Use of NSAIDs for the Chemoprevention of Colorectal Cancer

2003 ◽  
Vol 37 (11) ◽  
pp. 1664-1674 ◽  
Author(s):  
Jill M Herendeen ◽  
Celeste Lindley
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
General Population ◽  
Clinical Studies ◽  
Adenomatous Polyps ◽  
Medline Search ◽  
High Risk Patients ◽  
Incidence And Mortality ◽  
Risk Patients ◽  
Cox 2

OBJECTIVE: To discuss the role of nonsteroidal antiinflammatory drugs (NSAIDs) in the chemoprevention of colorectal cancer. DATA SOURCES: A MEDLINE search (1966–May 2003) was performed to identify key literature. Search items included, but were not limited to, NSAIDs, colorectal cancer, chemoprevention, cyclooxygenase-2 (COX-2)–specific inhibitors, and familial adenomatous polyposis (FAP). STUDY SELECTION AND DATA EXTRACTION: The search included experimental (in vitro and animal models) and clinical studies evaluating the use of NSAIDs for the chemoprevention of colorectal cancer. The MEDLINE search was supplemented by references from selected articles. DATA SYNTHESIS: Numerous experimental, epidemiologic, and clinical studies suggest that NSAIDs have promise as anticancer agents. The mechanism by which NSAIDs lead to decreased colon carcinogenesis is not fully understood, but may involve restoration of apoptosis and inhibition of prostaglandin-mediated angiogenesis. Compelling evidence from many observational studies has consistently documented a 40–50% reduction in the risk of adenomatous polyps, colorectal cancer incidence, and mortality in patients using NSAIDs. Recent randomized, controlled trials have demonstrated a benefit with aspirin in reducing the rate of development of new or recurrent adenomas in high-risk patients. In addition, randomized studies using sulindac and celecoxib in patients with FAP have documented significant regression of existing adenomatous polyps. CONCLUSIONS: Inhibition of COX-2 is an example of a targeted approach to the chemoprevention of colorectal cancer. However, controversy exists about the safety, efficacy, and optimal treatment regimen of NSAIDs as long-term chemopreventive agents in the general population. Ongoing studies in high-risk patients with both selective and nonselective COX inhibitors will provide important information in the area of colorectal chemoprevention, but clinical trials' use of adenomas as surrogate markers for chemoprevention trials makes their application to the general population limited.

scholarly journals Colorectal cancer risk following polypectomy in a multicentre, retrospective, cohort study: an evaluation of the 2020 UK post-polypectomy surveillance guidelines

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323411
Author(s):  
Amanda J Cross ◽  
Emma C Robbins ◽  
Kevin Pack ◽  
Iain Stenson ◽  
Bhavita Patel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
General Population ◽  
Cox Regression ◽  
Population Based ◽  
Low Risk ◽  
High Grade Dysplasia ◽  
High Grade ◽  
High Risk Patients ◽  
Risk Patients

ObjectiveColonoscopy surveillance aims to reduce colorectal cancer (CRC) incidence after polypectomy. The 2020 UK guidelines recommend surveillance at 3 years for ‘high-risk’ patients with ≥2 premalignant polyps (PMPs), of which ≥1 is ‘advanced’ (serrated polyp (or adenoma) ≥10 mm or with (high-grade) dysplasia); ≥5 PMPs; or ≥1 non-pedunculated polyp ≥20 mm; ‘low-risk’ patients without these findings are instead encouraged to participate in population-based CRC screening. We examined the appropriateness of these risk classification criteria and recommendations.DesignRetrospective analysis of patients who underwent colonoscopy and polypectomy mostly between 2000 and 2010 at 17 UK hospitals, followed-up through 2017. We examined CRC incidence by baseline characteristics, risk group and number of surveillance visits using Cox regression, and compared incidence with that in the general population using standardised incidence ratios (SIRs).ResultsAmong 21 318 patients, 368 CRCs occurred during follow-up (median: 10.1 years). Baseline CRC risk factors included age ≥55 years, ≥2 PMPs, adenomas with tubulovillous/villous/unknown histology or high-grade dysplasia, proximal polyps and a baseline visit spanning 2–90 days. Compared with the general population, CRC incidence without surveillance was higher among those with adenomas with high-grade dysplasia (SIR 1.74, 95% CI 1.21 to 2.42) or ≥2 PMPs, of which ≥1 was advanced (1.39, 1.09 to 1.75). For low-risk (71%) and high-risk (29%) patients, SIRs without surveillance were 0.75 (95% CI 0.63 to 0.88) and 1.30 (1.03 to 1.62), respectively; for high-risk patients after first surveillance, the SIR was 1.22 (0.91 to 1.60).ConclusionThese guidelines accurately classify post-polypectomy patients into those at high risk, for whom one surveillance colonoscopy appears appropriate, and those at low risk who can be managed by non-invasive screening.

scholarly journals A STING-related prognostic score predicts high-risk patients of colorectal cancer and provides insights into immunotherapy

2021 ◽  
Vol 9 (1) ◽  
pp. 14-14
Author(s):  
Si-Yuan Chen ◽  
Siyu Chen ◽  
Wanjing Feng ◽  
Ziteng Li ◽  
Yixiao Luo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Prognostic Score ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Stage IV Colorectal Cancer Patients with High Risk Mutation Profiles Survived 16 Months Longer with Individualized Therapies

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 393
Author(s):  
Alexander Hendricks ◽  
Anu Amallraja ◽  
Tobias Meißner ◽  
Peter Forster ◽  
Philip Rosenstiel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Practice ◽  
High Risk ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Standard Of Care ◽  
High Risk Patients ◽  
Risk Patients ◽  
Individualized Treatments ◽  
Colorectal Cancer Patients

Personalized treatment vs. standard of care is much debated, especially in clinical practice. Here we investigated whether overall survival differences in metastatic colorectal cancer patients are explained by tumor mutation profiles or by treatment differences in real clinical practice. Our retrospective study of metastatic colorectal cancer patients of confirmed European ancestry comprised 54 Americans and 54 gender-matched Germans. The Americans received standard of care, and on treatment failure, 35 patients received individualized treatments. The German patients received standard of care only. Tumor mutations, tumor mutation burden and microsatellite status were identified by using the FoundationOne assay or the IDT Pan-Cancer assay. High-risk patients were identified according to the mutational classification by Schell and colleagues. Results: Kaplan–Meier estimates show the high-risk patients to survive 16 months longer under individualized treatments than those under only standard of care, in the median (p < 0.001). Tumor mutation profiles stratify patients by risk groups but not by country. Conclusions: High-risk patients appear to survive significantly longer (p < 0.001) if they receive individualized treatments after the exhaustion of standard of care treatments. Secondly, the tumor mutation landscape in Americans and Germans is congruent and thus warrants the transatlantic exchange of successful treatment protocols and the harmonization of guidelines.

G-CSF PROPHYLAXIS IN HIGH RISK PATIENTS WITH COLORECTAL CANCER

Shock ◽  
2002 ◽  
Vol 17 (Supplement) ◽  
pp. 36
Author(s):  
A. Torossian ◽  
A. Bauhofer ◽  
M. Middeke ◽  
U. Plaul ◽  
H. Wulf ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Prognostic value of preoperative circulating tumor cells counts in patients with UICC stage I-IV colorectal cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252897
Author(s):  
Thaer S. A. Abdalla ◽  
Jan Meiners ◽  
Sabine Riethdorf ◽  
Alexandra König ◽  
Nathaniel Melling ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Stage I ◽  
Clinicopathological Parameters ◽  
Curative Intent ◽  
High Risk Patients ◽  
Risk Patients

Colorectal cancer (CRC) is one of the leading causes of cancer death worldwide. There is an urgent need to identify prognostic markers for patients undergoing curative resection of CRC. The detection of circulating tumor cells in peripheral blood is a promising approach to identify high-risk patients with disseminated disease in colorectal cancer. This study aims to evaluate the prognostic relevance of preoperative CTCs using the Cellsearch® system (CS) in patients, who underwent resection with curative intent of different stages (UICC I-IV) of colorectal cancer. Out of 91 Patients who underwent colorectal resection, 68 patients were included in this study. CTC analysis was performed in patients with CRC UICC stages I-IV immediately before surgery. Data were correlated with clinicopathological parameters and patient outcomes. One or more CTCs/7.5 mL were detected in 45.6% (31/68) of patients. CTCs were detected in all stages of the Union of International Cancer Control (UICC), in stage I (1/4, 25%), in stage II (4/12, 33.3%), in stage III (5/19, 26.3%) and in stage IV (21/33, 63.6%). The detection of ≥ 1 CTCs/ 7.5ml correlated to the presence of distant overt metastases (p = 0.014) as well as with shorter progression-free (p = 0.008) and overall survival (p = 0.008). Multivariate analyses showed that the detection of ≥ 1 CTCs/ 7.5ml is an independent prognostic indicator for overall survival (HR, 3.14; 95% CI, 1.18–8.32; p = 0.021). The detection of CTCs is an independent and strong prognostic factor in CRC, which might improve the identification of high-risk patients in future clinical trials.

scholarly journals Stromal Expression of Vimentin Predicts the Clinical Outcome of Stage II Colorectal Cancer for High-Risk Patients

2017 ◽  
Vol 23 ◽  
pp. 2897-2905 ◽  
Author(s):  
Li-guo Liu ◽  
Xue-bing Yan ◽  
Ru-ting Xie ◽  
Zhi-ming Jin ◽  
Yi Yang
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Clinical Outcome ◽  
Stage Ii ◽  
High Risk Patients ◽  
Risk Patients ◽  
Stage Ii Colorectal Cancer
Sign in / Sign up

Export Citation Format

Share Document