scholarly journals Role of random biopsies in surveillance of dysplasia in ulcerative colitis patients with high risk of colorectal cancer

2016 ◽  
Vol 14 (3) ◽  
pp. 264 ◽  
Author(s):  
Sawan Bopanna ◽  
Maitreyee Roy ◽  
Prasenjit Das ◽  
S Dattagupta ◽  
V Sreenivas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
High Risk

scholarly journals Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer

2020 ◽  
Author(s):  
Xiaobin Zheng ◽  
Jinhee Hur ◽  
Long H Nguyen ◽  
Jie Liu ◽  
Mingyang Song ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Diet Quality ◽  
Early Onset ◽  
Strong Support ◽  
Healthy Eating Index ◽  
Malignant Potential ◽  
Poor Diet ◽  
Increased Risk

Abstract Background The role of poor diet quality in the rising incidence of colorectal cancer (CRC) diagnosed under age 50 has not been explored. Based on molecular features of early-onset CRC, early-onset adenomas are emerging surrogate endpoints. Methods In a prospective cohort study (Nurses’ Health Study II), we evaluated two empirical dietary patterns (Western and prudent) and three recommendation-based indexes (Dietary Approaches to Stop Hypertension [DASH], Alternative Mediterranean Diet [AMED], and Alternative Healthy Eating Index [AHEI]-2010) with risk of early-onset adenoma overall and by malignant potential (high-risk: ≥1 cm, tubulovillous/villous histology, high-grade dysplasia, or ≥ 3 adenomas), among 29474 women with ≥1 lower endoscopy before age 50 (1991-2011). Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results We documented 1157 early-onset adenomas with 375 of high-risk. Western diet was positively, whereas prudent diet, DASH, AMED, and AHEI-2010 were inversely associated with risk of early-onset adenoma. The associations were largely confined to high-risk adenomas (OR [95% CI] for the highest versus lowest quintile: Western = 1.67 [1.18 to 2.37]; prudent = 0.69 [0.48 to 0.98]; DASH = 0.65 [0.45 to 0.93]; AMED = 0.55 [0.38 to 0.79]; AHEI-2010 = 0.71 [0.51 to 1.01]; all P  trend≤.03), driven by those identified in the distal colon and rectum (all P  trend≤.04 except AMED: Ptrend=.14). Conclusion Poor diet quality was associated with an increased risk of early-onset distal and rectal adenomas of high malignant potential. These findings provide preliminary but strong support to the role of diet in early-onset CRC.

scholarly journals 934 – A National Database Study on Colectomy and Colorectal Cancer in Ulcerative Colitis: What is the Role of Appendectomy?

2019 ◽  
Vol 156 (6) ◽  
pp. S-1419-S-1420
Author(s):  
Merel E. Stellingwerf ◽  
Willem A. Bemelman ◽  
Geert R. D'Haens ◽  
Cyriel Ponsioen ◽  
Christianne J. Buskens
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
National Database ◽  
Database Study

The role of FKBP51 in the prognosis of ulcerative colitis-associated colorectal cancer

2021 ◽  
Vol 66 (1) ◽  
pp. 89-97
Author(s):  
Zhixiu Xia ◽  
Guohua Zhang ◽  
Changliang Wang ◽  
Yong Feng
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis

scholarly journals Motion - Colonoscopic Surveillance is more Cost Effective than Colectomy in Patients with Ulcerative Colitis: Arguments Against the Motion

2003 ◽  
Vol 17 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Anders Ekbom
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
High Risk ◽  
Positive Family History ◽  
Case Series ◽  
Good Alternative ◽  
Surveillance Colonoscopy ◽  
Colonoscopic Surveillance ◽  
Prophylactic Colectomy ◽  
Surveillance Programs

There are insufficient data upon which to base recommendations about surveillance colonoscopy and prophylactic colectomy for the prevention of colorectal cancer in patients with ulcerative colitis. Case series, analyses of intermediate results and extrapolations from other patient groups do not constitute reliable evidence. Available studies are susceptible to several biases: the ’healthy worker’ effect, surveillance bias and selection bias. Patients who are enrolled in surveillance programs are more likely to be thoroughly evaluated beforehand, are more likely to be given a diagnosis of dysplasia or neoplasm even when asymptomatic and are more likely to comply with medical treatment, including maintenance anti-inflammatory medication. Comparisons of the rates of neoplasia or death between surveyed and nonsurveyed patients are, therefore, of questionable validity. Prophylactic colectomy, unlike surveillance colonoscopy, prevents death from colorectal cancer. Moreover, it is difficult to keep patients in surveillance programs, and those who withdraw from programs appear to be at high risk of developing cancer. Prophylactic colectomy should be strongly considered for patients with dysplasia, sclerosing cholangitis, longstanding pancolitis (especially if it began early in life) or a positive family history of colorectal cancer. This procedure is underused in clinical practice and is a good alternative to colonoscopic surveillance in high risk patients.

scholarly journals A Panel of Methylated MicroRNA Biomarkers for Identifying High-Risk Patients With Ulcerative Colitis-Associated Colorectal Cancer

2017 ◽  
Vol 153 (6) ◽  
pp. 1634-1646.e8 ◽  
Author(s):  
Yuji Toiyama ◽  
Yoshinaga Okugawa ◽  
Koji Tanaka ◽  
Toshimitsu Araki ◽  
Keiichi Uchida ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Human Papillomaviruses and Epstein–Barr Virus Interactions in Colorectal Cancer: A Brief Review

Pathogens ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 300 ◽  
Author(s):  
Queenie Fernandes ◽  
Ishita Gupta ◽  
Semir Vranic ◽  
Ala-Eddin Al Moustafa
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Cancer Progression ◽  
Epstein Barr Virus ◽  
Human Papillomaviruses ◽  
Colorectal Carcinogenesis ◽  
Mesenchymal Transition ◽  
Barr Virus ◽  
Epstein Barr

Human papillomaviruses (HPVs) and the Epstein–Barr virus (EBV) are the most common oncoviruses, contributing to approximately 10%–15% of all malignancies. Oncoproteins of high-risk HPVs (E5 and E6/E7), as well as EBV (LMP1, LMP2A and EBNA1), play a principal role in the onset and progression of several human carcinomas, including head and neck, cervical and colorectal. Oncoproteins of high-risk HPVs and EBV can cooperate to initiate and/or enhance epithelial-mesenchymal transition (EMT) events, which represents one of the hallmarks of cancer progression and metastasis. Although the role of these oncoviruses in several cancers is well established, their role in the pathogenesis of colorectal cancer is still nascent. This review presents an overview of the most recent advances related to the presence and role of high-risk HPVs and EBV in colorectal cancer, with an emphasis on their cooperation in colorectal carcinogenesis.

scholarly journals Dysplasia in Ulcerative Colitis

1990 ◽  
Vol 4 (7) ◽  
pp. 378-383 ◽  
Author(s):  
RH Riddell
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
High Risk ◽  
Large Bowel ◽  
Small Areas ◽  
Distal Ulcerative Colitis ◽  
High Risk Factors ◽  
Cancerous Lesion ◽  
Multiple Biopsies ◽  
Few Data

Patients at highest risk for developing cancer in ulcerative colitis are those with ‘extensive’ or total involvement of the large bowel who have had the disease for at least seven years. Dysplasia is used as a marker bur has many problems including those of sampling, reproducibility and management. The risk in patients with colitis is unclear particularly in those with left-sided or distal ulcerative colitis. In countries at high risk from colorectal cancer about 4 to 6% of the population can be expected to develop this disease. It is assumed that surveillance will reduce the mortality from colorectal cancer, although the evidence that this is happening is very limited. Cancers which are resected but from which the patient survives are an acceptable outcome, although less so in theory, as survival is to a certain extent fortuitous. Many surveillance studies include patients who have both developed and died from carcinoma. Surveillance also assumes that cancers can be detected before they have become lethal, or that a marker such as the presence of dysplasia precedes all carcinomas for a long enough period of time to be detectable. Considerable question has been raised as to whether dysplasia is both endoscopically detectable and morphologically identifiable. Surveillance is based on the principle that carcinoma arises from a cancerous lesion, and that the identification of dysplasia and excision of the large bowel in these patients prevents subsequent death from disseminated carcinoma. Conversely, patients with quiescent disease and no dysplasia could be followed and not subjected to unnecessary colectomy. There is currently no ‘best’ way of managing patients with colitis who are at risk for developing carcinoma. Routine follow-up of patients relies heavily on colonoscopy with multiple biopsies. Controversy continues regarding the management of dysplastic biopsies because there are relatively few data regarding the likelihood of an underlying invasive carcinoma on which to base a rational decision. The notion that all patients must be managed on an individual basis, guarantees that data remain difficult to obtain. The presence of a dysplasia-associated lesion or mass are high risk factors for carcinoma. Dysplasia is frequently confined to small areas of the mucosa causing major sampling problems for the endoscopist both in detection and if confirmation by re-endoscopy is proposed. The finding of aneuploidy as a marker for both dysplasia and carcinoma may prove useful in the detection of patients at greatest risk.

Role of the oncological-multidimensional prognostic index in older patients with metastatic colorectal cancer treated in a real-world setting.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11552-11552
Author(s):  
Letizia Procaccio ◽  
Antonella Brunello ◽  
Pasquale Fiduccia ◽  
Annunziata Lettiero ◽  
Giuseppina Tierno ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Geriatric Assessment ◽  
Real World ◽  
Prognostic Index ◽  
Risk Scores ◽  
Real World Setting ◽  
Significant Difference ◽  
Ecog Ps

11552 Background: About 50% of diagnoses of colorectal cancer (CRC) occur in patients (pts) older than 70 years. Though a comprehensive geriatric assessment (CGA) is recommended for proper management of older cancer pts, there is still no consensus on the best form of geriatric assessment. We investigated possible prognostic factors in elderly metastatic (m)CRC pts in a real-world setting, focusing on the role of the oncological-multidimensional prognostic index (onco-MPI). Methods: Pts aged ≥ 70 years with mCRC referred to the Medical Oncology 1 Unit from May 2010 to May 2017 were assessed by a multidisciplinary team and received a basal CGA. Onco-MPI was calculated by a validated algorithm as a weighted linear combination of the CGA domains, as previously described. The following 3 different prognostic groups were identified: low (scores 0.0-0.46), medium (scores 0.47-0.63) and high risk (scores 0.64-1.0). Results: A total of 206 mCRC pts were included, 123 males. Mean age was 76.1 years (69.2-90.8). ECOG PS was < 2 in 90% and mini-mental state examination was ≥ 24 in 85% of pts. Primary tumor was located in rectum, left and right side in 18%, 42% and 40% of pts, respectively. RAS and BRAF mutations were detected in 44% and 9% of pts, respectively. According to onco-MPI score, 32%, 39% and 28% of cases were low, medium and high risk, respectively. According to CGA as per Balducci’s criteria, 56% of pts were classified as fit, 31% vulnerable and 13% frail. Median overall survival (OS) was 26 months (95% CI 19.7-32.4). The following factors were significantly associated with OS: ECOG PS (0-1 vs > 1, 31% vs 15%, p = 0.004); onco-MPI score (low vs medium vs high risk, 29% vs 38% vs 19%, p = 0.005), treatment (monotherapy vs doublet vs triplet, 20% vs 31% vs 30%, p = 0.01). No significant difference in OS was observed in CGA-based groups (p = 0.15). In high onco-MPI score, doublet-regimen correlated with higher OS compared to monotherapy (79% vs 51%, p = 0,03). Conclusions: Onco-MPI emerged as a significant prognosticator in mCRC elderly pts. It may be useful in daily clinical practice for driving decision-making in this age group. Thanks to its marked standardization it may be also applied in clinical trials.

scholarly journals Real world data on adjuvant chemotherapy for high-risk stage II colorectal cancer: The role of tumour side

2019 ◽  
Vol 30 ◽  
pp. v211-v212
Author(s):  
C S Araujo de Carvalho ◽  
C.M.V. Moniz ◽  
G.Y. Watarai ◽  
J.A.R. Crespo ◽  
P V D S Nogueira ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Real World ◽  
Stage Ii ◽  
Real World Data ◽  
World Data ◽  
Stage Ii Colorectal Cancer

Role of Adjuvant Therapy After Resection of Colorectal Cancer Liver Metastases

2010 ◽  
Vol 28 (13) ◽  
pp. 2300-2309 ◽  
Author(s):  
Derek G. Power ◽  
Nancy E. Kemeny
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Liver Metastases ◽  
Metastatic Colorectal Cancer ◽  
Adjuvant Treatment ◽  
Systemic Chemotherapy ◽  
Perioperative Therapy

Liver resection is the goal of treatment strategies for liver-confined metastatic colorectal cancer. However, after resection the majority of patients will experience recurrence. Chemotherapy seems to improve outcomes compared with surgery alone. We reviewed the data of the role of adjuvant chemotherapy after resection of liver- confined metastatic colorectal cancer. Optimal regimens and sequencing of chemotherapies when liver resection is an option are unclear. Some suggest that resectable liver metastases, in the absence of high-risk features, should begin with surgery and consideration given to adjuvant chemotherapy after surgery. If high-risk features are present, most physicians prefer a short course of systemic preoperative chemotherapy. Perioperative therapy and regional therapy with hepatic arterial infusion (HAI) both increase disease-free survival (DFS) when compared with surgery alone. In unresectable disease, consideration should be given to systemic chemotherapy with or without a biologic agent or HAI with systemic therapy. If the disease becomes resectable, adjuvant treatment should follow surgery. Adjuvant chemotherapy is usually FOLFOX, but HAI combined with systemic chemotherapy is also an option. The role of adjuvant treatment post-liver resection should not be viewed in isolation but rather in the context of prior treatment, surgical preference, and individual patient characteristics. Perioperative therapy and regional therapy have both shown an increase in DFS. Conducting randomized trials examining the role of adjuvant chemotherapy has been difficult because of rapidly changing chemotherapies.

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