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Latest & greatest articles for colorectal cancer
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Effect of Vitamin D Supplementation on Relapse-Free Survival Among Patients With Digestive Tract Cancers: The AMATERASU Randomized Clinical Trial. Randomized clinical trials of vitamin D supplementation for secondary prevention in patients with cancer are needed, given positive results of observational studies.To determine whether postoperative vitamin D3 supplementation can improve survival of patients with digestive tract cancers overall and in subgroups stratified by 25-hydroxyvitamin D (25 (...) [OH]D) levels.The AMATERASU trial, a randomized, double-blind, placebo-controlled trial conducted at a single university hospital in Japan. Enrollment began in January 2010 and follow-up was completed in February 2018. Patients aged 30 to 90 years with cancers of the digestive tract from the esophagus to the rectum, stages I to III, were recruited. Of 439 eligible patients, 15 declined and 7 were excluded after operation.Patients were randomized to receive oral supplemental capsules of vitamin D
Early Detection for ColorectalCancer Resource-Stratified Guideline Early Detection for ColorectalCancer: ASCO Resource-Stratified Guideline | Journal of Global Oncology Search in: Menu Article Tools SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JGO.18.00213 Journal of Global Oncology - published online before print February 25, 2019 PMID: Early Detection for ColorectalCancer: ASCO Resource-Stratified Guideline , MD, MBA 1 (...) Lumpur, Malaysia 10 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico 11 Shahid Beheshti University, Tehran, Iran 12 Columbia Asia Hospitals, Bangalore, India, and Weill Cornell Medical College, New York, NY 13 New York-Presbyterian/Weill Cornell Medical Center, New York, NY 14 Makati Medical Center, Makati, Philippines 15 Homerton University Hospital Foundation Trust, BowelDisease Research Foundation, London, United Kingdom 16 The University of Puerto Rico
Treatment of Patients with Early-Stage ColorectalCancer Resource-Stratified Guideline Treatment of Patients With Early-Stage ColorectalCancer: ASCO Resource-Stratified Guideline | Journal of Global Oncology Search in: Menu Article Tools SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JGO.18.00214 Journal of Global Oncology - published online before print February 25, 2019 PMID: Treatment of Patients With Early-Stage (...) ColorectalCancer: ASCO Resource-Stratified Guideline , MD, MPH 1 x Ainhoa Costas-Chavarri ; , MD 2 3 x Govind Nandakumar ; , MSPH 4 x Sarah Temin ; , MD, MBA 5 x Gilberto Lopes ; , MD, PhD 6 x Andres Cervantes ; , MD, PhD 7 8 x Marcia Cruz Correa ; , MD 9 x Rena Engineer ; , MD, PhD 10 x Chisato Hamashima ; , MD 11 x Gwo Fuang Ho ; , MD 12 x Fidel David Huitzil ; , MD 13 x Mona Malekzadeh Moghani ; , MD 14 x Ala I. Sharara ; , PhD 15 x Mariana C. Stern ; , MD 16 x Catherine Teh ; , MD 12 x Sara E
Lymphocyte-C-reactive Protein Ratio as Promising New Marker for Predicting Surgical and Oncological Outcomes in ColorectalCancer MINI: In the present study, we systemically and comprehensively evaluated the prognostic significance of a combination of inflammatory factors using preoperative blood examination, and focused on the potential feasibility of our newly developed lymphocyte-CRP ratio (LCR) as a prognostic biomarker in CRC patients. We have firstly identified that a combination (...) of lymphocytic counts along with CRP levels, which we defined as LCR, is a more reliable indicator of poor prognosis compared with other combinations of inflammatory markers, in CRC patients. Furthermore, preoperative LCR could also identify CRC patients who are at higher risk for postoperative infectious complications.Systemic inflammation via host-tumor interactions is currently recognized as a hallmark of cancer. The aim of this study was to evaluate the prognostic value of various combinations
Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study No standard adjuvant treatment currently is recommended in localized biliary tract cancer (BTC) after surgical resection. We aimed to assess whether gemcitabine and oxaliplatin chemotherapy (GEMOX) would increase relapse-free survival (RFS) while maintaining health-related quality of life (HRQOL) in patients who undergo resection.We
in a multicentre, open-label RCT in six centres in the Netherlands. Patients with colorectalcancer scheduled for elective curative surgery with a primary anastomosis were eligible. Oral colistin, tobramycin and amphotericin B were administered to patients in the SDD group to decontaminate the digestive tract. Both treatment and control group received intravenous cefazolin and metronidazole for perioperative prophylaxis. Mechanical bowel preparation was given for left-sided colectomies, sigmoid and anterior (...) Randomized clinical trial of selective decontamination of the digestive tract in elective colorectalcancer surgery (SELECT trial) Infectious complications and anastomotic leakage affect approximately 30 per cent of patients after colorectalcancer surgery. The aim of this multicentre randomized trial was to investigate whether selective decontamination of the digestive tract (SDD) reduces these complications of elective colorectalcancer surgery.The effectiveness of SDD was evaluated
Participation and Ease of Use in ColorectalCancer Screening: A Comparison of 2 Fecal Immunochemical Tests The impact of fecal immunochemical test (FIT)-based colorectalcancer (CRC) screening on disease incidence and mortality is affected by participation, which might be influenced by ease of use of the FIT. We compared the participation rates and ease of use of 2 different FITs in a CRC screening program.There were two study designs within the Dutch CRC screening program. In a paired cohort
Aspirin Use to Prevent Cardiovascular Disease and ColorectalCancer 1 Aspirin Use to Prevent Cardiovascular Disease and ColorectalCancer Interim Guidance from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group October 5, 2018 Three randomized clinical trials (ARRIVE 1 , ASCEND 2 , and ASPREE 3 ) recently published results on aspirin use in patients without known Atherosclerotic Cardiovascular Disease (ASCVD). The studies looked at benefits including (...) daily. • There is no recommendation for or against aspirin therapy in adults aged < 50 or = 60 years. • Exclude adults with increased risk of bleeding. This includes those with a history of gastrointestinal (GI) bleeding, GI ulcers, intracranial bleed, bleeding disorders, renal failure, severe liver disease, thrombocytopenia, or using NSAIDS daily, or other medicine to prevent blood clots. The recommendations above reflect a change from initiate to consider in adults aged 50-59 years with 10-year
Familial colorectalcancer risk in half siblings and siblings: nationwide cohort study. To explore the risk of colorectalcancer in family members of patients with colorectalcancer, with an emphasis on subtypes of second degree relatives, especially half siblings, which were lacking in the literature.Ambidirectional cohort study.Nationwide Swedish Family Cancer Data (record linkage).All people residing in Sweden and born after 1931, with their biological parents, totalling >16 million (...) individuals (follow-up: 1958-2015); of those with clear genealogy, 173 796 developed colorectal cancer.Lifetime (0-79 years) cumulative risk and standardised incidence ratio of colorectalcancer among first degree relatives and second degree relatives.The overall lifetime cumulative risk of colorectalcancer in siblings of patients was 7%, which represents a 1.7-fold (95% confidence interval 1.6 to 1.7; n=2089) increase over the risk in those without any family history of colorectalcancer. A similarly
Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for ColorectalCancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564-2575. . Centers for Disease Control and Prevention. National Health Interview Survey. Available at: . Published March 1, 2014. Accessed June 21, 2018. .National Cancer Institute. SEER Cancer Statistics Fact sheets: Colon and Rectum Cancer. Available at: .Published September, 2014. Accessed June 21, 2018 (...) will continue to improve, and blood tests for CRC are in development. Research and one blood test, Epi pro Colon, was approved by the FDA in 2016. However, it is not currently recommended by the USPSTF. As this area of research develops, it is important that physicians remain aware of all the currently available USPTSF-approved screening modalities. “One size fits all” may not be the most effective cancer screening approach for all patients. Studies have shown that colonoscopy may be avoided by large
, SMAD4, BMPR1A, MLH1, MSH2, MSH6, PMS2, STK11, GREM1, MUTYH, and EPCAM* [*deletions associated with epigenetic silencing of MSH2]. Generally for the gastrointestinal (GI) cancer predisposition genes, those testing positive require close surveillance with colonoscopy to detect the rapidly growing cancers which occur driven by, for example, the mutator phenotype (accumulating hundreds of mutations in the tumours) typically of Lynch Syndrome. Those who do develop colorectalcancer are usually advised (...) this rearrangement. 3. Summary of consideration and rationale for MSAC’s advice MSAC noted that the proposed purposes and populations are (a) diagnostic testing of patients with either (i) colorectal or endometrial carcinoma and features suggestive of a hereditary basis, or (ii) a colonic polyposis syndrome, plus (b) cascade testing of relatives of those individuals who are diagnosed with the relevant germline gene variants. The diagnostic genetic test is to characterise germline gene variants in three or more
Making Patients Fit for Surgery: Introducing a Four Pillar Multimodal Prehabilitation Program in ColorectalCancer. Considering the relation between preoperative functional capacity and postoperative complications, enhancing patients' functional capacity before surgery with a prehabilitation program may facilitate faster recovery and improve quality of life. However, time before surgery is short, mandating a multimodal and high-intensity training approach. This study investigated feasibility (...) for colorectalcancer patients is feasible, safe, and effective. A randomized controlled trial (NTR5947) was initiated to determine whether prehabilitation may lower morbidity and mortality rates in colorectal surgery.
Adjuvant Chemotherapy of Locally Advanced ColonCancer: Final Results of a Randomized Trial Comparing 5-Fluorouracil and Folinic Acid with Folfiri. There is still the need to optimize adjuvant treatment of coloncancer (CC). Standard adjuvant chemotherapy using 5-fluorouracil (FU) and folinic acid (FA) was compared with a combination including irinotecan (Folfiri). The aim of the present report was to analyze overall survival (OS) after long-term follow-up, to summarize final recurrence rates (...) in 17 (12.8%) patients treated with FUFA and in 50 (36.8%) patients treated with Folfiri. Recurrences occurred in 46 of 133 (34.6%) and in 47 of 136 (34.6%) patients who received FUFA and Folfiri, respectively. 5-year OS rates were 69.9% (95% confidence interval (CI): 61.2-77.1) for FUFA and 72.7% (95% CI: 63.9-79.8) for Folfiri. OS was associated with tumor grading (1 & 2 vs. 3), tumor sub-stage (II vs. IIIa vs. IIIb vs. IIIc), and tumor location (left vs. right colon).Folfiri cannot be generally
Sequential Versus Combination Therapy of Metastatic ColorectalCancer Using Fluoropyrimidines, Irinotecan, and Bevacizumab: A Randomized, Controlled Study-XELAVIRI (AIO KRK0110) The XELAVIRI trial investigated the optimal treatment strategy for patients with untreated metastatic colorectalcancer. We tested the noninferiority of initial treatment with a fluoropyrimidine plus bevacizumab, followed by the addition of irinotecan at first progression (arm A) versus upfront use of fluoropyrimidine (...) of 421 randomly assigned patients (arm A: n = 212; arm B: n = 209) formed the full analysis set. Median age was 71 and 69 years, respectively. Noninferiority of TFS was not shown (hazard ratio [HR], 0.86; 90% CI, 0.73 to 1.02). In detail, patients with RAS/BRAF wild-type tumors benefitted from combination chemotherapy (HR, 0.61; 90% CI, 0.46 to 0.82; P = .005), whereas patients with RAS mutant tumors (HR, 1.09; 90% CI, 0.81 to 1.46; P = .58) did not (Cox model for interaction of study arm and RAS
Mortality From Postscreening (Interval) ColorectalCancers Is Comparable to That From Cancer in Unscreened Patients-A Randomized Sigmoidoscopy Trial Endoscopic screening for colorectalcancer (CRC) is performed at longer time intervals than the fecal occult blood test or screenings for breast or prostate cancer. This causes concerns about interval cancers, which have been proposed to progress more rapidly. We compared outcomes of patients with interval CRCs after sigmoidoscopy screening vs (...) diagnosed with CRC 30 days or longer after screening (interval cancer group, n = 163) and individuals diagnosed with CRC in the nonscreened group (controls, n = 1740). All CRCs in the control group were identified when they developed symptoms (clinically detected CRCs). Analyses were stratified by cancer site. We used Cox regression to estimate hazard ratio (HRs), adjusted for age and sex.Over the follow-up period, 43 individuals in the interval cancer group died from CRC; among controls, 525 died from
Colon capsule endoscopy (CCE-2) for the detection of colorectal polyps and cancer in adults with signs or symptoms of colorectalcancer or at increased risk of colorectalcancer SHTG Advice Statement | 1 Advice Statement 014-18 November 2018 Advice Statement Colon capsule endoscopy (CCE-2) for the detection of colorectal polyps and cancer in adults with signs or symptoms of colorectalcancer or at increased risk of colorectalcancer Advice for NHSScotland Colon capsule endoscopy (CCE-2 (...) ) is not recommended for routine use in NHSScotland for the detection of colorectal polyps and cancer. The clinical effectiveness evidence is currently limited, no relevant published evidence on the cost effectiveness of the technology was identified, and its place in the patient care pathway has still to be established. CCE-2 may however be considered as an additional testing option in patients who are able to undergo the intensive bowel cleansing needed for CCE-2 and who have contraindications for optical
with papillary thyroid cancer that is the cribriform-morular variant, or hepatoblastoma Individuals with a diagnosis of CRC and>10 colorectal adenomas Individuals with a personal history of20 adenomas Individuals with multiple gastrointestinal hamartomatous polyps or serrated polyposis syndrome Individuals from a family with a known hereditary syndrome associated with CRC with or without a known mutation Individuals with a desmoid tumor, multifocal or bilateral CHRPE CHRPE, congenital hypertrophy of retinal (...) of CRC or advanced adenoma warrants more intense screening for CRC. Well-designed prospective studies are needed in order to make de?nitive evidence-based recommendations about the age to commence screening and appropriate interval between screening tests. Keywords: Adenoma; Cancer; Colonoscopy; Colorectal; FOBT; Neoplasms; Polyp; Screening. Executive Summary Colorectalcancer (CRC) is the second leading cause of cancer deaths in Canada and the United States. A positive family history (FH) signi
) in children and adults? Clinical Bottom Line Incidental findings on dental radiographs could serve as screening tools for systemic diseases and syndromes. The attention should be raised when gene mutation, congenitally diseases or familial colorectalcancer are reported by patients during the medical history questionnaire. For patients with risk of FAP, the Dental panoramic radiographic score (DPRS) is inexpensive, and reinforce the referral for the further clinical investigation, gene mapping (...) . Perspective: These studies emphasize the extra-intestinal manifestations of colorectalcancer. The dental anomalies, commonly considered incidental findings, appear around 10 years before the clinical evidence of the intestinal polyps and the dental professional should be aware of these correlations. Since the gene mutation affects families, it is important to early detect, refer and map genetically these patients reducing the morbidity. The colorectalcancer is considered a public health issue, FAP