Incidence Rates, Treatment, and Survival of Rectal Cancer Among Young Patients: A Nationwide Cohort Study

Predictive value of preoperative handgrip strength on postoperative outcomes in patients with gastrointestinal tumors: a systematic review and meta-analysis

PURPOSE

This systematic review and meta-analysis aimed to explore the predictive value of preoperative handgrip strength on postoperative outcomes in patients with gastrointestinal tumors.

METHODS

Databases including Cochrane Library, Pubmed, Embase, Web of Science, and CINAHL Complete were searched for articles published from the establishment of database until August 7, 2021. Two researchers independently screened the literature, extracted the data, and evaluated the quality.

RESULTS

Eight studies were included, involving five prospective and three retrospective cohort studies with 2291 participants. The prevalence of preoperative low handgrip strength ranged from 11.8 to 62.7%. Preoperative low handgrip strength was associated with an increased risk of total complications (OR = 2.23, 95%CI = 1.43-3.50), pneumonia (OR = 5.16, 95%CI = 3.17-8.38), ileus (OR = 2.48, 95%CI = 1.09-5.65), and short-term mortality (OR = 7.28, 95%CI = 1.90-27.92).

CONCLUSION

This systematic review and meta-analysis indicated that preoperative HGS had important value to predict certain adverse postoperative outcomes among patients with GI tumors. Low handgrip strength criteria, definition of total complications, and country are the potential sources of heterogeneity, and more research are required to test and update these results.

Predictors of Lymph Node Metastasis in T1 Colorectal Cancer in Young Patients: Results from a National Cancer Registry

The objective of this study is to fill the knowledge gap by examining predictors of lymph node metastasis (LNM) in young patients, less than 45 years, using a national cancer registry. Methods: Patients diagnosed with T1 colorectal cancer were identified in the Surveillance, Epidemiology, and End Results registry. In total, 692 patients with T1 colorectal cancer were identified. Most tumors occurred in white race (77.7%), between 40 and 44 years of age (49.4%), with grade III tumor differentiation (59.8%) and 1 to 1.9 cm size (32.2%), and were left-sided tumors (61.1%). The overall rate of LNM was 22.5% (n = 149). LNM was associated with tumor grade IV (undifferentiated) (odds ratio (OR) 2.94, CI: 1.06–8.12; p = 0.038), and increasing tumor size (1 cm–1.9 cm: OR 2.92, CI: 1.71–4.97, p < 0.001; 2.0 cm–2.9 cm: OR 2.00, CI: 1.05–3.77, p = 0.034; and ≥3.0 cm: OR 2.68, CI: 1.43–5.01, p = 0.002). Five-year cancer-specific survival for patients with LNM was 91% and for patients without LNM this was 98%. Adjusted cox proportion models showed that LNM was associated with a four times higher rate of mortality (hazard ratio (HR) 4.43, CI: 1.27–15.52, p = 0.020). In this population-based analysis of patients with T1 colorectal cancer, tumor size and grade were significant predictors of LNM.

Gender and racial disparities in colorectal cancer incidence and mortality: a national cancer registry study

INTRODUCTION

The incidence of CRC is higher in minority racial and ethnic groups. However, studies assessing trends among sex and racial groups on the incidence and mortality of CRC are lacking. We aim to investigate disparities in CRC by reviewing a large national cancer registry.

METHODS

This is a retrospective cross-sectional study of the Surveillance, Epidemiology, and End Results Registry (SEER) of individuals aged 45-79 years from 2000-2017.

RESULTS

During the study period, the incidence of CRC decreased for both males and females, respectively (APC -2.14 vs -1.81). Among all racial groups, African American showed the least decline in incidence of CRC. African American females showed the highest risk for CRC (IRR 1.34; 95% CI 1.32-1.36, p< 0.001) compared to other females or males from different racial groups. Subgroup analysis using Kaplan-Meier estimations showed that African American females had the poorest 5-year survival rate (56%) compared to other female racial groups. Among males, American Indian/Alaska Natives had the poorest 5-year survival (54%) compared to male of other racial groups.

CONCLUSION

Overall, the incidence of colorectal cancer is declining. However, the incidence of CRC remains highest in African Americans females who are also burden with poor survival rates.