What Is the Optimal Means of Staging Colon Cancer?

Arena, E.; Bilchik, Anton J.

doi:10.1016/j.yasu.2013.03.001

Cited by 8 publications

(6 citation statements)

References 44 publications

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“…Furthermore, our analyses revealed that NBF1-stage had a 50.4% increased risk of cancer-specific mortality in colon cancer, which rose to 77.1% in non-metastatic colon cancer. Distinguishing between stages IIIA-NBF0 and IIIA-NBF1 in the TNM stage IIIA accounted for the improved prognosis of TNM stage IIIA than IIA [ 2 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis of patients with malignant colon cancer is influenced both by disease factors and patient-related factors, including biological factors and nonbiological factors (NBFs). The effect of different biological factors, such as American Joint Committee on Cancer (AJCC) staging system, microsatellite instability (MSI) status, and tumor grade on the survival of patients with colon cancer has been widely studied [ 2 , 3 , 4 ]. Several studies have demonstrated that NBFs, such as marital status [ 5 , 6 ], health insurance [ 7 , 8 ], and employment [ 9 ] were associated with the survival of patients with colon cancer.…”

Section: Introductionmentioning

confidence: 99%

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Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Liu

Luo

Cai

et al. 2018

Cancers

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Background: The present study analyzed the nonbiological factors (NBFs) together with the American Joint Committee on Cancer (AJCC) Tumor-Node-Metastasis (TNM) staging system to generate a refined, risk-adapted stage for the clinical treatment of colon cancer. Methods: Eligible patients (N = 28,818) with colon cancer between 1 January 2010 and 31 December 2014, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and Cox proportional hazards regression, analyzed the probabilities of cancer-specific survival (CSS) in patients with colon cancer, with different NBF-TNM stages. Results: Insurance status, marital status, and median household income were significant prognostic NBFs in the current study (p < 0.05). The concordance index of NBF-TNM stage was 0.857 (95% confidence interval (CI) = 0.8472–0.8668). Multivariate Cox analyses, indicated that NBF1-stage was independently associated with a 50.4% increased risk of cancer-specific mortality in colon cancer (p < 0.001), which increased to 77.1% in non-metastatic colon cancer. NBF0-stage improved in CSS as compared to the NBF1-stage in the respective stages (p < 0.05). Conclusions: The new proposed NBF-stage was an independent prognostic factor in colon cancer. Effect of NBFs on the survival of colon cancer necessitates further clinical attention. Moreover, the incorporation of NBF-stage into the AJCC TNM staging system is essential for prognostic prediction, and clinical guidance of adjuvant chemotherapy in stage II and III colon cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Liu

Luo

Cai

et al. 2018

Cancers

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“…As to date, the 7 th edition is used and the 8 th edition is on its way. Even the TNM system is based on the anatomical characteristics of the tumour, including tumour spread throughout the bowel wall, the spread to lymph nodes and the presence of metastatic disease 23 .…”

Section: Stagingmentioning

confidence: 99%

Colorectal Cancer Cells Adhere to Traumatized Peritoneal Tissue in Clusters, An Experimental Study

Falk

Jönsson

Swartling

et al. 2017

Journal of Investigative Surgery

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The use of human peritoneal tissue in an ex vivo model would appear to be a potentially useful tool for the study of interaction between human peritoneal membrane and free tumor cells. Experimental surgical trauma increases the ability of tumor cells to adhere to the peritoneal membrane. This ex vivo model should be useful in future studies on biological interactions between peritoneum and tumor cells in the search for novel forms of peritoneal cancer therapy.

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“…Fortunately, the P-stage could distinguish well between stages I–P0 and I–P1 in the TNM stage I, and extremely well between stages IIIA–P0 and IIIA–P1 in the TNM stage IIIA (which also seemed to account for the better prognosis of TNM stage IIIA than stage IIIA). 2 , 21 Moreover, toxicity and adverse events caused by adjuvant chemotherapy could result in significant patient morbidity. 22 The present study suggested that the recommendation of reduced chemotherapy in stage IIIA–P0 deserves further investigation and prospective studies with the incorporation of the newly proposed P-stage.…”

Section: Discussionmentioning

confidence: 99%

P–TNM staging system for colon cancer: combination of P-stage and AJCC TNM staging system for improving prognostic prediction and clinical management

Liu¹,

Luo²,

Cai³

et al. 2018

CMAR

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AimThis study focused on improving the American Joint Committee on Cancer TNM staging system and demonstrated an improvement in prognostic accuracy and clinical management of colon cancer using the P–TNM staging system.Patients and methodsEligible patients (N=56,800) were identified from the Surveillance, Epidemiology, and End Results database between January 1, 2010, and December 31, 2014. The P-stage (P0 or P1) was assigned to each patient based on age at diagnosis, tumor grade, and tumor size. The outcome of interest was cancer-specific survival (CSS). The Cox proportional hazards regression analyses were used to identify independent prognostic factors and analyze the CSS probabilities of patients with colon cancer having different P–TNM stages, respectively.ResultsA total of 29,627 patients were assigned to P0-stage and 27,173 patients were assigned to P1-stage. The P1-stage was associated with a 98.1% increased risk of cancer-specific mortality (hazard ratio =1.981, 95% confidence interval =1.891–2.076, P<0.001), which was higher in patients with nonmetastatic colon cancer. The P1-stage patients had improvement in CSS compared with those in P0-stage in respective stages (P<0.001). Moreover, CSS decreased in stage I–P1 compared with stage IIA–P0 or IIIA–P0 (P<0.001), stage IIIA–P1 compared with stage IIA–P0 (P<0.001), stage IIB–P1 compared with stage IIIB–P0 or IIC–P0 (P<0.001), stage IIIB–P1 compared with stage IIC–P0 (P<0.001), and stage IIC–P1 compared with stage IIIC–P0 (P<0.001).ConclusionP-stage was an independent prognostic factor for colon cancer. This study strongly supported the incorporation of P-stage into the American Joint Committee on Cancer TNM staging system for a better approach to prognostication and, thus, more individualized risk-adaptive therapies in colon cancer.

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What Is the Optimal Means of Staging Colon Cancer?

Cited by 8 publications

References 44 publications

Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Colorectal Cancer Cells Adhere to Traumatized Peritoneal Tissue in Clusters, An Experimental Study

P–TNM staging system for colon cancer: combination of P-stage and AJCC TNM staging system for improving prognostic prediction and clinical management

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What Is the Optimal Means of Staging Colon Cancer?

Cited by 8 publications

References 44 publications

Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Real-World Implications of Nonbiological Factors with Staging, Prognosis and Clinical Management in Colon Cancer

Colorectal Cancer Cells Adhere to Traumatized Peritoneal Tissue in Clusters, An Experimental Study

P&ndash;TNM staging system for colon cancer: combination of P-stage and AJCC TNM staging system for improving prognostic prediction and clinical management

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P–TNM staging system for colon cancer: combination of P-stage and AJCC TNM staging system for improving prognostic prediction and clinical management