scholarly journals Noninvasive Biomarkers of Colorectal Cancer: Role in Diagnosis and Personalised Treatment Perspectives

2018 ◽  
Vol 2018 ◽  
pp. 1-21 ◽  
Author(s):  
Gianluca Pellino ◽  
Gaetano Gallo ◽  
Pierlorenzo Pallante ◽  
Raffaella Capasso ◽  
Alfonso De Stefano ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Wide Spectrum ◽  
Disease Recurrence ◽  
Screening Tests ◽  
Serological Markers ◽  
The Third ◽  
Stage Of Diagnosis ◽  
Noninvasive Biomarkers ◽  
Personalised Treatment

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. It has been estimated that more than one-third of patients are diagnosed when CRC has already spread to the lymph nodes. One out of five patients is diagnosed with metastatic CRC. The stage of diagnosis influences treatment outcome and survival. Notwithstanding the recent advances in multidisciplinary management and treatment of CRC, patients are still reluctant to undergo screening tests because of the associated invasiveness and discomfort (e.g., colonoscopy with biopsies). Moreover, the serological markers currently used for diagnosis are not reliable and, even if they were useful to detect disease recurrence after treatment, they are not always detected in patients with CRC (e.g., CEA). Recently, translational research in CRC has produced a wide spectrum of potential biomarkers that could be useful for diagnosis, treatment, and follow-up of these patients. The aim of this review is to provide an overview of the newer noninvasive or minimally invasive biomarkers of CRC. Here, we discuss imaging and biomolecular diagnostics ranging from their potential usefulness to obtain early and less-invasive diagnosis to their potential implementation in the development of a bespoke treatment of CRC.

scholarly journals Colorectal Cancer Surveillance after Index Colonoscopy: Guidance from the Canadian Association of Gastroenterology

2013 ◽  
Vol 27 (4) ◽  
pp. 224-228 ◽  
Author(s):  
Desmond Leddin ◽  
Robert Enns ◽  
Robert Hilsden ◽  
Carlo A Fallone ◽  
Linda Rabeneck ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Task Force ◽  
Cancer Surveillance ◽  
Screening Tests ◽  
Average Risk ◽  
Health Care Environment ◽  
Canadian Association ◽  
The Us ◽  
Colonoscopy Surveillance

BACKGROUND: Differences between American (United States [US]) and European guidelines for colonoscopy surveillance may create confusion for the practicing clinician. Under- or overutilization of surveillance colonoscopy can impact patient care.METHODS: The Canadian Association of Gastroenterology (CAG) convened a working group (CAG-WG) to review available guidelines and provide unified guidance to Canadian clinicians regarding appropriate follow-up for colorectal cancer (CRC) surveillance after index colonoscopy. A literature search was conducted for relevant data that postdated the published guidelines.RESULTS: The CAG-WG chose the 2012 US Multi-Society Task Force (MSTF) on Colorectal Cancer to serve as the basis for the Canadian position, primarily because the US approach was the simplest and comprehensively addressed the issue of serrated polyps. Aspects of other guidelines were incorporated where relevant. The CAG-WG recommendations differed from the US MSTF guidelines in three main areas: patients with negative index colonoscopy should be followed-up at 10 years using any of the appropriate screening tests, including colonos-copy, for average-risk individuals; among patients with >10 adenomas, a one-year interval for subsequent colonoscopy is recommended; and for long-term follow-up, patients with low-risk adenomas on both the index and first follow-up procedures can undergo second follow-up colonos-copy at an interval of five to 10 years.DISCUSSION: The CAG-WG adapted the US MSTF guidelines for colonoscopy surveillance to the Canadian health care environment with a few modifications. It is anticipated that the present article will provide unified guidance that will enhance physician acceptance and encourage appropriate utilization of recommended surveillance intervals.

scholarly journals Urachal Tumor: A Case Report of an Extremely Rare Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
José Palla Garcia ◽  
Rita Sampaio ◽  
Carlos Peixoto
Keyword(s):  
Anterior Abdominal Wall ◽  
Bladder Wall ◽  
Disease Recurrence ◽  
Rare Tumor ◽  
Past Medical History ◽  
Third Trimester ◽  
Surgical Specimen ◽  
The Third ◽  
Mucosal Erosion

The urachus is a tubular structure that connects the bladder to the allantois in the embryonic development, involuting after the third trimester. The urachus carcinoma is an extremely rare tumor that accounts for <1% of all bladder cancers. We report a case of a 46-year-old woman, with no past medical history, complaining of hematuria with 6-month duration and a physical exam and an abdominal computed topographic scan revealing an exophytic mass of 6.8 cm longer axis that grew depending on the anterior bladder wall, invading the anterior abdominal wall. Cystoscopy detected mucosal erosion. The biopsy showed structures of adenocarcinoma of enteric type. The surgical specimen showed urachus adenocarcinoma of enteric type with stage IVA in the Sheldon system and stage III in the Mayo system. This case has a 3-year follow-up without disease recurrence.

scholarly journals Newer techniques in diagnostic imaging of colorectal carcinoma

2009 ◽  
Vol 56 (4) ◽  
pp. 113-119
Author(s):  
M.A. Lucic ◽  
I.S. Miucin-Vukadinovic ◽  
S.M. Lucic ◽  
K.M. Koprivek ◽  
M. Spirovski ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Diagnostic Imaging ◽  
Wide Spectrum ◽  
Imaging Techniques ◽  
Diagnostic Evaluation ◽  
Diagnostic Assessment ◽  
Colorectal Malignancy ◽  
Imaging Methods

A wide spectrum of nowadays availible radiological and imaging methods in the diagnostic evaluation of patients with colorectal cancer enabled not only the improvement of primary colorectal malignancy detection, precise staging, regional involvement and metastatic spread assessment, but also the posttherapeutical estimation and follow- up. Having in mind that the exact diagnostic assessment of colorectal carcinoma by use of different imaging modalities still raises a lots of contradictories, in this report we have tried to present the possibilities of newer imaging techniques in the diagnostic evaluation of the patients with colorectal cancer.

Evaluation of routine image follow-up in nonmetastatic colorectal cancer after curative surgical resection.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 524-524
Author(s):  
Lara Azevedo Diniz ◽  
Amanda Karani ◽  
Diogo De Brito Sales ◽  
Larissa Machado ◽  
Milton Jose Barros
Keyword(s):  
Colorectal Cancer ◽  
Disease Recurrence ◽  
Early Recurrence ◽  
Primary Treatment ◽  
Cancer Center ◽  
Published Data ◽  
Ct Image ◽  
Survival Difference ◽  
Pattern Of Recurrence

524 Background: Follow-up surveillance is performed after primary treatment in colorectal cancer (CRC), but it is controversial in the literature the real benefit of an intensive examination in terms of outcomes and resources. Intensive follow-up after surgery for colorectal cancer has been challenged by some new published data (CEA watch trial and FACS trial). These new data suggest that a less intensive follow-up program based on carcinoembryonic antigen (CEA) measurements or CEA-Triggered imaging would be enough to detected most of the recurrences. We believe that there is a high percentage of patients with recurrence disease and normal CEA value, for whom image screening would be necessary to detect early disease recurrence suitable to metastasectomy with curative intention. Methods: This is a retrospective study that included 372 patients from a tertiary cancer center in São-Paulo (Brazil) diagnosed with colorectal adenocarcinoma stages I to III. We observed, after primary treatment, a pattern of recurrence detected either by CT (computed tomography) imaging only or CEA elevation and CT image in combination. Results: Out of the 372 patients analyzed, 110 (29,5%) had recurrent disease with a median follow-up time of 34 months. Of the 110 recurrences detected, 75 (68,18%) were detected by CEA elevation in combination with CT image, 33 (30%) were detected only by CT image and 2 (1,81%) neither by CT nor by CEA alteration. There was no clinic feature that would predict pattern of recurrence when analyzed by qui square test. Metastasectomy rate from this analysis 53,6% and it was similar among both groups. Recurrence rate after metastasectomy was 59,3%. There is a 5-year overall survival difference between patients that underwent or not metastasectomy (79,4% vs. 54%, p 0,01). Conclusions: CEA-based follow-up program and CEA-triggered imaging failed to detect early recurrence in almost 30% of cases. We believe that this number is high enough to allow us to continue to perform image test during CRC follow-up.

scholarly journals Developments in Screening Tests and Strategies for Colorectal Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Justin L. Sovich ◽  
Zachary Sartor ◽  
Subhasis Misra
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Cancer Mortality ◽  
The United States ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Common Cause ◽  
Crc Screening ◽  
The Third ◽  
Incidence And Mortality

Background.Worldwide, colorectal cancer (CRC) is the third most common cancer in men and second most common in women. It is the fourth most common cause of cancer mortality. In the United States, CRC is the third most common cause of cancer and second most common cause of cancer mortality. Incidence and mortality rates have steadily fallen, primarily due to widespread screening.Methods.We conducted keyword searches on PubMed in four categories of CRC screening: stool, endoscopic, radiologic, and serum, as well as news searches in Medscape and Google News.Results.Colonoscopy is the gold standard for CRC screening and the most common method in the United States. Technological improvements continue to be made, including the promising “third-eye retroscope.” Fecal occult blood remains widely used, particularly outside the United States. The first at-home screen, a fecal DNA screen, has also recently been approved. Radiological methods are effective but seldom used due to cost and other factors. Serum tests are largely experimental, although at least one is moving closer to market.Conclusions.Colonoscopy is likely to remain the most popular screening modality for the immediate future, although its shortcomings will continue to spur innovation in a variety of modalities.

scholarly journals Plasma microRNA Levels Combined with CEA and CA19-9 in the Follow-Up of Colorectal Cancer Patients

Cancers ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 864 ◽  
Author(s):  
Martin Pesta ◽  
Radek Kucera ◽  
Ondrej Topolcan ◽  
Marie Karlikova ◽  
Katerina Houfkova ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Plasma Levels ◽  
Quantitative Estimation ◽  
High Specificity ◽  
Disease Recurrence ◽  
Palliative Surgery ◽  
Surgical Removal ◽  
Plasma Microrna ◽  
Low Sensitivity

Colorectal cancer (CRC) ranks among the most common cancers worldwide. Surgical removal remains the best strategy for treatment of resectable tumors. An important part of caring for patients after surgery is monitoring for early detection of a possible relapse of the disease. Efforts are being made to improve the sensitivity and specificity of routinely used carcinoembryonic antigen (CEA) with the use of additional biomarkers such as microRNAs. The aim of our study was to evaluate the prognostic potential of microRNAs and their use as markers of disease recurrence. The quantitative estimation of CEA, CA19-9, and 22 selected microRNAs (TaqMan Advanced miRNA Assays) was performed in 85 paired (preoperative and postoperative) blood plasma samples of CRC patients and in samples taken during the follow-up period. We have revealed a statistically significant decrease in plasma levels for miR-20a, miR-23a, miR-210, and miR-223a (p = 0.0093, p = 0.0013, p = 0.0392, and p = 0.0214, respectively) after surgical removal of the tumor tissue. A statistically significant relation to prognosis (overall survival; OS) was recorded for preoperative plasma levels of miR-20a, miR-21, and miR-23a (p = 0.0236, p = 0.0316, and p =0.0271, respectively) in a subgroup of patients who underwent palliative surgery. The best discrimination between patients with favorable and unfavorable outcomes was achieved by a combination of CEA, CA19-9 with miR-21, miR-20a, and miR-23a (p < 0.0001). The use of these microRNAs for early disease recurrence detection was affected by a low specificity in comparison with CEA and CA19-9. CEA and CA19-9 had high specificity but low sensitivity. Our results show the benefit of combining currently used standard biomarkers and microRNAs for precise prognosis estimation.

Effect of PET-CT on disease recurrence and its management in patients with potentially resectable colorectal cancer liver metastases: The long-term results of a randomized control trial.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 562-562
Author(s):  
Pablo Emilio Serrano Aybar ◽  
Chu-Shu Gu ◽  
Mohamed Husien ◽  
Diederick Jalink ◽  
Guillaume Martel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Surgical Management ◽  
Disease Recurrence ◽  
Long Term Results ◽  
Colorectal Cancer Liver Metastases ◽  
Pet Ct ◽  
Risks Factors

562 Background: The PETCAM randomized trial evaluated the effect of preoperative PET-CT (vs. no PET-CT) on surgical management in patients with colorectal cancer liver metastases. In this study, 8% of patients had a change in surgical management, including a higher proportion of major liver resections in the PET-CT arm. The current study compares the intervention groups for 5-year disease free (DFS) and overall survival (OS), and evaluated their long-term clinical course, i.e. sites of recurrence and management of disease recurrence. Methods: Recruitment to the trial occurred between 2005-2010, with last follow-up in 2013. Data on recurrence, management of recurrence and mortality from 2013-2017 was collected from patient’s charts. Recurrences according to site and management were described. Cox proportional Hazard Models were used to calculate the risk for recurrence and death. OS was calculated with Kaplan-Meir method and compared with log-rank test. Results: At 5 years, 157 of 404 (39%) patients were still alive and 19 patients were lost to follow-up. Median follow-up is 4.2 years. There were no differences in DFS (HR: 1.12, 95%CI: 0.88-1.42) or OS (HR: 0.97, 95%CI: 0.74-1.28) between groups. The median DFS for the 372 patients who had surgery was 17 months, 95%CI: 14.7-19.4. Risks factors for recurrence were: extrahepatic disease, liver tumour size, and nodal stage. The median OS for all patients was 50 months, 95%CI: 43.5-64.3. Risks factors for death also included age and prior use of chemotherapy. During the follow-up period, 287/404, 71% patients recurred (mostly liver and lung); 137 (48%) were treated solely with chemotherapy and 35% were treated with surgery with curative intent. Of these, the majority recurred (109/116, 94%). The median OS following first recurrence was 27.5 months, 95%CI: 23-30. Conclusions: PET-CT did not improve DFS or OS. Survival following liver resection is similar to previous reports, however most patients experience disease recurrence. A substantial proportion of patients who recur undergo surgery, however it is likely that they will recur again.

Hemangiosarcoma of the Breast Followed by Term Pregnancy

2000 ◽  
Vol 86 (2) ◽  
pp. 166-169
Author(s):  
Heitor R.C. Marana ◽  
Jurandyr M. de Andrade ◽  
Francisco Cyro Reis de C. Prado-Filho ◽  
Maria Angeles Sanches Llorach-Velludo ◽  
Sergio Pereira da Cunha ◽  
...  
Keyword(s):  
Disease Recurrence ◽  
Term Pregnancy ◽  
Primary Angiosarcoma ◽  
The Third ◽  
Dismal Prognosis ◽  
Local Surgery ◽  
Breast Nodule ◽  
Angiosarcoma Of The Breast ◽  
Recurrent Breast

Aims and background Primary angiosarcoma of the breast is an unusual neoplasm which is generally associated with a dismal prognosis. Given the poor prognosis and the predominance in the third and fourth decades of life when fertility tends to decrease, reports of term pregnancies after treatment of this disease are rare. Methods and study design We report a case of angiosarcoma of the breast in a 17-year-old patient with a recurrent breast nodule treated by local surgery only. After three years of follow-up without evidence of disease recurrence she became pregnant. Results A girl weighing 2,430 g was delivered at 38 weeks and two days. The patient has been free of disease for five years now. Conclusions Our experience of the present case shows the lack of full information about this tumor. Pregnancy does not seem to interfere negatively with the course of the disease.

scholarly journals Characterisation of the Expression of Neurotensin and Its Receptors in Human Colorectal Cancer and Its Clinical Implications

Biomolecules ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1145
Author(s):  
Shengyang Qiu ◽  
Stella Nikolaou ◽  
Jie Zhu ◽  
Peter Jeffery ◽  
Robert Goldin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Histological Grade ◽  
Significant Risk ◽  
Disease Free Survival ◽  
Significant Risk Factor ◽  
Disease Recurrence ◽  
Cancer Tissue ◽  
Normal Epithelium ◽  
Free Survival

Introduction: Colorectal Cancer (CRC) accounts for 9% of cancer deaths globally. Hormonal pathways play important roles in some cancers. This study investigated the association of CRC expression of neurotensin (NTS), NTS receptors 1 and 3 (NTSR1 and NTSR3) and clinical outcomes. Methods: A prospective cohort study which quantifies the protein expression of NTS, NTSR1 and NTSR3 in human CRCs using immunohistochemistry. Expression levels were then compared with clinico-pathological outcome including histological grade, overall survival (OS) and disease-free survival (DFS). Results: Sixty-four patients were enrolled with median follow-up of 44.0 months. There was significantly higher expression of NTS in cancer tissue in CRC with higher T stages (p < 0.01), N stages (p = 0.03), and AJCC clinical stages (p = 0.04). There was significantly higher expression of NTS, NTSR1 and NTSR3 in cancer tissue compared to surrounding normal epithelium (median H-score 163.5 vs 97.3, p < 0.01). There was significantly shorter DFS in individuals with CRC with high levels of NTS compared to lower levels of NTS (35.8 months 95% CI 28.7–42.8 months vs 46.4 months 95% CI 42.2–50.5 months, respectively, p = 0.02). Above median NTS expression in cancer tissue was a significant risk factor for disease recurrence (HR 4.10, 95% CI 1.14–14.7, p = 0.03). Discussion: The expression of NTS and its receptors has the potential to be utilised as a predictive and prognostic marker in colorectal cancer for postoperative selection for adjuvant therapy and identify individuals for novel therapies targeting the neurotensinergic pathways. Conclusions: High NTS expression appears to be associated with more advanced CRC and worse DFS.

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