J. Hopkinson, Catherine Kazmi, Jayne Elias, S. Wheelwright, Rhiannon Williams, A. Russell, C. Shaw
Aim: To investigate self-management of dietary intake by colorectal cancer patients receiving chemotherapy. Methods: A questionnaire was administered to 92 patients with nonmetastatic colorectal cancer receiving chemotherapy treatment at a UK cancer center in 2018–19. A maximum variation sample of 20 patients who completed the questionnaire were interviewed. Results: More than three in five patients were at nutritional risk but fewer than one in five were concerned about dietary intake or weight. Self-management of diet and weight was inconsistent with achieving the nutritional intake recommended by clinical guidelines on nutrition in cancer. Conclusion: There is potential for psychoeducation to support change in self-management of nutritional risk, with implications for better treatment tolerance and outcomes including quality of life.
{"title":"Diet and weight management by people with nonmetastatic colorectal cancer during chemotherapy: mixed methods research","authors":"J. Hopkinson, Catherine Kazmi, Jayne Elias, S. Wheelwright, Rhiannon Williams, A. Russell, C. Shaw","doi":"10.2217/crc-2019-0017","DOIUrl":"https://doi.org/10.2217/crc-2019-0017","url":null,"abstract":"Aim: To investigate self-management of dietary intake by colorectal cancer patients receiving chemotherapy. Methods: A questionnaire was administered to 92 patients with nonmetastatic colorectal cancer receiving chemotherapy treatment at a UK cancer center in 2018–19. A maximum variation sample of 20 patients who completed the questionnaire were interviewed. Results: More than three in five patients were at nutritional risk but fewer than one in five were concerned about dietary intake or weight. Self-management of diet and weight was inconsistent with achieving the nutritional intake recommended by clinical guidelines on nutrition in cancer. Conclusion: There is potential for psychoeducation to support change in self-management of nutritional risk, with implications for better treatment tolerance and outcomes including quality of life.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47350090","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}
M. Alemrajabi, M. Moradi, E. Amiri, Masoud Vahdani
After the outbreak of COVID-19, several issues in the field of general surgery have remained unknown. Here we present two consecutive patients operated on in a coronavirus center in February 2020, during the outbreak in Tehran, Iran. Moreover, we highlight some challenges surgeons face in the management of these patients during the outbreak. We suggest surgeons to perform the safest technique with the least risk. In borderline conditions, it is suggested to prefer stoma over anastomosis. This lessens the course of hospitalization and probable complication rates. We suggest establishing clean centers and prepare guidelines for the general surgery team members to lessen the risk for patients and healthcare providers.
{"title":"Therapeutic challenges in colorectal surgery practice during COVID-19 outbreak: a case series","authors":"M. Alemrajabi, M. Moradi, E. Amiri, Masoud Vahdani","doi":"10.2217/crc-2020-0014","DOIUrl":"https://doi.org/10.2217/crc-2020-0014","url":null,"abstract":"After the outbreak of COVID-19, several issues in the field of general surgery have remained unknown. Here we present two consecutive patients operated on in a coronavirus center in February 2020, during the outbreak in Tehran, Iran. Moreover, we highlight some challenges surgeons face in the management of these patients during the outbreak. We suggest surgeons to perform the safest technique with the least risk. In borderline conditions, it is suggested to prefer stoma over anastomosis. This lessens the course of hospitalization and probable complication rates. We suggest establishing clean centers and prepare guidelines for the general surgery team members to lessen the risk for patients and healthcare providers.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43525809","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}
Juan Manuel O'Connor, Federico Esteso, Matías Chacón
One of the early guidelines to protect cancer patients against the novel coronavirus (SARS-CoV-2) was developed in early March by the French High Council for Public Health at the request of the French Health Ministry. These guidelines were prepared by a representative group of medical oncologists and radiation oncologists, working in both academic and private practice. The results of this initiative were published by You et al. in Lancet Oncology on 25 March [1]. In addition to ethical and practical considerations for the management of cancer patients in the context of the COVID-19 pandemic, these official guidelines provide helpful recommendations [1]:
{"title":"Official French SARS-CoV-2 guidelines for cancer patients, a triage solution with precision medicine.","authors":"Juan Manuel O'Connor, Federico Esteso, Matías Chacón","doi":"10.2217/crc-2020-0018","DOIUrl":"10.2217/crc-2020-0018","url":null,"abstract":"One of the early guidelines to protect cancer patients against the novel coronavirus (SARS-CoV-2) was developed in early March by the French High Council for Public Health at the request of the French Health Ministry. These guidelines were prepared by a representative group of medical oncologists and radiation oncologists, working in both academic and private practice. The results of this initiative were published by You et al. in Lancet Oncology on 25 March [1]. In addition to ethical and practical considerations for the management of cancer patients in the context of the COVID-19 pandemic, these official guidelines provide helpful recommendations [1]:","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":"9 2","pages":"CRC21"},"PeriodicalIF":4.2,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/crc-2020-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38451753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Dufraing, C. Keppens, V. Tack, A. Siebers, G. Kafatos, S. Dube, L. Kroeze, M. Ligtenberg, J. V. Krieken, E. Dequeker
Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patients with metastatic colorectal cancer. Published RAS mutation rates differ and could be influenced by several factors including testing methods. This study aimed to describe the performance of laboratories to correctly identify RAS variants over time and to understand how RAS testing has evolved in Europe. Materials & methods: Misclassification and test failure rates were calculated and related to the used test methodology for 239 unique laboratories participating in external quality assessment for metastatic colorectal cancer between 2013 and 2018. In addition, 33 laboratories completed a survey aiming to obtain more details on their routine testing strategies, number of samples analyzed and RAS mutation rates between 2013 and 2017. Results: The mutation status was correctly analyzed in 96.1% (N = 5471) RAS and BRAF tests. A total of 4.6% (N = 2860) RAS tests included false-negative results. In 1.6% (N = 5562) RAS and BRAF tests, an analysis failure occurred. Misclassifications and technical failures both decreased between 2013 and 2018. The number of next-generation sequencing users increased from 6.9% (N = 130) in 2013 to 44.6% (N = 112) in 2018. Over time, more codons were included in the methodologies, yet 23.2% (N = 112) did not offer full RAS testing (exon 2, 3, 4) in 2018. Based on the survey the overall RAS mutation rate was estimated as 45.2% (N = 27,325). Conclusion: This is the largest observational study reporting RAS mutation rates to-date. There was no trend of RAS mutation rates over time despite having a clear shift to more sensitive tests and increased quality of testing.
{"title":"Evolution of RAS testing over time: factors influencing mutation rates in metastatic colorectal cancer patients","authors":"K. Dufraing, C. Keppens, V. Tack, A. Siebers, G. Kafatos, S. Dube, L. Kroeze, M. Ligtenberg, J. V. Krieken, E. Dequeker","doi":"10.2217/crc-2019-0013","DOIUrl":"https://doi.org/10.2217/crc-2019-0013","url":null,"abstract":"Aim: Correct identification of RAS gene variants is key for targeted treatment decisions in patients with metastatic colorectal cancer. Published RAS mutation rates differ and could be influenced by several factors including testing methods. This study aimed to describe the performance of laboratories to correctly identify RAS variants over time and to understand how RAS testing has evolved in Europe. Materials & methods: Misclassification and test failure rates were calculated and related to the used test methodology for 239 unique laboratories participating in external quality assessment for metastatic colorectal cancer between 2013 and 2018. In addition, 33 laboratories completed a survey aiming to obtain more details on their routine testing strategies, number of samples analyzed and RAS mutation rates between 2013 and 2017. Results: The mutation status was correctly analyzed in 96.1% (N = 5471) RAS and BRAF tests. A total of 4.6% (N = 2860) RAS tests included false-negative results. In 1.6% (N = 5562) RAS and BRAF tests, an analysis failure occurred. Misclassifications and technical failures both decreased between 2013 and 2018. The number of next-generation sequencing users increased from 6.9% (N = 130) in 2013 to 44.6% (N = 112) in 2018. Over time, more codons were included in the methodologies, yet 23.2% (N = 112) did not offer full RAS testing (exon 2, 3, 4) in 2018. Based on the survey the overall RAS mutation rate was estimated as 45.2% (N = 27,325). Conclusion: This is the largest observational study reporting RAS mutation rates to-date. There was no trend of RAS mutation rates over time despite having a clear shift to more sensitive tests and increased quality of testing.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/crc-2019-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47817522","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}
The aim was to examine the current trend in rectal cancer, which is to extend ’watch-and-wait’ to earlier-stage tumors, not normally treated with chemoradiotherapy, to define the up-side and down-side regarding quality of life (QOL) and anorectal/sexual/urinary function from this approach. We reviewed the literature regarding a ‘watch-and-wait’ strategy after neoadjuvant chemoradiotherapy. The primary outcome measure was complete clinical response. Secondary measures included colostomy rate, functional outcomes and QOL. There is a trend to use chemoradiotherapy in earlier tumors using dose-escalation of radiation and/or additional chemotherapy, resulting in high rates of complete clinical response, which may impact adversely on QOL if radical surgery is subsequently required. Focusing on organ-preservation as the primary goal of treatment rather than overall functional outcomes and QOL for the whole population, may not provide patients with sufficient information for optimal decision-making.
{"title":"Unintended consequences of treating early rectal cancers for complete clinical response with chemoradiotherapy","authors":"R. Glynne-Jones, N. Bhuva, M. Harrison","doi":"10.2217/crc-2019-0010","DOIUrl":"https://doi.org/10.2217/crc-2019-0010","url":null,"abstract":"The aim was to examine the current trend in rectal cancer, which is to extend ’watch-and-wait’ to earlier-stage tumors, not normally treated with chemoradiotherapy, to define the up-side and down-side regarding quality of life (QOL) and anorectal/sexual/urinary function from this approach. We reviewed the literature regarding a ‘watch-and-wait’ strategy after neoadjuvant chemoradiotherapy. The primary outcome measure was complete clinical response. Secondary measures included colostomy rate, functional outcomes and QOL. There is a trend to use chemoradiotherapy in earlier tumors using dose-escalation of radiation and/or additional chemotherapy, resulting in high rates of complete clinical response, which may impact adversely on QOL if radical surgery is subsequently required. Focusing on organ-preservation as the primary goal of treatment rather than overall functional outcomes and QOL for the whole population, may not provide patients with sufficient information for optimal decision-making.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/crc-2019-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44062170","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}
John L Marshall*,1, Ronit I Yarden2 & Benjamin A Weinberg3 1Hematology & Oncology, The Ruesch Center for the Cure of GI Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC 20057, USA 2Colorectal Cancer Alliance, 1025 Vermont Ave., Washington DC 20005, USA 3Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC 20007, USA *Author for correspondence: Tel.: +202 444 2223; Fax: +202 444 1229; marshalj@georgetown.edu
John L Marshall*，1，Ronit I Yarden2和Benjamin A Weinberg3 1肿瘤与病理学，Ruesch胃肠道癌症治疗中心，Lombardi综合癌症中心，乔治敦大学医学中心，华盛顿特区20057，美国2结肠癌症联盟，华盛顿特区佛蒙特大道1025号，华盛顿特区20005，乔治敦大学，华盛顿特区，20007，美国*通信作者：电话：+202 444 2223；传真：+202 444 1229；marshalj@georgetown.edu
{"title":"Colorectal cancer care in the age of coronavirus: strategies to reduce risk and maintain benefit","authors":"J. Marshall, R. Yarden, B. Weinberg","doi":"10.2217/crc-2020-0010","DOIUrl":"https://doi.org/10.2217/crc-2020-0010","url":null,"abstract":"John L Marshall*,1, Ronit I Yarden2 & Benjamin A Weinberg3 1Hematology & Oncology, The Ruesch Center for the Cure of GI Cancers, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC 20057, USA 2Colorectal Cancer Alliance, 1025 Vermont Ave., Washington DC 20005, USA 3Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC 20007, USA *Author for correspondence: Tel.: +202 444 2223; Fax: +202 444 1229; marshalj@georgetown.edu","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":"0 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/crc-2020-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45770492","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 : 2020-02-01DOI: 10.1200/jco.2020.38.4_suppl.16
E. Erbs, S. Rafaelsen, J. Lindebjerg, L. Jensen, T. Hansen
Aims: We sought to investigate if mismatch repair (MMR) status influences the preoperative staging of local colon cancer. Methods: Data from 590 patients in the Danish Colorectal Cancer Group national clinical database who were operated on for stage I-III colon cancer in 2010-15 were included. MMR status was determined by immunohistochemistry. Results: 22.9% had deficient(d) MMR tumors. Correlation of the clinical and pathological T-category was significant for both groups. The correlation of pre- and postoperative N-category was inferior (p >0.05) in dMMR cancers compared to a significant (p <0.01) correlation in proficient MMR cancers. 64.8% of dMMR tumors assessed node-positive demonstrated no sign of metastatic involvement at the postoperative assessment. Conclusion: MMR status seems to impact the accuracy of preoperative lymph node staging.
{"title":"The impact of mismatch repair status to the preoperative staging of colon cancer: implications for clinical management","authors":"E. Erbs, S. Rafaelsen, J. Lindebjerg, L. Jensen, T. Hansen","doi":"10.1200/jco.2020.38.4_suppl.16","DOIUrl":"https://doi.org/10.1200/jco.2020.38.4_suppl.16","url":null,"abstract":"Aims: We sought to investigate if mismatch repair (MMR) status influences the preoperative staging of local colon cancer. Methods: Data from 590 patients in the Danish Colorectal Cancer Group national clinical database who were operated on for stage I-III colon cancer in 2010-15 were included. MMR status was determined by immunohistochemistry. Results: 22.9% had deficient(d) MMR tumors. Correlation of the clinical and pathological T-category was significant for both groups. The correlation of pre- and postoperative N-category was inferior (p >0.05) in dMMR cancers compared to a significant (p <0.01) correlation in proficient MMR cancers. 64.8% of dMMR tumors assessed node-positive demonstrated no sign of metastatic involvement at the postoperative assessment. Conclusion: MMR status seems to impact the accuracy of preoperative lymph node staging.","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47741944","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}
{"title":"BRAF mutations as a therapeutic target in metastatic colorectal cancer patients: a long due success","authors":"I. Sahin, J. Klostergaard","doi":"10.2217/crc-2019-0012","DOIUrl":"https://doi.org/10.2217/crc-2019-0012","url":null,"abstract":"","PeriodicalId":43638,"journal":{"name":"Colorectal Cancer","volume":"8 1","pages":""},"PeriodicalIF":4.2,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44162733","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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