer, ensuring a focused investigation into the specific context of this disease. The trial design emphasizes its global scope and collaboration across multiple centers, enhancing the generalizability of the findings. DISCUSSION This study's primary objective is to elucidate the potential superiority in 5-year overall survival benefits of D3 lymph node dissection compared to the conventional D2 approach in patients with stage II-III right colon cancer. By examining this specific subset of patients, the research aims to contribute valuable insights into optimizing surgical strategies for improved long-term outcomes. The trial's international and multicenter nature enhances its applicability across diverse populations. The outcomes of this study may inform future guidelines and contribute to the ongoing discourse surrounding the standardization of colon cancer surgery, particularly in the context of right colon cancer. TRIAL REGISTRATION ClinicalTrials.gov NCT03200834. Registered on June 27, 2017.
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Affiliation(s)
| | - Mikhail Mutyk
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
| | - Nikolay Bondarenko
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
- M. Gorky Donetsk National Medical University, Donetsk, Ukraine
| | - Stanislav Zolotukhin
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
- M. Gorky Donetsk National Medical University, Donetsk, Ukraine
| | - Oleg Sovpel
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
- M. Gorky Donetsk National Medical University, Donetsk, Ukraine
| | - Igor Sovpel
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
- M. Gorky Donetsk National Medical University, Donetsk, Ukraine
| | - Dmitriy Zykov
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
| | - Igor Rublevskiy
- G.V. Bondar Republican Cancer Center, Donetsk, Ukraine
- M. Gorky Donetsk National Medical University, Donetsk, Ukraine
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Arredondo J, Almeida A, Castañón C, Sánchez C, Villafañe A, Tejedor P, Simó V, Baixauli J, Rodríguez J, Pastor C. The ELECLA trial: A multicentre randomised control trial on outcomes of neoadjuvant treatment on locally advanced colon cancer. Colorectal Dis 2024; 26:745-753. [PMID: 38362850 DOI: 10.1111/codi.16908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Colon cancer (CC) is a public health concern with increasing incidence in younger populations. Treatment for locally advanced CC (LACC) involves oncological surgery and adjuvant chemotherapy (AC) to reduce recurrence and improve overall survival (OS). Neoadjuvant chemotherapy (NAC) is a novel approach for the treatment of LACC, and research is underway to explore its potential benefit in terms of survival. This trial will assess the efficacy of NAC in LACC. METHODS This is a multicentre randomised, parallel-group, open label controlled clinical trial. Participants will be selected based on homogenous inclusion criteria and randomly assigned to two treatment groups: NAC, surgery, and AC or surgery followed by AC. The primary aim of this study is to evaluate the 2-year progression-free survival (PFS), with secondary outcomes including 5-year PFS, 2- and 5-year OS, toxicity, radiological and pathological response, morbidity, and mortality. DISCUSSION The results of this study will determine whether NAC induces a clinical and histological tumour response in patients with CCLA and if this treatment sequence improves survival without increasing morbidity and mortality. REGISTRATION NUMBER NCT04188158.
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Affiliation(s)
- Jorge Arredondo
- Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - Ana Almeida
- Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Carmen Castañón
- Department of Oncology, University Hospital of León, Leon, Spain
| | - Carlos Sánchez
- Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - Amaya Villafañe
- Department of General Surgery, University Hospital of León, Leon, Spain
| | - Patricia Tejedor
- Department of General Surgery, University Hospital Gregorio Marañón, Madrid, Spain
| | - Vicente Simó
- Department of General Surgery, University Hospital Río Hortega, Valladolid, Spain
| | - Jorge Baixauli
- Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
- Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - Javier Rodríguez
- Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
- Department of Oncology, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Carlos Pastor
- Department of General Surgery, Clínica Universidad de Navarra, University of Navarra, Madrid, Spain
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Lloy S, Lin M, Franko J, Raman S. The Future of Interventions for Stage IV Colorectal Cancers. Clin Colon Rectal Surg 2024; 37:114-121. [PMID: 38327731 PMCID: PMC10843879 DOI: 10.1055/s-0043-1761624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Future options for the management of stage IV colorectal cancer are primarily focused on personalized and directed therapies. Interventions include precision cancer medicine, utilizing nanocarrier platforms for directed chemotherapy, palliative pressurized intraperitoneal aerosol chemotherapy (PIPAC), adjunctive oncolytic virotherapy, and radioembolization techniques. Comprehensive genetic profiling provides specific tumor-directed therapy based on individual genetics. Biomimetic magnetic nanoparticles as chemotherapy delivery systems may reduce systemic side effects of traditional chemotherapy by targeting tumor cells and sparing healthy cells. PIPAC is a newly emerging option for patients with peritoneal metastasis from colorectal cancer and is now being used internationally, showing promising results as a palliative therapy for colorectal cancer. Oncolytic virotherapy is another emerging potential treatment option, especially when combined with standard chemotherapy and/or radiation, as well as immunotherapy. And finally, radioembolization with yttrium-90 ( 90 Y) microspheres has shown some success in treating patients with unresectable liver metastasis from colorectal cancer via selective arterial injection.
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Affiliation(s)
- Samantha Lloy
- General Surgery Residency Program, MercyOne Des Moines Medical Center, Des Moines, Iowa
| | - Mayin Lin
- General Surgery Residency Program, MercyOne Des Moines Medical Center, Des Moines, Iowa
| | - Jan Franko
- General Surgery Residency Program, MercyOne Des Moines Medical Center, Des Moines, Iowa
| | - Shankar Raman
- General Surgery Residency Program, MercyOne Des Moines Medical Center, Des Moines, Iowa
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8
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Schepers EJ, Hartman SJ, Whitrock JN, Quillin RC. Liver Transplantation for Colorectal Liver Metastases. Surg Clin North Am 2024; 104:227-242. [PMID: 37953038 DOI: 10.1016/j.suc.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Colorectal cancer is one of the most common malignancies worldwide. Approximately half of the patients diagnosed will develop colorectal liver metastases (CRLM). Liver resection has a 50% 5-year survival; however, only a fourth of cases are resectable. Unresectable CRLM has poor prognosis despite improved systemic and local ablative treatments. Liver transplantation (LT) has demonstrated a survival benefit in initial prospective clinical trials. Current use of LT for CRLM is limited to several randomized trials and high-performing centers. Improving patient selection criteria and perioperative management, LT will likely become an important part of the multidisciplinary approach to managing the metastatic disease.
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Affiliation(s)
- Emily J Schepers
- Division of Transplantation, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA.
| | - Stephen J Hartman
- Division of Transplantation, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA
| | - Jenna N Whitrock
- Division of Transplantation, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA
| | - Ralph C Quillin
- Division of Transplantation, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA
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Mroczkowski P, Kim S, Otto R, Lippert H, Zajdel R, Zajdel K, Merecz-Sadowska A. Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection. Cancers (Basel) 2024; 16:218. [PMID: 38201643 PMCID: PMC10778473 DOI: 10.3390/cancers16010218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/10/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Due to the impact of nodal metastasis on colon cancer prognosis, adequate regional lymph node resection and accurate pathological evaluation are required. The ratio of metastatic to examined nodes may bring an additional prognostic value to the actual staging system. This study analyzes the identification of factors influencing a high lymph node yield and its impact on survival. The lymph node ratio was determined in patients with fewer than 12 or at least 12 evaluated nodes. The study included patients after radical colon cancer resection in UICC stages II and III. For the lymph node ratio (LNR) analysis, node-positive patients were divided into four categories: i.e., LNR 1 (<0.05), LNR 2 (≥0.05; <0.2), LNR 3 (≥0.2; <0.4), and LNR 4 (≥0.4), and classified into two groups: i.e., those with <12 and ≥12 evaluated nodes. The study was conducted on 7012 patients who met the set criteria and were included in the data analysis. The mean number of examined lymph nodes was 22.08 (SD 10.64, median 20). Among the study subjects, 94.5% had 12 or more nodes evaluated. These patients were more likely to be younger, women, with a lower ASA classification, pT3 and pN2 categories. Also, they had no risk factors and frequently had a right-sided tumor. In the multivariate analysis, a younger age, ASA classification of II and III, high pT and pN categories, absence of risk factors, and right-sided location remained independent predictors for a lymph node yield ≥12. The univariate survival analysis of the entire cohort demonstrated a better five-year overall survival (OS) in patients with at least 12 lymph nodes examined (68% vs. 63%, p = 0.027). The LNR groups showed a significant association with OS, reaching from 75.5% for LNR 1 to 33.1% for LNR 4 (p < 0.001) in the ≥12 cohort, and from 74.8% for LNR2 to 49.3% for LNR4 (p = 0.007) in the <12 cohort. This influence remained significant and independent in multivariate analyses. The hazard ratios ranged from 1.016 to 2.698 for patients with less than 12 nodes, and from 1.248 to 3.615 for those with at least 12 nodes. The LNR allowed for a more precise estimation of the OS compared with the pN classification system. The metastatic lymph node ratio is an independent predictor for survival and should be included in current staging and therapeutic decision-making processes.
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Affiliation(s)
- Paweł Mroczkowski
- Department for General and Colorectal Surgery, Medical University of Lodz, Pl. Hallera 1, 90-647 Lodz, Poland;
- Institute for Quality Assurance in Operative Medicine Ltd., Otto-von-Guericke-University, Leipziger Str. 44, 39120 Magdeburg, Germany; (S.K.); (R.O.); (H.L.)
- Department for Surgery, University Hospital Knappschaftskrankenhaus, Ruhr-University, In der Schornau 23-25, 44892 Bochum, Germany
| | - Samuel Kim
- Institute for Quality Assurance in Operative Medicine Ltd., Otto-von-Guericke-University, Leipziger Str. 44, 39120 Magdeburg, Germany; (S.K.); (R.O.); (H.L.)
- Sanitätsversorgungszentrum Torgelow, Bundeswehr Neumühler Str. 10b, 17358 Torgelow, Germany
| | - Ronny Otto
- Institute for Quality Assurance in Operative Medicine Ltd., Otto-von-Guericke-University, Leipziger Str. 44, 39120 Magdeburg, Germany; (S.K.); (R.O.); (H.L.)
| | - Hans Lippert
- Institute for Quality Assurance in Operative Medicine Ltd., Otto-von-Guericke-University, Leipziger Str. 44, 39120 Magdeburg, Germany; (S.K.); (R.O.); (H.L.)
- Department for General, Visceral and Vascular Surgery, Otto-von-Guericke-University, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Radosław Zajdel
- Department of Economic and Medical Informatics, University of Lodz, 90-214 Lodz, Poland;
- Department of Medical Informatics and Statistics, Medical University of Lodz, 90-645 Lodz, Poland;
| | - Karolina Zajdel
- Department of Medical Informatics and Statistics, Medical University of Lodz, 90-645 Lodz, Poland;
| | - Anna Merecz-Sadowska
- Department of Economic and Medical Informatics, University of Lodz, 90-214 Lodz, Poland;
- Department of Allergology and Respiratory Rehabilitation, Medical University of Lodz, 90-725 Lodz, Poland
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10
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Zhang T, Miao YC. Prognostic evaluation of preoperative systemic immune inflammatory index in patients with colorectal cancer. Front Oncol 2023; 13:1260796. [PMID: 38188293 PMCID: PMC10768044 DOI: 10.3389/fonc.2023.1260796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/25/2023] [Indexed: 01/09/2024] Open
Abstract
Objective To investigate the impact of preoperative systemic immune inflammatory index (SII) on the clinical prognosis of patients undergoing colorectal cancer (CRC) surgery. Methods One hundred and sixty CRC patients who underwent surgical treatment in our gastrointestinal surgery department from January 2019 to May 2023 were collected. ROC curves were applied to determine the sensitivity and specificity of SII, determine the optimal cut-off value into low SII and high SII groups, compare the clinicopathological data of SII patients in the two groups, and analyze the postoperative survival of patients in the two groups using Kaplan-Meier and Log-rank methods. Univariate and multifactor COX proportional risk regression models were used to analyze clinical prognostic factors. Results The ROC curve showed that the area under the curve of SII for the evaluation of OS in CRC patients was 0.859, and the best cut-off value was 513.53. There was statistical significance (P < 0.05) in terms of tissue grading and diabetes mellitus in both groups. The Kaplan-Meier survival curves showed that the overall survival rates of the SII<513.53 group and the SII≥513.53 group were 50.88% (29/57) and 32.04% (33/103), and the overall survival rate of the SII<513.53 group was significantly higher than that of the SII≥513.53 group, and the difference was statistically significance (χ2 = 8.375, P=0.004). COX proportional risk regression showed that TNM stage, lymph node metastases, anastomotic fistula and SII were independent risk factors affecting postoperative survival in patients with CRC. Conclusion Preoperative SII is an independent prognostic factor for CRC, which is simple, convenient, and non-invasive, and can be used to predict the prognosis of CRC patients.
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Affiliation(s)
| | - Yong chang Miao
- Department of Gastrointestinal Surgery, Bengbu Medical College Lianyungang Clinical College, The Second People’s Hospital of Lianyungang, Lianyungang, Lianyungang, Jiangsu, China
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11
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He M, Cao ZF, Huang L, Zhong WJ, Xu XM, Zeng XL, Wang J. Correlation between the expressions of metastasis-associated factor-1 in colon cancer and vacuolar ATP synthase. World J Gastrointest Surg 2023; 15:2463-2469. [PMID: 38111774 PMCID: PMC10725535 DOI: 10.4240/wjgs.v15.i11.2463] [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: 07/27/2023] [Revised: 08/18/2023] [Accepted: 10/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Clinical prognosis often worsens due to high recurrence rates following radical surgery for colon cancer. The examination of high-risk recurrence factors post-surgery provides critical insights for disease evaluation and treatment planning. AIM To explore the relationship between metastasis-associated factor-1 in colon cancer (MACC1) and vacuolar ATP synthase (V-ATPase) expression in colon cancer tissues, and recurrence rate in patients undergoing radical colon cancer surgery. METHODS We selected 104 patients treated with radical colon cancer surgery at our hospital from January 2018 to June 2021. Immunohistochemical staining was utilized to assess the expression levels of MACC1 and V-ATPase in these patients. RESULTS The rates of MACC1 and V-ATPase positivity were 64.42% and 67.31%, respectively, in colon cancer tissues, which were significantly higher than in paracancerous tissues (P < 0.05). Among patients with TNM stage III, medium to low differentiation, and lymph node metastasis, the positive rates of MACC1 and V-ATPase were significantly elevated in comparison to patients with TNM stage I-II, high differentiation, and no lymph node metastasis (P < 0.05). The rate of MACC1 positivity was 76.67% in patients with tumor diameters > 5 cm, notably higher than in patients with tumor diameters ≤ 5 cm (P < 0.05). We observed a positive correlation between MACC1 and V-ATPase expression (rs = 0.797, P < 0.05). The positive rates of MACC1 and V-ATPase were significantly higher in patients with recurrence compared to those without (P < 0.05). Logistic regression analysis revealed TNM stage, lymph node metastasis, MACC1 expression, and V-ATPase expression as risk factors for postoperative colon cancer recurrence (OR = 6.322, 3.435, 2.683, and 2.421; P < 0.05). CONCLUSION The upregulated expression of MACC1 and V-ATPase in colon cancer patients appears to correlate with clinicopathological features and post-radical surgery recurrence.
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Affiliation(s)
- Miao He
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Zuo-Feng Cao
- Department of Cardiology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Li Huang
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Wen-Juan Zhong
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Xue-Ming Xu
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Xiao-Li Zeng
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
| | - Jing Wang
- Department of Oncology, The First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, Jiangxi Province, China
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12
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Yang Y, Xu P, Zhang C. Construction of the survival nomograms for colon cancer patients of different ages based on the SEER database. J Cancer Res Clin Oncol 2023; 149:15395-15406. [PMID: 37639008 PMCID: PMC10620318 DOI: 10.1007/s00432-023-05323-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Three nomograms for predicting the outcomes of early- and late-onset colon cancer (COCA) among patients not stratified by age were constructed using data in the Epidemiology and End Results (SEER) database (1975-2019). The accuracy of the nomogram was then assessed. METHOD Clinical data of 6107 patients with COCA were obtained from the SEER database. The patients were randomly divided into training and validation cohorts in a ratio of 7:3. Univariate and multivariate COX analyses of factors that could independently impact the prognosis of COCA were performed, and the corresponding nomograms for early-onset and late-onset COCA were constructed. Calibration curves, ROC curves, and C-index were used to determine the predictive accuracy. The discriminatory ability of the nomograms to assess their clinical utility, which was compared with the TNM staging system of the 8th edition of AJCC, was verified using survival analysis. RESULT Tumor primary site, ethnicity, and serum carcinoembryonic antigen (CEA) level significantly impacted the prognosis of colon cancer. Race, brain metastasis, and CEA were independent factors for predicting COCA prognosis. C-index, ROC, and calibration curves demonstrated that the three nomograms were accurate and superior to the traditional TNM staging system. Among the three nomograms, the early-onset COCA nomogram had the highest predictive accuracy, followed by that of colon cancer not stratified by age. CONCLUSION Three nomograms for patients not stratified by age, early-onset colon cancer, and late-onset colon cancer were constructed. The accuracies of the nomograms were good and were all superior to the conventional TNM staging system. The early- and late-onset COCA nomograms are useful for clinical management and individualized treatment of COCA patients at different ages.
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Affiliation(s)
- Yuzhou Yang
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Peng Xu
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China.
| | - Cheng Zhang
- Department of General Surgery, General Hospital of Northern Theater Command (General Hospital of Shenyang Military Command), Shenyang, Liaoning Province, China.
- Jinzhou Medical University, Jinzhou, Liaoning Province, China.
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13
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Lei YP, Song QZ, Liu S, Xie JY, Lv GQ. Predicting lymph node metastasis in colorectal cancer: An analysis of influencing factors to develop a risk model. World J Gastrointest Surg 2023; 15:2234-2246. [PMID: 37969707 PMCID: PMC10642478 DOI: 10.4240/wjgs.v15.i10.2234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a significant global health issue, and lymph node metastasis (LNM) is a crucial prognostic factor. Accurate prediction of LNM is essential for developing individualized treatment strategies for patients with CRC. However, the prediction of LNM is challenging and depends on various factors such as tumor histology, clinicopathological features, and molecular characteristics. The most reliable method to detect LNM is the histopathological examination of surgically resected specimens; however, this method is invasive, time-consuming, and subject to sampling errors and interobserver variability. AIM To analyze influencing factors and develop and validate a risk prediction model for LNM in CRC based on a large patient queue. METHODS This study retrospectively analyzed 300 patients who underwent CRC surgery at two Peking University Shenzhen hospitals between January and December 2021. A deep learning approach was used to extract features potentially associated with LNM from primary tumor histological images while a logistic regression model was employed to predict LNM in CRC using machine-learning-derived features and clinicopathological variables as predictors. RESULTS The prediction model constructed for LNM in CRC was based on a logistic regression framework that incorporated machine learning-extracted features and clinicopathological variables. The model achieved high accuracy (0.86), sensitivity (0.81), specificity (0.87), positive predictive value (0.66), negative predictive value (0.94), area under the curve for the receiver operating characteristic (0.91), and a low Brier score (0.10). The model showed good agreement between the observed and predicted probabilities of LNM across a range of risk thresholds, indicating good calibration and clinical utility. CONCLUSION The present study successfully developed and validated a potent and effective risk-prediction model for LNM in patients with CRC. This model utilizes machine-learning-derived features extracted from primary tumor histology and clinicopathological variables, demonstrating superior performance and clinical applicability compared to existing models. The study provides new insights into the potential of deep learning to extract valuable information from tumor histology, in turn, improving the prediction of LNM in CRC and facilitate risk stratification and decision-making in clinical practice.
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Affiliation(s)
- Yun-Peng Lei
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Qing-Zhi Song
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Shuang Liu
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Ji-Yan Xie
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Guo-Qing Lv
- Department of Gastrointestinal Surgery, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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Jurescu A, Văduva A, Vița O, Gheju A, Cornea R, Lăzureanu C, Mureșan A, Cornianu M, Tăban S, Dema A. Colorectal Carcinomas: Searching for New Histological Parameters Associated with Lymph Node Metastases. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1761. [PMID: 37893479 PMCID: PMC10608479 DOI: 10.3390/medicina59101761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Colorectal cancer (CRC) continues to be an essential public health problem. Our study aimed to evaluate the prognostic significance of classic prognostic factors and some less-studied histopathological parameters in CRC. Materials and Methods: We performed a retrospective study on 71 colorectal carcinoma patients who underwent surgery at the "Pius Brînzeu" County Clinical Emergency Hospital in Timișoara, Romania. We analyzed the classic parameters but also tumor budding (TB), poorly differentiated clusters (PDCs) of cells, tumor-infiltrating lymphocytes (TILs), and the configuration of the tumor border on hematoxylin-eosin slides. Results: A high degree of malignancy (p = 0.006), deep invasion of the intestinal wall (p = 0.003), an advanced stage of the disease (p < 0.0001), lymphovascular invasion (p < 0.0001), perineural invasion (p < 0.0001), high-grade TB (p < 0.0001), high-grade PDCs (p < 0.0001), infiltrative tumor border configuration (p < 0.0001) showed a positive correlation with lymph node metastases. Conclusions: The analyzed parameters positively correlate with unfavorable prognostic factors in CRC. We highlight the value of classic prognostic factors along with a series of less-known parameters that are more accessible and easier to evaluate using standard staining techniques and that could predict the risk of relapse or aggressive evolution in patients with CRC.
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Affiliation(s)
- Aura Jurescu
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Adrian Văduva
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Octavia Vița
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Adelina Gheju
- Emergency County Hospital Deva, 330032 Deva, Romania
| | - Remus Cornea
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Codruța Lăzureanu
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Anca Mureșan
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Marioara Cornianu
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Sorina Tăban
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
| | - Alis Dema
- Department of Microscopic Morphology-Morphopathology, ANAPATMOL Research Center, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pathology, “Pius Brînzeu” County Clinical Emergency Hospital, 300723 Timişoara, Romania
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Ling J, Lin Z, Shi L, Lin Y, Liu X, Lin J, Li J, Zhang J, Hu H, Cai Y, Deng Y. Capecitabine maintenance therapy in metastatic colorectal cancer patients with no evidence of disease: CAMCO trial. Future Oncol 2023; 19:2045-2054. [PMID: 37814832 DOI: 10.2217/fon-2023-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Abstract
Background: In patients with metastatic colorectal cancer (mCRC) exhibiting no evidence of disease (NED), this study assessed the efficacy and safety of capecitabine maintenance therapy. Methods: The single-arm, phase II CAMCO trial enrolled mCRC-NED patients after first-line treatment, administering oral capecitabine maintenance for 1 year. Results: A total of 93 patients were enrolled. The primary end point, 3-year disease-free survival, yielded a rate of 51.6% (95% CI: 41.3-62.0%). Secondary end points included a 3-year overall survival rate of 83.9% (95% CI: 76.3-91.5%). Grade 3 adverse events (AE) were observed in seven patients (7.5%). Predominantly grade 1 and 2, the most common AE was hand-foot syndrome. Conclusion: In mCRC-NED patients, capecitabine maintenance demonstrated a manageable 3-year disease-free survival rate of 51.6%, accompanied by manageable AEs. Clinical Trial Registration: NCT01880658 (ClinicalTrials.gov).
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Affiliation(s)
- Jiayu Ling
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Ziqin Lin
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Lishuo Shi
- Center for Clinical Research, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Yan Lin
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Xin Liu
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Junyan Lin
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Jianxia Li
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Jianwei Zhang
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Huabin Hu
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Yue Cai
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Provincial Key Laboratory of Colorectal & Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
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16
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Lee CS. Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes. Ann Coloproctol 2023; 39:287-288. [PMID: 37648422 PMCID: PMC10475799 DOI: 10.3393/ac.2023.00486.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 07/30/2023] [Accepted: 07/30/2023] [Indexed: 09/01/2023] Open
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17
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Liu J, Tao Y, Lan R, Zhong J, Liu R, Chen P. Identifying the critical state of cancers by single-sample Markov flow entropy. PeerJ 2023; 11:e15695. [PMID: 37520244 PMCID: PMC10373650 DOI: 10.7717/peerj.15695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/14/2023] [Indexed: 08/01/2023] Open
Abstract
Background The progression of complex diseases sometimes undergoes a drastic critical transition, at which the biological system abruptly shifts from a relatively healthy state (before-transition stage) to a disease state (after-transition stage). Searching for such a critical transition or critical state is crucial to provide timely and effective scientific treatment to patients. However, in most conditions where only a small sample size of clinical data is available, resulting in failure when detecting the critical states of complex diseases, particularly only single-sample data. Methods In this study, different from traditional methods that require multiple samples at each time, a model-free computational method, single-sample Markov flow entropy (sMFE), provides a solution to the identification problem of critical states/pre-disease states of complex diseases, solely based on a single-sample. Our proposed method was employed to characterize the dynamic changes of complex diseases from the perspective of network entropy. Results The proposed approach was verified by unmistakably identifying the critical state just before the occurrence of disease deterioration for four tumor datasets from The Cancer Genome Atlas (TCGA) database. In addition, two new prognostic biomarkers, optimistic sMFE (O-sMFE) and pessimistic sMFE (P-sMFE) biomarkers, were identified by our method and enable the prognosis evaluation of tumors. Conclusions The proposed method has shown its capability to accurately detect pre-disease states of four cancers and provide two novel prognostic biomarkers, O-sMFE and P-sMFE biomarkers, to facilitate the personalized prognosis of patients. This is a remarkable achievement that could have a major impact on the diagnosis and treatment of complex diseases.
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Affiliation(s)
- Juntan Liu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Yuan Tao
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Ruoqi Lan
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Jiayuan Zhong
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
- School of Mathematics and Big Data, Foshan University, Foshan, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Pei Chen
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong Province, China
- Pazhou Lab, Guangzhou, Guangdong Province, China
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Gao L, Yuan C, Fu J, Tian T, Huang H, Zhang L, Li D, Liu Y, Meng S, Liu Y, Zhang Y, Xu J, Jia C, Zhang D, Zheng T, Fu Q, Tan S, Lan L, Yang C, Zhao Y, Liu Y. Prognostic scoring system based on eosinophil- and basophil-related markers for predicting the prognosis of patients with stage II and stage III colorectal cancer: a retrospective cohort study. Front Oncol 2023; 13:1182944. [PMID: 37519795 PMCID: PMC10375403 DOI: 10.3389/fonc.2023.1182944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Background Systemic inflammation is associated with the prognosis of colorectal cancer (CRC). The current study aimed to construct a comprehensively inflammatory prognostic scoring system named risk score (RS) based on eosinophil- and basophil-related markers and assess its prognostic value in patients with stage II and stage III CRC. Patients and methods A total of 3,986 patients were enrolled from January 2007 to December 2013. The last follow-up time was January 2019. They were randomly assigned to the training set and testing set in a 3:2 split ratio. Least absolute shrinkage and selection operator (LASSO)-Cox regression analysis was performed to select the optimal prognostic factors in the construction of RS. The Kaplan-Meier curve, time-dependent receiver operating characteristic (ROC), and Cox analysis were used to evaluate the association between RS and overall survival (OS). Results In the training set, all inflammatory markers showed certain prognostic values. Based on LASSO-Cox analysis, nine markers were integrated to construct RS. The Kaplan-Meier curve showed that a higher RS (RS > 0) had a significantly worse prognosis (log-rank p< 0.0001). RS (>0) remained an independent prognostic factor for OS (hazard ratio (HR): 1.70, 95% confidence interval (CI), 1.43-2.03, p< 0.001). The prognostic value of RS was validated in the entire cohort. Time-dependent ROC analysis showed that RS had a stable prognostic effect throughout the follow-up times and could enhance the prognostic ability of the stage by combination. Nomogram was established based on RS and clinicopathological factors for predicting OS in the training set and validated in the testing set. The area under the curve (AUC) values of the 3-year OS in the training and testing sets were 0.748 and 0.720, respectively. The nomogram had a satisfactory predictive accuracy and had better clinical application value than the tumor stage alone. Conclusions RS might be an independent prognostic factor for OS in patients with stage II and III CRC, which is helpful for risk stratification of patients. Additionally, the nomogram might be used for personalized prediction and might contribute to formulating a better clinical treatment plan.
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Affiliation(s)
- Lijing Gao
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Chao Yuan
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Jinming Fu
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Tian Tian
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Hao Huang
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Lei Zhang
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Dapeng Li
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Yupeng Liu
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Shuhan Meng
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Liu
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuanyuan Zhang
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Jing Xu
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Chenyang Jia
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Ding Zhang
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Ting Zheng
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Qingzhen Fu
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Shiheng Tan
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Li Lan
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, Heilongjiang, China
| | - Chao Yang
- Division of Chronic and Non-communicable Diseases, Harbin Center for Diseases Control and Prevention, Harbin, Heilongjiang, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, NHC Key Laboratory of Etiology and Epidemiology (23618504), Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanlong Liu
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
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19
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Li S, Yao W, Liu R, Lu Y, Zhang H, Liang X. Severe lymphopenia as a prognostic factor in rectal cancer patients receiving adjuvant chemoradiotherapy: a retrospective study. Sci Rep 2023; 13:7566. [PMID: 37161043 PMCID: PMC10170099 DOI: 10.1038/s41598-023-34145-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/25/2023] [Indexed: 05/11/2023] Open
Abstract
The relationship between total lymphocyte counts (TLCs) and survival is not well documented in rectal cancer. This study aimed to investigate the association between TLCs and disease-free survival (DFS) and identify factors associated with lymphopenia in locally advanced rectal cancer patients receiving chemoradiotherapy. Thirty-six patients with locally advanced rectal cancer were retrospectively analyzed. TLCs were evaluated before surgery (pre-S), before radiotherapy (pre-RT), and during concurrent chemoradiotherapy (CCRT). The relationship between TLCs and DFS was analyzed by univariate and multivariate analysis. Potential clinical factors associated with lymphopenia were also evaluated. Median TLC declined significantly during radiotherapy. Severe lymphopenia during CCRT was significantly associated with poorer DFS on Kaplan-Meier analysis (p = 0.01), univariate regression analysis (p = 0.036), and multivariate regression analysis (p = 0.038). Pre-S TLCs (p = 0.009) and pre-RT TLCs (p = 0.042) were significantly associated with severe lymphopenia on univariate regression analysis; however, only pre-S TLCs (p = 0.026) were significantly associated with severe lymphopenia on multivariate regression analysis. Severe lymphopenia was a predictor of poorer DFS in patients with locally advanced rectal cancer receiving adjuvant chemoradiotherapy. Pre-S TLCs were predictors of severe lymphopenia. Further study is warranted to reduce the rate of severe lymphopenia.
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Affiliation(s)
- Shuang Li
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Jinzhou Medical University, Jinzhou, 121001, Liaoning, China
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Weiping Yao
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Ruiqi Liu
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Yanwei Lu
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Haibo Zhang
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
| | - Xiaodong Liang
- Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
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20
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Cho Y, Park SB, Yoon JY, Kwak MS, Cha JM. Neutrophil to lymphocyte ratio can predict overall survival in patients with stage II to III colorectal cancer. Medicine (Baltimore) 2023; 102:e33279. [PMID: 36930098 PMCID: PMC10019177 DOI: 10.1097/md.0000000000033279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR) is a prognostic inflammatory marker in colorectal cancer (CRC), however, little is known for its prognostic role in stage II to III CRC patients underwent curative resection. This study was aimed to investigate prognostic role of NLR in stage II to III CRC patients underwent surgery. Medical records of 1378 newly diagnosed CRC patients between June 2006 and March 2020 were reviewed. Data were collected by using electronic medical record software. Survival rate were analyzed using the Kaplan-Meier method. The cutoff values of NLR in stage II to III CRC patients were defined by maximally selected log-rank statistics. Multivariable cox proportional-hazard models were performed to find risk factors associated with overall survival (OS) in stage II to III CRC patients underwent surgery. Among 1378 CRC patients enrolled, 910 patients underwent surgery. In entire surgical cohort, age, body mass index (BMI), CEA, carbohydrate antigen 19-9 (CA 19-9), lymphatic invasion, NLR, and albumin-to-globulin ratio (AGR) were found to be risk factors associated with OS (all P < .05). In stage II to III CRC patients underwent curative resection (n = 623), age, BMI, lymphatic invasion, AGR, and NLR were found to be risk factors associated with OS (all P < .05). In the multivariable analysis, CA 19-9 and lymphatic invasion were independent risk factors for OS in entire surgical cohort. In the multivariable analysis for the stage II to III CRC patients, age, BMI, lymphatic invasion and NLR (Hazard ratio = 2.41, 95% confidential interval [CI]: 1.04-5.595, P = .041) were independent risk factors for OS. NLR can be used as a clinically simple and useful parameter for predicting OS in stage II to III CRC patients undergoing curative resection, however, its optimal cutoff value should be further evaluated.
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Affiliation(s)
- Yerim Cho
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Su Bee Park
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jin Young Yoon
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, College of Medicine, Seoul, Republic of Korea
| | - Min Seob Kwak
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, College of Medicine, Seoul, Republic of Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University, College of Medicine, Seoul, Republic of Korea
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21
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Ciocan A, Ciocan RA, Al Hajjar N, Benea AM, Pandrea SL, Cătană CS, Drugan C, Oprea VC, Dîrzu DS, Bolboacă SD. Exploratory Evaluation of Neopterin and Chitotriosidase as Potential Circulating Biomarkers for Colorectal Cancer. Biomedicines 2023; 11:biomedicines11030894. [PMID: 36979873 PMCID: PMC10046191 DOI: 10.3390/biomedicines11030894] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023] Open
Abstract
Chronic inflammation is demonstrated to play a direct role in carcinogenesis. Our exploratory study aimed to assess the potential added value of two inflammation biomarkers, chitotriosidase and neopterin, in follow-up evaluation of patients with colorectal cancer (CRC). An observational exploratory study was conducted. Patients with CRC and matched controls (1:1, age, sex, and living environment) were evaluated. The patients with CRC (CRC group) and controls were assessed at baseline (before surgical intervention for patients with CRC). Patients with CRC were also evaluated at 1-year follow-up. Significantly more patients with blood group A (54.5% vs. 25.0%) and smokers (50.0% vs. 22.7%) were in the CRC group. The serum values of chitotriosidase and neopterin were higher in CRC patients than in controls, but only neopterin reached the conventional level of statistical significance (p-value = 0.015). The circulating chitotriosidase and neopterin values decreased significantly at 1-year follow-up (p-value < 0.0001). Patients with higher N- and M-stage showed statistically significant higher levels of chitotriosidase and neopterin at baseline and 1-year follow-up (p-values < 0.03). Circulating chitotriosidase levels also showed statistically significant differences regarding baseline and 1-year follow-up on patients with CRC and different differentiation grades (p-values < 0.02). The circulating levels of neopterin significantly decreased at 1-year follow-up, indicating its potential as a prognostic marker. The circulating values of chitotriosidase and neopterin exhibit significant differences in patients with than without recurrences. Our results support further evaluation of chitotriosidase and neopterin as prognostic markers in patients with CRC.
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Affiliation(s)
- Andra Ciocan
- Department of Surgery—Surgery Clinic III, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Răzvan A. Ciocan
- Department of Surgery—Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
- County Emergency Clinical Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
- Correspondence: (R.A.C.); (S.D.B.)
| | - Nadim Al Hajjar
- Department of Surgery—Surgery Clinic III, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Andreea M. Benea
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Stanca L. Pandrea
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, 400006 Cluj-Napoca, Romania
- Department of Microbiology, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania
| | - Cristina S. Cătană
- Department of Medical Biochemistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania
| | - Cristina Drugan
- Department of Medical Biochemistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania
| | - Valentin C. Oprea
- Department of Surgery—Surgery Clinic II, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400006 Cluj-Napoca, Romania
- “Dr. Constantin Papilian” Military Emergency Hospital Cluj-Napoca, 400132 Cluj-Napoca, Romania
| | - Dan S. Dîrzu
- County Emergency Clinical Hospital Cluj-Napoca, 400006 Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400349 Cluj-Napoca, Romania
- Correspondence: (R.A.C.); (S.D.B.)
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22
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Balla A, Saraceno F, Guida A, Scaramuzzo R, Corallino D, Ettorre GM, Lepiane P. Long-term Oncological Results After Laparoscopic Sigmoidectomy for Adenocarcinoma. J Laparoendosc Adv Surg Tech A 2023; 33:397-403. [PMID: 36716190 DOI: 10.1089/lap.2022.0565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Purpose: Sigmoidectomy is performed in most cases for benign pathologies and mainly in cases of diverticulitis. Few studies in the literature report oncological results after sigmoidectomy for adenocarcinoma. The aim of this study was to report the long-term oncological outcomes after elective laparoscopic sigmoidectomy (LS) for adenocarcinoma. Methods: This study is a retrospective analysis of prospectively collected data. From January 2003 to February 2021, 173 patients underwent elective LS for adenocarcinoma. Twenty-four patients with a diagnosis of preoperative distant metastases were excluded (13.9%). Results: Seven postoperative complications were observed (7.1%). Of these, 2 (2%) anastomotic leakages were treated surgically by the Hartmann procedure (Clavien-Dindo grade III-b). The mean number of harvested lymph nodes with the specimen was 14.2 ± 7.1. At a median follow-up of 115 months (interquartile range 133.8), 2 (2%) and 9 patients (9.2%) had developed recurrence and metastases, respectively. During follow-up, 6 patients (6.1%) with metastases died due to disease progression and 6 other patients (6.1%) died due to causes other than cancer related. At the 5- and 10-year follow-ups, the overall survival rates were 90.5% ± 3.4% and 83.8% ± 4.5%, respectively, while the disease-free survival rates were 87.1% ± 4.1% and 83.5% ± 4.7%, respectively. Conclusion: LS is a safe and feasible technique both in terms of the number of harvested lymph nodes and oncological results. The possibility of sparing the colon without mobilizing the splenic flexure and dividing the left colic artery could reduce intra- and postoperative complications. Further studies with larger samples of patients are required to confirm these data.
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Affiliation(s)
- Andrea Balla
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo," Civitavecchia, Rome, Italy
| | - Federica Saraceno
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo," Civitavecchia, Rome, Italy
| | - Anna Guida
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo," Civitavecchia, Rome, Italy
| | - Rosa Scaramuzzo
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo," Civitavecchia, Rome, Italy
| | - Diletta Corallino
- Department of General Surgery and Surgical Specialties "Paride Stefanini," Sapienza University of Rome, Rome, Italy
| | - Giuseppe Maria Ettorre
- Dipartimento di Chirurgia Generale e Trapianti, Ospedale San Camillo-Forlanini, Rome, Italy
| | - Pasquale Lepiane
- UOC of General and Minimally Invasive Surgery, Hospital "San Paolo," Civitavecchia, Rome, Italy
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23
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Osseis M, Dahboul H, Mouawad C, Aoun R, Kassar S, Chakhtoura G, Noun R. Laparoscopic and robotic multivisceral resection in colorectal cancer: A case series and systematic review. Asian J Endosc Surg 2023. [PMID: 36599163 DOI: 10.1111/ases.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 12/25/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Multivisceral resection (MVR) with open approach is the standard surgical treatment for locally advanced colorectal cancer. However, the medical literature concerning the practice of minimally invasive MVR in order to reduce postoperative complications and hospital stay has been growing exponentially over the last years. The present study aimed to examine our experience and to provide a systematic review about the results and complications of minimally invasive MVR. METHODS Data of patients that underwent minimally invasive MVR for locally advanced colorectal cancer from 2015 to 2021 were retrospectively reviewed. The literature was searched for studies concerning minimally invasive MVR for colorectal cancer. RESULTS A total of 39 laparoscopic MVR were performed in our department. Complications occurred in 14 patients (35.9%) with major complications in five patients (18.82%) according to Clavien-Dindo classification. Conversion was required in one case (2.56%) with subsequent mortality (2.56%). Pathologic adjacent organs or structures invasion was observed in 30 patients (76.9%) and positive resection margin occurred in two cases (5.2%). Twenty-two studies including 1055 patients were identified after literature search. In these studies, laparoscopic surgery and robotic surgery were performed in 90.15% and 9.85% of the patients, respectively. R0 resection was established in 95% of cases, conversion rate varied between 0% and 41.7%, and postoperative mortality ranged between 0% and 7.7% in the included articles. CONCLUSION Minimally invasive approach may be a safe option for patients requiring MVR for locally advanced colorectal cancer, with equivalent oncological results and could result in better early postoperative outcomes to open approach. However, further studies on this topic are needed to confirm the results of the current study.
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Affiliation(s)
- Michael Osseis
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Houssam Dahboul
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Christian Mouawad
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Rany Aoun
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Serge Kassar
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ghassan Chakhtoura
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roger Noun
- Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University of Beirut, Beirut, Lebanon
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24
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Zhang Y, Zhang Z, Wei L, Wei S. Construction and validation of nomograms combined with novel machine learning algorithms to predict early death of patients with metastatic colorectal cancer. Front Public Health 2022; 10:1008137. [PMID: 36605237 PMCID: PMC9810140 DOI: 10.3389/fpubh.2022.1008137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the clinical and non-clinical characteristics that may affect the early death rate of patients with metastatic colorectal carcinoma (mCRC) and develop accurate prognostic predictive models for mCRC. Method Medical records of 35,639 patients with mCRC diagnosed from 2010 to 2019 were obtained from the SEER database. All the patients were randomly divided into a training cohort and a validation cohort in a ratio of 7:3. X-tile software was utilized to identify the optimal cutoff point for age and tumor size. Univariate and multivariate logistic regression models were used to determine the independent predictors associated with overall early death and cancer-specific early death caused by mCRC. Simultaneously, predictive and dynamic nomograms were constructed. Moreover, logistic regression, random forest, CatBoost, LightGBM, and XGBoost were used to establish machine learning (ML) models. In addition, receiver operating characteristic curves (ROCs) and calibration plots were obtained to estimate the accuracy of the models. Decision curve analysis (DCA) was employed to determine the clinical benefits of ML models. Results The optimal cutoff points for age were 58 and 77 years and those for tumor size of 45 and 76. A total of 15 independent risk factors, namely, age, marital status, race, tumor localization, histologic type, grade, N-stage, tumor size, surgery, radiation, chemotherapy, bone metastasis, brain metastasis, liver metastasis, and lung metastasis, were significantly associated with the overall early death rate of patients with mCRC and the cancer-specific early death rate of patients with mCRC, following which nomograms were constructed. The ML models revealed that the random forest model accurately predicted outcomes, followed by logistic regression, CatBoost, XGBoost, and LightGBM models. Compared with other algorithms, the random forest model provided more clinical benefits than other models and can be used to make clinical decisions in overall early death and specific early death caused by mCRC. Conclusion ML algorithms combined with nomograms may play an important role in distinguishing early deaths owing to mCRC and potentially help clinicians make clinical decisions and follow-up strategies.
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Affiliation(s)
- Yalong Zhang
- Department of Ultrasound Medicine, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zunni Zhang
- Department of Clinical Laboratory, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Liuxiang Wei
- Department of Ultrasound Medicine, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shujing Wei
- Department of Ultrasound Medicine, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China,*Correspondence: Shujing Wei ✉
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25
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Zhong J, Han C, Wang Y, Chen P, Liu R. Identifying the critical state of complex biological systems by the directed-network rank score method. Bioinformatics 2022; 38:5398-5405. [PMID: 36282843 PMCID: PMC9750123 DOI: 10.1093/bioinformatics/btac707] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/21/2022] [Accepted: 10/24/2022] [Indexed: 12/25/2022] Open
Abstract
MOTIVATION Catastrophic transitions are ubiquitous in the dynamic progression of complex biological systems; that is, a critical transition at which complex systems suddenly shift from one stable state to another occurs. Identifying such a critical point or tipping point is essential for revealing the underlying mechanism of complex biological systems. However, it is difficult to identify the tipping point since few significant differences in the critical state are detected in terms of traditional static measurements. RESULTS In this study, by exploring the dynamic changes in gene cooperative effects between the before-transition and critical states, we presented a model-free approach, the directed-network rank score (DNRS), to detect the early-warning signal of critical transition in complex biological systems. The proposed method is applicable to both bulk and single-cell RNA-sequencing (scRNA-seq) data. This computational method was validated by the successful identification of the critical or pre-transition state for both simulated and six real datasets, including three scRNA-seq datasets of embryonic development and three tumor datasets. In addition, the functional and pathway enrichment analyses suggested that the corresponding DNRS signaling biomarkers were involved in key biological processes. AVAILABILITY AND IMPLEMENTATION The source code is freely available at https://github.com/zhongjiayuan/DNRS. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Jiayuan Zhong
- School of Mathematics and Big Data, Foshan University, Foshan 528000, China
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Chongyin Han
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510640, China
| | - Yangkai Wang
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Pei Chen
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
- Pazhou Lab, Guangzhou 510330, China
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26
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Bi F, Li X, Zhang Y, Wang Z, Dong Q, Zhang J, Sun D. Prognostic value of elastic lamina staining in patients with stage III colon cancer. World J Surg Oncol 2022; 20:391. [PMID: 36503509 PMCID: PMC9743714 DOI: 10.1186/s12957-022-02865-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The objectives of this study were to analyze the difference between the preoperative radiological and postoperative pathological stages of colorectal cancer (CRC) and explore the feasibility of elastic lamina invasion (ELI) as a prognostic marker for patients with stage III colon cancer. METHODS A total of 105 consecutive patients underwent radical surgery (R0 resection) for stage III colon cancer at the Cancer Hospital of China Medical University between January 2015 and December 2017. Clinicopathological features, including radiological stage and elastic lamina staining, were analyzed for prognostic significance in stage III colon cancer. RESULTS A total of 105 patients with stage III colon cancer who met the criteria and had complete data available were included. The median follow-up period of survivors was 41 months. During the follow-up period, 33 (31.4%) patients experienced recurrence after radical resection, and the 3-year disease-free survival (DFS) rate was 64.8%. The consistency between preoperative radiological and postoperative pathological staging was poor (κ = 0.232, P < 0.001). The accuracy of ≤ T2 stage diagnoses was 97.1% (102/105), that of T3 stage was 60.9% (64/105), that of T4a stage was 68.6% (72/105) and that of T4b stage was 91.4% (96/105). The DFS rate of T3 ELI (+) patients was significantly lower than that of both T3 ELI (-) patients (P = 0.000) and pT4a patients (P = 0.013). The DFS rate of T3 ELI (-) patients was significantly higher than that of pT4b patients (P=0.018). T3 ELI (+) (HR (Hazard ratio), 8.444 [95% CI, 1.736-41.067]; P = 0.008), T4b (HR, 57.727[95% CI, 5.547-600.754]; P = 0.001), N2 stage (HR, 10.629 [95% CI, 3.858-29.286]; P < 0.001), stage III (HR, 0.136 [95% CI, 0.31-0.589]; P = 0.008) and perineural invasion (PNI) (HR, 8.393 [95% CI, 2.094-33.637]; P = 0.003) were independent risk factors for postoperative recurrence of stage III colon cancer. CONCLUSIONS The consistency between preoperative radiological and postoperative pathological staging was poor, especially for tumors located in the ascending colon and descending colon. Elastic lamina staining is expected to become a stratified indicator of recurrence risk for patients with stage III colon cancer and a guide for individualized adjuvant chemotherapy, thus improving patient prognosis.
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Affiliation(s)
- Feifei Bi
- grid.459742.90000 0004 1798 5889Medical Oncology Department of Gastrointestinal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Xiaoyan Li
- grid.459742.90000 0004 1798 5889Department of Pathology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Yong Zhang
- grid.459742.90000 0004 1798 5889Department of Pathology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Zekun Wang
- grid.459742.90000 0004 1798 5889Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Qian Dong
- grid.459742.90000 0004 1798 5889Medical Oncology Department of Gastrointestinal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Jingdong Zhang
- grid.459742.90000 0004 1798 5889Medical Oncology Department of Gastrointestinal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Deyu Sun
- grid.459742.90000 0004 1798 5889Department of Radiation Oncology Gastrointestinal and Urinary and Musculoskeletal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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27
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Muacevic A, Adler JR, Abushaikha SS, Hamdan AM, Pillai V, Ayash AM, Vincent PK, Sultan K, Al Ejji KM, Singh R, Alabdulla S, Abdulmalik M, Al Kaabi S. High Adenoma Detection Rates in Fecal Immunochemical Test-Based Colorectal Cancer Screening: Interim Results of the National Bowel Cancer Screening Program in Qatar. Cureus 2022; 14:e32274. [PMID: 36628034 PMCID: PMC9822526 DOI: 10.7759/cureus.32274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Colorectal cancer is one of the most common cancers globally. Recent reductions in mortality rates have been primarily attributed to screening programs. The State of Qatar established a national bowel cancer screening program in 2016. METHODOLOGY Fecal immunochemical testing (FIT) was used for average-risk individuals aged 50 to 74 years. Fecal immunochemical testing -positive participants were referred for total colonoscopy to detect polyps and cancers. RESULTS Among 32,751 FIT invitees, 11,130 took the test, and 758 (6%) of those were FIT positive. Of these, 375 (56.13%) participants underwent a colonoscopy, and polyps were detected in 198 (52.8%) and cancers in 19 (5.1%) participants. The adenoma detection rate exceeded 40%. DISCUSSION AND CONCLUSION The high yield of polyps and cancers in the screening program justifies an active, resource-intensive, and organized bowel cancer screening effort. The high adenoma detection rate in a FIT-based program warrants recalibration of target adenoma detection rates in screening programs.
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Tian M, Zhou Z. Chemotherapy exacerbates the survival paradox of colon cancer: a propensity score matching analysis. Transl Cancer Res 2022; 11:4241-4253. [PMID: 36644182 PMCID: PMC9834597 DOI: 10.21037/tcr-22-1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/07/2022] [Indexed: 12/30/2022]
Abstract
Background Colon cancer is one of the most common tumor diseases in the world. Currently, clinicians usually evaluate the survival and prognosis of patients according to their tumor-node-metastasis (TNM) stage. However, current studies have found that there is a certain survival paradox in TNM staging. Methods In the Surveillance, Epidemiology, and End Results (SEER) database, patients diagnosed with colon cancer by surgical pathology from 2004 to 2011 were selected for analysis of 5-year overall survival (OS). Propensity score matching (PSM) was performed to analyze the difference in survival between different stages and the effect of chemotherapy on prognosis. Results The OS of stage IIIA colon cancer sufferers was significantly superior to stage IIB/IIC and separate stage IIB or IIC colon cancer patients before and after PSM analysis (P<0.05 for all). Moreover, the difference in survival was more significant when stage IIB/IIC patients were compared with stage IIIA patients with chemotherapy. Conclusions The survival paradox existed both in all stage IIB/IIC patients, or individual stage IIB or IIC patients compared with stage IIIA sufferers, and the survival paradox between stage IIIA and stage IIC was more obvious. Moreover, chemotherapy had a positive effect on the prognosis of patients with stage IIIA, IIC and IIB in this study. Chemotherapy exacerbates the survival paradox of colon cancer, even if it is not the cause of the survival paradox.
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Affiliation(s)
- Mengxiang Tian
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China;,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhongyi Zhou
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China;,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Liu X, Qin J, Nie J, Sun H, Pan Y, Wang S. Reclassifying TNM stage I/II colorectal cancer into two subgroups with different overall survival, tumor microenvironment, and response to immune checkpoint blockade treatment. Front Genet 2022; 13:948920. [PMID: 36212126 PMCID: PMC9532767 DOI: 10.3389/fgene.2022.948920] [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: 05/20/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background: The traditional TNM staging system is often insufficient to differentiate the survival discrepancies of colorectal cancer (CRC) patients at TNM stage I/II. Our study aimed to reclassify stage I/II CRC patients into several subgroups with different prognoses and explore their suitable therapeutic methods. Methods: Single-cell RNA (scRNA) sequencing data, bulk RNA sequencing data, and clinicopathological information of CRC patients were enrolled from the TCGA and GEO databases. The tumor microenvironment of CRC tissues was accessed by the ESTIMATE algorithm. The prognostic genes were identified by Cox regression analysis. GO and KEGG analyses were conducted in the DAVID database. GSEA analysis was performed for annotation of the correlated gene sets. Results: We successfully reclassified stage I/II CRC patients into two subgroups and discovered that patients in cluster-2 underwent worse overall survival than those in cluster-1. GSEA analysis showed that immune-associated gene sets were positively enriched in cluster-2. Besides, the differentially expressed genes (DEGs) between cluster-1 and cluster-2 patients also participated in immune-related biological processes and signaling pathways. Moreover, we found that more immune cells infiltrated the microenvironment of cluster-2 patients compared to that of cluster-1 patients, such as Tregs and tumor-associated macrophages. ScRNA sequencing analysis uncovered that most of the enriched immune-associated signaling in cluster-2 patients was mainly attributed to these upregulated immune cells whose infiltration levels were also high in CRC tissues rather than in normal tissues. In addition, we demonstrated that the expression of immune checkpoint genes was significantly higher in cluster-2 patients compared to cluster-1 patients. ScRNA sequencing analysis revealed that the infiltrated CD8+T cells in CRC were naïve T cells and can be activated into effector T cells after immune checkpoint blockade (ICB) treatment. Conclusion: TNM stage I/II CRC patients can be divided into two subgroups, which have different overall survival rates, tumor microenvironment, and response to ICB therapy.
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Affiliation(s)
- Xiangxiang Liu
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jian Qin
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Junjie Nie
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huiling Sun
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuqin Pan
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- *Correspondence: Yuqin Pan, ; Shukui Wang,
| | - Shukui Wang
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- *Correspondence: Yuqin Pan, ; Shukui Wang,
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Liu X, Zhang YF, Shi Q, Yang Y, Yao BH, Wang SC, Geng GY. Prediction value of 18F-FDG PET/CT intratumor metabolic heterogeneity parameters for recurrence after radical surgery of stage II/III colorectal cancer. Front Oncol 2022; 12:945939. [PMID: 36158649 PMCID: PMC9493298 DOI: 10.3389/fonc.2022.945939] [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: 05/17/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose We explored the predictive effect of intratumor metabolic heterogeneity indices extracted from 18F-FDG PET/CT on recurrence in stage II/III colorectal cancer after radical surgery. Methods A total of 140 stage II/III colorectal cancer patients who received preoperative 18F-FDG PET/CT and radical resection were enrolled. 18F-FDG traditional parameters including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) under different thresholds; heterogeneity indices including the coefficient of variation with SUV 2.5 as a threshold (CV2.5), CV40%, heterogeneity index-1 (HI-1) calculated by the fixed-threshold method, and HI-2 calculated by the percentage threshold method; and clinicopathological information were collected. We concluded that relationships exist between these data and patients’ disease-free survival (DFS). Results Regional lymph node status (P < 0.001), nerve invasion (P = 0.036), tumor thrombus (P = 0.005), and HI-1 (P = 0.010) exhibited significant differences between the relapse and non-relapse groups, while SUVmax, MTV2.5, MTV40%, TLG2.5, TLG40%, CV2.5, CV40%, HI-2, and other clinicopathological factors had no differences between the relapse and non-relapse groups. Multivariate analysis demonstrated that HI-1 (HR = 1.02, 1.00–1.04, P = 0.038), regional lymph node metastasis (HR = 2.95, 1.37–6.38, P = 0.006), and tumor thrombus status (HR = 2.37, 1.13–4.99, P = 0.022) were independent factors significantly related to DFS. Conclusion HI-1, tumor thrombus status, and regional lymph node status could predict the recurrence of stage II/III colorectal cancer after radical resection and had an advantage over other 18F-FDG PET/CT conventional parameters and heterogeneity indices.
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Affiliation(s)
- Xin Liu
- Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yi-Fan Zhang
- Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Qin Shi
- Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yi Yang
- Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ben-Hu Yao
- Technical and Quality Department, Zhongke Meiling Cryogenics Co., Ltd., Hefei, China
| | - Shi-Cun Wang
- Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Guang-Yong Geng, ; Shi-Cun Wang,
| | - Guang-Yong Geng
- Department of General Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Guang-Yong Geng, ; Shi-Cun Wang,
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Ji X, Kang M, Zhao X, Li X, Guo Y, Xie P, Yu Y, Tian Z. Poorly differentiated cluster grade-a vital predictor for lymph node metastasis and oncological outcomes in patients with T1 colorectal cancer: a retrospective study. BMC Gastroenterol 2022; 22:409. [PMID: 36064316 PMCID: PMC9442993 DOI: 10.1186/s12876-022-02492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background T1 colorectal cancers have a low lymph node metastasis rate and good prognosis. Thus, endoscopic resection is an attractive choice. This study aimed to describe the value of poorly differentiated cluster grade in identifying endoscopically curable T1 colorectal cancers. Methods We included 183 T1 colorectal cancer patients who underwent curative resection. Univariate and multivariate logistic regressions were used to identify lymph node metastasis predictors. The Akaike information criterion was used to determine whether poorly differentiated cluster grade was the best predictor. Backward regression was used to screen the variables. Survival analyses were conducted to determine the prognostic predictive power of poorly differentiated cluster grade. Correlations among predictors and concordance between our pathologists were also investigated. Results Poorly differentiated cluster grade was an independent predictor for lymph node metastasis (adjusted odds ratio [OR]G 3 = 0.001; 95% confidence interval [95% CI]G 3 = < 0.001, 0.139) in T1 colorectal cancer patients; moreover, it had the best predictive value (AIC = 61.626) among all indicators. It was also screened for inclusion in the predictive model. Accordingly, a high poorly differentiated cluster grade independently indicated shorter overall survival (hazard ratio [HR]G 2 = 4.315; 95% CIG 2 = 1.506, 12.568; HRG 3 = 5.049; 95% CIG 3 = 1.326, 19.222) and disease-free survival (HRG 3 = 6.621; 95% CIG 3 = 1.472, 29.786). Conclusions Poorly differentiated cluster grade is a vital reference to manage T1 colorectal cancer. It could serve as an indicator to screen endoscopically curable T1 colorectal cancers.
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Affiliation(s)
- Xiaolin Ji
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Mei Kang
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Xianzhi Zhao
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Xiaoyu Li
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Yingjie Guo
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Ping Xie
- Department of Internal Medicine, Weicheng District Weifang City Peoples Hospital, Weifang, Shandong, China
| | - Yanan Yu
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Zibin Tian
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China.
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Yang Y, Wang Y, Wang Z. Construction of a new clinical staging system for colorectal cancer based on the lymph node ratio: A validation study. Front Surg 2022; 9:929576. [PMID: 36090338 PMCID: PMC9452833 DOI: 10.3389/fsurg.2022.929576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Aim This study aims to construct a new staging system for colorectal cancer (CRC) based on the lymph node ratio (LNR) as a supplement to the American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) staging system for predicting the prognosis of CRC patients with <12 lymph nodes. Methods The data of 26,695 CRC patients with <12 lymph nodes were extracted from the Surveillance, Epidemiology, and End Results (SEER) database as a training set. A total of 635 CRC patients were also enrolled from Northern Jiangsu People's Hospital affiliated with Yangzhou University as an independent validation set. Classification and regression tree analysis was used to obtain the LNR cutoff value. Survival curves were estimated using the Kaplan–Meier method, and the log-rank test was used for comparisons of differences among the survival curves. The monotonic decreasing trend of the overall survival curve in the staging system was expressed by the linear correlation degree R. Results The 5-year survival rates of patients in the training set based on the AJCC staging system from stage I to stage IV were 75.6% (95%CI: 74.4–76.8), 59.8% (95%CI: 58.6–61.0), 42.1% (95%CI: 34.5–49.7), 33.2% (95%CI: 24.6–41.8), 72.0% (95%CI: 69.1–74.9), 48.8% (95%CI: 47.4–50.2), 26.5% (95%CI: 23.0–30.0), and 11.3% (95%CI: 10.3–12.3). The 5-year survival rates of patients in the training set from stage I to stage IIIC were 80.4%, 72.9%, 59.8%, 48.4%, 32.5%, and 15.0%, according to the TNM + LNR (TNRM) staging system. According to the AJCC staging system, the 5-year survival rates of patients in the validation set from stage I to stage IIIC were 91.3%, 90.8%, 72.6%, 61.3%, 72.4%, 58.1%, and 32.8%. Based on the TNRM staging system, the 5-year survival rates of patients in the validation set from stage I to stage IIIC were 99.2%, 90.5%, 81.4%, 78.6%, 60.2%, and 35.8%. Conclusion The TNRM staging system successfully eliminated “survival paradox” in the AJCC staging system, which might be superior to the AJCC staging system.
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Affiliation(s)
- Yan Yang
- Department of General Surgery, Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University, Yangzhou, China
- Department of Gastrointestinal Surgery, Clinical Medical School, Northern Jiangsu People's Hospital affiliated to Yangzhou University, Yangzhou, China
| | - Yawei Wang
- Department of Gastrointestinal Surgery, Clinical Medical School, Northern Jiangsu People's Hospital affiliated to Yangzhou University, Yangzhou, China
- Department of General Surgery, Jiangsu Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing, China
| | - Zhengbin Wang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Yangzhou University, Yangzhou, China
- Correspondence: Zhengbin Wang
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Crafa F, Vanella S, Catalano OA, Pomykala KL, Baiamonte M. Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection. World J Gastroenterol 2022; 28:4019-4043. [PMID: 36157105 PMCID: PMC9403438 DOI: 10.3748/wjg.v28.i30.4019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/03/2022] [Accepted: 07/22/2022] [Indexed: 02/06/2023] Open
Abstract
Current histopathological staging procedures in colorectal cancer (CRC) depend on midline division of the lymph nodes (LNs) with one section of hematoxylin and eosin staining. Cancer cells outside this transection line may be missed, which could lead to understaging of Union for International Cancer Control Stage II high-risk patients. The one-step nucleic acid amplification (OSNA) assay has emerged as a rapid molecular diagnostic tool for LN metastases detection. It is a molecular technique that can analyze the entire LN tissue using a reverse-transcriptase loop-mediated isothermal amplification reaction to detect tumor-specific cytokeratin 19 mRNA. Our findings suggest that the OSNA assay has a high diagnostic accuracy in detecting metastatic LNs in CRC and a high negative predictive value. OSNA is a standardized, observer-independent technique, which may lead to more accurate staging. It has been suggested that in stage II CRC, the upstaging can reach 25% and these patients can access postoperative adjuvant chemotherapy. Moreover, intraoperative OSNA sentinel node evaluation may allow early CRC to be treated with organ-preserving surgery, while in more advanced-stage disease, a tailored lymphadenectomy can be performed considering the presence of aberrant lymphatic drainage and skip metastases.
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Affiliation(s)
- Francesco Crafa
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
| | - Serafino Vanella
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
| | - Onofrio A Catalano
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Kelsey L Pomykala
- Department of Nuclear Medicine, Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles, University Hospital Essen, University of Duisburg-Essen, Essen 45141, Germany
| | - Mario Baiamonte
- Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy
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Wang H, Yang W, Qin Q, Yang X, Yang Y, Liu H, Lu W, Gu S, Cao X, Feng D, Zhang Z, He J. E3 ubiquitin ligase MAGI3 degrades c-Myc and acts as a predictor for chemotherapy response in colorectal cancer. Mol Cancer 2022; 21:151. [PMID: 35864508 PMCID: PMC9306183 DOI: 10.1186/s12943-022-01622-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background Recurrence and chemoresistance constitute the leading cause of death in colorectal cancer (CRC). Thus, it is of great significance to clarify the underlying mechanisms and identify predictors for tailoring adjuvant chemotherapy to improve the outcome of CRC. Methods By screening differentially expressed genes (DEGs), constructing random forest classification and ranking the importance of DEGs, we identified membrane associated guanylate kinase, WW and PDZ domain containing 3 (MAGI3) as an important gene in CRC recurrence. Immunohistochemical and western blot assays were employed to further detect MAGI3 expression in CRC tissues and cell lines. Cell counting kit-8, plate colony formation, flow cytometry, sub-cutaneous injection and azoxymethane plus dextran sulfate sodium induced mice CRC assays were employed to explore the effects of MAGI3 on proliferation, growth, cell cycle, apoptosis, xenograft formation and chemotherapy resistance of CRC. The underlying molecular mechanisms were further investigated through gene set enrichment analysis, quantitative real-time PCR, western blot, co-immunoprecipitation, ubiquitination, GST fusion protein pull-down and immunohistochemical staining assays. Results Our results showed that dysregulated low level of MAGI3 was correlated with recurrence and poor prognosis of CRC. MAGI3 was identified as a novel substrate-binding subunit of SKP1-Cullin E3 ligase to recognize c-Myc, and process c-Myc ubiquitination and degradation. Expression of MAGI3 in CRC cells inhibited cell growth, promoted apoptosis and chemosensitivity to fluoropyrimidine-based chemotherapy by suppressing activation of c-Myc in vitro and in vivo. In clinic, the stage II/III CRC patients with MAGI3-high had a significantly good recurrence-free survival (~ 80%, 5-year), and were not necessary for further adjuvant chemotherapy. The patients with MAGI3-medium had a robustly good response rate or recurrence-free survival with fluoropyrimidine-based chemotherapy, and were recommended to undergo fluoropyrimidine-based adjuvant chemotherapy. Conclusions MAGI3 is a novel E3 ubiquitin ligase by degradation of c-Myc to regulate CRC development and may act as a potential predictor of adjuvant chemotherapy for CRC patients. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12943-022-01622-9.
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Affiliation(s)
- Haibo Wang
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Wenjing Yang
- Department of Oncology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People's Republic of China
| | - Qiong Qin
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Xiaomei Yang
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Ying Yang
- Core Facilities Center, Capital Medical University, Beijing, People's Republic of China
| | - Hua Liu
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Wenxiu Lu
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Siyu Gu
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Xuedi Cao
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China
| | - Duiping Feng
- Department of Interventional Radiology, First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Zhongtao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, No.95 Yong-anRoad, Xi-Cheng District, Beijing, 100050, People's Republic of China.
| | - Junqi He
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, People's Republic of China.
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Nugteren S, den Uil SH, Delis-van Diemen PM, Simons-Oosterhuis Y, Lindenbergh-Kortleve DJ, van Haaften DH, Stockmann HBAC, Sanders J, Meijer GA, Fijneman RJA, Samsom JN. High expression of secretory leukocyte protease inhibitor (SLPI) in stage III micro-satellite stable colorectal cancer is associated with reduced disease recurrence. Sci Rep 2022; 12:12174. [PMID: 35842496 PMCID: PMC9288430 DOI: 10.1038/s41598-022-16427-5] [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: 03/31/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Secretory leukocyte protease inhibitor (SLPI) is a pleiotropic protein produced by healthy intestinal epithelial cells. SLPI regulates NF-κB activation, inhibits neutrophil proteases and has broad antimicrobial activity. Recently, increased SLPI expression was found in various types of carcinomas and was suggested to increase their metastatic potential. Indeed, we demonstrated that SLPI protein expression in colorectal cancer (CRC) liver metastases and matched primary tumors is associated with worse outcome, suggesting that SLPI promotes metastasis in human CRC. However, whether SLPI plays a role in CRC before distant metastases have formed is unclear. Therefore, we examined whether SLPI expression is associated with prognosis in CRC patients with localized disease. Using a cohort of 226 stage II and 160 stage III CRC patients we demonstrate that high SLPI protein expression is associated with reduced disease recurrence in patients with stage III micro-satellite stable tumors treated with adjuvant chemotherapy, independently of established clinical risk factors (hazard rate ratio 0.54, P-value 0.03). SLPI protein expression was not associated with disease-free survival in stage II CRC patients. Our data suggest that the role of SLPI in CRC may be different depending on the stage of disease. In stage III CRC, SLPI expression may be unfavorable for tumors, whereas SLPI expression may be beneficial for tumors once distant metastases have established.
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Affiliation(s)
- Sandrine Nugteren
- Division Gastroenterology and Nutrition, Laboratory of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Room Ee1567A, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Sjoerd H den Uil
- Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands
| | | | - Ytje Simons-Oosterhuis
- Division Gastroenterology and Nutrition, Laboratory of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Room Ee1567A, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Dicky J Lindenbergh-Kortleve
- Division Gastroenterology and Nutrition, Laboratory of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Room Ee1567A, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Daniëlle H van Haaften
- Division Gastroenterology and Nutrition, Laboratory of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Room Ee1567A, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | | | - Joyce Sanders
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gerrit A Meijer
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Remond J A Fijneman
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Janneke N Samsom
- Division Gastroenterology and Nutrition, Laboratory of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Room Ee1567A, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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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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Peng H, Zhong J, Chen P, Liu R. Identifying the critical states of complex diseases by the dynamic change of multivariate distribution. Brief Bioinform 2022; 23:6590435. [DOI: 10.1093/bib/bbac177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/10/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
The dynamics of complex diseases are not always smooth; they are occasionally abrupt, i.e. there is a critical state transition or tipping point at which the disease undergoes a sudden qualitative shift. There are generally a few significant differences in the critical state in terms of gene expressions or other static measurements, which may lead to the failure of traditional differential expression-based biomarkers to identify such a tipping point. In this study, we propose a computational method, the direct interaction network-based divergence, to detect the critical state of complex diseases by exploiting the dynamic changes in multivariable distributions inferred from observable samples and local biomolecular direct interaction networks. Such a method is model-free and applicable to both bulk and single-cell expression data. Our approach was validated by successfully identifying the tipping point just before the occurrence of a critical transition for both a simulated data set and seven real data sets, including those from The Cancer Genome Atlas and two single-cell RNA-sequencing data sets of cell differentiation. Functional and pathway enrichment analyses also validated the computational results from the perspectives of both molecules and networks.
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Affiliation(s)
- Hao Peng
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Jiayuan Zhong
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
- School of mathematics and big data, Foshan University, Foshan 528225, China
| | - Pei Chen
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou 510640, China
- Pazhou Lab, Guangzhou 510330, China
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Takei D, Harada K, Nouso K, Miyahara K, Dohi C, Matsushita H, Kinugasa H, Hiraoka S, Nishimura SI, Okada H. Clinical utility of a serum glycome analysis in patients with colorectal cancer. J Gastroenterol Hepatol 2022; 37:727-733. [PMID: 35064597 DOI: 10.1111/jgh.15781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Serum glycans are known to be good markers for the early diagnosis and prognostic prediction in many cancers. The aims of this study were to reveal the serum glycan changes comprehensively during the process of carcinogenesis from colorectal adenoma (CRA) to colorectal cancer (CRC) and to evaluate the usefulness of the glycan profiles as clinical markers for CRC. METHODS Serum samples were obtained from 80 histologically proven CRC and 36 CRA cases. The levels of glycans in the serum were examined with a comprehensive, quantitative, high-throughput unique glycome analysis, and their diagnostic and prognostic abilities were evaluated. RESULTS Among 34 stably detected glycans, nine were differentially expressed between CRC and CRA. Serum levels of hybrid type glycans were increased in patients with CRC compared with those with CRA (P < 0.001), and both hybrid-type and multi-antennary glycans were significantly increased in advanced cancer cases. The glycan, m/z 1914, showed the highest diagnostic value among the decreased glycans, whereas m/z 1708 showed the highest among the increased glycans. The glycan ratio m/z 1708/1914 showed a higher area under the receiver operating characteristic curve (0.889) than any other single glycan or conventional tumor marker, such as carcinoembryonic antigen (0.766, P = 0.040) and carbohydrate antigen 19-9 (0.615, P < 0.001). High m/z 1708/1914 was also correlated with an advanced cancer stage and short overall survival. CONCLUSION Serum glycans, especially the m/z 1708/1914 ratio, were useful for the diagnosis, staging, and prognosis prediction of CRC.
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Affiliation(s)
- Daisuke Takei
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keita Harada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuhiro Nouso
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - Koji Miyahara
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chihiro Dohi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Matsushita
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideaki Kinugasa
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Sakiko Hiraoka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shin-Ichiro Nishimura
- Field of Drug Discovery Research, Faculty of Advanced Life Science and Graduate School of Life Science, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Basso C, Gennaro N, Dotto M, Ferroni E, Noale M, Avossa F, Schievano E, Aceto P, Tommasino C, Crucitti A, Incalzi RA, Volpato S, Petrini F, Carron M, Pace MC, Bettelli G, Chiumiento F, Corcione A, Montorsi M, Trabucchi M, Maggi S, Corti MC. Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes. Updates Surg 2022; 74:609-617. [PMID: 34115323 PMCID: PMC8995267 DOI: 10.1007/s13304-021-01086-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/10/2021] [Indexed: 12/03/2022]
Abstract
There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection.
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Affiliation(s)
- Cristina Basso
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy.
| | - Nicola Gennaro
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
| | - Matilde Dotto
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
| | - Eliana Ferroni
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
| | - Marianna Noale
- National Research Council (CNR), Neuroscience Institute, Aging Branch, Padua, Italy
- Consorzio di Ricerca "Luigi Amaducci", Padua, Italy
| | - Francesco Avossa
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
| | - Elena Schievano
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
| | - Paola Aceto
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Concezione Tommasino
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- Department of Biomedical, Surgical and Odontoiatric Sciences, University of Milano, Anaesthesia and Intensive Care, Polo Universitario Ospedale San Paolo, Milan, Italy
| | - Antonio Crucitti
- SICG, Società Italiana di Chirurgia Geriatrica, Naples, Italy
- Cristo Re Hospital, Catholic University Rome, Rome, Italy
| | - Raffaele Antonelli Incalzi
- SIGG, Società Italiana di Geriatria e Gerontologia, Florence, Italy
- AIP, Società Italiana di Psicogeriatria, Brescia, Italy
- Cattedra di Medicina Interna e Geriatria, Università Campus Bio-Medico, Rome, Italy
| | - Stefano Volpato
- SIGG, Società Italiana di Geriatria e Gerontologia, Florence, Italy
- AIP, Società Italiana di Psicogeriatria, Brescia, Italy
- Dipartimento di Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - Flavia Petrini
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- Perioperative Medicine, Pain Therapy, ICU and Emergency Department, Chieti-Pescara University, Pescara, Italy
| | - Michele Carron
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- Department of Medicine, DIMED, Section of Anesthesiology and Intensive Care, University of Padova, Padua, Italy
| | - Maria Caterina Pace
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontostomatologiche, Università di Milano, Milan, Italy
| | - Gabriella Bettelli
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- University of San Marino, San Marino, San Marino
- Department of Anaestesia, Intensive Care, Day Surgery and Pain Therapy and Geriatric Surgery Area, IRCCS INRCA, Italian National Research Centres on Aging, Ancona, Italy
| | - Fernando Chiumiento
- SIAARTI, Italian Society of Anaesthesia, Analgesia, Resuscitation and Intensive Care, Rome, Italy
- Dipartimento Area Critica, ASL Salerno, Salerno, Italy
| | - Antonio Corcione
- Dipartimento di Area Critica UOC Anestesia e TIPO, AORN dei Colli-Monaldi, Naples, Italy
| | - Marco Montorsi
- SIC, Società Italiana di Chirurgia, Rome, Italy
- Humanitas University and Research Hospital IRCCS, Milan, Italy
| | | | - Stefania Maggi
- National Research Council (CNR), Neuroscience Institute, Aging Branch, Padua, Italy
- Consorzio di Ricerca "Luigi Amaducci", Padua, Italy
| | - Maria Chiara Corti
- Epidemiological Department (SER), Azienda Zero, Via Jacopo Avanzo 35, Veneto Region, 35132, Padua, Italy
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Zhang F, Fan G, Wang X. Correlation between BTG3, CASP9 and LRP4 single-nucleotide polymorphisms and susceptibility to papillary thyroid carcinoma. Biomark Med 2022; 16:537-547. [PMID: 35362324 DOI: 10.2217/bmm-2021-0711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To study the association of BTG3, CASP9 and LRP4 single-nucleotide polymorphisms with susceptibility to papillary thyroid carcinoma (PTC). Methods: The BTG3 rs9977638, CASP9 rs884363 and LRP4 rs898604 genotypes of 175 PTC patients and 175 controls were analyzed. Results: Rs9977638 TC genotype and CC genotype, rs884363 CC genotype and rs898604 GG genotype were related to a lower PTC susceptibility risk (p < 0.01). The risk of PTC susceptibility was higher when carrying BTG3 rs9977638 CC, CASP9 rs884363 AC and LRP4 rs898604 AG at the same time (p < 0.01). Conclusion: Combined BTG3, CASP9 and LRP4 genotype analysis has a certain application value in the diagnosis of PTC.
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Affiliation(s)
- Fei Zhang
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy,Tianjin Cancer Institute, National Clinical Research Center for Cancer, Tianjin, 300060, China.,Department of Thyroid Breast Hernia Surgery, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region, 010017, China
| | - Guidong Fan
- Department of Thyroid Breast Hernia Surgery, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia Autonomous Region, 010017, China
| | - Xudong Wang
- Department of Maxillofacial & E.N.T. Oncology, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Cancer Prevention and Therapy,Tianjin Cancer Institute, National Clinical Research Center for Cancer, Tianjin, 300060, China
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Boyaval F, Dalebout H, Van Zeijl R, Wang W, Fariña-Sarasqueta A, Lageveen-Kammeijer GSM, Boonstra JJ, McDonnell LA, Wuhrer M, Morreau H, Heijs B. High-Mannose N-Glycans as Malignant Progression Markers in Early-Stage Colorectal Cancer. Cancers (Basel) 2022; 14:1552. [PMID: 35326703 PMCID: PMC8945895 DOI: 10.3390/cancers14061552] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023] Open
Abstract
The increase incidence of early colorectal cancer (T1 CRC) last years is mainly due to the introduction of population-based screening for CRC. T1 CRC staging based on histological criteria remains challenging and there is high variability among pathologists in the scoring of these criteria. It is crucial to unravel the biology behind the progression of adenoma into T1 CRC. Glycomic studies have reported extensively on alterations of the N-glycomic pattern in CRC; therefore, investigating these alterations may reveal new insights into the development of T1 CRC. We used matrix-assisted laser desorption ionization (MALDI) mass spectrometry imaging (MSI) to spatially profile the N-glycan species in a cohort of pT1 CRC using archival formalin-fixed and paraffin-embedded (FFPE) material. To generate structural information on the observed N-glycans, CE-ESI-MS/MS was used in conjunction with MALDI-MSI. Relative intensities and glycosylation traits were calculated based on a panel of 58 N-glycans. Our analysis showed pronounced differences between normal epithelium, dysplastic, and carcinoma regions. High-mannose-type N-glycans were higher in the dysplastic region than in carcinoma, which correlates to increased proliferation of the cells. We observed changes in the cancer invasive front, including higher expression of α2,3-linked sialic acids which followed the glycosylation pattern of the carcinoma region.
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Affiliation(s)
- Fanny Boyaval
- Department of Pathology, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands;
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - Hans Dalebout
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - René Van Zeijl
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - Wenjun Wang
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - Arantza Fariña-Sarasqueta
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Guinevere S. M. Lageveen-Kammeijer
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - Jurjen J. Boonstra
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands;
| | - Liam A. McDonnell
- Fondazione Pisana per la Scienza ONLUS, Via Ferruccio Giovannini, 56017 San Giuliano Terme, Italy;
| | - Manfred Wuhrer
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands;
| | - Bram Heijs
- Center for Proteomics & Metabolomics, Leiden University Medical Center, Albinusdreef, 2333 ZA Leiden, The Netherlands; (H.D.); (R.V.Z.); (W.W.); (G.S.M.L.-K.); (M.W.)
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BENEK S, PEDÜK Ş, ZENGIN M. Platelet-lymphocyte ratio predicts poor prognosis in stage II / III colon and rectum cancer. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1056614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Reitz ACW, Switchenko JM, Gillespie TW. Is Medicaid Expansion Associated with Improved Nonmetastatic Colon Cancer Survival? An Analysis of the National Cancer Database. Am Surg 2022:31348211050816. [PMID: 35213813 DOI: 10.1177/00031348211050816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
METHODS This retrospective study of 86 413 patients (40-64 years old) undergoing surgical resection for a new diagnosis of invasive, nonmetastatic colon cancer included in the National Cancer Database (NCDB) from 2010 to 2015 compared overall survival (OS) in MES to NES. Cox proportional hazard models, fit for OS, and propensity score-matching (PSM) analysis were performed. RESULTS In this sample, 51 297 cases (59.2%) lived in MES and 35 116 (40.8%) in NES. Medicaid expansion states had earlier pathological stage compared to NES (stage I 25.38% vs 24.17%, stage II 32.93 vs 33.4%, and stage III 41.69 vs 42.43%; P < .001). 5-year OS in MES was higher than NES (79.1% vs 77.3%; P < .001); however, on both multivariable analysis (MVA) and PSM analysis, MES did not have significantly different OS from NES (hazard ratio (HR), .99, 95% confidence interval (CI), .95-1.03; P = .570; HR, .99, 95% CI, .95-1.03; P = .68). CONCLUSION Among NCDB patients with invasive, nonmetastatic colon cancer residing in MES at time of diagnosis was associated with earlier pathological stage. However, on both MVA and PSM analysis, OS was not significantly different in MES vs NES. Research on patient outcomes, such as receipt of guideline concordant care, can further inform the impact of insurance coverage expansion efforts on cancer outcomes.
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Affiliation(s)
- Alexandra C W Reitz
- Department of Surgery, 160352Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey M Switchenko
- Department of Biostatistics and Bioinformatics, 25798Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Theresa W Gillespie
- Department of Surgery, 160352Emory University School of Medicine, Atlanta, GA, USA.,Department of Hematology and Medical Oncology, 12239Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, USA
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Tai Q, Xue W, Li M, Zhuo S, Zhang H, Fang F, Zhang J. Survival Nomogram for Metastasis Colon Cancer Patients Based on SEER Database. Front Genet 2022; 13:832060. [PMID: 35222547 PMCID: PMC8864078 DOI: 10.3389/fgene.2022.832060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction: A prediction model for the 1-, 3-, and 5-year survival rates of metastatic colon cancer (mCC) patients was developed by analyzing important risk factors for the prognosis of mCC patients based on the SEER database. Method: The characteristic of 10,946 patients diagnosed with mCC between 2010 and 2015 was obtained from the SEER database. The population was randomly divided into a training cohort and an internal validation cohort in a 7:3 ratio. Univariate and multivariate cox for independent predictors of mCC prognosis were performed, and nomogram was constructed. The accuracy of the model was verified by calibration curves, ROC curves, and C-index, and the clinical utility of the model was analyzed using decision analysis curves. Result: Age, primary site, grade, surgery, and other eight factors were significantly associated with the prognosis of mCC patients, and these predictors were included in the construction of the nomogram. The C-index was 0.731 (95% CI 0.725–0.737) and 0.736 (95% CI 0.726–0.746) for the training cohort and the validation set, respectively. The results of the ROC curve analysis indicated that the area under the curve (AUC) exceeded 0.7 for both the training cohort and the validation set at 1, 3, and 5 years. Conclusion: The constructed prediction model had an excellent predictive accuracy, which will help clinical decision-making of mCC patients after surgery and individualized treatment.
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Affiliation(s)
- Qinwen Tai
- Department of General Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- *Correspondence: Qinwen Tai, ; Jinhui Zhang,
| | - Wei Xue
- Department of Pharmacy, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
| | - Mengying Li
- The First College of Clinical Science, Anhui Medical University, Hefei, China
| | - Shuli Zhuo
- Medical College of Shaoguan University, Shaoguan, China
| | - Heng Zhang
- Department of General Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Fa Fang
- Department of General Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Jinhui Zhang
- Department of General Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- *Correspondence: Qinwen Tai, ; Jinhui Zhang,
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Chen YC, Chen WM, Chiang MF, Shia BC, Wu SY. Association between Pre-Existing Sleep Disorders and Survival Rates of Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14030798. [PMID: 35159065 PMCID: PMC8834375 DOI: 10.3390/cancers14030798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE: To investigate the effects of pre-existing sleep disorders on the survival outcomes of women receiving standard treatments for breast invasive ductal carcinoma (IDC). METHODS: We recruited patients from the Taiwan Cancer Registry Database who had received surgery for clinical stage I–III breast IDC. The Cox proportional hazards model was used to analyze all-cause mortality. We categorized the patients into those with and without sleep disorders (Groups 1 and 2, respectively) through propensity score matching. RESULTS: In the multivariate Cox regression analysis, the adjusted hazard ratio for all-cause mortality for Group 1 compared with Group 2 was 1.51 (95% confidence interval: 1.19, 1.91; p < 0.001). CONCLUSION: Our study demonstrated that the sleep disorder group had poorer survival rates than the non-sleep disorder group in breast cancer. Therefore, patients should be screened and evaluated for pre-existing sleep disorders prior to breast surgery, with such disorders serving as a predictor of survival in patients with breast cancer. Future studies may investigate the survival benefits of pharmacological and behavioral treatments for sleep problems in patients with breast cancer.
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Affiliation(s)
- Yen-Chang Chen
- Division of Chest Medicine, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan;
| | - Wan-Ming Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242062, Taiwan;
| | - Ming-Feng Chiang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan;
| | - Ben-Chang Shia
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242062, Taiwan;
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242062, Taiwan
- Correspondence: (B.-C.S.); (S.-Y.W.)
| | - Szu-Yuan Wu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242062, Taiwan;
- Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242062, Taiwan
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
- Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
- Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan
- Correspondence: (B.-C.S.); (S.-Y.W.)
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46
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Lv L, Xin B, Hao Y, Yang Z, Xu J, Wang L, Wang X, Song S, Guo X. Radiomic analysis for predicting prognosis of colorectal cancer from preoperative 18F-FDG PET/CT. J Transl Med 2022; 20:66. [PMID: 35109864 PMCID: PMC8812058 DOI: 10.1186/s12967-022-03262-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background To develop and validate a survival model with clinico-biological features and 18F- FDG PET/CT radiomic features via machine learning, and for predicting the prognosis from the primary tumor of colorectal cancer. Methods A total of 196 pathologically confirmed patients with colorectal cancer (stage I to stage IV) were included. Preoperative clinical factors, serum tumor markers, and PET/CT radiomic features were included for the recurrence-free survival analysis. For the modeling and validation, patients were randomly divided into the training (n = 137) and validation (n = 59) set, while the 78 stage III patients [training (n = 55), and validation (n = 23)] was divided for the further experiment. After selecting features by the log-rank test and variable-hunting methods, random survival forest (RSF) models were built on the training set to analyze the prognostic value of selected features. The performance of models was measured by C-index and was tested on the validation set with bootstrapping. Feature importance and the Pearson correlation were also analyzed. Results Radiomics signature (containing four PET/CT features and four clinical factors) achieved the best result for prognostic prediction of 196 patients (C-index 0.780, 95% CI 0.634–0.877). Moreover, four features (including two clinical features and two radiomics features) were selected for prognostic prediction of the 78 stage III patients (C-index was 0.820, 95% CI 0.676–0.900). K–M curves of both models significantly stratified low-risk and high-risk groups (P < 0.0001). Pearson correlation analysis demonstrated that selected radiomics features were correlated with tumor metabolic factors, such as SUVmean, SUVmax. Conclusion This study presents integrated clinico-biological-radiological models that can accurately predict the prognosis in colorectal cancer using the preoperative 18F-FDG PET/CT radiomics in colorectal cancer. It is of potential value in assisting the management and decision making for precision treatment in colorectal cancer. Trial registration The retrospectively registered study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center (No. 1909207-14-1910) and the data were analyzed anonymously. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03262-5.
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Affiliation(s)
- Lilang Lv
- Department of Radiotherapy, Fudan University Shanghai Cancer Center, No.270 Dong'an Road, Xuhui district, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bowen Xin
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Yichao Hao
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Ziyi Yang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No.270 Dong'an Road, Xuhui district, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Center for Biomedical Imaging, Fudan University, Shanghai, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
| | - Junyan Xu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No.270 Dong'an Road, Xuhui district, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Center for Biomedical Imaging, Fudan University, Shanghai, China.,Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
| | - Lisheng Wang
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xiuying Wang
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No.270 Dong'an Road, Xuhui district, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. .,Center for Biomedical Imaging, Fudan University, Shanghai, China. .,Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China.
| | - Xiaomao Guo
- Department of Radiotherapy, Fudan University Shanghai Cancer Center, No.270 Dong'an Road, Xuhui district, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer. Int J Colorectal Dis 2022; 37:365-372. [PMID: 34850277 DOI: 10.1007/s00384-021-04070-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to analyze the effect of ascitic carcinoembryonic antigen (CEA) levels on the long-term oncologic outcomes of colorectal cancer (CRC) following curative treatment. METHODS A total of 191 patients with stage II/III CRC were included. CEA was analyzed on the peritoneal fluid samples taken at the start of each surgery. Long-term oncologic outcomes were analyzed using known risk factors for recurrence in CRC. RESULT Multivariate analysis of recurrence showed that lymphatic invasion (hazards ratio (HR) 2.7, 95% confidence interval (CI) 1.1-7, p = 0.038), vascular invasion (HR 2.8, 95% CI 1.2-6.3, p = 0.013), mucinous cancer (HR 3.6, 95% CI 1.3-10.1, p = 0.017), and peritoneal fluid CEA exceeding 5 ng/dl (odds ratio 3.1, 95% CI 1.2-7.7, p = 0.017) were significant risk factors. There were 14 patients with liver metastasis, 11 of whom had high ascitic CEA levels and no peritoneal metastasis. Additionally, eight had lung metastasis, and seven of them had high ascitic CEA levels. CONCLUSION High ascitic CEA levels showed significantly lower disease-free survival and were significantly associated with distant metastasis in the lung and liver.
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Lee SW, Park HL, Yoon N, Kim JH, Oh JK, Buyn JH, Choi EK, Hong JH. Prognostic Impact of Total Lesion Glycolysis (TLG) from Preoperative 18F-FDG PET/CT in Stage II/III Colorectal Adenocarcinoma: Extending the Value of PET/CT for Resectable Disease. Cancers (Basel) 2022; 14:cancers14030582. [PMID: 35158851 PMCID: PMC8833504 DOI: 10.3390/cancers14030582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 01/27/2023] Open
Abstract
We investigated the prognostic role of metabolic parameters from preoperative 18F-FDG PET/CT in stage II/III colorectal adenocarcinoma. A total of 327 stage II/III colorectal adenocarcinoma patients who underwent curative resection were included. The maximal standard uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were analyzed for optimal cut-offs and their effect on DFS. Differences in DFS rates and hazard ratios for DFS between cut-offs were statistically significant in SUVmax, MTV2.5, MTV3, TLG 2.5, TLG3, and TLG30%. Factors significantly related to DFS in univariate Cox regression were age, sex, stage, preoperative CEA, SUVmax, MTV2.5, MTV3, TLG2.5, TLG3, and TLG30%. Age, sex, preoperative CEA, and TLG2.5 (p = 0.009) sustained statistically significant difference in multivariate analysis. The 1-, 3-, and 5-year DFS rates for TLG2.5 ≤ 448.5 were 98.1%, 79.6%, and 74.8%, significantly higher than 78.4%, 68.5%, and 61.1% of TLG2.5 > 448.5, respectively (p = 0.012). TLG, a parameter indicating both the metabolic activity and metabolic volume, was the strongest predictor independently associated with DFS, among several PET parameters with statistical significance. These results suggest the potential prognostic value of preoperative 18F-FDG PET/CT in stage II/III resectable colorectal cancer.
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Affiliation(s)
- Sea-Won Lee
- Department of Radiation Oncology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea;
| | - Hye Lim Park
- Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea;
| | - Nara Yoon
- Department of Pathology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
| | - Ji Hoon Kim
- Department of General Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
| | - Jin Kyoung Oh
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
| | - Jae Ho Buyn
- Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
| | - Eun Kyoung Choi
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea;
- Correspondence: (E.K.C.); (J.H.H.); Tel.: +82-32-280-5242 (E.K.C.); +82-2-2030-4361 (J.H.H.)
| | - Ji Hyung Hong
- Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea
- Correspondence: (E.K.C.); (J.H.H.); Tel.: +82-32-280-5242 (E.K.C.); +82-2-2030-4361 (J.H.H.)
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Ren D, Wang WL, Wang G, Chen WW, Li XK, Li GD, Bai SX, Dong HM, Chen WH. Development and Internal Validation of a Nomogram-Based Model to Predict Three-Year and Five-Year Overall Survival in Patients with Stage II/III Colon Cancer. Cancer Manag Res 2022; 14:225-236. [PMID: 35058717 PMCID: PMC8765714 DOI: 10.2147/cmar.s335665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/20/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The aim of this study was to develop a nomogram-based model to predict the three-year and five-year overall survival (OS) of patients with stage II/III colon cancer following radical resection. METHODS A total of 1156 patients with stage II/III colon cancer who underwent radical resection at the Affiliated Hospital of Guizhou Medical University between December 2012 and December 2018 were enrolled. Lasso regression was used to screen out 12 variables: age, prealbumin, albumin, degree of differentiation, total tumor-node-metastasis (TNM) stage, T stage, N stage, prognostic nutritional index (PNI), platelet/lymphocyte count, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA19-9), and postoperative adjuvant chemotherapy. The data set was then randomly split into a modeling set and a validation set, and the bootstrap method was used to verify the internal validity of the final model. A nomogram was then used to present the model, and the risk groups were categorized according to the total score in the nomogram. RESULTS This study established and developed a simple, easy-to-use predictive model that included age, degree of differentiation, N stage, CA19-9, PNI, and postoperative chemotherapy as variables. In the multivariate Cox regression analysis, only postoperative chemotherapy was identified as an independent risk factor for death in patients with colon cancer. The receiver operating characteristic curve showed that the model demonstrated good resolution, with an area under the curve of 0.803. Decision curve analysis indicated that the model had a good positive net gain, and the bootstrap method was used to verify its stability. In the OS rate, the C-index was 0.78. According to the total score of the nomogram, the risk group was layered by drawing the Kaplan-Meier (K-M) curve. In the three-year OS K-M curve, the survival rates of the low-risk group, the medium-risk group, and the high-risk group were 96%, 93%, and 82%, respectively. In the five-year OS K-M curve, the survival rates of the low-risk group, the medium-risk group, and the high-risk group were 94%, 90%, and 73%, respectively. CONCLUSION The nomogram-based prediction model developed in this study is stable and has good resolution, reliability, and net gain. It will therefore be useful for clinicians performing risk stratification and postoperative monitoring and in the development of personalized treatment options for patients with stage II/III colon cancer.
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Affiliation(s)
- Dan Ren
- Oncology Department, Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Wen-Ling Wang
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Gang Wang
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Wei-Wei Chen
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Xiao-Kai Li
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Guo-Dong Li
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Sai-Xi Bai
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Hong-Min Dong
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
| | - Wang-Hua Chen
- Department of Abdominal Oncology, Affiliated Hospital of Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, 550000, People’s Republic of China
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Losurdo P, Samardzic N, Di Lenarda F, de Manzini N, Giudici F, Bortul M. The real-word impact of breast and colorectal cancer surgery during the SARS-CoV-2 pandemic. Updates Surg 2022; 74:1063-1072. [PMID: 34978052 PMCID: PMC8720543 DOI: 10.1007/s13304-021-01212-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/20/2021] [Indexed: 12/09/2022]
Abstract
The postponing of screening and the health care system reorganization, due to the Covid-19 pandemic and lockdown, could led to a concerning decline in breast and colorectal cancer diagnoses. This monocentric retrospective analysis has compared the pre-Covid period (March 2019 to March 2020) to the Covid period (April 2020 to April 2021) in terms of screening programs, clinical, surgical and pathological. A total of 799 patients diagnosed with Breast Cancer (BC) and Colorectal Cancer (CRC) underwent surgery during the two periods. In FVG in 2020 a decrease in mammography screening of 17.1% has been registered compared to 2019; this reduction has been higher for CRC screening, which summed up to 24.5%. As far as BC is concerned, screening-detected tumours rose significantly from 18 to 28%, mastectomies decreased from 40 to 31% and advanced tumours treated surgically decreased from 12 to 6%. Concerning CRC, a significant increase in admissions through the Emergency Department has been registered in spite of a stable percentage of urgent surgery performed, proving that severely symptomatic patients have been treated adequately. Open surgery has significantly decreased, whereas the tumoral stage and complications have remained constant in the two periods. This study has proved that maintaining standards of care and validated protocols during emergency is the most adequate and winning strategy: impact on BC and CRC has been less important than expected. These results support the recommendations for immediate and rapid screening program resumption at operating speed, using prioritization strategies to make up for the diagnostic delays.
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Affiliation(s)
- Pasquale Losurdo
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
- Department of Surgery, University of Trieste-Ospedale di Cattinara, 34100, Trieste, Italy.
| | - Natasa Samardzic
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Francesca Di Lenarda
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Nicolò de Manzini
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Fabiola Giudici
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Marina Bortul
- Surgical Clinic Unit, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
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