Sex-related differences in primary metastatic site in rectal cancer; associated with hemodynamic factors?

Abstract

Background and purposeWe investigated how features relating to pelvic cavity anatomy and tumor hemodynamic factors may influence systemic failure in rectal cancer.Materials and methodsRectal cancer patients (207 women, 343 men), who had been prospectively enrolled onto six cohorts and given curative-intent therapy, were analyzed for the first metastatic event. In one of the cohorts, the diameter of the inferior mesenteric vein (IMV) was assessed on diagnostic abdominal computed tomography images (n = 113). Tumor volume (n = 193) and histologic response to neoadjuvant therapy (n = 445) were recorded from diagnostic magnetic resonance images and surgical specimens, respectively.ResultsMore women than men developed lung metastasis (p = 0.037), while the opposite was the case for liver metastasis (p = 0.040). Wider IMV diameter correlated with larger tumor volume (r = 0.481, p < 0.001) and male sex (p < 0.001). Female sex was the only adverse prognostic factor for lung metastasis. When sex, tumor volume, and histologic response were taken into consideration, poor tumor response remained the only determinant for liver metastasis (p = 0.002).ConclusionsIn a diverse rectal cancer population given curative-intent treatment, women and men had different outcome with regard to the primary metastatic site. Tumor hemodynamic factors should be considered in rectal cancer risk stratification.

Sex disparities in vitamin D status and the impact on systemic inflammation and survival in rectal cancer

“…Interestingly, CXCL7 has been proposed as a circulating biomarker for CRC detection [ 46 ]. With regard to vascular processes, we recently showed that hemodynamic factors of the rectal cancer differ and result in distinctive outcomes in men and women [ 47 , 48 ]. In our previous vitamin D study, a weak inverse correlation between circulating 25(OH) D and SIR markers appeared in all patients analyzed together [ 13 ]—it might be that stronger and more distinct modes of systemic inflammation with respect to the vitamin D status had been revealed if male and female patients had been analyzed separately.…”

Sex Disparities in Vitamin D Status and the Impact on Systemic Inflammation and Survival in Rectal Cancer

“…Interestingly, CXCL7 has been proposed as a circulating biomarker for CRC detection [46]. With regard to vascular processes, we recently showed that hemodynamic factors of the rectal cancer differ and result in distinctive outcomes in men and women [47,48]. In our previous vitamin D study, a weak inverse correlation between circulating 25(OH) D and SIR markers appeared in all patients analyzed together [13]-it might be that stronger and more distinct modes of systemic inflammation with respect to the vitamin D status had been revealed if male and female patients had been analyzed separately.…”

The circulating soluble form of the CD40 costimulatory immune checkpoint receptor and liver metastasis risk in rectal cancer

“…The patient cohorts with demographic data have been detailed in full previously. 19 Briefly, the IC (NCT01816607) consisted of 122 stage I-III patients with a mean age of 64 years, enrolled at Akershus University Hospital (Lørenskog, Norway) between October 28th, 2013 and December 17th, 2017, and was censored on January 2nd, 2020. The study was designed as a prospective biomarker study for patients enrolled according to unselected recruitment.…”

“…The VC1 was used because 35.4% of the 79 cases had organ-invasive (T4) disease that is at particularly high risk of poor outcome. 18 The VC2 was chosen because 49.6% of the 135 cases had low primary tumour (5 cm or less from the anal verge) with the specific risk of developing lung metastases 19 and therefore might challenge our hypothesis. The VC3 was analysed because its 59 cases resembled those of VC1.…”