scholarly journals The impact of molecular profile on the lymphatic spread pattern in stage III colon cancer

2021 ◽  
Author(s):  
Jihyung Song ◽  
Kozo Kataoka ◽  
Takeshi Yamada ◽  
Manabu Shiozawa ◽  
Tomohiro Sonoyama ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymphatic Spread ◽  
Stage Iii ◽  
Molecular Profile ◽  
Stage Iii Colon Cancer ◽  
Spread Pattern ◽  
The Impact

The effect of gaps in chemotherapy on survival in patients with high-risk stage II and stage III colon cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 180-180
Author(s):  
Yvonne Sada ◽  
Zhigang Duan ◽  
Hashem El-Serag ◽  
Jessica Davila
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Stage Ii ◽  
Stage Iii ◽  
Clinical Factors ◽  
Stage Iii Colon Cancer ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Multivariable Regression ◽  
The Impact

180 Background: Current guidelines recommend six months of chemotherapy (CT) for stage III colon cancer and consideration for high-risk stage II colon cancer. No previous studies have examined the impact of CT gaps on survival. This retrospective study examines determinants of CT gaps and the effect of gaps on survival. Methods: Using national Surveillance, Epidemiology, and End Results registry-Medicare linked data, high-risk stage II and stage III colon cancer patients diagnosed between 2000-2007 who received surgery and CT were identified. CT duration and gaps were calculated. CT gap was defined as 30 to 90 days between two CT claims. Data on demographics, clinical factors (comorbidity, tumor grade), and treatment factors (time to CT initiation, toxicity, hospitalization) were collected. Multivariable regression was used to examine factors associated with gaps. Cox proportional hazards analysis examined the effect of gaps on risk of mortality. Results: 7,371 patients were identified. Median age was 75 (IQR: 71-79); 47% were male. Among all patients, 1,803 (24%) had a gap. 2,674 patients (36%) received 5 to 7 months of CT, of which 469 (18%) had a gap. Multivariable regression analysis showed that patients who were black (OR 1.3, 95% CI: 1.1-1.7), stage III (1.2, 1.0-1.3), had toxicity (1.3, 1.1-1.4), or had 3 to 4 months of CT (vs. 5-7 months, 2.6, 2.3-3.0) were more likely to have a gap, while patients with a more recent diagnosis in 2007(vs. 2000, 0.6, 0.5-0.8) were less likely to have a gap. 3-year cancer-specific survival was the same in all patients with CT gaps compared with no gaps (80%, 95% CI: 78%-82% vs. 81%, 95% CI: 80%-82%). Cox proportional hazard models showed that patients with gaps did not have increased risk of mortality (HR 0.99, 0.89-1.1) adjusting for patient and clinical factors. Among those who received 5 to 7 months of CT, 3-year survival was 8% lower in patients with gaps compared to those with no gaps (80%, 95% CI: 75%-83% vs. 88%, 95% CI: 87%-90%). Conclusions: Nearly 25% of high-risk stage II and III patients who received CT had a gap. CT gaps were associated with worse survival in patients who received 5 to 7 months of CT. Interventions to improve CT toxicity management and reduce gaps are needed to maximize the benefit of CT.

The impact of census-tract socioeconomic status on survival in stage III colon cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7032-7032
Author(s):  
Amina Dhahri ◽  
Jori Lee Kaplan ◽  
Shana Ntiri ◽  
Iman Imanirad ◽  
Seth Felder ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Socioeconomic Status ◽  
Census Tract ◽  
Predictor Variable ◽  
Stage Iii ◽  
National Database ◽  
Lower Grade ◽  
Stage Iii Colon Cancer ◽  
Census Tract Level ◽  
The Impact

7032 Background: Socioeconomic status (SES) has been associated with worse outcomes in stage III colon cancer. However, these studies have used large geographic areas (zip codes or counties) as a proxy for SES which may bias results. To overcome this challenge, we used a national database with census-tract level SES to assess the impact on cancer-specific (CSS) and overall survival (OS). Methods: Using the SEER Census-Tract Dataset from 2004-2015, we identified 8th edition AJCC stage III colon adenocarcinoma patients who underwent curative-intent surgery and initiated adjuvant chemotherapy. The predictor variable was census-tract level SES, consisting of 7 variables such as income, housing, and education. SES was analyzed as quartiles. Statistical analysis included chi square tests for association and Kaplan-Meier and Cox regression for survival analysis. Results: We identified 27,222 patients who met inclusion criteria. Lower SES was associated with younger age, Black or Hispanic race/ethnicity, Medicaid or uninsured status, higher T stage, <12 lymph nodes examined and lower grade tumors. Median CSS was not reached; the 25th percentile CSS time was 54 months for the lowest SES (LSES) quartile and 80 months for the highest (HSES). Median OS was 113 months for LSES and not reached for HSES. The 5-year CSS rate was 72.4% for the LSES quartile compared to 78.9% in the HSES (p<0.001). The 5-year OS rate was 66.5% for LSES and 74.6% in the HSES (p<0.001). After adjusting for potential confounders (age, sex, race, insurance, pathologic T and N stage and grade), LSES was associated with increased cancer-specific death relative to the HSES (HR 1.22; 95% CI [1.114-1.327]) Conclusions: This is the first study to evaluate CSS and OS in a national cohort of stage III colon cancer patients using a granular, standardized measure of SES. Despite receipt of guideline-based treatment, low SES remained a predictor of increased cancer-specific mortality. These data suggest that investigating treatment barriers beyond adjuvant therapy is needed to address colon cancer survival disparities. [Table: see text]

The impact of smoking on cancer recurrence and survival in patients with stage III colon cancer: Findings from intergroup trial CALGB 89803

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 4039-4039 ◽  
Author(s):  
N. A. Jackson ◽  
C. S. Fuchs ◽  
D. Niedzwiecki ◽  
D. R. Hollis ◽  
L. B. Saltz ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Recurrence ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Intergroup Trial ◽  
The Impact

A novel interaction of genotype, gender, and adjuvant treatment in survival after resection of stage III colon cancer: Results of CALGB 89803.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 452-452
Author(s):  
Chloe Evelyn Atreya ◽  
Robert S. Warren ◽  
Donna Niedzwiecki ◽  
Robert J. Mayer ◽  
Richard M. Goldberg ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Phase Iii ◽  
Zinc Binding ◽  
Stage Iii ◽  
P53 Mutations ◽  
Stage Iii Colon Cancer ◽  
Mutational Status ◽  
The Impact

452 Background: The p53 tumor suppressor gene is frequently mutated in colorectal cancer, but reports on the effect of p53 mutations on response to adjuvant chemotherapy and survival are inconclusive. This study investigates whether p53 mutational status (wild-type, zinc or non-zinc binding mutations) impacts survival following adjuvant therapy containing fluorouracil/leucovorin with or without irinotecan (5FU/LV or IFL) in women and men with stage III colon cancer. Methods: As part of a retrospective analysis of prospectively accrued data, p53 mutational status was determined for 609 patients with stage III colon cancer who were randomized on CALGB 89803, a phase III adjuvant chemotherapy trial. p53 exons 5-8 were analyzed by direct sequencing or sequencing by hybridization. p53 mutations were identified in 276 tumors (45%), of which 134 were in the zinc binding and 142 were in the non-zinc binding regions of the core domain. Cox regression was used to study the impact of p53 mutational status, sex, and adjuvant chemotherapy on disease-free (DFS) and overall survival (OS). Results: p53 mutational status did not predict differential survival or response to adjuvant therapy among the 609 patients assessed. However, a significant sex by treatment interaction was observed for both DFS (Pinteraction=0.008) and OS (Pinteraction=0.002). Significant differences in DFS by p53 mutational status were observed among women (logrank P = 0.009). No such differences were observed among men (logrank P = 0.33). Similar results were observed for OS. There was marginal evidence of a treatment-related impact on the interaction between sex and p53 mutational status for both DFS and OS (DFS Pinteraction = 0.07; OS Pinteraction = 0.11). There was a trend toward improved OS when women with zinc binding mutations received IFL versus 5FU/LV (P = 0.08) and toward worse DFS when women with non-zinc binding mutations were treated with IFL versus 5FU/LV (P =0.08). Conclusions: This exploratory subset analysis suggests that p53 mutational status may be used to predict prognosis in a sex- and potentially chemotherapeutic regimen-specific manner.

The impact of single and multiagent chemotherapy on stage III colon cancer survival.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e13093-e13093
Author(s):  
Aabra Ahmed ◽  
Ahmed I Tahseen ◽  
Katrina Wolfe ◽  
Ryan W Walters ◽  
Peter T. Silberstein
Keyword(s):  
Colon Cancer ◽  
Cancer Survival ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Multiagent Chemotherapy ◽  
The Impact

The impact of physical activity on patients with stage III colon cancer: Findings from Intergroup trial CALGB 89803

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 3534-3534 ◽  
Author(s):  
J. A. Meyerhardt ◽  
D. Heseltine ◽  
D. Niedzwiecki ◽  
D. Hollis ◽  
L. B. Saltz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Colon Cancer ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Intergroup Trial ◽  
The Impact

Microsatellite instability predicts improved response to adjuvant therapy with irinotecan, 5-fluorouracil and leucovorin in stage III colon cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10003-10003 ◽  
Author(s):  
M. M. Bertagnolli ◽  
C. C. Compton ◽  
D. Niedzwiecki ◽  
R. S. Warren ◽  
S. Jewell ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Microsatellite Instability ◽  
Statistical Significance ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Colon Cancers ◽  
Early Results ◽  
The Impact

10003 Background: Colon cancers exhibiting a high level of microsatellite instability (MSI-H) show distinct clinicopathological features, including both better prognosis and reduced response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the impact of adjuvant chemotherapy containing irinotecan in patients with MSI-H colon cancers. Methods: CALGB protocol 89803 randomized 1264 patients with resected stage III colon cancer to receive post-operative 5-FU and leucovorin (LV) with or without irinotecan. Paraffin blocks containing primary tumor and normal tissue were collected. Microsatellite instablility was assessed using a panel of mono- and di-nucleotide markers. Disease free survival (DFS) was measured from trial entry until documented disease progression or death from any cause. A statistical significance level of 0.2 was used in screening to generate hypotheses regarding MSI status and outcome. Median follow-up at analysis was 3.8 years. Overall C89803 showed no advantage for addition of irinotecan to 5-FU/LV. Results: Patients with and without tumor samples analyzed did not differ by treatment, age, gender, primary site, T-stage, differentiation, # positive nodes, or mucinous type. Of 482 tumors analyzed, 75 (16%) demonstrated MSI-H. MSI-H cancers were more likely to be located in the proximal colon (p<0.0001), of high histologic grade (p<0.0001) and mucinous histology (p<0.0001), and also had increased numbers of tumor-containing lymph nodes (mean # positive nodes/case = 3.5 for MSI Low/Stable vs. 4.7 for MSI-H; p = 0.04). At the time of analysis 143 of 482 patients (36%) analyzed experienced tumor recurrence and/or death due to any cause. For patients with MSI-H tumors, DFS was better in those treated with irinotecan in addition to 5-FU/LV (logrank p=0.18). Among patients with MSI Low/Stable tumors there was no difference in DFS between those treated with and without irinotecan (logrank p =0.39). Conclusions: Early results from CALGB protocol 89803 indicate that addition of postoperative irinotecan to 5-FU/LV may improve DFS in patients with stage III colon cancers that exhibit MSI-H. Longer follow-up is required to confirm this finding. [Table: see text]

Provider feedback improves reporting on quality measures: National profile reports for adjuvant chemotherapy for stage III colon cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6572-6572 ◽  
Author(s):  
A. K. Stewart ◽  
E. G. Gay ◽  
L. Patel-Parekh ◽  
D. P. Winchester ◽  
S. B. Edge ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Cancer Registry ◽  
Registry Data ◽  
Stage Iii ◽  
Quality Data ◽  
Data Repositories ◽  
Stage Iii Colon Cancer ◽  
National Quality ◽  
The Impact

6572 Background: The National Quality Forum recently announced accountability measures including use of chemotherapy (ACT) with Stage III colon cancer. This study examines the impact of performance reporting using cancer registry data to assess the quality of care for Stage III colon cancer patients using the Commission on Cancer's (CoC) Cancer Program Practice Profile Reports. Cancer registries are the primary source for measurement but adjuvant treatment may be incomplete. Methods: In January 2005 the CoC provided reports to 1,337 hospitals using registry data on over 80,000 Stage III colon cancer patients diagnosed from 1998–2003. Each hospital received a weighted performance rate (PR) and comparison to hospitals of similar types, nationally and regionally. Hospitals could review and correct missing or inaccurate data to provide an updated profile. Results: The initial overall hospital-level PR was 66.2%, hospitals in the top quartile had PRs =80.1%. After 24 months 603 hospitals had corrected data. The mean PR was 74.9%, an increase of 8.7%. The top quartile PR was =89.7%. The PRs for hospitals in the top quartile increased on average by 4.3%, and for hospitals outside this group by 22.7%. The proportion of hospitals with PRs =90% increased from 7.9% to 23.9%. Conclusions: With over two-fifths of hospitals correcting data, the concordance rate with ACT in Stage III colon cancer has significantly increased compared to initial registry data. Reporting quality data and allowing auditing and correction on key quality indicators corrects the data gap in cancer registry out-patient treatment data. Exposure to profile reports can spur local providers to promote better communication with centralized data repositories, significantly contributing to the assessment of care provided to cancer patients. No significant financial relationships to disclose.

Increasing Negative Lymph Node Count Is Independently Associated With Improved Long-Term Survival in Stage IIIB and IIIC Colon Cancer

2006 ◽  
Vol 24 (22) ◽  
pp. 3570-3575 ◽  
Author(s):  
Paul M. Johnson ◽  
Geoff A. Porter ◽  
Rocco Ricciardi ◽  
Nancy N. Baxter
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Stage Iiib ◽  
Stage Iii ◽  
Disease Specific Survival ◽  
Term Survival ◽  
Stage Iii Colon Cancer ◽  
The Impact ◽  
Negative Lymph Nodes ◽  
Disease Specific

PurposeThe purpose of this study was to examine the impact of the number of negative lymph nodes on survival in patients with stage III colon cancer.Patients and MethodsPatients who underwent surgery for stage III colon cancer between January 1988 and December 1997 were identified from the Surveillance, Epidemiology and End Results cancer registry. The number of negative and positive nodes was determined for 20,702 eligible patients. Disease-specific survival was examined by substage according to the number of negative nodes identified. A proportional hazards model was constructed to determine the effect of the number of negative nodes on survival.ResultsFor stage IIIB and IIIC patients, there was a significant decrease in disease-specific mortality as the number of negative nodes increased; cumulative 5-year cancer mortality was 27% in stage IIIB patients with 13 or more negative nodes identified versus 45% in those with three or fewer negative lymph nodes evaluated (P < .0001). In patients with stage IIIC cancer, those with 13 or more negative nodes had a 5-year mortality of 42% versus 65% in those with three or fewer negative lymph nodes evaluated (P < .0001). There was no association between the number of negative nodes identified and disease-specific survival for patients with stage IIIA disease. After controlling for the number of positive nodes, a higher number of negative nodes was found to be independently associated with improved disease-specific survival.ConclusionThe number of negative nodes is an important independent prognostic factor for patients with stage IIIB and IIIC colon cancer.

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