Gastrointestinal: Sarcomatoid carcinoma of the colon, a rare and highly aggressive tumor subtype

Luca-Johnson, Javier De; Zenali, Maryam

doi:10.1111/jgh.13160

Cited by 7 publications

(6 citation statements)

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“…In the subgroup analyses of initial hemostasis, we found that, even when TC-325 was used as rescue therapy, there was a high rate of success in terms of the initial hemostasis. Application of TC-325 has produced favorable results in cases of uncontrolled bleeding after standard therapies, bleeding in hard-to-reach locations, bleeding caused by large ulcers, bleeding caused by tumors, large bleeding surfaces, and bleeding in other problematic situations 22 33 37 43 44 57 59 62 65 72 73 74 . In additional analyses, we observed a similar (92.3 %) success rate in patients on anticoagulation therapy.…”

Section: Discussionmentioning

confidence: 99%

Use of hemostatic powder in treatment of upper gastrointestinal bleeding: a systematic review and meta-analysis

et al. 2019

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Background and study aims TC-325 is a novel mineral hemostatic powder that creates a mechanical barrier by absorbing blood components and promoting clotting. Recently approved for use in humans, it has shown promise for treatment of upper gastrointestinal bleeding (UGIB). However, because there have been no large studies of TC-325, its true efficacy and safety profile remain unknown. We performed a systematic review and meta-analysis to determine the safety and efficacy of TC-325 in treating UGIB, based on rates of initial hemostasis, rebleeding, and adverse events (AEs). Methods We searched the MEDLINE/PubMed, EMBASE, CENTRAL, Latin-American and Caribbean Health Sciences Literature databases, as well as the gray literature, to identify articles describing use of TC-325 up to October 2018. Primary outcomes were initial hemostasis and rebleeding. AEs were described as a secondary outcome. Risk of bias was assessed with international scores. Results We identified 2077 records after removal of duplicates. We included 50 studies, involving a collective total of 1445 patients, in the quantitative synthesis. Primary hemostasis and rebleeding rates were 90.7 % and 26.1 %, respectively. Subgroup analyses showed similar results. Only eight AEs were reported. Conclusions TC-325 appears to be a safe, effective treatment for UGIB. The overall rate of initial hemostasis after TC-325 use is high, regardless of etiology of bleeding or whether TC-325 is used as a primary or rescue therapy. Although it is also associated with high rebleeding rates, rates of AEs and equipment failure after TC-325 use are extremely low.

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Section: Discussionmentioning

confidence: 99%

Use of hemostatic powder in treatment of upper gastrointestinal bleeding: a systematic review and meta-analysis

et al. 2019

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“…Spindle cell carcinoma (SpCC) (alternatively named mesenchymal or sarcomatoid carcinoma) is a rare variant of CRC, with less than 20 cases reported up to now [98,99,100].…”

Section: Spindle Cell Carcinoma (Spcc)mentioning

confidence: 99%

“…SpCC has mean age at presentation similar to that of conventional CRC with no gender predilection [98,99,100].…”

Section: Spindle Cell Carcinoma (Spcc)mentioning

confidence: 99%

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Morphology and Molecular Features of Rare Colorectal Carcinoma Histotypes

Remo¹,

Fassan

Vanoli

et al. 2019

Cancers

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Several histopathological variants of colorectal carcinoma can be distinguished, some associated with specific molecular profiles. However, in routine practice, ninety/ninety-five percent of all large bowel tumors are diagnosed as conventional adenocarcinoma, even though they are a heterogeneous group including rare histotypes, which are often under-recognized. Indeed, colorectal cancer exhibits differences in incidence, location of tumor, pathogenesis, molecular pathways and outcome depending on histotype. The aim is therefore to review the morphological and molecular features of these rare variants of intestinal carcinomas which may hold the key to differences in prognosis and treatment.

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“…Carcinoma with sarcomatoid components is extremely rare, with ~50 reported cases 4–53 and one National Cancer Database search 54 previously published in the literature, the former exclusively as single-case reports. These publications usually employed the term “carcinosarcoma” or “sarcomatoid carcinoma,” with the specific term “carcinoma with sarcomatoid components” not used in the literature before the 2019 publication of the latest WHO classification.…”

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confidence: 99%

Colorectal Carcinoma With Sarcomatoid Components

Golconda,

McHugh,

Allende

et al. 2023

American Journal of Surgical Pathology

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Colorectal carcinoma with sarcomatoid components (which includes so-called carcinosarcomas and sarcomatoid carcinomas) is a rare subtype with 50 reported cases in the literature and overlapping criteria with undifferentiated carcinoma. We collected and described 15 cases from 10 men and 5 women, with a mean age of 66 years. Symptoms included abdominal pain and gastrointestinal bleeding. Most tumors presented in the rectosigmoid region, with a mean size of 8.2 cm. The sarcomatoid component, on average, represented 58% of the tumors and took many forms, including spindled (10 cases), anaplastic (9 cases), and rhabdoid (3 cases); one case showed osteoid matrix. Tumor budding was usually high, and tumor-infiltrating lymphocytes were usually low. The sarcomatoid component was keratin-positive in 10 cases. One case showed loss of mismatch repair protein expression, and 2 cases showed SMARCA4 loss (1 also with SMARCA2 loss). Molecular testing identified mutations in KRAS (n=1), NRAS (n=2), BRAF (n=2), APC (n=1), and TP53 (n=1) in a few cases. Tumors often presented at advanced stage, with 11 cases pT4, 9 cases with nodal metastases, and 7 cases with distant metastases. Follow-up was available for 10 cases (median: 2 months), with 2 alive without disease, 3 alive with disease, and 5 dead. Our findings roughly corresponded with those in previously reported cases. Colorectal carcinoma with sarcomatoid components is rare and aggressive, with a poor prognosis for many patients. We suggest that spindled cells, anaplasia, heterologous elements, and/or a component with definable sarcomatous lineage be used to distinguish colorectal carcinoma with sarcomatoid components from undifferentiated carcinoma.

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Gastrointestinal: Sarcomatoid carcinoma of the colon, a rare and highly aggressive tumor subtype

Cited by 7 publications

References 0 publications

Use of hemostatic powder in treatment of upper gastrointestinal bleeding: a systematic review and meta-analysis

Use of hemostatic powder in treatment of upper gastrointestinal bleeding: a systematic review and meta-analysis

Morphology and Molecular Features of Rare Colorectal Carcinoma Histotypes

Colorectal Carcinoma With Sarcomatoid Components

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