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Omar Abdelrahman - One of the best experts on this subject based on the ideXlab platform.

  • outcomes of non Metastatic Colon Cancer patients in relationship to socioeconomic status an analysis of seer census tract level socioeconomic database
    International Journal of Clinical Oncology, 2019
    Co-Authors: Omar Abdelrahman
    Abstract:

    OBJECTIVE To evaluate the outcomes of non-Metastatic Colon Cancer patients in relation to the socioeconomic status (SES) at diagnosis based on the Surveillance, Epidemiology, and End Results (SEER) census tract level-SES database. METHODS SEER SES census tract level database represents a specially designed database to integrate different aspects of SES among Cancer patients. It reports a composite SES index for each patient. Patients were then stratified into three SES groups. Patients with a non-Metastatic Colon Cancer diagnosis, diagnosed (2004-2015), and who were included in this specialized database were included in the current study. Multivariate Cox regression analysis was used to assess the impact of SES index on Colon Cancer-specific survival. RESULTS A total of 80,121 patients with non-Metastatic Colon Cancer were included in the current study. Comparing patients in the lower SES group with patients in the higher SES group, patients with lower SES were more likely to have a younger age at presentation (P < 0.001), black race (P < 0.001) and more advanced stage at presentation (P < 0.001). The impact of the SES on Colon Cancer-specific survival was evaluated through multivariate Cox regression analysis adjusted for age, sex, race, stage, and Colon Cancer side. Lower SES was associated with worse Colon Cancer-specific survival (hazard ratio for group 1 versus group 3: 1.257; 1.190-1.328; P < 0.001). Interaction testing between race (black race versus white race) and SES was non-significant (P = 0.932). CONCLUSIONS Lower SES is associated with worse Colon Cancer-specific survival among non-Metastatic Colon Cancer patients.

  • outcomes of non Metastatic Colon Cancer patients in relationship to socioeconomic status an analysis of seer census tract level socioeconomic database
    International Journal of Clinical Oncology, 2019
    Co-Authors: Omar Abdelrahman
    Abstract:

    To evaluate the outcomes of non-Metastatic Colon Cancer patients in relation to the socioeconomic status (SES) at diagnosis based on the Surveillance, Epidemiology, and End Results (SEER) census tract level-SES database. SEER SES census tract level database represents a specially designed database to integrate different aspects of SES among Cancer patients. It reports a composite SES index for each patient. Patients were then stratified into three SES groups. Patients with a non-Metastatic Colon Cancer diagnosis, diagnosed (2004–2015), and who were included in this specialized database were included in the current study. Multivariate Cox regression analysis was used to assess the impact of SES index on Colon Cancer-specific survival. A total of 80,121 patients with non-Metastatic Colon Cancer were included in the current study. Comparing patients in the lower SES group with patients in the higher SES group, patients with lower SES were more likely to have a younger age at presentation (P < 0.001), black race (P < 0.001) and more advanced stage at presentation (P < 0.001). The impact of the SES on Colon Cancer-specific survival was evaluated through multivariate Cox regression analysis adjusted for age, sex, race, stage, and Colon Cancer side. Lower SES was associated with worse Colon Cancer-specific survival (hazard ratio for group 1 versus group 3: 1.257; 1.190–1.328; P < 0.001). Interaction testing between race (black race versus white race) and SES was non-significant (P = 0.932). Lower SES is associated with worse Colon Cancer-specific survival among non-Metastatic Colon Cancer patients.

Yujing Fang - One of the best experts on this subject based on the ideXlab platform.

  • expression of voltage gated sodium channel nav1 5 in non Metastatic Colon Cancer and its associations with estrogen receptor er β expression and clinical outcomes
    Chinese Journal of Cancer, 2017
    Co-Authors: Jianhong Peng, Rongxin Zhang, Qian Zhao, Wu Jiang, Desen Wan, Zhizhong Pan, Yujing Fang
    Abstract:

    Voltage-gated sodium channel 1.5 (Nav1.5) potentially promotes the migratory and invasive behaviors of Colon Cancer cells. Hitherto, the prognostic significance of Nav1.5 expression remains undetermined. The present study aimed to explore the associations of Nav1.5 expression with clinical outcomes and estrogen receptor-β (ER-β) expression in non-Metastatic Colon Cancer patients receiving radical resection. A total of 269 consecutive patients with pathologically confirmed stages I–III Colon Cancer who underwent radical resection were selected. Nav1.5 and ER-β expression was detected by using immunohistochemistry (IHC) on tissue microarray constructed from paraffin-embedded specimens. IHC score was determined according to the percentage and intensity of positively stained cells. Statistical analysis was performed with the X-tile method, k coefficient, Chi square test or Fisher’s exact test, logistic regression, log-rank test, and Cox proportional hazards models. We found that Nav1.5 was commonly expressed in tumor tissues with higher mean IHC score as compared with matched tumor-adjacent normal tissues (5.1 ± 3.5 vs. 3.5 ± 2.7, P < 0.001). The high expression of Nav1.5 in Colon Cancer tissues was associated with high preoperative carcinoembryonic antigen level [odds ratio (OR) = 2.980; 95% confidential interval (CI) 1.163–7.632; P = 0.023] and high ER-β expression (OR = 2.808; 95% CI 1.243–6.343; P = 0.013). Log-rank test results showed that high Nav1.5 expression contributed to a low 5-year disease-free survival (DFS) rate in Colon Cancer patients (77.2% vs. 92.1%, P = 0.048), especially in patients with high ER-β expression tumor (76.2% vs. 91.3%, P = 0.032). Analysis with Cox proportional hazards model demonstrated that high Nav1.5 expression [hazard ratio (HR) = 2.738; 95% CI 1.100–6.819; P = 0.030] and lymph node metastasis (HR = 2.633; 95% CI 1.632–4.248; P < 0.001) were prognostic factors for unfavorable DFS in Colon Cancer patients. High expression of Nav1.5 was associated with high expression of ER-β and indicated unfavorable oncologic prognosis in patients with non-Metastatic Colon Cancer.

  • Expression of voltage-gated sodium channel Nav1.5 in non-Metastatic Colon Cancer and its associations with estrogen receptor (ER)-β expression and clinical outcomes
    BMC, 2017
    Co-Authors: Jianhong Peng, Rongxin Zhang, Qian Zhao, Wu Jiang, Desen Wan, Zhizhong Pan, Yujing Fang
    Abstract:

    Abstract Background Voltage-gated sodium channel 1.5 (Nav1.5) potentially promotes the migratory and invasive behaviors of Colon Cancer cells. Hitherto, the prognostic significance of Nav1.5 expression remains undetermined. The present study aimed to explore the associations of Nav1.5 expression with clinical outcomes and estrogen receptor-β (ER-β) expression in non-Metastatic Colon Cancer patients receiving radical resection. Methods A total of 269 consecutive patients with pathologically confirmed stages I–III Colon Cancer who underwent radical resection were selected. Nav1.5 and ER-β expression was detected by using immunohistochemistry (IHC) on tissue microarray constructed from paraffin-embedded specimens. IHC score was determined according to the percentage and intensity of positively stained cells. Statistical analysis was performed with the X-tile method, k coefficient, Chi square test or Fisher’s exact test, logistic regression, log-rank test, and Cox proportional hazards models. Results We found that Nav1.5 was commonly expressed in tumor tissues with higher mean IHC score as compared with matched tumor-adjacent normal tissues (5.1 ± 3.5 vs. 3.5 ± 2.7, P 

Geert Kazemier - One of the best experts on this subject based on the ideXlab platform.

  • ten year outcomes of a randomised trial of laparoscopic versus open surgery for Colon Cancer
    Surgical Endoscopy and Other Interventional Techniques, 2017
    Co-Authors: Charlotte L Deijen, Jeanine E Vasmel, Elly S M De Langede Klerk, Miguel A Cuesta, P P L O Coene, Johan F Lange, Jeroen W Meijerink, Jack J Jakimowicz, J Jeekel, Geert Kazemier
    Abstract:

    Laparoscopic surgery for Colon Cancer is associated with improved recovery and similar Cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the Colon Cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Between March 1997 and March 2003, patients with non-Metastatic Colon Cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right Colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) −10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI −10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI −11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4). Laparoscopic surgery for non-Metastatic Colon Cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.

Ayse Saatci Yasar - One of the best experts on this subject based on the ideXlab platform.

Nancy E Kemeny - One of the best experts on this subject based on the ideXlab platform.

  • treatment of Metastatic Colon Cancer the times they are a changing
    Journal of Clinical Oncology, 2013
    Co-Authors: Nancy E Kemeny
    Abstract:

    In the 1950s, Colon Cancer was the poor stepchild for chemotherapists, with a median survival of 12 months for patients with Metastatic disease. Now patients with Metastatic disease, even hepatic metastases, can survive 5 years when surgical techniques for liver resection and new chemotherapy, with or without targeted agents, are used. In the article that accompanies this editorial, Ye et al prospectively randomly assigned patients with unresectable, liver-limited metastases (KRAS wild type) to systemic chemotherapy with or without cetuximab (Cetx). The primary end point was the number of patients converted to hepatic resection. The patients receiving chemotherapy plus Cetx had a significantly higher resection rate: 25% versus 7.4%. The patients were well matched for individual prognostic factors, but the two study groups differed slightly: high clinical risk score of 25% versus 35%; rectal primaries, 38% versus 48%; lesion larger than 5 cm, 44% versus 55%; and major vessel involvement, 37% versus 44%, for the chemotherapy plus Cetx group versus chemotherapy group, respectively. Overall, the chemotherapy plus Cetx group had 22% fewer patients with poor prognostic indicators. This may explain why patients who underwent resection and did not receive Cetx had a shorter survival than those who received chemotherapy plus Cetx (median survival, 22 months v 34.8 months, respectively). The 5-year survival rates obtained with liver resection, 30% to 50%, are superior to rates of survival obtained with systemic chemotherapy alone. Early studies showed a 30% 5-year survival for patients who had resection of one to three liver metastases. More recent studies have shown that resection is possible in patients with a greater volume of disease. Currently, the main consideration is not the total number of liver metastases but whether enough viable liver can be preserved to provide adequate liver function. What about patients with initially unresectable disease that becomes resectable after chemotherapy— what is their survival? French investigators have shown that patients withunresectablediseasewhosediseasebecomesresectableafterchemotherapy have a similar prognosis as those whose disease was initially resectable, with 5-year survivals of 33% for the converted group. To examine long-term outcomes: of 184 patients with unresectable disease whose disease became resectable and who were followed for 5 years or more, 33% had a 5-year survival and 27% had a 10-year survival. There was a greater chance of achieving long-term survival with fewer than three metastases. Others have reported a 23% actual 5-year survival in downstaged patients. In patients with resectable disease, trials should address whether neoadjuvant therapy is useful and, if so, what type of therapy should be used. A European Organisation for Research and Treatment of Cancer (EORTC) study that used both preoperative and postoperative therapy stated that preoperative chemotherapy was beneficial, given that there was an increase in 3-year disease-free survival (DFS) in the treated group versus the surgery alone group (36.2% v 27.8%, respectively, for eligible patients). There was no difference in 5-year survival (51.2% v 47.8%). The benefit of preoperative chemotherapy is not clear because patients received both preand postoperative therapy. Ninety-four percent of these patients had one to three liver metastases and other favorable characteristics. Do patients with good characteristics need preoperative chemotherapy? Are there poor-risk groups who would be helped by preoperative chemotherapy? In patients with unresectable hepatic metastases whose disease can be converted to resectable disease, what is the best preoperative chemotherapy regimen? The article by Ye et al attempts to answer this conversion question. For this type of trial, what is the definition of resectability? A multidisciplinary hepatobiliary team is needed to address this question. Are certain types of patients less likely to have disease that can be made resectable, such as patients with involvement of hepatic veins or inferior vena cava involvement? A Memorial SloanKettering Cancer Center trial outlined the reasons for unresectability for each patient and then reported which of these patients had disease that was made resectable, thus providing a framework to compare studies. Are there patients whose disease can be made resectable but who do not benefit from resection? Do some patients have a higher recurrence rate? Do techniques that enable more patients to undergo resection, such as portal vein embolization, two-stage resection, and radiofrequency ablation, produce a higher rate of recurrence? These are questions that need to be addressed in future trials. Is adjuvant chemotherapy after hepatic resection useful? The initial randomized trials of fluorouracil/leucovorin versus no treatment did not show a clear increase in progression-free survival, but a multivariable pooled analysis of two studies showed a significant benefit. Adding irinotecan to fluorouracil/leucovorin did not increase overall survival or DFS. Infusional fluorouracil, leucovorin, and oxaliplatin after resection has not been tested in a randomized study. JOURNAL OF CLINICAL ONCOLOGY E D I T O R I A L VOLUME 31 NUMBER 16 JUNE 1 2013