Pub Date : 2011-12-12DOI: 10.2174/1876820201104010013
A. Lebedyev, D. Urban, D. Rosin, A. Ayalon, D. Aderka, M. Gutman, O. Zmora
Purpose: The use of laparoscopic techniques has been widely accepted for most solid organ malignancies, but its use for distal colorectal cancer is still controversial. The aim of this study is to review our experience with laparoscopic resections of distal colorectal cancer and to assess patients' outcome. Methods: A retrospective chart review of prospectively entered data base was made to identify patients who underwent laparoscopic resections of distal colorectal cancer. Data relative to demographics, tumor characteristics, surgical proce- dure and adjuvant or neoadjuvant treatment were recorded. Long term follow up (survival and recurrence) was established from the patients' charts and telephone interviews. Results: 94 consecutive patients underwent laparoscopic resections due to distal colorectal cancer. Surgery was in curative intent in 89 cases (95%). Conversion rate was 20%. Four patients (4%) died from different septic complications in the early postoperative period. Complete long term follow up follow up was achieved in 71 (75%) patients. There were no port site metastases. Local recurrence was diagnosed in 3 cases (4%). Twenty one patients (30%) died during this period, 11 due to metastatic disease, 1 from pneumonia, 9 patients from other non cancer related reasons. Conclusions: Laparoscopic surgery may be safe and feasible for the treatment of distal colorectal cancer with acceptable long term oncologic results. The complexity of the procedure as well as the level of anastomosis results in relatively high complication rate, which may potentially improve by overcoming the "institutional learning curve". Randomized con- trolled trials comparing open and laparoscopic surgery for rectal cancer should verify these results, before the laparo- scopic approach can be widely recommended.
{"title":"The Laparoscopic Approach in the Treatment of Distal Colorectal Cancer","authors":"A. Lebedyev, D. Urban, D. Rosin, A. Ayalon, D. Aderka, M. Gutman, O. Zmora","doi":"10.2174/1876820201104010013","DOIUrl":"https://doi.org/10.2174/1876820201104010013","url":null,"abstract":"Purpose: The use of laparoscopic techniques has been widely accepted for most solid organ malignancies, but its use for distal colorectal cancer is still controversial. The aim of this study is to review our experience with laparoscopic resections of distal colorectal cancer and to assess patients' outcome. Methods: A retrospective chart review of prospectively entered data base was made to identify patients who underwent laparoscopic resections of distal colorectal cancer. Data relative to demographics, tumor characteristics, surgical proce- dure and adjuvant or neoadjuvant treatment were recorded. Long term follow up (survival and recurrence) was established from the patients' charts and telephone interviews. Results: 94 consecutive patients underwent laparoscopic resections due to distal colorectal cancer. Surgery was in curative intent in 89 cases (95%). Conversion rate was 20%. Four patients (4%) died from different septic complications in the early postoperative period. Complete long term follow up follow up was achieved in 71 (75%) patients. There were no port site metastases. Local recurrence was diagnosed in 3 cases (4%). Twenty one patients (30%) died during this period, 11 due to metastatic disease, 1 from pneumonia, 9 patients from other non cancer related reasons. Conclusions: Laparoscopic surgery may be safe and feasible for the treatment of distal colorectal cancer with acceptable long term oncologic results. The complexity of the procedure as well as the level of anastomosis results in relatively high complication rate, which may potentially improve by overcoming the \"institutional learning curve\". Randomized con- trolled trials comparing open and laparoscopic surgery for rectal cancer should verify these results, before the laparo- scopic approach can be widely recommended.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"4 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116074569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-10-05DOI: 10.2174/1876820201104010006
I. Cameron
This report examines the anatomical distribution of colorectal cancer CRC in the human large bowel. The find- ings indicate the high occurrence of cancer in the rectum. The reason for the high incidence of rectal cancer is explored. Published data were compiled and analyzed to correlate the high occurrence of CRC in the human rectum to the high oc- currence of lymphoid nodules (LNs). Histopathologic classification and distribution of CRC types was reviewed. Statisti- cal findings reveal a significant (p < 0.01) positive relationship between number of LNs and number of CRCs. Histopa- thological findings indicate that LNs promote epithelial hyperplasia and a nonpolyploid pathway of cancer development especially in the rectum.The findings of a 7 to 8 fold higher density of rectal cancer per cm length in the human rectum compared to the other segments of the large bowel emphasize the importance of careful endoscope screening for the de- tection of nonpolyploid rectal cancers. Review of human and rat literature suggests that drugs that suppress the immune system and that aspirin, an anti-inflammatory agent,may work to reduce risk of CRC via their effect on lymphoid nodules.
{"title":"Promotional Role of Lymphoid Nodules in Colorectal Cancer: Implicationsfor Endoscopic Screening and Prevention","authors":"I. Cameron","doi":"10.2174/1876820201104010006","DOIUrl":"https://doi.org/10.2174/1876820201104010006","url":null,"abstract":"This report examines the anatomical distribution of colorectal cancer CRC in the human large bowel. The find- ings indicate the high occurrence of cancer in the rectum. The reason for the high incidence of rectal cancer is explored. Published data were compiled and analyzed to correlate the high occurrence of CRC in the human rectum to the high oc- currence of lymphoid nodules (LNs). Histopathologic classification and distribution of CRC types was reviewed. Statisti- cal findings reveal a significant (p < 0.01) positive relationship between number of LNs and number of CRCs. Histopa- thological findings indicate that LNs promote epithelial hyperplasia and a nonpolyploid pathway of cancer development especially in the rectum.The findings of a 7 to 8 fold higher density of rectal cancer per cm length in the human rectum compared to the other segments of the large bowel emphasize the importance of careful endoscope screening for the de- tection of nonpolyploid rectal cancers. Review of human and rat literature suggests that drugs that suppress the immune system and that aspirin, an anti-inflammatory agent,may work to reduce risk of CRC via their effect on lymphoid nodules.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116677353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-04-19DOI: 10.2174/1876820201104010001
A. Sameer, S. Nissar, S. Bashir, A. Bashir, M. Siddiqi
Aims: The angiotensin-converting enzyme (ACE) gene in humans has an insertion-deletion (I/D) polymorphic state in intron 16 on chromosome 17q23. This polymorphism has been widely investigated in different cancers and has been implicated as the risk factor for the development of various cancers. To investigate the ACE I/D genotype frequency in CRC cases in Kashmiri population and to correlate it with the known clinicopathological characters of CRC cases. Methods: We designed a case control study, where 86 CRC cases were studied for ACE I/D polymorphism against 150 controls taken from general population. The polymorphisms of ACE gene were investigated using polymerase chain reaction for detection of an I/D polymorphism. Results: Among CRC (86) cases we found the frequency of ACE DD genotype to be 41.86 % (36/86), II 13.95% (12/86) and DI 44.2% (38/86). There was no significant association between the ACE I/D genotype with any of the known clini- copathological characters. Conclusion: The ACE I/D polymorphism is not a significant risk factor in the CRC carcinogenesis in our population.
{"title":"ACE Polymorphism in Colorectal Cancer Patients of Kashmiri Population - A Short Report","authors":"A. Sameer, S. Nissar, S. Bashir, A. Bashir, M. Siddiqi","doi":"10.2174/1876820201104010001","DOIUrl":"https://doi.org/10.2174/1876820201104010001","url":null,"abstract":"Aims: The angiotensin-converting enzyme (ACE) gene in humans has an insertion-deletion (I/D) polymorphic state in intron 16 on chromosome 17q23. This polymorphism has been widely investigated in different cancers and has been implicated as the risk factor for the development of various cancers. To investigate the ACE I/D genotype frequency in CRC cases in Kashmiri population and to correlate it with the known clinicopathological characters of CRC cases. Methods: We designed a case control study, where 86 CRC cases were studied for ACE I/D polymorphism against 150 controls taken from general population. The polymorphisms of ACE gene were investigated using polymerase chain reaction for detection of an I/D polymorphism. Results: Among CRC (86) cases we found the frequency of ACE DD genotype to be 41.86 % (36/86), II 13.95% (12/86) and DI 44.2% (38/86). There was no significant association between the ACE I/D genotype with any of the known clini- copathological characters. Conclusion: The ACE I/D polymorphism is not a significant risk factor in the CRC carcinogenesis in our population.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126251486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-15DOI: 10.2174/1876820201003010032
F. Bozzetti, L. Mariani
Although more than 20 years have elapsed since the performance of the first laparoscopic colectomy, the scien- tific community is still divided between the overoptimistic enthusiasm of surgeons who would apply this procedure to all colon cancers and those who would favor a more prudent and selective approach. In the last years the issue was further complicated by the results of a randomized clinical trial which repeatedly claimed better oncologic results in patients undergoing laparoscopic colectomy as compared with those receiving the traditional open procedure. This short review focuses on the distinct randomized clinical trials comparing the two procedures, the published meta- analyses obtained thereof, in order to comment on the reliability of the studies claiming the evidence of an oncologic benefit with the laparoscopic approach. There is a scientific evidence that in the patients' population eligible for randomization in the published randomized clini- cal trials the oncologic results appear quite similar. Nothing can be stated for the vast patients' population which did not meet the inclusion criteria in the trial and was there- fore excluded. The actual difficulty to generalise the results of randomized clinical trials to all the colon cancer patients suggests a cau- tious approach to the problem and emphasizes the need of a full explanation to the patients about the limits of the cur- rently available scientific evidence. In the meantime the short-term benefits of the laparoscopic approach have to be weighed against the recent results of the enhanced recovery programmes.
{"title":"Should All Colon Cancer Patients Undergo Laparoscopic Colectomy? The Evidence from the Randomized Clinical Trials","authors":"F. Bozzetti, L. Mariani","doi":"10.2174/1876820201003010032","DOIUrl":"https://doi.org/10.2174/1876820201003010032","url":null,"abstract":"Although more than 20 years have elapsed since the performance of the first laparoscopic colectomy, the scien- tific community is still divided between the overoptimistic enthusiasm of surgeons who would apply this procedure to all colon cancers and those who would favor a more prudent and selective approach. In the last years the issue was further complicated by the results of a randomized clinical trial which repeatedly claimed better oncologic results in patients undergoing laparoscopic colectomy as compared with those receiving the traditional open procedure. This short review focuses on the distinct randomized clinical trials comparing the two procedures, the published meta- analyses obtained thereof, in order to comment on the reliability of the studies claiming the evidence of an oncologic benefit with the laparoscopic approach. There is a scientific evidence that in the patients' population eligible for randomization in the published randomized clini- cal trials the oncologic results appear quite similar. Nothing can be stated for the vast patients' population which did not meet the inclusion criteria in the trial and was there- fore excluded. The actual difficulty to generalise the results of randomized clinical trials to all the colon cancer patients suggests a cau- tious approach to the problem and emphasizes the need of a full explanation to the patients about the limits of the cur- rently available scientific evidence. In the meantime the short-term benefits of the laparoscopic approach have to be weighed against the recent results of the enhanced recovery programmes.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133729539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-03DOI: 10.2174/1876820201003010027
R. Alexander, A. Alexander, S. Surgenor, E. Williams, G. Nash
Introduction: Iron deficiency anaemia (IDA) is commonly a result of colorectal cancer. Higher preoperative haemoglobin (Hb) is associated with an improved post-operative survival. The endpoint of normalising patients Hb is to reduce the need for perioperative blood transfusion which has oncological, safety and economic benefits. Methods: This study aims to compare the overall effect and cost between oral iron and two forms of parenteral iron, in raising the Hb of 53 consecutive colorectal cancer patients with IDA. The pre- and post-treatment Hb were measuring over time for oral and two formulations of parenteral iron (CosmoFer® and Venofer®), as were the need for supplemental pre-operative blood transfusions. The Total Hb rise and Hb rise/day were calculated as was the overall cost (including blood transfusions) in each of the three iron supplementation groups. Results: Both total Hb rise and Hb rise/day were significantly higher in the Venofer® (p=0.048, p=0.002) and CosmoFer® groups (p=0.034 & p=0.001) over oral iron. The oral iron group required significantly more blood than the Venofer® (p=0.04) and CosmoFer® groups (p=0.01). Although there was a trend for oral iron to cost more than parenteral, this did not reach significance. Conclusions: This study suggests that the end point of transfusion reduction is possible by the increased Hb rise rate of Venofer® or CosmoFer®. In addition, parenteral iron supplementation is no more costly than the traditional oral route, taking into account blood transfusion requirement.
{"title":"Optimal Iron Replacement for Colorectal Cancer-Induced Anaemia","authors":"R. Alexander, A. Alexander, S. Surgenor, E. Williams, G. Nash","doi":"10.2174/1876820201003010027","DOIUrl":"https://doi.org/10.2174/1876820201003010027","url":null,"abstract":"Introduction: Iron deficiency anaemia (IDA) is commonly a result of colorectal cancer. Higher preoperative haemoglobin (Hb) is associated with an improved post-operative survival. The endpoint of normalising patients Hb is to reduce the need for perioperative blood transfusion which has oncological, safety and economic benefits. Methods: This study aims to compare the overall effect and cost between oral iron and two forms of parenteral iron, in raising the Hb of 53 consecutive colorectal cancer patients with IDA. The pre- and post-treatment Hb were measuring over time for oral and two formulations of parenteral iron (CosmoFer® and Venofer®), as were the need for supplemental pre-operative blood transfusions. The Total Hb rise and Hb rise/day were calculated as was the overall cost (including blood transfusions) in each of the three iron supplementation groups. Results: Both total Hb rise and Hb rise/day were significantly higher in the Venofer® (p=0.048, p=0.002) and CosmoFer® groups (p=0.034 & p=0.001) over oral iron. The oral iron group required significantly more blood than the Venofer® (p=0.04) and CosmoFer® groups (p=0.01). Although there was a trend for oral iron to cost more than parenteral, this did not reach significance. Conclusions: This study suggests that the end point of transfusion reduction is possible by the increased Hb rise rate of Venofer® or CosmoFer®. In addition, parenteral iron supplementation is no more costly than the traditional oral route, taking into account blood transfusion requirement.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132808312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-10-11DOI: 10.2174/18768202010030100012
P. López, J. S. Albero, Julio A. Carbayo Herencia, J. Montes, M. A. L. Cara, Ángel Celada Rodríguez
Objective: to assess the relationship between different colorectal cancer (CC) risk factors in the province of Al- bacete, Spain Subjects And Methods: the study was designed to be population-based, observational, analytical, descriptive and cross- sectional and used a questionnaire. The study area included the Primary Care Health Centres in the province of Albacete. We compared two previously assessed areas, one with a high CC incidence and the other with a low CC incidence, along with the factors that could influence these differences. We used a questionnaire to collect personal and consumer habit data in relation to CC. We did bivariate and multivariate (logistic regression) statistical analyses. The predictor variables considered in this model were age, gender, body mass index (BMI), level of education, intensity of physical activity, presence or absence of a disease, smoking habit (packs per year), alcohol intake, number of defeca- tions per week, being on a diet, intake frequencies (IF) of pasta and rice, IF of eggs or omelette, IF of white fish, IF of blue fish, IF of pulses, IF of vegetables and salads, fruit, cold meats, meat, water intake and relatives with cancer. Results: The high CC incidence areas presented an incidence between 26.9 and 30.2 cases per 100,000 citizens per year, while the rates of the low incidence areas were between 5.1 and 6.5. A total of 417 people participated (56.8% women), of whom 245 (58.8%) came from the low CC incidence area (41.2% men) and 172 (41.2%) were from the high CC incidence area (45.9% men). After adjusting the model in the logistic regression analysis, the variables related to high cancer inci- dence were alcohol intake, odds ratio (OR) 1,79 (CI: 1.8-2.96; P=0.024 eating eating pasta and rice more than two days per week: OR 2.23 (CI: 1.33-3.72; P=0.002); eating eggs and/or omelette more than two days per week: OR 2.68 (CI: 1.49-4.80; P=0.001), and drinking more than two litres of water per day: OR 2.87 (CI: 1.51-5.46; P=0.001. Frequent physical exercise related with a low CC incidence: OR 3.38 (CI: 1.30-8.84; P=0.013). Conclusions: In this study, the highest CC incidence is associated with alcohol intake and a high intake of water, pasta and rice, and eggs. Doing physical exercise regularly has a protective effect.
{"title":"Impact of Life Habits on Colorectal Cancer","authors":"P. López, J. S. Albero, Julio A. Carbayo Herencia, J. Montes, M. A. L. Cara, Ángel Celada Rodríguez","doi":"10.2174/18768202010030100012","DOIUrl":"https://doi.org/10.2174/18768202010030100012","url":null,"abstract":"Objective: to assess the relationship between different colorectal cancer (CC) risk factors in the province of Al- bacete, Spain Subjects And Methods: the study was designed to be population-based, observational, analytical, descriptive and cross- sectional and used a questionnaire. The study area included the Primary Care Health Centres in the province of Albacete. We compared two previously assessed areas, one with a high CC incidence and the other with a low CC incidence, along with the factors that could influence these differences. We used a questionnaire to collect personal and consumer habit data in relation to CC. We did bivariate and multivariate (logistic regression) statistical analyses. The predictor variables considered in this model were age, gender, body mass index (BMI), level of education, intensity of physical activity, presence or absence of a disease, smoking habit (packs per year), alcohol intake, number of defeca- tions per week, being on a diet, intake frequencies (IF) of pasta and rice, IF of eggs or omelette, IF of white fish, IF of blue fish, IF of pulses, IF of vegetables and salads, fruit, cold meats, meat, water intake and relatives with cancer. Results: The high CC incidence areas presented an incidence between 26.9 and 30.2 cases per 100,000 citizens per year, while the rates of the low incidence areas were between 5.1 and 6.5. A total of 417 people participated (56.8% women), of whom 245 (58.8%) came from the low CC incidence area (41.2% men) and 172 (41.2%) were from the high CC incidence area (45.9% men). After adjusting the model in the logistic regression analysis, the variables related to high cancer inci- dence were alcohol intake, odds ratio (OR) 1,79 (CI: 1.8-2.96; P=0.024 eating eating pasta and rice more than two days per week: OR 2.23 (CI: 1.33-3.72; P=0.002); eating eggs and/or omelette more than two days per week: OR 2.68 (CI: 1.49-4.80; P=0.001), and drinking more than two litres of water per day: OR 2.87 (CI: 1.51-5.46; P=0.001. Frequent physical exercise related with a low CC incidence: OR 3.38 (CI: 1.30-8.84; P=0.013). Conclusions: In this study, the highest CC incidence is associated with alcohol intake and a high intake of water, pasta and rice, and eggs. Doing physical exercise regularly has a protective effect.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"30 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113975183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-05-04DOI: 10.2174/1876820201003010005
K. Lai, B. Stotler
{"title":"Marital Status and Colon Cancer Stage at Diagnosis~!2009-10-21~!2010-01-27~!2010-04-22~!","authors":"K. Lai, B. Stotler","doi":"10.2174/1876820201003010005","DOIUrl":"https://doi.org/10.2174/1876820201003010005","url":null,"abstract":"","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126466418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-04-21DOI: 10.2174/1876820201003010023
J. Zekri, M. Abubacker
Introduction: In the management of patients with metastatic colorectal cancer (mCRC) failing anti-cancer agents/regimens are substituted by others. There is no data in the literature showing that combining 2 failing agents/regimens can induce tumor response. Case: We report a case with mCRC who failed first line XELOX/bevacicumab and second line FOLFIRI. However, the tumour responded to third line FOLFIRI/bevacizumab. Conclusion: Retreatment with bevacizumab in combination with a failing chemotherapy regimen is a possible treatment option after exhaustion of all standard treatments. This approach seems to be effective in overcoming clinical tumor drug resistance to irinotecan based chemotherapy
{"title":"Bevacizumab May Overcome Clinical Tumor Drug Resistance to IrinotecanBased Chemotherapy in Patients with Metastatic Colorectal Cancer:Case Report","authors":"J. Zekri, M. Abubacker","doi":"10.2174/1876820201003010023","DOIUrl":"https://doi.org/10.2174/1876820201003010023","url":null,"abstract":"Introduction: In the management of patients with metastatic colorectal cancer (mCRC) failing anti-cancer agents/regimens are substituted by others. There is no data in the literature showing that combining 2 failing agents/regimens can induce tumor response. Case: We report a case with mCRC who failed first line XELOX/bevacicumab and second line FOLFIRI. However, the tumour responded to third line FOLFIRI/bevacizumab. Conclusion: Retreatment with bevacizumab in combination with a failing chemotherapy regimen is a possible treatment option after exhaustion of all standard treatments. This approach seems to be effective in overcoming clinical tumor drug resistance to irinotecan based chemotherapy","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116451396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-08-19DOI: 10.2174/1876820200902010021
H. Tsai, Chin‐Fan Chen, Chien-Yu Lu, W. Fang, Deng-Chyang Wu, I-Chen Wu, M. Sheen, Shiu‐Ru Lin, Jaw-Yuan Wang
Aim: To investigate the association between UDP-glucuronosyltransferase 1A1 (UGT1A1) genotypes and severe toxicity in Taiwanese patients with metastatic colorectal cancer (mCRC) receiving irinotecan chemotherapy. Methods: We genotyped the UGT1A1 gene by direct sequencing. All the patients were evaluated to see whether the variant UGT1A1 genotype would correlate to severe toxicity of irinotecan consisting of grade III-IV neutropenia, diarrhea and nausea/vomiting. Genomic DNA was genotyped for UGT1A1, and patients were designated as 6/6, 6/7, or 7/7 depending on the number of TA repeats in the promoter region. Results: The results showed that the genotype distribution of UGT1A1 in Taiwanese subjects differed significantly from that in Caucasians. Furthermore, patients with 6/7 or 7/7 genotype were associated with a higher incidence of grade III-IV neutropenia or diarrhea or nausea/vomiting (all p < 0.0001). The less frequencies of 6/7 and 7/7 genotypes may be responsible for the considerably lower occurrence of grade III-IV neutropenia and diarrhea in Taiwanese patients. Indeed, the UGT1A1 genotype was closely related to clinical response (p = 0.018). Conclusion: UGT1A1 genotyping is a potential predictor of severe toxicity for Taiwanese mCRC patients treated with irinotecan chemotherapy, and may be useful to identify patients at-risk of toxicity, and thus could be used as a screening tool prior to therapy.
{"title":"Significant Correlation between Polymorphisms of UGT1A1 Gene andLow Irinotecan Toxicity in Colorectal Cancer Patients with FOLFIRI","authors":"H. Tsai, Chin‐Fan Chen, Chien-Yu Lu, W. Fang, Deng-Chyang Wu, I-Chen Wu, M. Sheen, Shiu‐Ru Lin, Jaw-Yuan Wang","doi":"10.2174/1876820200902010021","DOIUrl":"https://doi.org/10.2174/1876820200902010021","url":null,"abstract":"Aim: To investigate the association between UDP-glucuronosyltransferase 1A1 (UGT1A1) genotypes and severe toxicity in Taiwanese patients with metastatic colorectal cancer (mCRC) receiving irinotecan chemotherapy. Methods: We genotyped the UGT1A1 gene by direct sequencing. All the patients were evaluated to see whether the variant UGT1A1 genotype would correlate to severe toxicity of irinotecan consisting of grade III-IV neutropenia, diarrhea and nausea/vomiting. Genomic DNA was genotyped for UGT1A1, and patients were designated as 6/6, 6/7, or 7/7 depending on the number of TA repeats in the promoter region. Results: The results showed that the genotype distribution of UGT1A1 in Taiwanese subjects differed significantly from that in Caucasians. Furthermore, patients with 6/7 or 7/7 genotype were associated with a higher incidence of grade III-IV neutropenia or diarrhea or nausea/vomiting (all p < 0.0001). The less frequencies of 6/7 and 7/7 genotypes may be responsible for the considerably lower occurrence of grade III-IV neutropenia and diarrhea in Taiwanese patients. Indeed, the UGT1A1 genotype was closely related to clinical response (p = 0.018). Conclusion: UGT1A1 genotyping is a potential predictor of severe toxicity for Taiwanese mCRC patients treated with irinotecan chemotherapy, and may be useful to identify patients at-risk of toxicity, and thus could be used as a screening tool prior to therapy.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125539410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-06-29DOI: 10.2174/1876820200902010016
J. Frossard, J. Brault, L. Spahr, R. D. Peyer, C. Felley, A. Hadengue
Purpose: The fecal occult blood test is recommended for detecting colorectal cancer in asymptomatic patients. These tests are based on the fact that colonic cancer and large polyps spontaneously tend to bleed. Whether these tests are of any use in symptomatic patients remains debated. Our aim was to compare guaiac-based test and immunochemical test in symptomatic patients requiring total colonoscopy, to correlate these results to colonoscopy findings and to establish the performance of these tests for mucosal colonic lesion detection other than colorectal cancer. Methods: Prospective study aimed at including 100 consecutive symptomatic patients whose condition required a total colonoscopy. All patients had 12 hours before endoscopy both tests performed on the same stool sample. Results: 113 patients were included of which 100 had complete colonoscopy. Guaiac-based occult fecal test and the im- munochemical test had similar performances whatever the mucosal injury and whatever the location of the injury were found at colonoscopy. Conclusions: Despite numerous previous studies reporting higher performances of the immunochemical test over the guaiac-based test, the incremental increase performance of the immunochemical test remains non significant in the setting of the current study. Therefore generalization of this test should be taken with caution.
{"title":"Comparison of Immunochemical and Guaiac-Based Occult Fecal Tests with Colonoscopy Findings in Symptomatic Patients","authors":"J. Frossard, J. Brault, L. Spahr, R. D. Peyer, C. Felley, A. Hadengue","doi":"10.2174/1876820200902010016","DOIUrl":"https://doi.org/10.2174/1876820200902010016","url":null,"abstract":"Purpose: The fecal occult blood test is recommended for detecting colorectal cancer in asymptomatic patients. These tests are based on the fact that colonic cancer and large polyps spontaneously tend to bleed. Whether these tests are of any use in symptomatic patients remains debated. Our aim was to compare guaiac-based test and immunochemical test in symptomatic patients requiring total colonoscopy, to correlate these results to colonoscopy findings and to establish the performance of these tests for mucosal colonic lesion detection other than colorectal cancer. Methods: Prospective study aimed at including 100 consecutive symptomatic patients whose condition required a total colonoscopy. All patients had 12 hours before endoscopy both tests performed on the same stool sample. Results: 113 patients were included of which 100 had complete colonoscopy. Guaiac-based occult fecal test and the im- munochemical test had similar performances whatever the mucosal injury and whatever the location of the injury were found at colonoscopy. Conclusions: Despite numerous previous studies reporting higher performances of the immunochemical test over the guaiac-based test, the incremental increase performance of the immunochemical test remains non significant in the setting of the current study. Therefore generalization of this test should be taken with caution.","PeriodicalId":331708,"journal":{"name":"The Open Colorectal Cancer Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130012947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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