A population-based study of the extent of surgical resection of potentially curable colon cancer

Easson, Alexandra M.; Cotterchio, Michelle; Crosby, Jacqueline A.; Sutherland, Heather J.; Dale, Darlene; Aronson, Melyssa; Holowaty, Eric J.; Gallinger, Steven

doi:10.1007/bf02573873

Cited by 27 publications

(14 citation statements)

References 32 publications

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“…The reasons for such an approach are that a subtotal colectomy may increase stool frequency, and synchronous colon anastomoses do not appear to be associated with an increased risk of complications [42]. Based on the available evidence, it appears that when the patient’s general condition is suitable for undergoing an operation or when the patient is at an increased risk of anastomotic complications, such as in cases of malnourishment, immunosuppression or sepsis, then subtotal colectomy seems a justifiable choice [34,40,42]. In some case reports, the authors treated T1 rectal cancer with SCRCs by transanal endoscopic microsurgery before performing a radical operation for the second lesion [43].…”

Section: Treatment Option and Prognosismentioning

confidence: 99%

“…There is still some controversy on how to best treat synchronous lesions in separate segments. Some authors have suggested that total or subtotal colectomy should be performed [9,14,40,41], because if synchronous lesions are overlooked at the time of surgery, the patient may soon have to undergo repeated surgery and the lesions are likely to have advanced in their pathological stage and to be associated with a poorer prognosis [4]. Some authors have suggested the utility of extensive procedures such as proctocolectomy with J-pouch ileoanal anastomosis, total abdominal colectomy with ileorectal anastomosis, and proctosigmoidectomy with coloanal anastomosis [33].…”

Section: Treatment Option and Prognosismentioning

confidence: 99%

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Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

2011

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Background/Aims: With the development of early diagnostic technologies, more synchronous colorectal cancers (SCRCs) can be clinically detected. Although SCRCs are recognized as a significant clinical entity, their clinical features, diagnosis, treatment, and prognosis have yet to be definitively established. In order to obtain a comprehensive understanding of this disease and to establish an efficient profile by which to recognize individuals at high risk of developing SCRCs, we carried out a review of the relevant literature. Methods: The PubMed database was searched for publications of ‘synchronous colorectal carcinoma/cancer/adenocarcinoma’ and ‘multiple colorectal carcinomas’. All publications up to January 2011 were considered, and then only articles in English were retrieved for inclusion in this review. Results: The incidence of SCRCs was found to be higher in older and male patients. The prognosis in patients with SCRCs was equivalent to that in patients with solitary CRC. The failure to diagnose synchronous lesions before and during the operation was associated with repeated surgery. Conclusion: SCRCs possess distinctive features compared to solitary CRC. While all colorectal patients should be carefully assessed to rule out the presence of concurrent colon adenomas, since missed lesions can result in additional surgery and poor prognosis, particular attention should be given to the high-risk group of older male patients.

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Section: Treatment Option and Prognosismentioning

confidence: 99%

Section: Treatment Option and Prognosismentioning

confidence: 99%

Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

2011

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“…Several studies have suggested that increasing age is an adverse prognostic factor in RCC, with older age associated with higher tumor stage and grade (Denzinger et al , 2007; Verhoest et al , 2007; Karakiewicz et al , 2008; Jung et al , 2009), although others have found that age has little impact on presentation or survival (Doherty et al , 1999; Thompson et al , 2008; Scoll et al , 2009). In general, survival tends to be poorer in older cancer patients (Bouchardy et al , 2003; Petignat et al , 2004; Quaglia et al , 2009; Janssen-Heijnen et al , 2010), reflecting a complex picture of less frequent referral to cancer specialists (Tyldesley et al , 2000; Delva et al , 2011); inadequate treatment (Mor et al , 1985; Earle et al , 2002; Easson et al , 2002; Bouchardy et al , 2003; Houterman et al , 2006; Vulto et al , 2006); and impact of comorbidities (Extermann, 2007), since older patients are at significant risk for multiple comorbidities (e.g., 35% of patients age 65 years or older who are eligible for both US Medicare and Medicaid have ⩾4 comorbidities (Fox and Reichard, 2013)). In addition, aging trends will only exacerbate this issue.…”

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confidence: 99%

Efficacy and safety of sunitinib in elderly patients with metastatic renal cell carcinoma

et al. 2014

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Background:We retrospectively analyzed sunitinib outcome as a function of age in metastatic renal cell carcinoma (mRCC) patients.Methods:Data were pooled from 1059 patients in six trials. Kaplan–Meier estimates of progression-free survival (PFS) and overall survival (OS) were compared by log-rank test between patients aged <70 (n=857; 81%) and ⩾70 (n=202; 19%) years.Results:In first-line patients, median PFS was comparable in younger and older patients, 9.9 vs 11.0 months, respectively (HR, 0.89; 95% CI: 0.73–1.09; P=0.2629), as was median OS, 23.6 vs 25.6 months (HR, 0.93; 95% CI: 0.74–1.18; P=0.5442). Similarly, in cytokine-refractory patients, median PFS was 8.1 vs 8.4 months (HR, 0.79; 95% CI: 0.49–1.28; P=0.3350), while median OS was 20.2 vs 15.8 months (HR, 1.14; 95% CI: 0.73–1.79; P=0.5657). Some treatment-emergent adverse events were significantly less common in younger vs older patients, including fatigue (60% vs 69%), cough (20% vs 29%), peripheral edema (17% vs 27%), anemia (18% vs 25%), decreased appetite (13% vs 29%), and thrombocytopenia (16% vs 25% all P<0.05). Hand–foot syndrome was more common in younger patients (32% vs 24%).Conclusions:Advanced age should not be a deterrent to sunitinib therapy and elderly patients may achieve additional clinical benefit.

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“…The OFCCR did not request proxies to consent, which resulted in systematic exclusion of many patients who died within 1–2 years of diagnosis. The proportion of stage IV disease was 8%, yet one would expect up to 25% 31. Therefore, survival analyses and multivariate modelling was undertaken for stage I–III cases only.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a population‐based approach to familial colorectal cancer

et al. 2017

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As Newfoundland has the highest rate of familial colorectal cancer (CRC) in the world, we started a population‐based clinic to provide colonoscopic and Lynch syndrome (LS) screening recommendations to families of CRC patients based on family risk. Of 1091 incident patients 51% provided a family history. Seventy‐two percent of families were at low or intermediate–low risk of CRC and colonoscopic screening recommendations were provided by letter. Twenty‐eight percent were at high and intermediate–high risk and were referred to the genetic counsellor, but only 30% (N = 48) were interviewed by study end. Colonoscopy was recommended more frequently than every 5 years in 35% of families. Lower family risk was associated with older age of proband but the frequency of screening colonoscopy recommendations varied across all age groups, driven by variability in family history. Twenty‐four percent had a high MMR predict score for a Lynch syndrome mutation, and 23% fulfilled the Provincial Program criteria for LS screening. A population‐based approach in the provision of colonoscopic screening recommendations to families at risk of CRC was limited by the relatively low response rate. A family history first approach to the identification of LS families was inefficient.

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A population-based study of the extent of surgical resection of potentially curable colon cancer

Abstract: Young age, teaching hospital, and multiple cancers but not family history were important factors for performing a TAC-IR.

Cited by 27 publications

References 32 publications

Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

Synchronous Colorectal Cancers: A Review of Clinical Features, Diagnosis, Treatment, and Prognosis

Efficacy and safety of sunitinib in elderly patients with metastatic renal cell carcinoma

Evaluation of a population‐based approach to familial colorectal cancer

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