Is Neoadjuvant Therapy an Alternative Strategy to Immediate Surgery in Locally Perforated Colon Cancer?

2021 ◽  
Author(s):  
Joseph C Kong ◽  
Jordan Lee ◽  
Rathin Gosavi ◽  
Samuel Y Ngan ◽  
Matthew M Tillman ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Therapy ◽  
Alternative Strategy ◽  
Immediate Surgery ◽  
Perforated Colon

scholarly journals Retroperitoneal Abscess due to Perforated Colon Cancer. Report of Three Cases.

1992 ◽  
Vol 25 (8) ◽  
pp. 2232-2236
Author(s):  
Hiromi Nakayama ◽  
Koki Tanaka ◽  
Mitsunobu Uto ◽  
Akira Taira
Keyword(s):  
Colon Cancer ◽  
Retroperitoneal Abscess ◽  
Perforated Colon

scholarly journals Neoadjuvant therapy in locally advanced colon cancer: a meta-analysis and systematic review

2020 ◽  
Vol 11 (5) ◽  
pp. 847-857
Author(s):  
Chin Kai Cheong ◽  
Kameswara Rishi Yeshayahu Nistala ◽  
Cheng Han Ng ◽  
Nicholas Syn ◽  
Heidi Sian Ying Chang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Colon Cancer

Adjuvant HIPEC in patients with colon cancer at high risk of peritoneal metastases: Primary outcome of the COLOPEC multicenter randomized trial.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 482-482 ◽  
Author(s):  
Charlotte Emma Louise Klaver ◽  
Daniel D Wisselink ◽  
Cornelis J. A. Punt ◽  
Petur Snaebjornsson ◽  
Johannes Crezee ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Systemic Chemotherapy ◽  
Tumor Resection ◽  
Multicenter Trial ◽  
Peritoneal Metastases ◽  
Long Term Results ◽  
Control Versus ◽  
Drop Outs ◽  
Perforated Colon

482 Background: Patients with T4 or perforated colon cancer are at high risk (~25%) of peritoneal metastases (PM). Sensitivity of imaging modalities for PM is limited and the majority of patients is diagnosed in a palliative setting. This provides a rationale for adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC). In this study, the effectiveness of adjuvant HIPEC in reducing the risk of PM was determined. Methods: In this multicenter trial, patients with T4 (either cT4 or pT4, N0-2, M0) or perforated colon cancer, who underwent curative resection were randomized to adjuvant HIPEC followed by routine adjuvant systemic chemotherapy or to adjuvant systemic chemotherapy alone (1:1). Adjuvant HIPEC with oxaliplatin was performed simultaneously (9%) or within five-eight weeks (91%) after the primary tumor resection. Patients without evidence of recurrent disease at 18 months based on CT imaging underwent diagnostic laparoscopy in both arms. The primary endpoint was PM free survival (PMFS) at 18 months using Kaplan Meier analysis. Results: Between April 2015 and January 2017, 204 patients were randomized: 102 in the control arm (0 drop-outs), 102 in the experimental arm (two drop-outs). Surgical exploration at the start of the HIPEC procedure at five-eight weeks postoperatively revealed metastases in 11 patients (PM in 9/11) in the experimental arm, and adjuvant HIPEC was not applied. Adjuvant systemic chemotherapy was administered in 89/100 eligible patients after median 6 weeks (IQR 5-7) in the control arm and in 84/89 after 10 weeks (IQR 9-12) in the experimental arm. PM rate after completion of 18 months follow-up was 22/102 and 18/100, respectively. In the ITT analysis no difference in 18 months PMFS was observed: 77% (control) versus 81% (experimental), HR 0.836 (0.489-1.428)). Also, no differences were observed in 18 months DFS (HR 1.016 (0.646-1.598)) and OS (HR 1.139 (0.532-2.439)). One patient developed encapsulating peritoneal sclerosis after HIPEC. Conclusions: Adjuvant HIPEC with oxaliplatin for patients with T4 or perforated colon cancer does not result in improved 18 months PMFS. Long-term results have to be awaited to assess the role of HIPEC in the adjuvant setting. Clinical trial information: NCT02231086.

A Hemophagocytic Syndrome-Like Condition After Emergency Colectomy for Perforated Colon Cancer: Report of a Case

Surgery Today ◽  
2002 ◽  
Vol 32 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Takayuki Yamada ◽  
Toshiro Ikeya ◽  
Tetsushi Ogawa ◽  
Minoru Nakano ◽  
Hidemi Ogura ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Hemophagocytic Syndrome ◽  
Emergency Colectomy ◽  
Perforated Colon

scholarly journals Neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in perforated colon cancer: a propensity score analysis.

2020 ◽  
Author(s):  
Chunyi Wu ◽  
Jy-Ming Chiang ◽  
Jeng-Fu You ◽  
Reiping Tang ◽  
Jinn-Shiun Chen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Disease Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Disease Free ◽  
Perforated Colon

Abstract Background: The neutrophil-to-lymphocyte ratio is a significant prognostic marker in resectable colorectal cancer; however, there are no equivalent findings for perforated colon cancer. Using our colorectal cancer database, we retrospectively analyzed the data from 1995 to 2015 to determine whether the preoperative neutrophil-to-lymphocyte ratio is associated with survival outcomes in patients with perforated colon cancer.Methods: One-to-one propensity score matching was applied to minimize the difference between the high (>5) and low (≤5) neutrophil-to-lymphocyte ratio groups. Clinicopathological factors, long-term overall survival, and disease-free survival were analyzed and compared between the two groups. The primary outcomes were overall survival and disease-free survival.Results: Before propensity score matching, the high neutrophil-to-lymphocyte ratio group had a significantly higher prevalence of leukocytosis (low vs. high neutrophil-to-lymphocyte ratio groups: 12 [12.9%] vs. 46 [59.7%], p<0.001), lower serum albumin levels (low vs. high neutrophil-to-lymphocyte ratio groups: 30 [32.3%] vs. 42 [54.5%], p=0.003), and a higher emergent operation rate (low vs. high neutrophil-to-lymphocyte ratio groups: 5 [5.4%] vs. 20 [26.0%], p<0.001). After one-to-one propensity score matching, the groups comprised 41 patients each; none of the parameters were significantly different between the two groups. The mean follow-up period was 76.3 months. The 5-year overall survival (p=0.637) and disease-free survival (p=0.827) rates were not significantly different between the high and low neutrophil-to-lymphocyte ratio groups.Conclusions: The neutrophil-to-lymphocyte ratio has limited predictive value for determining outcomes in patients with perforated colon cancer.

Clinical lymph node staging by imaging in colorectal cancer: A flip of the coin?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15160-e15160 ◽  
Author(s):  
Nelleke Pietronella Maria Brouwer ◽  
Rutger Carel Hubert Stijns ◽  
Lemmens Valery ◽  
Iris D. Nagtegaal ◽  
Regina GH Beets-Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Lymph Node Staging ◽  
Preoperative Treatment ◽  
Positive Lymph Nodes

e15160 Background: Clinical lymph node staging by MRI and CT is important in stratification for neoadjuvant therapy in colorectal cancer. Overstaging may result in unnecessary neoadjuvant therapy, but understaging may refrain patients from adequate preoperative treatment. This study aims to provide insight in current daily practice in clinical lymph node staging in CRC in the Netherlands. Methods: All patients with primary CRC, diagnosed between 2003-2014, who underwent lymph node dissection were selected from the nationwide population-based Netherlands Cancer Registry (n=100,211). Trends in patient- and tumor-characteristics, and lymph node staging were analyzed. For the years 2011-2014, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were calculated for clinical lymph node staging, with histology as the gold standard. Only patients without preoperative treatment were analyzed. Since prospective studies have shown that 5x5 Gy radiotherapy (RT) followed by total mesorectal excision within 10 days does not lead to nodal downstaging, an additional analysis was performed in this group. Results: The proportion clinically positive lymph nodes increased significantly between 2003-2014; from 7% to 22% for colon cancer and from 7% to 53% for rectal cancer. The proportion histological positive lymph nodes remained fairly stable over time (±35% colon, ±33% rectum). During 2011-2014, clinical lymph node staging was available in the registry in 86% of colon cancer patients, 92% of rectal cancer patients without neoadjuvant treatment and 95% of rectal cancer patients with 5x5 Gy RT. The parameters based on data from this period are presented in table 1. Conclusions: With a sensitivity and PPV of approximately 50%, clinical lymph node staging is about as accurate as flipping a coin. This leads to overtreatment in patients with rectal cancer with neoadjuvant RT. Acceptable specificity and NPV limit the risk of undertreatment. [Table: see text]

Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

2015 ◽  
Vol 30 (8) ◽  
pp. 1067-1073 ◽  
Author(s):  
Armin Wiegering ◽  
Meik Kunz ◽  
Mohamed Hussein ◽  
Ingo Klein ◽  
Verena Wiegering ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Ct Scan ◽  
Neoadjuvant Therapy ◽  
Diagnostic Value ◽  
Preoperative Ct

scholarly journals CT Colonography in Preoperative Staging of Colon Cancer: Evaluation of FOxTROT Inclusion Criteria for Neoadjuvant Therapy

2019 ◽  
Vol 212 (1) ◽  
pp. 94-102 ◽  
Author(s):  
Natally Horvat ◽  
Aradhna Raj ◽  
Sandy Liu ◽  
Kristina A. Matkowskyj ◽  
Andrea Knezevic ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Therapy ◽  
Ct Colonography ◽  
Preoperative Staging ◽  
Inclusion Criteria

Pseudocirrhosis After Anti-EGFR–Based Neoadjuvant Therapy for Hepatic Metastasis From Colon Cancer: A Different Point of View

2014 ◽  
Vol 13 (3) ◽  
pp. e13-e15 ◽  
Author(s):  
Sofia Battisti ◽  
Francesco Maria Guida ◽  
Elisa Pagliara ◽  
Giuseppe Tonini ◽  
Bruno Beomonte Zobel ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Therapy ◽  
Hepatic Metastasis ◽  
Point Of View
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