Surgical resection and survival outcomes in metastatic young adult colorectal cancer patients

Arhin, Nina D.; Shen, Chan; Bailey, Christina E.; Matsuoka, Lea; Hawkins, Alexander T.; Holowatyj, Andreana N.; Ciombor, Kristen K.; Hopkins, Maeve K.; Geiger, Timothy M.; Kam, Audrey E.; Roth, Megan; Lee, Cody Lebeck; LaPelusa, Michael; Dasari, Arvind; Eng, Cathy

doi:10.1002/cam4.3940

Cited by 17 publications

(8 citation statements)

References 39 publications

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“…For those with initially non-resectable metastasis, current guides suggested that systemic chemotherapy should be administrated first to achieve secondary resection 22 . In this study, our analysis suggested that metastasectomy was an independent prognostic factor for survival, which was similar to the results of previous studies 23 , 24 . However, whether metastasectomy should be performed simultaneously with primary cancer or should be delayed remains controversial 25 , 26 .…”

Section: Discussionsupporting

confidence: 92%

Prognostic impact of increased lymph node yield in colorectal cancer patients with synchronous liver metastasis: a population-based retrospective study of the US database and a Chinese registry

Jiao

Guan

Wei

et al. 2023

International Journal of Surgery

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Background: The National Quality Forum has endorsed at least 12 lymph node yield (LNY) as a surgical quality indicator in colorectal cancer (CRC), but the prognostic value of adequate lymphadenectomy has rarely been investigated for CRC patients with distant metastatic disease. Methods: A total of 4575 CRC patients with synchronous liver metastasis who underwent primary tumor resection were identified from a Chinese registry and the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. The Kaplan–Meier methods and Cox regression models were performed to assess the correlations between LNY and 3-year cancer-specific survival (CSS). Propensity score matching were used to confirmed the survival comparison between patients with less than 12 and of at least 12 LNY. Results: The retrieval of at least 12 LNY was identified in most CRC patients (SEER database, 3380/3899, 86.7%; Chinese cohort, 565/676, 83.6%). In both the SEER database and the Chinese cohort, the patients with LNY ≥12 was significantly associated with better CSS compared with patients with LNY <12 before and after propensity score matching, with all P -value less than 0.05. After controlling for the confounders, multivariate analysis demonstrated that LNY was also an independent prognostic factor for patients with distant metastasis in both cohorts. In subgroup analysis, the CSS benefit for patients with LNY ≥12 was observed across most of the subgroups. Conclusions: Clinical feasibility of the 12-node threshold as a guideline quality metric of cancer care for CRC patients is necessary, and an oncologically adequate lymphadenectomy is still a critical component of high-quality surgical standard in CRC patients with distant metastases.

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Section: Discussionsupporting

confidence: 92%

Prognostic impact of increased lymph node yield in colorectal cancer patients with synchronous liver metastasis: a population-based retrospective study of the US database and a Chinese registry

Jiao

Guan

Wei

et al. 2023

International Journal of Surgery

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“…Due to the substantial improvements of multimodal therapies, several metastatic neoplasms can be treated by surgery. For example, resections have been successful to improve the survival of metastatic colorectal carcinoma and neuroendocrine neoplasms in selected patients (24)(25)(26). However, the benefit of surgery for metastatic MiNENs is unknown.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs): A SEER database analysis of 767 cases

et al. 2023

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BackgroundMixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is an extremely rare entity, consisting of neuroendocrine and non-neuroendocrine components. It can occur in various organs throughout the body, with a rising incidence. Its clinical management is a rapidly growing field of interest; however, large-scale patient cohorts are still missing to guide clinical practice.Patients and methodsThe demographic, clinicopathological, and survival information of all patients diagnosed with MiNEN in the national Surveillance, Epidemiology, and End Results (SEER) program database (2000–2017) were extracted and further analyzed. The information of the patients before and after 2010 was compared to understand the epidemiological changes of MiNEN. The characteristics of MiNEN originating in different organs were compared. The clinical significance of surgical resection for metastatic MiNENs was also analyzed.ResultsA total of 1081 patients were screened, and after applying the exclusion criteria, 767 patients were finally analyzed. There was no obvious sex preference (49.2% vs 50.8%, p>0.05) and the majority of the patients were Caucasians (n=627, 81.7%). A total of 88.3% of the patients were older than 50 years old, and the median age was 60 years. 79.3% of the tumors are located in the distal digestive tract, and 67.7% were grade 3/4. Distant metastasis was presented in 33.9% of the patients at diagnosis. A total of 88% of the patients underwent surgical treatments. The number of patients increased 10-fold between 2000 and 2017. There was no significant difference in sex, race, stage, or surgical treatments among the patients diagnosed before and after 2010. More patients older than 60 years were diagnosed after 2010 (p=0.009). The median survival was 61.0 ± 9.8 months for the whole cohort. After multivariate analysis, older age (>60 years, p<0.01), more advanced stage (p<0.01), grade 3/4 (p<0.01), and non-surgical treatment (p<0.01) were independent risk factors for poorer survival. The appendiceal MiNENs showed the best prognosis. A total of 260 metastatic MiNENs were further analyzed. Only patients with metastatic MiNENs originating from the appendix had a potential benefit from surgical resection, compared to other sites (p=0.05).ConclusionThis study provides the epidemiological, clinicopathological, and survival information of the largest number of MiNEN patients. Although MiNEN is an extremely rare malignant neoplasm, its incidence increases rapidly. The majority of the patients suffered from advanced-stage disease, which highlights the need for improvement of early detection in the future. The appendix is the most common primary site of MiNEN, and surgical resection for selected metastatic MiNEN originating in the appendix has favorable survival outcomes.

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“…The study emphasized that colorectal cancer cases should be diagnosed early to perform surgery, which is known to have a significant impact on survival, and in this respect, the importance of regular screening of healthy individuals. In another recent study, Arhin et al 22 examined the relationship between surgical resection and survival outcomes in young patients diagnosed with colorectal cancer and found that resection of both primary tumors and metastases separately increased survival in colorectal cancers independently of all other variables. It was found to increase the duration.…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis of studies investigating the prognostic value of pre-treatment CA 19-9 levels in colorectal cancer cases reported that CA 19-9 level is associated with overall survival and progression-free survival time and can predict mortality. [22][23][24][25] The increase in CA 19-9 level is associated with the formation of tumor cell-induced platelet aggregation, a necessary process that plays a role in distant metastasis of colorectal cancer. It has been reported that CA 19-9 level recorded at diagnosis is a prognostic factor independent of other variables in metastatic colorectal cancers, it can predict bevacizumab efficacy and is associated with KRAS/BRAF mutation status.…”

Section: Discussionmentioning

confidence: 99%

The role of initial sodium and globulin values in the prognosis prediction of patients diagnosed with colon cancer

Yavas¹,

Çi̇fci̇²,

Keleş³

2023

JCHOR

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Aims: Early prediction of prognosis in malignancies can help determine life expectancy and take necessary further measures accordingly. There is no consensus on using any biomarker in predicting prognosis in colon cancer cases. A study reported that the sodium/globulin ratio is a valuable biomarker in predicting the prognosis of gastric cancer. This study aimed to investigate the role of baseline sodium, globulin, and sodium/globulin ratio in the prediction of prognosis and survival in colon cancer cases. Methods: The files of patients diagnosed with colon cancer who applied to Kırıkkale University Faculty of Medicine Medical Oncology Clinic between January 1, 2015, and December 31, 2020, were retrospectively analyzed. The relationship between the clinical and laboratory characteristics of the cases and their progression and survival were investigated. Results: 140 patients diagnosed with colon cancer were included in the study (82 men, 58 women). The average age at diagnosis was 64.1±12.6 years, 99.3% of them were adenocarcinoma, and 32.9% of them were stage 4 cancers. It was determined that 42.1% of the patients died (average survival time 54.0±3.2 months), and progression developed in 18.6% during the study period. The average baseline sodium/globulin ratio was 51.10±8.70. No significant correlation was found between initial serum sodium level, globulin level, sodium/globulin ratio, survival time, and progression status (p>0.05). Baseline serum globulin level showed a weak negative correlation with both progression-free and overall survival time (r=-0.23, p<0.05 and r=-0.24, p<0.05, respectively), while the sodium/globulin ratio showed a weak positive correlation with progression-free survival time (r=0.26, p<0.01) and overall survival time (r=0.25, p<0.01). The ROC curve analysis determined that initial serum sodium and globulin levels and sodium/globulin ratio were not predictive of progression and survival at any cut-off point (p>0.05). Conclusion: Although baseline serum sodium level, globulin level, and serum sodium/globulin ratio were weakly correlated with progression-free and overall survival time of patients diagnosed with colon cancer, they were not valuable in predicting progression and survival.

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Surgical resection and survival outcomes in metastatic young adult colorectal cancer patients

Cited by 17 publications

References 39 publications

Prognostic impact of increased lymph node yield in colorectal cancer patients with synchronous liver metastasis: a population-based retrospective study of the US database and a Chinese registry

Prognostic impact of increased lymph node yield in colorectal cancer patients with synchronous liver metastasis: a population-based retrospective study of the US database and a Chinese registry

Comprehensive analysis of mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs): A SEER database analysis of 767 cases

The role of initial sodium and globulin values in the prognosis prediction of patients diagnosed with colon cancer

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