Colon Cancer In Clinical Practice Research Articles

Identifying important microbial biomarkers for the diagnosis of colon cancer using a random forest approach

Colon cancer is one of the most common cancers, with 30–50 % of patients returning or metastasizing within 5 years of treatment. Increasingly, researchers have highlighted the influence of microbes on cancer malignant activity, while no studies have explored the relationship between colon cancer and the microbes in tumors. Here, we used tissue and blood samples from 67 colon cancer patients to identify pathogenic microorganisms associated with the diagnosis and prediction of colon cancer and evaluate the predictive performance of each pathogenic marker and its combination based on the next-generation sequencing data by using random forest algorithms. The results showed that we constructed a database of 13,187 pathogenic microorganisms associated with human disease and identified 2 pathogenic microorganisms (Synthetic.construct_32630 and Dicrocoelium.dendriticum_57078) associated with colon cancer diagnosis, and the constructed diagnostic prediction model performed well for tumor tissue samples and blood samples. In summary, for the first time, we provide new molecular markers for the diagnosis of colon cancer based on the expression of pathogenic microorganisms in order to provide a reference for improving the effective screening rate of colon cancer in clinical practice and ameliorating the personalized treatment of colon cancer patients.

Czy ocena jakości życia w przerzutowym raku jelita grubego w praktyce klinicznej ma sens? Głos w dyskusji

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Adamowicz K. Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion. Psychoonkologia. 2018;22(2):63-67. doi:10.5114/pson.2018.81153. APA Adamowicz, K. (2018). Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion. Psychoonkologia, 22(2), 63-67. https://doi.org/10.5114/pson.2018.81153 Chicago Adamowicz, Krzysztof. 2018. "Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion". Psychoonkologia 22 (2): 63-67. doi:10.5114/pson.2018.81153. Harvard Adamowicz, K. (2018). Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion. Psychoonkologia, 22(2), pp.63-67. https://doi.org/10.5114/pson.2018.81153 MLA Adamowicz, Krzysztof. "Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion." Psychoonkologia, vol. 22, no. 2, 2018, pp. 63-67. doi:10.5114/pson.2018.81153. Vancouver Adamowicz K. Does the assessment of the quality of life in metastatic colon cancer in clinical practice make sense? Voice for discussion. Psychoonkologia. 2018;22(2):63-67. doi:10.5114/pson.2018.81153.

Localization of the primary tumor of the colon: аre there essential differences?

Colon cancer is a heterogenous disease with each subtype having a distinct clinical picture and, consequently, different prognosis. Therefore, the tumors can be classified according to their localization: as emerging from the left or right side of the colon. The proximal and distal colon have different embryogenesis which determines the boundary between the right and left colon at the level of the distal margin of the middle third of the colon. In literature, there’s enough data to consider other differences apart from embryogenesis. Right- and left-side colon tumors differ epidemiologically, clinically and pathomorphologically, molecularly and genetically. This, presumably, explains differences in screening, prevention, and treatment of these tumors. The objective of this review is to analyze differences between colon tumors with different localizations and to determine if such subdivision of colon cancer in clinical practice affects treatment and prevention approaches.

Impact of the 12-Gene Colon Cancer Assay on Clinical Decision Making for Adjuvant Therapy in Stage II Colon Cancer Patients

ObjectivesTo evaluate the impact of the 12-gene Colon Cancer Recurrence Score Assay—a clinically validated prognosticator in stage II colon cancer after surgical resection—on adjuvant treatment decisions in T3 mismatch repair proficient (MMR-P) stage II colon cancer in clinical practice. MethodsThis retrospective analysis included all patients with T3 MMR-P stage II colon cancer (Clalit Health Services members) with Recurrence Score results (time frame January 2011 to May 2012). Treatment recommendations pretesting were compared with the treatments received. Changes were categorized as decreased (to observation alone/removing oxaliplatin from the therapy) or increased (from observation alone/adding oxaliplatin to the therapy) intensity. ResultsThe analysis included 269 patients; 58%, 32%, and 10% of the values were in the low (<30), intermediate (30–40), and high (≥41) score groups, respectively. In 102 patients (38%), treatment changed post-testing (decreased/increased intensity 76/26 patients). The overall impact was decreased chemotherapy use (45.0% to 27.9%; P < 0.001). Treatment changes occurred in all score groups, but more frequently in the high (change rate 63.0%; 95% confidence interval [CI] 42.3%–80.6%) than in the intermediate (30.6%; 95% CI 21.0%–41.5%) and low (37.6%; 95% CI 30.0%–45.7%) score groups. The direction of the change was consistent with the assay result, with increased intensity more common in higher score values and decreased intensity more common in lower score values. ConclusionsTesting significantly affected adjuvant treatment in T3 MMR-P stage II colon cancer in clinical practice. The study is limited by its design, which compared treatment recommendations pretesting to actual treatments received post-testing, lack of a control group, and nonassessment of confounding factors that may have affected treatment decisions.

Oxaliplatin/5-fluorouracil-based adjuvant chemotherapy as a standard of care for colon cancer in clinical practice: Outcomes of the ACCElox registry.

The ACCElox registry was set up to assess therapeutic management of early-stage colon cancer with oxaliplatin/5-fluorouracil (5-FU)-based regimen and the duration of adjuvant chemotherapy in current clinical practice. This prospective observational study was conducted between 2006 and 2008 in 19 countries on 1548 newly diagnosed patients with stage II/III colon cancer, who had complete resection of the primary tumor and treated with at least one dose of oxaliplatin. The patient/disease characteristics, dose intensity, toxicity management, treatment delay and duration of disease-free survival (DFS)/relapse were assessed. About 73 and 27% of the patients were diagnosed with stage III (Dukes C) and stage II (Dukes B2) colon cancer, respectively. Overall, 74.4% patients completed the prescribed chemotherapy (FOLFOX 88%) and 97.6% patients received at least two cycles of oxaliplatin chemotherapy. The median actual dose intensity of oxaliplatin per cycle was 85 mg/m(2) . Relapse within 3 years occurred in 18.4% of patients with similar rate in all three groups (FOLFOX - 18.1%, FLOX - 19%, XELOX - 18.6%). At 3 years follow-up only 72 deaths were reported. The most common adverse events (AEs) at any cycle were neutropenia (63.9%), thrombocytopenia (23.3%), diarrhea (9.7%), sensory neuropathy (4.5%) and infection (2.6%). Disorders of central and peripheral nervous systems were frequently reported AEs at 6 months (54.3%, grade ≥1) and 12 months (36.4%, grade ≥1) of follow-up. Majority of the patients completed the prescribed oxaliplatin/5-FU regimen. There was no significant difference in the DFS among these regimens. Our results confirm the favorable benefit/risk profile of oxaliplatin/5-FU-based regimens in this setting in clinical practice.

Expression and significance of chemokine receptor CXC chemokine receptor-5 and its ligand CXCL13 in colon cancer

Objective To investigate the correlation between CXC chemokine receptor-5 (CXCR5)-CXCL13 expression and clinicopathological features in colorectal carcinoma.Methods The real-time transcription polymerase chain reaction (Real-time PCR) technique was used to examine mRNA expression of CXCR5 and CXCL13 in 25 paired specimens of colorectal cancer and tissues adjacent carcinoma and 13 samples of colorecal adenoma.The immunohistochemistry staining method was used to detect the protein expression of CXCR5 and CXCL13 in 153 paired specimens of colorectal cancer and tissues adjacent carcinoma and 62 samples of colorecal adenoma.Results The mRNA and protein levels of CXCR5-CXCL13 in colorectal cancer were up-regulated than tissues adjacent carcinoma and adenoma (P ＜ 0.05).The mRNA and protein levels of CXCR5-CXCL13 in colorectal cancer correlated positively (PCR:r =0.681,P ＜ 0.01 ; IHC:r =0.196,P ＜ 0.05).The positive stain of CXCR5-CXCLI3 correlated with lymph node involved,metastasis,higher TNM stage and relapse (P ＜ 0.05).Additionally,CXCL13 positive staining correlated with poor differentiation (P ＜ 0.05).By Kaplan-Merie' s analysis,CXCR5-CXCL13 positive staining favored poor prognosis parameters,such as 5-year relapse rate (CXCR5:48.6％ vs.14.8％,CXCL13:41.5％ vs.22.7％),5-year survival rate (CXCR5:55.6％ vs.91.4％,CXCL13:61.5％ vs.84.1％),the median disease free time [CXCR5:(13.0 ± 1.3) months vs.(45.0 ± 7.8) months,CXCL13:(13.0 ± 1.3) months vs.(29.0 ± 11.2) months] and the median survival time [CXCR5:(17.0 ± 1.1) months vs.(55.0 ± 14.4) months,CXCL13:(17.0 ± 1.9) months vs.(25.0 ± 11.2)months] (P ＜0.05).Conclusion CXCR5 and CXCL13 may play a crucial role in carcinogenesis,development,metastasis and relapse of colon cancer.It can be used as prognostic markers of colon cancer in clinical practice. Key words: CXC chemokine receptor-5; CXCL13; Colorectal cancer; Metastasis; Prognosis

Uptake of adjuvant chemotherapy (AC) for colon cancer in older and younger patients (pts) in the Irish population.

e14515 Background: The use of AC in older patients with colon cancer in clinical practice is uncertain. We examined uptake of AC and it’s impact on survival in older pts with stage II and III colon cancer in a national cohort. Methods: Using the National cancer Registry of Ireland, 3,486 pts with stage II and III colon cancer treated with curative resection from 2004-2009 were identified. Clinopathological features and AC use were compared between those ≥70 yrs and those &lt; 70 yrs. Data from a single institution were reviewed to determine drivers of treatment decisions. Results: 2,026 pts with stage II disease were identified, 60% ≥ 70 yrs. AC was utilized in 10% and 40% of ≥ 70 and &lt;70 yrs, respectively (p&lt;0.0001). A benefit for AC over observation was seen in older [HR 0.36; p &lt;0.0001] and younger pts [HR 0.43; p&lt;0.0004]. Of 46 stage II pts from a single institution there were no significant differences between ≥ 70yrs (n=26) and &lt;70yrs (n=23) in terms of ECOG PS, Charlson comorbidity scores (CCI), tumor grade, T3/T4 disease, R0/R1 resections, obstruction/perforation, lymphovascular invasion or nodal yield. However, only 12% ≥ 70yrs received AC compared to 57% of &lt;70yrs (p=0.0002). Of 1,460 pts with stage III disease, 51% were ≥ 70 yrs. 34% of older and 83% of younger pts received AC (p&lt;0.0001). A benefit from AC compared to observation was seen in pts ≥ 70yrs [HR 0.30; p &lt;0.0001] and &lt;70yrs [HR 0.22; p&lt;0.0001]. Of 65 stage III pts from the single institution there were no differences in CCI, ECOG PS, tumor grade, R0/R1 resections between &gt;70yrs (n=20) and &lt;70yrs (n=45). There was a difference in those receiving AC: 75% ≥ 70yrs compared to 96% &lt;70yrs (p=0.02). Conclusions: Adoption of AC is associated with a survival benefit in older pts (age ≥ 70 yrs), however, is still underutilized in clinical practice. Age impacts the decision to treat in our cohort.

5-aminosalicylic acid is an attractive candidate agent for chemoprevention of colon cancer in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) is classically subdivided into ulcerative colitis (UC) and Crohn's disease (CD). Patients with IBD have increased risk for colorectal cancer. Because the pathogenesis of colorectal carcinoma has not been entirely defined yet and there is no ideal treatment for colon cancer, cancer prevention has become increasingly important in patients with IBD. The two adopted methods to prevent the development of colon cancer in clinical practice include the prophylactic colectomy and colonoscopic surveillance. But patients and physicians seldom accept colectomy as a routine preventive method and most patients do not undergo appropriate colonoscopic surveillance. Chemoprevention refers to the use of natural or synthetic chemical agents to reverse, suppress, or to delay the process of carcinogenesis. Chemoprevention is a particularly useful method in the management of patients at high risk for the development of specific cancers based on inborn genetic susceptibility, the presence of cancer-associated disease, or other known risk factors. Prevention of colorectal cancer by administration of chemopreventive agents is one of the most promising options for IBD patients who are at increased risks of the disease. The chemopreventive efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) against intestinal tumors has been well established. But with reports that NSAIDs aggravated the symptoms of colitis, their sustained use for the purpose of cancer chemoprevention has been relatively contraindicated in IBD patients. Another hopeful candidate chemoprevention drug for IBD patients is 5-aminosalicylic acid (5-ASA), which is well tolerated by most patients and has limited systemic adverse effects, and no gastrointestinal toxicity. 5-ASA lacks the well-known side effects of long-term NSAIDs use. Retrospective correlative studies have suggested that the long-term use of 5-ASA in IBD patients may significantly reduce the risk of development of colorectal cancer. According to the literature, this agent might well satisfy clinical expectations with respect to a safe and effective chemopreventive agent.