scholarly journals Imaging all the people : Associations of computed tomography-based body composition with mortality and fatigue in stage I-III colorectal cancer patients

2021 ◽  
Author(s):  
Harm van Baar
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Body Composition ◽  
Cancer Patients ◽  
Stage I ◽  
The People ◽  
Colorectal Cancer Patients

A study on the genomic alterations of transformation from colorectal adenoma to colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15607-e15607
Author(s):  
Qingjian Chen ◽  
Pan Yang ◽  
Linna Luo ◽  
Wenhua Fan ◽  
Chen Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Tissue Sample ◽  
Intraepithelial Neoplasia ◽  
Stage I ◽  
Tissue Samples ◽  
Diagnostic Potential ◽  
Notch Pathways ◽  
Colorectal Cancer Patients ◽  
Villous Adenomas

e15607 Background: Colorectal cancer is one of the most common malignancies worldwide. Approximately 85% of colorectal cancers are thought to result from adenoma. However, the molecular mechanism of adenoma transformation into colorectal cancer is still unclear. Methods: Ninety-nine adenoma patients aged from 25 to 78 years old were enrolled in this study. We collected tissue sample from each patient and 77 matched blood samples. Pathological subtypes included tubular villous adenomas, villous adenomas, tubular adenomas, high-grade intraepithelial neoplasia, and polyps. Eighty-one stage I colorectal cancer patients (CRC I) were also enrolled in this study. All samples underwent Next-generation sequencing with a panel of 405 cancer related genes. Results: Mutational profiles of adenoma and CRC I patients were compared. The top 5 most frequently mutated genes in adenoma were APC (71%), KRAS (41%), ATM (33%), RIF1 (31%), SYNE1 (28%). While in CRC I patients, top 5 mutated genes were APC (78%), TP53 (57%), TTN (35%), KRAS (33%) and TCF7L2 (22%). There were significant differences between TP53 and TTN by chi-square test. The frequency, number and TMB of mutations in stage I colorectal cancer patients were significantly higher than those in various adenoma subtypes. Stage I colorectal cancer patients have more mutated genes enriched in the Wnt and Notch pathways than adenoma patients. We analyzed mutation signatures in CRC I and adenoma patients, and CRC I were more focused on mutation signatures of mismatch repair such as signature 1, signature 6, signature 10, and signature 15. A total of 391 mutations were identified in tissue samples, while 130 mutations were found in plasma cell-free DNA, with 116 mutations shared between them. The two genes with the highest consistency between tissue and blood were PAX7 and KMT2D. Conclusions: TP53 and TTN are associated with the transition from CRC I to adenoma, and Wnt and Notch pathways may also be involved. PAX7 and KMT2D mutations frequently found in adenoma tissue and blood cfDNA demonstrate the diagnostic potential of these two genes in clinic.

scholarly journals Monitoring treatment response in metastasic colorectal cancer: Economic evaluation of PrediCTC versus computed tomography scan

2019 ◽  
Vol 2019 ◽  
pp. 228424031985833
Author(s):  
Cristina Antón Rodríguez ◽  
Miguel Abal Posada ◽  
Lorena Alonso Alconada ◽  
Sonia Candamio Folgar ◽  
Rafael López López ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Side Effects ◽  
Adverse Events ◽  
Treatment Response ◽  
Cancer Patients ◽  
Societal Perspective ◽  
Cost Utility ◽  
Life Years ◽  
Colorectal Cancer Patients

Background: Late state colorectal cancer treatments have important side effects that should be avoided in patients where drug effectiveness is not adequate. PrediCTC is a new biomarkers blood test developed to determinate the chemotherapy response in unresectable metastatic colorectal cancer patients that could allow to obviate unnecessary treatments. Aim: To assess from the Spanish Societal Perspective the cost-utility of the test PrediCTC compared to the computed tomography in aim to evaluate chemotherapy treatment response in late stage colorectal cancer patients. Methods: Based on the results of Barbazán et al., a Markov model has been developed, in which the different lines and cycles that the colorectal patient can receive and how they can move between them according to the computed tomography or PrediCTC have been represented. The effectiveness has been expressed in quality adjusted life years (QALYs), avoiding adverse events. Results: Base case analysis shows savings in different types of costs for PrediCTC (per patient): €14.30 in those arise from adverse events, €22,345.73 in chemotherapy costs, €4849.61 in other direct costs, and €306.21 in indirect costs. Although computed tomography 12-week assessed patients gain 0.17 QALYs compared with PrediCTC. Conclusions: From the Spanish Societal Perspective, PrediCTC is not a cost-utility option but allows to identify earlier patients who are not benefiting from first-line chemotherapy avoiding unnecessary side effects and costs.

scholarly journals Assessment of the Clinical Usefulness of Preoperative Computed Tomography in Colorectal Cancer Patients Who Received Unplanned Reoperation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rui Wang ◽  
Yi Gao ◽  
Jia-Yi Li ◽  
Zhong-Hui Wang ◽  
Qin-qing Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Ct Imaging ◽  
Preoperative Imaging ◽  
Imaging Evaluation ◽  
Preoperative Ct ◽  
Colorectal Cancer Patients ◽  
Statistical Indicators

Background. In the unplanned reoperation of colorectal cancer patients, computed tomography (CT) is increasingly utilized to locate postoperative complications and previously unlocalized lesions. The purpose of this study is to explore the application of CT in the mortality and complications of the reoperation of colorectal cancer. Patients and Methods. We performed a retrospective review of collected data from the colorectal surgeries of 90 identified colorectal cancer patients who received an unplanned reoperation from 2010 to 2018. Patients were stratified according to those with preoperative CT imaging (CT group, n=36) and those without preoperative CT imaging (NCT group, n=54). Twenty-four statistical indicators of each patient were studied, including their preoperative risk, surgical characteristics, and postoperative outcomes, and satisfaction was evaluated. All data were statistically analysed for predicting postoperative complications by univariate and multivariate logistic regression analyses. Results. Ninety patients received an unplanned reoperation in the study, and 40% (36/90) of these patients underwent preoperative CT examination. Patients’ risk factors were similar between CT and NCT groups. Preoperative imaging was more commonly performed for reoperative new anastomosis + ileostomy but less common for reoperative Dixon’s procedure. The operative duration of the NCT group was longer (139 vs. 104 min, respectively, P=0.01). Preoperative NCT examination (OR 1.24; 95% CI=1.09‐1.42; P=0.01) was an independent predictor of postoperative complications. Importantly, three patients died after an unplanned reoperation for colorectal cancer, which occurred only in the NCT group (5.6% vs. 0.0%, P=0.01). Conclusion. The use of conventional preoperative CT optimizes the choice of the surgical site and the strategy of laparotomy, so as to reduce the length of operation. Preoperative imaging evaluation should be performed for patients undergoing repeat abdominal surgery.

Chest Computed Tomography Screening in Colorectal Cancer Patients

2009 ◽  
Vol 33 (6) ◽  
pp. 1325-1326 ◽  
Author(s):  
Carl Chartrand-Lefebvre ◽  
Réal Lapointe ◽  
Louise Samson ◽  
Marie-Pierre Cordeau ◽  
Julie Prenovault
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Cancer Patients ◽  
Chest Computed Tomography ◽  
Colorectal Cancer Patients

scholarly journals Optimal Follow-up of Stage I Colorectal Cancer Patients

2006 ◽  
Vol 59 (10) ◽  
pp. 857-862 ◽  
Author(s):  
T. Higuchi ◽  
M. Enomoto ◽  
K. Sugihara
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Stage I ◽  
Colorectal Cancer Patients

Prognostication based on TNM staging for socioeconomically disadvantaged colorectal cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19036-e19036
Author(s):  
Yan Lu ◽  
Aaron Gehr ◽  
Jolonda Bullock ◽  
Bassam Ghabach ◽  
Latha Sri Neerukonda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Stage Iv ◽  
Safety Net ◽  
Stage I ◽  
Socioeconomically Disadvantaged ◽  
Pathologic Stage ◽  
Eligible Population ◽  
Prognostic Groups ◽  
Colorectal Cancer Patients

e19036 Background: The TNM classification system is the global standard for staging solid tumors, but the ability of TNM to differentiate prognostic groups may vary between settings because of differences in case-mix and treatments. Little information is available about prognostication using TNM in safety-net health systems, which provide care for socioeconomically disadvantaged individuals and have limited resources. Therefore, we aimed to assess the ability of TNM to differentiate prognostic groups for colorectal cancer patients in an urban safety-net cancer center. Methods: We used institutional registry data from the JPS Oncology and Infusion Center (Fort Worth, TX), which is a Comprehensive Community Cancer Program. Our eligible population included adults who were diagnosed with first primary colorectal cancer between 2008 and 2017, had TNM pathologic stage I – IV, and received at least part of the first course treatment at JPS. Our outcome of interest was 5-year all-cause mortality and our exposure of interest was TNM pathologic stage. Patients were followed from cancer diagnosis until death, loss to follow up, or end of study (December 31, 2018), whichever occurred first. We used a pseudo-observation approach and generalized linear models with log link to estimate risk ratios (RR) and corresponding 95% confidence limits (CL) comparing 5-year mortality between TNM stages, where stage I was the reference category. Results: Our eligible population comprised 655 colorectal cancer survivors, of whom 85% were aged < 65 years, 54% were male, 60% were racial/ethnic minorities, and 65% were uninsured at time of diagnosis. Stage IV patients had 4.4 times higher risk of 5-year mortality compared with stage I (RR = 4.4, 95% CL: 2.9, 6.6). Stage III patients had 2.1 times higher risk of 5-year mortality compared with stage I (RR = 2.1, 95% CL: 1.3, 3.2). Stage II patients had 1.4 times higher risk of 5-year mortality compared with stage I (RR = 1.4, 95% CL: 0.81, 2.3). Conclusions: Our findings suggest that TNM stages do not adequately differentiate colorectal cancer prognostic groups in a socioeconomically disadvantaged population. Stage IV is distinct, but stages I – III have limited differentiation and notable overlap. The use of TNM stages for colorectal cancer prognostication may be misleading for socioeconomically disadvantaged individuals. Factors beyond TNM should be considered for better prognostication in this population.

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