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Son IT, Kim M, Oh BY, Kim MJ, Yoon SN, Park JH, Kim BC, Kim JW. Oncologic relevance of genetic alterations in sporadic synchronous and solitary colorectal cancer: a retrospective multicenter study. BMC Gastroenterol 2023; 23:297. [PMID: 37667167 PMCID: PMC10478293 DOI: 10.1186/s12876-023-02937-7] [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: 03/24/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Oncologic impact of genetic alteration across synchronous colorectal cancer (CRC) still remains unclear. This study aimed to compare the oncologic relevance according to genetic alteration between synchronous and solitary CRC with performing systematic review. METHODS Multicenter retrospective analysis was performed for CRC patients with curative resection. Genetic profiling was consisted of microsatellite instability (MSI) testing, RAS (K-ras, and N-ras), and BRAF (v-Raf murine sarcoma viral oncogene homolog B1) V600E mutation. Multivariate analyses were conducted using logistic regression for synchronicity, and Cox proportional hazard model with stage-adjusting for overall survival (OS) and disease-free survival (DFS). RESULTS It was identified synchronous (n = 36) and solitary (n = 579) CRC with similar base line characteristics. RAS mutation was associated to synchronous CRC with no relations of MSI and BRAF. During median follow up of 77.8 month, Kaplan-meier curves showed significant differences according to MSI-high for OS, and in RAS, and BRAF mutation for DFS, respectively. In multivariable analyses, RAS and BRAF mutation were independent factors (RAS, HR = 1.808, 95% CI = 1.18-2.77, p = 0.007; BRAF, HR = 2.417, 95% CI = 1.32-4.41, p = 0.004). Old age was independent factor for OS (HR = 3.626, 95% CI = 1.09-12.00, p = 0.035). CONCLUSION This study showed that oncologic outcomes might differ according to mutation burden characterized by RAS, BRAF, and MSI between synchronous CRC and solitary CRC. In addition, our systematic review highlighted a lack of data and much heterogeneity in genetic characteristics and survival outcomes of synchronous CRC relative to that of solitary CRC.
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Affiliation(s)
- Il Tae Son
- Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea
| | - Minsung Kim
- Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea
| | - Bo Young Oh
- Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea
| | - Min Jeong Kim
- Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Sang Nam Yoon
- Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jun Ho Park
- Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Byung Chun Kim
- Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jong Wan Kim
- Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40, Sukwoo-Dong, Hwaseong-Si, Gyeonggi-Do, Republic of Korea.
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2
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Al Laham O, Atia F, Ibrahim D, Shaheen J, Hokouk B. An exceedingly rare simultaneous incidental occurrence of synchronous primary malignancies; Invasive Ductal Carcinoma and Renal Cell Carcinoma in a male - A Case Report. Int J Surg Case Rep 2022; 96:107367. [PMID: 35785686 PMCID: PMC9284067 DOI: 10.1016/j.ijscr.2022.107367] [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: 05/26/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Synchronous malignancies are defined as the emergence of one or more tumors which either occur simultaneously or within 6 months of each other. Populations older than 50 years of age are the most vulnerable. Documented prevalence rates of synchronous neoplasia are 4.5-11.7 %. To the best of our knowledge, ours is the first documented case of synchronous primary incidental occurrence of Invasive Ductal Carcinoma (IDC) and Renal Cell Carcinoma (RCC) in a Middle Eastern male. This type of co-occurrence must be borne in mind because such neoplastic occurrence is potentially fatal. Documentation is essential to raise awareness and to decrease the resultant morbidity and mortality. CASE PRESENTATION We present a case of a 61-year-old male who presented to our clinic with a 22-day-history of gradual, painless, and disproportionate hypertrophy of his left breast. CT scan revealed incidental breast and right kidney masses. Therapeutic intervention included a modified radical mastectomy with Sentinel lymph node excision along with right radical nephrectomy. CLINICAL DISCUSSION Treatment of our patient was multimodal. Accurate radiological studying together with clinical examination helped us in making a diagnosis. Treatment options for this pathology consist of a combination of surgery and/or adjuvant therapy. CONCLUSION Synchronous IDC and RCC are an extremely rare co-occurrence, especially in males, particularly Middle Eastern males, and more specifically, those presenting asymptomatically as incidental findings. It is vital to further document and study such cases to establish innovative surgical techniques, screening modalities for males, and to overcome the consequential morbidity and mortality.
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Affiliation(s)
- Omar Al Laham
- Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria,Department of Surgery, Al Assad University Hospital, Damascus, Syria,Corresponding author at: Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria.
| | - Fareed Atia
- Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria,Department of Surgery, Al Assad University Hospital, Damascus, Syria
| | | | - Jack Shaheen
- Department of Surgery, Al-Mouwasat University Hospital, Damascus, Syria,Department of Surgery, Al Assad University Hospital, Damascus, Syria
| | - Bashir Hokouk
- Damascus University, Damascus, Syria,Department of Surgery, Al_Abbasieen Hospital, Damascus, Syria
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3
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Diraviam S, Al-Bayati A, Mayovska O, Chaudhry R, Patel SV. Multiple Primary Malignancies With Hypercalcemia Presentation: A Case Report. Cureus 2022; 14:e24266. [PMID: 35607588 PMCID: PMC9123354 DOI: 10.7759/cureus.24266] [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] [Accepted: 04/18/2022] [Indexed: 11/15/2022] Open
Abstract
Multiple primary malignancies (MPMs) are defined as having more than one primary malignancy and when each tumor is histologically distinct and unrelated to the others. Multiple risk factors have been found to be associated with MPMs. These include familial syndromes, sequela from treatments of previous malignancies, and environmental factors such as smoking, alcohol consumption, obesity, and male sex. Hypercalcemia has a well-known association with malignancy and is often the first abnormality that leads to further testing. Lung cancer followed by colorectal cancer has the highest mortality of all cancers in the USA, with adenocarcinoma being the most prevalent histological subtype. Further, estimates show that those with one malignancy have a 1.29 times higher risk of developing another malignancy. Hereby, we present a case of a patient with squamous cell carcinoma of the lung who presented with hypercalcemia and incidentally was found to have another primary adenocarcinoma of the colon.
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Dayer N, Fasquelle F, Salati E, Dietrich G. Multiple primary malignancies: synchronous lymphoma, pancreatic neuroendocrine tumour and colorectal cancer. BMJ Case Rep 2021; 14:14/6/e241938. [PMID: 34088689 PMCID: PMC8183193 DOI: 10.1136/bcr-2021-241938] [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] [Indexed: 11/03/2022] Open
Abstract
A 67-year-old woman underwent a medical check-up by her general practitioner after complaining of atypical pain in the shoulder girdle. Due to the important inflammatory syndrome noticed on blood testing, a polymyalgia rheumatica was suspected and she was started on corticosteroid treatment with good clinical response, but no impact on inflammation. She underwent extensive imaging with a thoraco-abdominal CT scanner that demonstrated a pancreatic mass, then later a PET-CT showed 3 different hyperactive lesions. Biopsies then revealed simultaneous diffuse large B-cell lymphoma (DLBCL), colorectal adenocarcinoma and pancreatic neuroendocrine tumour. She benefited from low rectal endoscopic excision of the colorectal tumour, R-CHOP chemotherapy for DLBCL and laparoscopic left pancreatectomy. Successful treatment required a good multidisciplinary collaboration between the different specialists. The patient made a good recovery and achieved complete remission at 1 year. This an unusual presentation of multiple primary malignancies.
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Affiliation(s)
| | | | | | - Gilles Dietrich
- Orthopedic Surgery, Hôpital Riviera-Chablais, Rennaz, Switzerland
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5
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Hassan MA, Fakhrudiin N, Farhat F. Synchronous invasive ductal carcinoma of the breast and clear cell renal carcinoma with rare presentation and behaviour: a case report with a literature review. Ecancermedicalscience 2020; 14:1120. [PMID: 33209111 PMCID: PMC7652543 DOI: 10.3332/ecancer.2020.1120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 01/22/2023] Open
Abstract
The presence of two or more primary tumours is a relatively uncommon phenomenon. Recently with the improvement of diagnostic modalities, such cases are increasingly reported in the literature. This paper presents a rare case of synchronous breast and renal tumour with unusual features including RCC metastasis to the duodenum and stomach, rapid recurrence of the tumour at the nephrectomy site, rapid renal cell carcinoma growth rate and the rare presence of syncytial-type giant cells in the renal cell tumour.
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Affiliation(s)
- Mona Ali Hassan
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Najla Fakhrudiin
- Department of Pathology, Hammoud Hospital University Medical Center, Sidon, Lebanon
| | - Fadi Farhat
- Department of Hematology and Oncology, Hammoud Hospital University Medical Center, Sidon, Lebanon
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Hänninen UA, Wirta EV, Katainen R, Tanskanen T, Hamberg J, Taipale M, Böhm J, Renkonen-Sinisalo L, Lepistö A, Forsström LM, Pitkänen E, Palin K, Seppälä TT, Mäkinen N, Mecklin JP, Aaltonen LA. Exome and immune cell score analyses reveal great variation within synchronous primary colorectal cancers. Br J Cancer 2019; 120:922-930. [PMID: 30894686 PMCID: PMC6734647 DOI: 10.1038/s41416-019-0427-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/26/2019] [Accepted: 03/01/2019] [Indexed: 12/15/2022] Open
Abstract
Background Approximately 4% of colorectal cancer (CRC) patients have at least two simultaneous cancers in the colon. Due to the shared environment, these synchronous CRCs (SCRCs) provide a unique setting to study colorectal carcinogenesis. Understanding whether these tumours are genetically similar or distinct is essential when designing therapeutic approaches. Methods We performed exome sequencing of 47 primary cancers and corresponding normal samples from 23 patients. Additionally, we carried out a comprehensive mutational signature analysis to assess whether tumours had undergone similar mutational processes and the first immune cell score analysis (IS) of SCRC to analyse the interplay between immune cell invasion and mutation profile in both lesions of an individual. Results The tumour pairs shared only few mutations, favouring different mutations in known CRC genes and signalling pathways and displayed variation in their signature content. Two tumour pairs had discordant mismatch repair statuses. In majority of the pairs, IS varied between primaries. Differences were not explained by any clinicopathological variable or mutation burden. Conclusions The study shows major diversity within SCRCs. Rather than rely on data from one tumour, our study highlights the need to evaluate both tumours of a synchronous pair for optimised targeted therapy.
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Affiliation(s)
- Ulrika A Hänninen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Erkki-Ville Wirta
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - Riku Katainen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Tomas Tanskanen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jiri Hamberg
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Minna Taipale
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Jan Böhm
- Department of Pathology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Laura Renkonen-Sinisalo
- Department of Surgery, Helsinki University Central Hospital, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Anna Lepistö
- Department of Surgery, Helsinki University Central Hospital, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Linda M Forsström
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Esa Pitkänen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Genome Biology Unit, European Molecular Biology Unit (EMBL), Heidelberg, Germany
| | - Kimmo Palin
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Toni T Seppälä
- Department of Surgery, Helsinki University Central Hospital, Hospital District of Helsinki and Uusimaa, Helsinki, Finland
| | - Netta Mäkinen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jukka-Pekka Mecklin
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri A Aaltonen
- Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland. .,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.
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7
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Flor N, Zanchetta E, Di Leo G, Mezzanzanica M, Greco M, Carrafiello G, Sardanelli F. Synchronous colorectal cancer using CT colonography vs. other means: a systematic review and meta-analysis. Abdom Radiol (NY) 2018; 43:3241-3249. [PMID: 29948053 DOI: 10.1007/s00261-018-1658-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The objective of our study was to systematically review the evidence about synchronous colorectal cancer diagnosed with or without computed tomography colonography (CTC). MATERIALS AND METHODS Two systematic searches were performed (PubMed and EMBASE) for studies reporting the prevalence of synchronous colorectal cancer (CRC): one considering patients who underwent CTC and the another one considering patients who did not undergo CTC. A three-level analysis was performed to determine the prevalence of patients with synchronous CRC in both groups of studies. Heterogeneity was explored for multiple variables. Pooled prevalence and 95% confidence interval (CI) were calculated. A quality assessment (STROBE) was done for the studies. RESULTS For CTC studies, among 2645 articles initially found, 21 including 1673 patients, published from 1997 to 2018, met the inclusion criteria. For non-CTC studies, among 6192 articles initially found, 27 including 111,873 patients published from 1974 to 2015 met the inclusion criteria. The pooled synchronous CRC prevalence was 5.7% (95% CI 4.7%-7.1%) for CTC studies, and 3.9% (95% CI 3.3%-4.4%) for non-CTC studies, with a significant difference (p = 0.004). A low heterogeneity was found for the CTC group (I2 = 10.3%), whereas a high heterogeneity was found in the non-CTC group of studies (I2 = 93.5%), and no significant explanatory variables were found. Of the 22 STROBE items, a mean of 18 (82%) was fulfilled by CTC studies, and a mean of 16 (73%) by non-CTC studies. CONCLUSIONS The prevalence of synchronous CRC was about 4-6%. The introduction of CTC is associated with a significant increase of the prevalence of synchronous CRCs.
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Affiliation(s)
- Nicola Flor
- Unità Operativa di Radiologia Diagnostica e Interventistica, Azienda Servizi Socio Territoriali Santi Paolo e Carlo, Presidio San Paolo, Via di Rudinì 8, 20142, Milan, Italy.
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Via di Rudinì 8, 20142, Milan, Italy.
| | - Edoardo Zanchetta
- Postgraduation School in Radiodiagnostics, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Giovanni Di Leo
- Unità di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Dipartimento di Scienze Biomediche della Salute, Università degli Studi di Milano, Piazza E. Malan, 20097, San Donato Milanese, Italy
| | - Miriam Mezzanzanica
- Postgraduation School in Radiodiagnostics, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Massimiliano Greco
- Postgraduation School in Radiodiagnostics, Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Gianpaolo Carrafiello
- Unità Operativa di Radiologia Diagnostica e Interventistica, Azienda Servizi Socio Territoriali Santi Paolo e Carlo, Presidio San Paolo, Via di Rudinì 8, 20142, Milan, Italy
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Via di Rudinì 8, 20142, Milan, Italy
| | - Francesco Sardanelli
- Unità di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Dipartimento di Scienze Biomediche della Salute, Università degli Studi di Milano, Piazza E. Malan, 20097, San Donato Milanese, Italy
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8
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Banimostafavi ES, Tayebi S, Tayebi M, Montazer F. Case Report: Synchronous primary malignancy including the breast and endometrium. F1000Res 2018; 6:1502. [PMID: 29333235 PMCID: PMC5754747 DOI: 10.12688/f1000research.11971.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2018] [Indexed: 01/22/2023] Open
Abstract
Breast and endometrial cancer are the most common types of female cancers, but the incidence of both of these malignancies in a single patient is a rare event. Multiple primary malignancy has been increasingly reported over the past decade, and double primary cancer is considered as the most common type. In this study, we present a 53-year-old woman with synchronous primary malignancy of breast and endometrium. This patient had a history of breast and endometrial cancer in her family. Mammography and chest CT of the patient revealed a mass in the right breast and left supraclavicular region. However, the patient did not want to initiate treatment. Subsequently, the patient returned with a chief complaint of persistent abnormal vaginal bleeding. Abdominopelvic CT scan of the patient revealed a huge soft tissue mass in the pelvic cavity. She underwent hysterectomy, and pathology revealed endometrioid carcinoma, which had invaded the full thickness of uterine wall. Since this type of malignancy is rare and several risk factors are associated with it, it is worth being considered by clinicians when making decisions about screening or strategy for prevention.
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Affiliation(s)
| | - Sepideh Tayebi
- Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Tayebi
- Radiology Department, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Montazer
- Department of Pathology, Gastrointestinal Cancer Research Center, Imam Khomeini Hospital, Mazandaran university of Medical Sciences, Sari, Iran
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9
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Bos ACRK, Matthijsen RA, van Erning FN, van Oijen MGH, Rutten HJT, Lemmens VEPP. Treatment and Outcome of Synchronous Colorectal Carcinomas: A Nationwide Study. Ann Surg Oncol 2017; 25:414-421. [PMID: 29159744 DOI: 10.1245/s10434-017-6255-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Synchronous colorectal carcinomas (CRC) occur in 1-8% of patients diagnosed with CRC. This study evaluated treatment patterns and patient outcomes in synchronous CRCs compared with solitary CRC patients. METHODS All patients diagnosed with primary CRC between 2008 and 2013, who underwent elective surgery, were selected from the Netherlands Cancer Registry. Using multivariable regressions, the effects of synchronous CRC were assessed for both short-term outcomes (prolonged postoperative hospital admission, anastomotic leakage, postoperative 30-day mortality, administration of neoadjuvant or adjuvant treatment), and 5-year relative survival (RS). RESULTS Of 41,060 CRC patients, 1969 patients (5%) had synchronous CRC. Patients with synchronous CRC were older (mean age 71 ± 10.6 vs. 69 ± 11.4 years), more often male (61 vs. 54%), and diagnosed with more advanced tumour stage (stage III-IV 54 vs. 49%) compared with solitary CRC (all p < 0.0001). In 50% of the synchronous CRCs, an extended surgery was conducted (n = 934). Synchronous CRCs with at least one stage II-III rectal tumour less likely received neoadjuvant (chemo)radiation [78 vs. 86%; adjusted OR 0.6 (0.48-0.84)], and synchronous CRCs with at least one stage III colon tumour less likely received adjuvant chemotherapy [49 vs. 63%; adjusted OR 0.7 (0.55-0.89)]. Synchronous CRCs were independently associated with decreased survival [RS 77 vs. 71%; adjusted RER 1.1 (1.01-1.23)]. CONCLUSIONS The incidence of synchronous CRCs in the Dutch population is 5%. Synchronous CRCs were associated with decreased survival compared with solitary CRC. The results emphasize the importance of identifying synchronous tumours, preferably before surgery to provide optimal treatment.
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Affiliation(s)
- A C R K Bos
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
| | - R A Matthijsen
- Department of Surgery, Elisabeth - Tweesteden Hospital, Tilburg, The Netherlands
| | - F N van Erning
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - M G H van Oijen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - H J T Rutten
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.,GROW School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands
| | - V E P P Lemmens
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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10
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Lorenc Z, Waniczek D, Lorenc-Podgórska K, Krawczyk W, Domagała M, Majewski M, Mazurek U. Profile of Expression of Genes Encoding Matrix Metallopeptidase 9 (MMP9), Matrix Metallopeptidase 28 (MMP28) and TIMP Metallopeptidase Inhibitor 1 (TIMP1) in Colorectal Cancer: Assessment of the Role in Diagnosis and Prognostication. Med Sci Monit 2017; 23:1305-1311. [PMID: 28293015 PMCID: PMC5363457 DOI: 10.12659/msm.901593] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Studies on the pathomechanism of colorectal cancer (CRC) expansion indicate a significant role of metalloproteinases and their inhibitors in the extracellular matrix. The results of the analysis of a profile of transcriptional activity of genes encoding metalloproteinases were the basis of the hypothesis indicating changes in the expression of genes encoding MMP9, MMP28, and TIMP1 as an additional diagnostic and prognostic marker of CRC. Material/Methods The material consisted of samples obtained from resected tumors and healthy tissue samples from 15 CRC patients (aged 46–72 years) at clinical stages (CSs) I and II–IV. Gene expression analysis was done using microarrays. Microarray data analysis was done using the GeneSpring 11.5 platform. The results were validated using the qRT-PCR technique. Results We found high levels of expression of MMP9 at each CS, as well as in the tissues at the early stage of CRC. Additionally, we observed high levels of expression of TIMP1 and low levels of MMP28 genes in CS II–IV. No statistically significant differences based on the stage of CRC were observed. Conclusions MMP9 gene profile may be a complementary diagnostic marker in CRC. The results suggest a crucial role of MMP9 at the early stage of carcinogenesis in the large intestine. The increase in MMP9 and TIMP1 mRNA concentration and the decrease in MMP28 in the large intestinal tissue may be a confirmation of cancer, but it may not indicate the advance of CRC.
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Affiliation(s)
- Zbigniew Lorenc
- Chair and Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Sosnowiec, Poland
| | - Dariusz Waniczek
- Department of Propaedeutics Surgery, Chair of General, Colorectal and Polytrauma Surgery, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Lorenc-Podgórska
- Chair and Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland
| | - Wiktor Krawczyk
- Chair and Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland
| | - Maciej Domagała
- Chair and Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland
| | - Mateusz Majewski
- Chair and Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Katowice, Poland
| | - Urszula Mazurek
- Department of Molecular Biology, Medical University of Silesia, Katowice, Poland
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11
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Kim WS, Lee HS, Lee JM, Kwak MS, Hwang SW, Park SH, Yang DH, Kim KJ, Myung SJ, Yang SK, Byeon JS. Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography for the detection of proximal synchronous lesions in patients with obstructive colorectal cancer. J Gastroenterol Hepatol 2017; 32:401-408. [PMID: 27418280 DOI: 10.1111/jgh.13486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM We aimed to investigate the ability of fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) to detect synchronous neoplasms, specifically obstructive colorectal cancer (CRC) and CRC in the proximal colon and to suggest a management strategy based on FDG PET/CT findings. METHODS From the CRC surgery database of our institution, 518 patients with obstructive CRC whose proximal colon could not be examined by colonoscopy and who underwent preoperative FDG PET/CT were eligible for this study. Of these, final analyses were performed in 345 patients who had reference standards for the proximal colon, which were a surgical colectomy specimen and/or postsurgical colonoscopy. The per-patient and per-lesion performances of FDG PET/CT for synchronous CRC diagnosis were determined. RESULTS Of 345 patients, 14 (4.1%) had 14 proximal synchronous CRCs. Thirty-four patients showed 39 areas of abnormal FDG uptake on PET/CT in the colon proximal to the obstructive CRC. PET/CT detected all of the 14 proximal synchronous CRCs. The per-patient PET/CT sensitivity, specificity, positive predictive value, and negative predictive value for proximal synchronous CRC were 100%, 93.9%, 41.2%, and 100%, respectively. Per-lesion values were 100%, 92.6%, 35.9%, and 100%, respectively. The per-lesion sensitivity and negative predictive value of PET/CT for advanced adenoma were 45.5% and 92.7%, respectively. CONCLUSIONS The FDG PET/CT shows a high sensitivity and negative predictive value for the detection of proximal synchronous CRC in patients with obstructive CRC, enabling negative findings in the proximal colon on PET/CT to definitively exclude proximal synchronous CRC. Preoperative PET/CT recommended to determine the proper surgical plan in patients with obstructive CRC.
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Affiliation(s)
- Wan Soo Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo Sang Lee
- Department of Nuclear Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Jeong-Mi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Seob Kwak
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Jo Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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12
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Arjunan R, Kumar D, Kumar KVV, Premlatha CS. Breast Cancer with Synchronous Renal Cell Carcinoma: A Rare Presentation. J Clin Diagn Res 2016; 10:XD03-XD05. [PMID: 27891445 PMCID: PMC5121783 DOI: 10.7860/jcdr/2016/20362.8683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/08/2016] [Indexed: 01/30/2023]
Abstract
Primary cancer arising from multiple organs is a well known fact. Synchronous tumours have been most commonly associated with kidney cancer. Bladder, prostate, colorectal and lung cancer are the most common synchronous primaries with Renal Cell Carcinoma (RCC) identified till date. We found metachronous tumours of breast with RCC in literature search which included both metastatic tumours as well second primaries. Overall, 25 cases of metastatic breast tumours and eight cases of second primary in previously treated RCC have been reported in the literature. Here, we are reporting a case of synchronous presentation of carcinoma breast with RCC which is very rare because most of the multiple malignancies reported in the literature are metastatic tumours or metachronous breast malignancy with RCC.
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Affiliation(s)
- Ravi Arjunan
- Associate Professor, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - Durgesh Kumar
- Senior Resident, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - K V Veerendra Kumar
- Professor, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - C S Premlatha
- Associate Professor, Department of Pathology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
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13
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Jiang X, Xu C, Tang D, Wang D. Laparoscopic subtotal colectomy for synchronous triple colorectal cancer: A case report. Oncol Lett 2016; 12:1525-1528. [PMID: 27446464 PMCID: PMC4950764 DOI: 10.3892/ol.2016.4803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 05/23/2016] [Indexed: 02/07/2023] Open
Abstract
Synchronous colorectal cancers refer to the simultaneous occurrence of multiple colorectal tumors in a single patient, excluding any metastases from other organs. At present, radical surgery is considered the standard curative treatment; however, individualized surgical strategies depend on tumor location, the depth of invasion and the general health of the patient. In the present study, the case of a 52-year-old man who presented with a 2-month history of abdominal pain that was accompanied by intermittent hematochezia and weight loss is reported. The patient had no family history of cancer. Computed tomography (CT) of the abdomen revealed intestinal wall thickness in the transverse colon and volvulus in the hepatic flexure of colon. Colonoscopy identified 3 tumors: The first tumor was located in the descending colon with lumen stenosis ~60 cm from the anal verge, the second tumor was located in the hepatic flexure of the colon, and the third tumor was located in the sigmoid colon, 23 cm from the anal verge. Subsequently, laparoscopic subtotal colectomy was performed and all three tumors were removed, and the diagnosis was confirmed by histopathological examination. The patient did not undergo chemotherapy following surgery, due to personal reasons. Subsequent to 19 months of follow-up examinations using CT and colonoscopy every 6 months, the patient exhibited no signs of recurrence. Thus, laparoscopic subtotal colectomy represents an effective surgical approach for the treatment of synchronous colorectal cancer following imaging and endoscopic diagnosis.
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Affiliation(s)
- Xuetong Jiang
- Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China
| | - Chuanqi Xu
- Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China
| | - Dong Tang
- Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China
| | - Daorong Wang
- Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, Yangzhou, Jiangsu 225001, P.R. China
- Correspondence to: Professor Daorong Wang, Department of Gastrointestinal Surgery, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu, 98 Nantong West Road, Yangzhou, Jiangsu 225001, P.R. China, E-mail:
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14
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Lam AKY, Chan SSY, Leung M. Synchronous colorectal cancer: Clinical, pathological and molecular implications. World J Gastroenterol 2014; 20:6815-6820. [PMID: 24944471 PMCID: PMC4051920 DOI: 10.3748/wjg.v20.i22.6815] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/05/2013] [Accepted: 03/19/2014] [Indexed: 02/06/2023] Open
Abstract
Synchronous colorectal carcinoma refers to more than one primary colorectal carcinoma detected in a single patient at initial presentation. A literature review has shown that the prevalence of the disease is approximately 3.5% of all colorectal carcinomas. This disease has a male to female ratio of 1.8:1. The mean age at presentation of patients with synchronous colorectal cancer is in the early half of the seventh decade. Patients with inflammatory bowel diseases (ulcerative colitis and Crohn’s disease), hereditary non-polyposis colorectal cancer, familial adenomatous polyposis and serrated polyps/hyperplastic polyposis are known to have a higher risk of synchronous colorectal carcinoma. These predisposing factors account for slightly more than 10% of synchronous colorectal carcinomas. Synchronous colorectal carcinoma is more common in the right colon when compared to solitary colorectal cancer. On pathological examination, some synchronous colorectal carcinomas are mucinous adenocarcinomas. They are usually associated with adenomas and metachronous colorectal carcinomas. Most of the patients with synchronous colorectal cancer have two carcinomas but up to six have been reported in one patient. Patients with synchronous colorectal carcinoma have a higher proportion of microsatellite instability cancer than patients with a solitary colorectal carcinoma. Also, limited data have revealed that in many synchronous colorectal carcinomas, carcinomas in the same patient have different patterns of microsatellite instability status, p53 mutation and K-ras mutation. Overall, the prognosis of patients with synchronous colorectal carcinoma is not significantly different from that in patients with solitary colorectal carcinoma, although a marginally better prognosis has been reported in patients with synchronous colorectal carcinoma in some series. A different management approach and long-term clinical follow-up are recommended for some patients with synchronous colorectal cancer.
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15
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Sakellakis M, Peroukides S, Iconomou G, Boumpoucheropoulos S, Kalofonos H. Multiple primary malignancies: a report of two cases. Chin J Cancer Res 2014; 26:215-8. [PMID: 24826064 DOI: 10.3978/j.issn.1000-9604.2014.02.15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/17/2014] [Indexed: 12/29/2022] Open
Abstract
The diagnosis of multiple primary malignancies (MPMs) in a patient has been reported rather frequently during the past decade. Here we present two cases with three synchronous primary malignant tumors. The first patient is a 66-year-old male with synchronous colorectal cancer, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC). The second patient is a 64-year-old female with breast cancer, transitional cell carcinoma of the ureter and endometrial cancer. MPMs seem to be diagnosed in a higher incidence than that predicted only by the influence of hazard and, whenever found, they raise questions regarding not only possible common etiologic factors or same pathogenetic mechanisms but also they cause a lot of troubles to both clinicians and patients because the therapeutic options usually become limited.
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Affiliation(s)
- Minas Sakellakis
- Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece
| | - Stavros Peroukides
- Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece
| | - Gregoris Iconomou
- Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece
| | | | - Haralabos Kalofonos
- Division of Oncology, Department of Medicine, University Hospital of Patras, Rion 26504, Greece
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Abstract
BACKGROUND Synchronous colorectal carcinoma occurs in 1% to 8% of cases. There are little data on the impact of synchronous colorectal cancer on surgical treatment and short-term postoperative outcomes. OBJECTIVE The purpose of this work was to evaluate clinical characteristics and treatment patterns of synchronous colorectal carcinoma and their influence on short-term postoperative outcomes in comparison with solitary colorectal carcinoma. DESIGN This was a population-based observational study. Patient and tumor characteristics, treatment patterns, and postoperative outcomes are described for patients with a solitary and synchronous colorectal carcinoma separately. Multivariable logistic regression analysis was used to analyze the association between synchronous colorectal carcinoma and postoperative complications in comparison with a solitary colorectal carcinoma. SETTINGS The study included in-hospital registration for the Dutch Surgical Colorectal Audit. PATIENTS Patients were those with primary colorectal carcinoma from 2009 to 2011. MAIN OUTCOME MEASURES Severe postoperative complications, reinterventions, and 30-day mortality were measured. RESULTS Of 25,413 patients with colorectal cancer, 884 (3.5%) had synchronous colorectal tumors. Patients with synchronous colorectal carcinoma were older and more often of male sex compared with patients with solitary colorectal carcinoma. In ≥ 35% of cases, an extended surgical procedure was conducted (n = 310). In multivariable logistic regression analysis, synchronous colorectal carcinoma was associated with a higher risk of severe postoperative complications (OR, 1.40; 95% CI, 1.20-1.63) and reinterventions (OR, 1.37; 95% CI, 1.14-1.65) compared with solitary colorectal carcinoma but not with higher 30-day mortality (OR, 1.34; 95% CI, 0.96-1.88). LIMITATIONS This study was limited by the data being self-reported. Case-mix adjustment was limited to information available in the data set, and no long-term outcome data were available. CONCLUSIONS Synchronous colorectal carcinomas are prevalent in 3.5% of patients and require a different treatment strategy in comparison with solitary colorectal carcinoma. Postoperative outcomes are unfavorable, most likely because of extensive surgery.
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Helewa RM, Turner D, Wirtzfeld D, Park J, Hochman D, Czaykowski P, Singh H, Shu E, Xue L, McKay A. Does geography influence the treatment and outcomes of colorectal cancer? A population-based analysis. World J Surg Oncol 2013; 11:140. [PMID: 23773619 PMCID: PMC3685603 DOI: 10.1186/1477-7819-11-140] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 06/01/2013] [Indexed: 02/06/2023] Open
Abstract
Background The Canadian province of Manitoba covers a large geographical area but only has one major urban center, Winnipeg. We sought to determine if regional differences existed in the quality of colorectal cancer care in a publicly funded health care system. Methods This was a population-based historical cohort analysis of the treatment and outcomes of Manitobans diagnosed with colorectal cancer between 2004 and 2006. Administrative databases were utilized to assess quality of care using published quality indicators. Results A total of 2,086 patients were diagnosed with stage I to IV colorectal cancer and 42.2% lived outside of Winnipeg. Patients from North Manitoba had a lower odds of undergoing major surgery after controlling for other confounders (odds ratio (OR): 0.48, 95% confidence interval (CI): 0.26 to 0.90). No geographic differences existed in the quality measures of 30-day operative mortality, consultations with oncologists, surveillance colonoscopy, and 5-year survival. However, there was a trend towards lower survival in North Manitoba. Conclusion We found minimal differences by geography. However, overall compliance with quality measures is low and there are concerning trends in North Manitoba. This study is one of the few to evaluate population-based benchmarks for colorectal cancer therapy in Canada.
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Affiliation(s)
- Ramzi M Helewa
- Department of Surgery, University of Manitoba, AE101-820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada
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18
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Kodeda K, Nathanaelsson L, Jung B, Olsson H, Jestin P, Sjövall A, Glimelius B, Påhlman L, Syk I. Population-based data from the Swedish Colon Cancer Registry. Br J Surg 2013; 100:1100-7. [PMID: 23696510 DOI: 10.1002/bjs.9166] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Evaluating the external validity of clinical trials requires knowledge not only of the study population but also of a relevant reference population. The main aim of this study was to present data from a large, contemporary, population-based cohort of patients with colonic cancer. METHODS Data on patients diagnosed between 2007 and 2011 were extracted from the Swedish Colon Cancer Registry. The data, registered prospectively in a national population of almost 10 million, included over 99 per cent of all diagnosed adenocarcinomas of the colon. RESULTS This analysis included 18,889 patients with 19,526 tumours (3·0 per cent had synchronous tumours). The sex distribution was fairly equal, and the median age was 74·1 (interquartile range 65-81) years. The overall and relative (cancer-specific) survival rates after 3 years were 62·7 and 71·4 per cent respectively. Some 88·0 per cent of the patients were operated on, and 83·8 per cent had tumours resected. Median blood loss during bowel resection was 200 (mean 311) ml, and the median operating time was 160 min; 5·6 per cent of the procedures were laparoscopic. Preoperative chemotherapy was administered to 2·1 per cent of patients; postoperative chemotherapy was planned in 90·1 per cent of fit patients aged less than 75 years with stage III disease. In patients operated on in an emergency setting (21·5 per cent), the preoperative evaluation was less extensive, the proportion of R0 resections was lower, and the outcomes were poorer, in both the short and long term. CONCLUSION These population-based data represent good-quality reference points.
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Affiliation(s)
- K Kodeda
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Lu X, Wang FL, Guo X, Wang L, Zhang HB, Xia WX, Li SW, Li NW, Qian CN, Xiang YQ. Favorable prognosis of female patients with nasopharyngeal carcinoma. CHINESE JOURNAL OF CANCER 2013; 32:283-8. [PMID: 22980419 PMCID: PMC3845557 DOI: 10.5732/cjc.012.10058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/03/2012] [Accepted: 06/06/2012] [Indexed: 11/11/2022]
Abstract
The female sex is traditionally considered a favorable prognostic factor for nasopharyngeal carcinoma (NPC). However, no particular study has reported this phenomenon. To explore the prognostic impact of gender on patients with NPC after definitive radiotherapy, we reviewed the clinical data of 2063 consecutive patients treated between 1st January 2000 and 31st December 2003 in the Sun Yat-sen University Cancer Center. The median follow-up for the whole series was 81 months. The female and male patients with early stage disease comprised 49.4% and 28.1% of the patient population, respectively. Both the 5-year overall survival (OS) and disease-specific survival (DSS) rates of female patients were significantly higher than those of male patients (OS: 79% vs. 69%, P < 0.001; DSS: 81% vs. 70%, P < 0.001). For patients with locoregionally advanced NPC, the 5-year OS and DSS rates of female vs. male patients were 74% vs. 63% (P < 0.001) and 76% vs. 64%, respectively (P < 0.001). A multivariate analysis showed that gender, age, and TNM stage were independent prognostic factors for the 5-year OS and DSS of NPC patients. The favorable prognosis of female patients is not only attributed to the early diagnosis and treatment but might also be attributed to some intrinsic factors of female patients.
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Affiliation(s)
- Xing Lu
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Fei-Li Wang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Xiang Guo
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Lin Wang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Hai-Bo Zhang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Wei-Xiong Xia
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Si-Wei Li
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Ning-Wei Li
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Chao-Nan Qian
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
| | - Yan-Qun Xiang
- State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China;
- Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.
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