Clinical Features and Outcome of Sporadic Colorectal Carcinoma in Young Patients: A Cross-Sectional Analysis from a Developing Country

Zahir, Muhammad Nauman; Azhar, Eisha Mahpara; Rafiq, Sobia; Ghias, Kulsoom; Shabbir-Moosajee, Munira

doi:10.1155/2014/461570

Cited by 25 publications

(35 citation statements)

References 30 publications

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“…Our study reported a much younger age of presentation. This younger age group preponderance has been reported previously in other hematological and nonhematological malignancies [13][14][15] from our region, consolidating that cancer, in our population, has a predilection for a younger population. The major gastrointestinal toxicities observed were grade III to IV nausea/vomiting, diarrhea, and mucositis.…”

Section: Discussionsupporting

confidence: 84%

Autologous Hematopoietic Stem Cell Transplantation—10 Years of Data From a Developing Country

Ali

Adil

Shaikh

2015

Stem Cells Translational Medicine

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Intensive chemotherapy followed by autologous stem cell transplantation is the treatment of choice for patients with hematological malignancies. The objective of the present study was to evaluate the outcomes of patients with mainly lymphoma and multiple myeloma after autologous stem cell transplant. The pretransplant workup consisted of the complete blood count, an evaluation of the liver, kidney, lung, and infectious profile, chest radiographs, and a dental review. For lymphoma, all patients who achieved at least a 25% reduction in the disease after salvage therapy were included in the study. Mobilization was done with cyclophosphamide, followed by granulocyte colonystimulating factor, 300 mg twice daily. The conditioning regimens included BEAM (carmustine, etoposide, cytarabine, melphalan) and high-dose melphalan. A total of 206 transplants were performed from April 2004 to December 2014. Of these, 137 were allogeneic transplants and 69 were autologous. Of the patients receiving an autologous transplant, 49 were male and 20 were female. Of the 69 patients, 26 underwent transplantation for Hodgkin's lymphoma, 23 for non-Hodgkin's lymphoma, and 15 for multiple myeloma and 4 and 1 for Ewing's sarcoma and neuroblastoma, respectively. The median age 6 SD was 34 6 13.1 years (range, 4-64). A mean of 4.7 3 10 8 6 1.7 mononuclear cells per kilogram were infused. The median time to white blood cell recovery was 18.2 6 5.34 days. Transplant-related mortality occurred in 10 patients. After a median follow-up period of 104 months, the overall survival rate was 86%. High-dose chemotherapy, followed by autologous stem cell transplant, is an effective treatment option for patients with hematological malignancies, allowing further consolidation of response. STEM CELLS TRANSLATIONAL MEDICINE 2015;4:873-877 SIGNIFICANCEThis report presents the results of autologous stem cell transplant in hematological malignancies from a developing country. This is a large cohort from Pakistan, with overall survival comparable to that from international data.

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Section: Discussionsupporting

confidence: 84%

Autologous Hematopoietic Stem Cell Transplantation—10 Years of Data From a Developing Country

Ali

Adil

Shaikh

2015

Stem Cells Translational Medicine

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“…A cross-sectional study by Zahir et al19 also reported a higher prevalence of CRC among young patients in 2004 to 2011. According to their study, 581 patients were reported, among whom 32% were younger than 45 years.…”

Section: Discussionmentioning

confidence: 93%

Red flag symptoms: detailed account of clinicopathological features in young-onset colorectal cancer

2017

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Background/AimsColorectal cancer has long been considered disease of the West, typically occurring in old age; however, the incidence is rising in Asia. The pattern of disease is quite different in Asia, occurring at a younger age and at an advanced stage. Recognition of disease at an early stage is still a challenge for physicians. Few data are available regarding young-onset colorectal cancer in Pakistan. We conducted this study to fill this gap and provide deeper insight into clinical symptoms and histopathological features of young-onset colorectal cancer.MethodsWe collected data regarding clinical features by directly interviewing patients and obtaining histopathological data from hospital records. Patients aged less than 50 years were included in the study. Statistical analysis was performed using IBM SPSS version 20.0.ResultsResults in 105 patients showed mean age at diagnosis was 35.90±9.39, with male predominance; the majority of patients had no family history of colorectal cancer. Most patients had left-sided tumors with advance stage and intermediate grade (grade 2). Mucinous histology was common. Rectal bleeding was the first symptom for left-sided tumors, whereas most of the right-sided lesions presented with sudden obstruction.ConclusionsPainless rectal bleeding in the early thirties should alert physicians to advise appropriate investigation, as the majority of young-onset colorectal cancer patients develop painless bleeding 2 to 3 years before appearance of other symptoms.

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“…Epidemiological data suggested that sporadic CRC was more common in developed countries. Nevertheless the incidence in developing countries was increasing and it had been reported that the incidence of early onset CRC in developing was much higher [32, 33]. Whether HCMV played a role in these phenomena needed explaining by more data and further research.…”

Section: Discussionmentioning

confidence: 99%

Human cytomegalovirus infection and colorectal cancer risk: a meta-analysis

et al. 2016

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Human cytomegalovirus infection (HCMV) has been recently considered as a factor for tumorigenesis. The current study used meta-analytical techniques to explore the prevalence of HCMV in tumor tissues and the relationship between human cytomegalovirus and colorectal cancer (CRC) risk. 11 studies detecting HCMV DNA in tumor tissues were included in meta-analysis. The prevalence rate and odds ratio (OR) were two main parameters. The overall prevalence of human cytomegalovirus DNA in tumor tissues were 27.5% (95% CI = 17.2%−37.8%). Binary logistic regression showed that the studies reported before 2010 involving formalin-fixed specimens from patients in developed region represented a lower proportion of HCMV. The tumor tissues had a significantly higher rate of virus infection compared with normal tissues (OR = 6.59, 95% CI = 4.48−9.69, I2 = 0%, P = 0.71). Subgroup analysis revealed the prevalence of the virus didn't differ in patients with different tumor stages, in tumor cells with different histologic grades, also in different kinds of specimen (polyp and adenocarcinoma). The results of current study suggested a statistically association between the virus infection and an increased risk of colorectal cancer.

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Clinical Features and Outcome of Sporadic Colorectal Carcinoma in Young Patients: A Cross-Sectional Analysis from a Developing Country

Cited by 25 publications

References 30 publications

Autologous Hematopoietic Stem Cell Transplantation—10 Years of Data From a Developing Country

Autologous Hematopoietic Stem Cell Transplantation—10 Years of Data From a Developing Country

Red flag symptoms: detailed account of clinicopathological features in young-onset colorectal cancer

Human cytomegalovirus infection and colorectal cancer risk: a meta-analysis

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