scholarly journals Smoking-Related Risks of Colorectal Cancer by Anatomical Subsite and Sex

2020 ◽  
Vol 189 (6) ◽  
pp. 543-553 ◽  
Author(s):  
Inger T Gram ◽  
Song-Yi Park ◽  
Lynne R Wilkens ◽  
Christopher A Haiman ◽  
Loïc Le Marchand
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cox Regression ◽  
Left Colon ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Increased Risk ◽  
The Right ◽  
Incident Cases

Abstract The purpose of this study was to examine whether the increased risk of colorectal cancer due to cigarette smoking differed by anatomical subsite or sex. We analyzed data from 188,052 participants aged 45–75 years (45% men) who were enrolled in the Multiethnic Cohort Study in 1993–1996. During a mean follow-up period of 16.7 years, we identified 4,879 incident cases of invasive colorectal adenocarcinoma. In multivariate Cox regression models, as compared with never smokers of the same sex, male ever smokers had a 39% higher risk (hazard ratio (HR) = 1.39, 95% confidence interval (CI): 1.16, 1.67) of cancer of the left (distal or descending) colon but not of the right (proximal or ascending) colon (HR = 1.03, 95% CI: 0.89, 1.18), while female ever smokers had a 20% higher risk (HR = 1.20, 95% CI: 1.06, 1.36) of cancer of the right colon but not of the left colon (HR = 0.96, 95% CI: 0.80, 1.15). Compared with male smokers, female smokers had a greater increase in risk of rectal cancer with number of pack-years of smoking (P for heterogeneity = 0.03). Our results suggest that male smokers are at increased risk of left colon cancer and female smokers are at increased risk of right colon cancer. Our study also suggests that females who smoke may have a higher risk of rectal cancer due to smoking than their male counterparts.

Oncogenic mutations in colorectal cancer, indications for anatomical sites, and targeted intervention.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22037-e22037
Author(s):  
Giovanni Corso ◽  
Valeria Pascale ◽  
Giuseppe Flauti ◽  
Daniele Marrelli ◽  
Franco Roviello
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Microsatellite Instability ◽  
Cancer Patients ◽  
Left Colon ◽  
Targeted Intervention ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Oncogenic Mutations ◽  
Colorectal Cancer Patients

e22037 Background: Oncogenic mutations, such as KRAS, in colorectal cancer patients are considered standard molecular biomarkers that predict the clinical benefit for the targeted intervention with EGFR inhibitors. In addition, these mutations are associated with specific anatomical area in the colon tumor development, as BRAF mutations with the microsatellite instability. Methods: In this translational study we aim to assess the mutation frequencies of the EGFR [hotspot area and polyadenine deletions (A13_del)], KRAS, BRAFV600E, and PIK3CA oncogenes in a series of 280 colorectal cancer patients. Microsatellite instability phenotype is considered in this series. All patients' clinicopathological data were considered for statistical analysis and associations. Results: In this study, we verified multiple associations between oncogenic mutations and specified clinicopathological tumor features. Respectively, we identified the following significant results: 1) EGFR A13_deletions are associated with right colon carcinoma (22.2% vs. 3.3%; p<0.005), mucinous histotype (16% vs. 7.8%; p=0.042), G3 grading (19% vs. 7.3%; p=0.024) and microsatellite instability status (p<0.005); 2) PIK3CA mutations are related mucinous histotype (12% vs. 4.4%; p=0.021) 3) KRASG12 and KRASG13mutations are correlated respectively with the left (91.4% vs. 59.3%) and right (40.7% vs. 8.6%) colon cancer development (p<0.005), and finally 4) microsatellite instability is associated with right colon tumors (28.4% vs. 5.5%; p<0.005). Conclusions: Mostly, we verified a high frequency rate of the KRASG13 and EGFR A13_del oncogene mutations in right colon cancer; whereas KRASG12 codon mutation occurs more frequently in left colon cancers. In particular, we assessed that right colon cancer is associated with specific molecular characteristics, in comparison to left colon tumors. These evidences, in association with specific clinicopathological data, can delineate novel approaches for the colorectal cancer classification and targeted intervention.

Characteristics and outcomes of patients with colorectal cancer and bone metastasis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15063-e15063 ◽  
Author(s):  
Faisal Shahjehan ◽  
Saivaishnavi Kamatham ◽  
Jordan Cochuyt ◽  
Zhuo Li ◽  
Dorin Colibaseanu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Cox Regression ◽  
Right Colon ◽  
Related Factors ◽  
Right Colon Cancer ◽  
Colon And Rectal Cancer

e15063 Background: Bone metastasis from colorectal cancer is a relatively rare phenomenon. The aim of this study is to identify the risk factors and survival patterns of bone metastasis after colorectal cancer diagnosis. Methods: A total of 23,846 colorectal cancer patients who were diagnosed between 1972 and 2017 at Mayo Clinic were included in the analysis. Freedom from bone metastasis since diagnosis at 5, 10, 15, 25 and 35-years were estimated using Kaplan-Meier method. Multivariable Cox regression models were used to assess the differences in overall survival rate for patients with different cancer sides and cancer locations. All tests were two-sided with alpha level set at 0.05. Results: A total of 798 (3.3%) patients had a diagnosis of bone metastasis after colorectal cancer diagnosis over a median follow up of 3.2 years. Thirty-five year freedom from bone metastasis was 83% (95%CI: 80%-86%) for all patients, and were 87.13%, 82.29% and 77.26% for left colon, right colon and rectal cancer patients. Male gender, recent surgical years, and higher cancer stage were associated with higher risk of developing bone metastasis after colorectal cancer diagnosis. Rectal cancer patients had higher hazard of developing bone metastases compared to left and right colon cancer patients. Conclusions: We were able to identify several patient and tumor-related factors associated with the development of bone metastasis in patients with colorectal cancer. The proportion and factors identified are similar to other studies. Future directions would be to analyze other molecular determinants within this subset of patients.[Table: see text]

scholarly journals COLODUODENAL FISTULA IN RIGHT COLORECTAL CANCER: CASE REPORT AND REVIEW OF THE LITERATURE

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Patricia Ciriano Hernández ◽  
Carlos Martínez Pinedo ◽  
Rafael Picón Rodríguez ◽  
Elisa Jiménez Higuera ◽  
Daniel Sánchez Peláez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Palliative Surgery ◽  
Cancer Case ◽  
Duodenal Fistula ◽  
Right Colon ◽  
Right Colon Cancer ◽  
High Incidence ◽  
Colorectal Cancer Case ◽  
Duodenal Invasion

In spite of the high incidence of colorectal cancer, cases of right colon cancer presenting with local invasion are not common. This is even more infrequent if we focus on duodenal invasion and presence of duodenal fistula. We present the case of a patient admitted to our hospital due to severe weight loss, malnutrition and bowel obstruction. The patient was diagnosed of advanced right colon cancer with coloduodenal fistula and concomitant liver metastasis. According to diagnosis, palliative surgery was performed

scholarly journals Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications

2016 ◽  
Vol 106 (2) ◽  
pp. 107-115 ◽  
Author(s):  
J. Alsabilah ◽  
W. R. Kim ◽  
N. K. Kim
Keyword(s):  
Colon Cancer ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Vascular Structures ◽  
Gastrocolic Trunk ◽  
The Right

Background and Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer. Materials and Methods: Medical literature was searched for the articles highlighting the vascular variation relevant to the right colon cancer surgery. Results: Recently, there have been many detailed studies on applied surgical vascular anatomy based on cadaveric dissections, as well as radiological and intraoperative examinations to overcome misconceptions concerning the arterial supply and venous drainage to the right colon. Ileocolic artery and middle colic artery are consistently present in all patients arising from the superior mesenteric artery. Even though the ileocolic artery passes posterior to the superior mesenteric vein in most of the cases, in some cases courses anterior to the superior mesenteric artery. The right colic artery is inconsistently present ranging from 63% to 10% across different studies. Ileocolic vein and middle colic vein is always present, while the right colic vein is absent in 50% of patients. The gastrocolic trunk of Henle is present in 46%–100% patients across many studies with variation in the tributaries ranging from bipodal to tetrapodal. Commonly, it is found that the right colonic veins, including the right colic vein, middle colic vein, and superior right colic vein, share the confluence forming the gastrocolic trunk of Henle in a highly variable frequency and different forms. Conclusion: Understanding the incidence and variations of the vascular anatomy of right side colon is of crucial importance. Failure to recognize the variation during surgery can result in troublesome bleeding especially during minimal invasive surgery.

scholarly journals Extramural Venous Invasion as Prognostic Factor of Recurrence in Stage 1 and 2 Colon Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
E. E. van Eeghen ◽  
M. J. Flens ◽  
M. M. R. Mulder ◽  
R. J. L. F. Loffeld
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Cox Regression ◽  
Venous Invasion ◽  
Prognostic Indicator ◽  
Hazard Ratio ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
Additional Value ◽  
Stage 1

Aim. Extramural venous invasion (EMVI) is a prognostic indicator in patients with colorectal cancer. However, its additional value in patients with stage 1 and 2 colorectal cancer is uncertain. In the present study, the incidence of EMVI and the hazard ratio for recurrence in patients with stage 1 and 2 colon cancer were studied. Methods. 184 patients treated for stage 1 and 2 colon cancer were included with a follow-up of at least 5 years. Chart review was performed and EMVI was assessed by two separate pathologists. EMVI was scored with additional caldesmon staining on the resection specimen. Primary outcomes were recurrence-free survival (RFS) measured through the Cox regression analysis and prevalence of EMVI. Results. There were 10 cases of EMVI and 3 cases of intramural venous invasion (IMVI) all occurring in patients with stage 2 disease corresponding to a prevalence of 9%. Thirty-one percent of the patients with venous invasion experienced recurrence versus 14% in patients without, corresponding with a hazard ratio of 2.39 (p=0.11). Conclusion. The present study demonstrates a trend towards an increased risk of recurrence in patients with stage 2 colon cancer with venous invasion. This warrants consideration of adjuvant chemotherapy despite the lack of lymph node metastases.

scholarly journals Changes in the quality of care of colorectal cancer in Estonia: a population-based high-resolution study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035556
Author(s):  
Heigo Reima ◽  
Jaan Soplepmann ◽  
Anneli Elme ◽  
Mari Lõhmus ◽  
Rena Tiigi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Clinical Data ◽  
Population Based ◽  
Treatment Patterns ◽  
Stage Iii ◽  
Liver Imaging ◽  
Colon And Rectal Cancer ◽  
Incident Cases

ObjectivesLarge disparities in colorectal cancer (CRC) management and survival have been observed across Europe. Despite recent increases, the survival deficit of Estonian patients with CRC persists, particularly for rectal cancer. The aim of this study was to examine diagnostic, staging and treatment patterns of CRC in Estonia, comparing clinical data from 1997 and 2011.DesignNationwide population-based retrospective study.SettingEstonia.ParticipantsAll incident cases of colon and rectal cancer diagnosed in 1997 and 2011 identified from the Estonian Cancer Registry. Clinical data gathered from medical records.Outcome measuresDifferences in diagnostic, staging and treatment patterns; 5-year relative survival ratios.ResultsThe number of colon cancer cases was 337 in 1997 and 498 in 2011; for rectal cancer, the respective numbers were 209 and 349. From 1997 to 2011, large increases were seen in the use of colonoscopy and lung and liver imaging. Radical resection rate increased from 48% to 59%, but emergency surgeries showed a rise from 18% to 26% in colon and from 7% to 14% in rectal cancer. The proportion of radically operated patients with ≥12 lymph nodes examined pathologically increased from 2% to 58% in colon cancer and from 2% to 50% in rectal cancer. The use of neoadjuvant radiotherapy increased from 6% to 39% among stage II and from 20% to 50% among patients with stage III rectal cancer. The use of adjuvant chemotherapy in stage III colon cancer increased from 42% to 63%. The 5-year RSR increased from 50% to 58% in colon cancer and from 37% to 64% in patients with rectal cancer.ConclusionsMajor improvements were seen in the diagnostics, staging and treatment of CRC in Estonia contributing to better outcomes. Increase in emergency surgeries highlights possible shortcomings in timely diagnosis and treatment.

The correlation between mismatch repair status and clinicopathological characteristics in Chinese colorectal cancer patients.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 544-544 ◽  
Author(s):  
Zhi-tao Xiao ◽  
Rong-xin Zhang ◽  
Yang Zhao ◽  
Jian-Hong Peng ◽  
Pei-Rong Ding ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Mismatch Repair ◽  
Mucinous Adenocarcinoma ◽  
Clinicopathological Characteristics ◽  
Left Colon ◽  
Stage Ii ◽  
Chinese Patients ◽  
Right Colon ◽  
Significant Difference

544 Background: Our study aimed to explore the relationship between mismatch repair (MMR) status and clinicopathological characteristics in Chinese patients with colorectal cancer (CRC). Methods: A total of 2684 patients with histologically confirmed adenocarcinoma of CRC were consecutively recruited between May 2011 and May 2015 at Sun Yat-sen University cancer center. The exclusion criteria included multiple primary tumors, synchronous and metachronous CRC, and familial adenomatous polyposis. The CRC was defined as left colon with the tumor located below the splenic flexure or rectum, otherwise grouped as right colon. Correlations of MMR status and patient’s demographics, tumor characteristics and TNM staging (exclude 315 CRC patients receiving neoadjuvant therapy) were investigated. Results: We found that deficient MMR (dMMR) status was more likely detected in younger CRC patients compared to the the elderly (12.7% vs 7.5%, P < 0.001). The dMMR rate in right colon cancer was significantly higher than that in left colon cancer and rectal cancer (22.7% vs 7.2% vs 5.2%, P < 0.001).With respect to tumor differentiation, we found that the mucinous adenocarcinoma had the highest rate of dMMR(24.4%), followed by poorly differentiated adenocarcinoma(18.5%), signet-ring cell carcinoma(17.6%), well differentiated adenocarcinoma(9.5%), moderately differentiated adenocarcinoma(8.9%), and neuroendocrine carcinoma (0%) ( P < 0.001). In addition, the proportions in stage I, stage II, stage III and stage IV CRC were 9.7%, 16.5% , 8.5% and 3.9%, respectively ( P < 0.001). There was no significant difference in gender (P = 0.114). Conclusions: At the first time, our study demonstrated that dMMR status was most likely detected at younger age (less than 59 years) and stage II right colon mucinous adenocarcinoma in large volume Chinese patients, which was similar to the results in western countries.

Predictive Value of Body Composition Analysis for the Prognosis of Patients with Advanced Gastrointestinal Tumors

2020 ◽  
Vol 5 (4) ◽  
pp. 182-188
Author(s):  
Hai Mei Yang ◽  
◽  
Yi Zhuo Wang ◽  
Xiang Liang Liu ◽  
Wei Ji ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Colon Cancer ◽  
Body Composition ◽  
Left Colon ◽  
First Line ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Left Colon Cancer

Objective There is strong evidence that the body composition can affect the progression-free survival (PFS) and overall survival (OS) in patients with a variety of cancers. The main objective of this study was to investigate the effect of body composition on the prognosis of patients with advanced gastrointestinal and colorectal cancers who received first-line palliative chemotherapy. Methods Patients who were newly-diagnosed with advanced gastrointestinal or colorectal cancer and received standard first-line palliative chemotherapy from January 2017 to December 2018 were included in this retrospective study. An analysis of computed tomography images was performed to determine the skeletal muscle index (SMI), which reflects the skeletal muscle mass and skeletal muscle density (SMD) related to muscle strength. A Kaplan-Meier survival analysis and log-rank test were used to compare the survival relationships among groups stratified by the SMI, and a Cox proportional hazard model was used for a multivariate analysis. Results A total of 108 patients met the inclusion criteria, including 41 cases of gastric cancer, 46 cases of left colorectal cancer, and 21 cases of right colon cancer. In patients with gastric cancer, the OS of women was significantly shorter than that of men. The OS of patients with a low SMI, low SMD, and low phase angle (PA) was significantly shorter than that of patients with high values (P ≤ 0.05). In the multivariate analysis, the SMD was significantly associated with the patients' long-term survival [Hazard Ratio (HR) = 0.904, 95% CI: 0.840~0.974, P = 0.008]. For patients with a low SMI and PA, the PFS was significantly shorter than that of patients with high values (P ≤ 0.05). In patients with left colon cancer, the PA and SMD were both independent risk factors for a poorer long-term prognosis (HR = 0.375, 95% CI: = 0.167~0.840, P = 0.017; HR = 0.887, 95% CI: 0.824~0.954, P = 0.001). Among right colon cancer patients, the PFS and OS of those with a low SMD were significantly lower than those for patients with high values (P ≤ 0.05). Conclusion The PA is an independent risk factor for the OS of left colon cancer patients; the SMD is an independent risk factor for the survival of patients with gastric cancer, left colon cancer, and right colon cancer.

scholarly journals Diabetes, plasma glucose and incidence of colorectal cancer in Chinese adults: a prospective study of 0.5 million people

2018 ◽  
Vol 72 (10) ◽  
pp. 919-925 ◽  
Author(s):  
Yuanjie Pang ◽  
Christiana Kartsonaki ◽  
Yu Guo ◽  
Yiping Chen ◽  
Ling Yang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Blood Glucose ◽  
Plasma Glucose ◽  
Cox Regression ◽  
Chinese Adults ◽  
Duration Of Diabetes ◽  
Colon And Rectal Cancer ◽  
Diagnosed Diabetes ◽  
Incident Cases

BackgroundDiabetes is associated with higher risk of colorectal cancer (CRC). Uncertainty remains about the relevance of duration of diabetes and about the association of blood glucose with CRC risk among individuals without diabetes.MethodsThe prospective China Kadoorie Biobank recruited 512 713 participants in 2004–2008 from 10 diverse areas in China. After 10 years of follow-up, 3024 incident cases of CRC (1745 colon, 1716 rectal) were recorded among 510 136 participants without prior cancer at baseline. Cox regression was used to estimate adjusted HRs for CRC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG).ResultsOverall 5.8% of participants had diabetes at baseline. Individuals with diabetes had an adjusted HR of 1.18 (95% CI 1.04 to 1.33) for CRC, with similar risk for colon and rectal cancer (1.19 [1.01 to 1.39] vs 1.14 [0.96 to 1.35]). The HRs decreased with longer duration of diabetes (p for trend 0.03). Among those without previously diagnosed diabetes, RPG was positively associated with CRC, with adjusted HRs per 1 mmol/L higher baseline RPG of 1.04 (1.02 to 1.05) for CRC, again similar for colon and rectal cancer (1.03 [1.01to 1.05] and 1.04 [1.02 to 1.06], respectively). The associations of diabetes and RPG appeared stronger in men than in women, but the differences were non-significant (p for heterogeneity 0.3 and 0.2).DiscussionAmong Chinese adults, diabetes and higher blood glucose levels among those without known diabetes are associated with higher risk of CRC.

Sign in / Sign up

Export Citation Format

Share Document