• 제목/요약/키워드: Metastatic colorectal

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Metastatic Thymic Adenocarcinoma from Colorectal Cancer

  • Lee, Mina;Choi, Suk Jin;Yoon, Yong Han;Kim, Joung-Taek;Baek, Wan Ki;Kim, Young Sam
    • Journal of Chest Surgery
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    • 제48권6호
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    • pp.447-451
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    • 2015
  • This report describes the case of a 57-year-old man with an anterior mediastinal tumor. Four years previously, he underwent laparoscopic anterior resection for sigmoid colon cancer. Thirty months after that procedure, bilateral pulmonary metastasectomy was performed. Twelve months later, follow-up computed tomography revealed a 1-cm pulmonary nodule on the upper lobe of the right lung and a solid mass on the anterior mediastinum, and the patient was also observed to have an elevated serum carcinoembryonic antigen (CEA) level. Repeated pulmonary nodule resection and total thymectomy were performed. Immunohistochemical staining of the anterior mediastinal tumor revealed adenocarcinoma, and his serum CEA level returned to normal after the operation. These findings strongly suggested metastatic thymic adenocarcinoma from a colorectal cancer.

Mutation Analysis of KRAS and BRAF Genes in Metastatic Colorectal Cancer: a First Large Scale Study from Iran

  • koochak, Aghigh;Rakhshani, Nasser;Niya, Mohammad Hadi Karbalaie;Tameshkel, Fahimeh Safarnezhad;Sohrabi, Masoud Reza;Babaee, Mohammad Reza;Rezvani, Hamid;Bahar, Babak;Imanzade, Farid;Zamani, Farhad;Khonsari, Mohammad Reza;Ajdarkosh, Hossein;Hemmasi, Gholamreza
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.603-608
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    • 2016
  • Background: The investigation of mutation patterns in oncogenes potentially can make available a reliable mechanism for management and treatment decisions for patients with colorectal cancer (CRC). This study concerns the rate of KRAS and BRAF genes mutations in Iranian metastatic colorectal cancer (mCRC) patients, as well as associations of genotypes with clinicopathological features. Materials and Methods: A total of 1,000 mCRC specimens collected from 2008 to 2012 that referred to the Mehr Hospital and Partolab center, Tehran, Iran enrolled in this cross sectional study. Using HRM, Dxs Therascreen and Pyrosequencing methods, we analyzed the mutational status of KRAS and BRAF genes in these. Results: KRAS mutations were present in 33.6% cases (n=336). Of KRAS mutation positive cases, 85.1% were in codon 12 and 14.9% were in codon 13. The most frequent mutation at KRAS codon 12 was Gly12Asp; BRAF mutations were not found in any mCRC patients (n=242). In addition, we observed a strong correlation of KRAS mutations with some clinicopathological characteristics. Conclusions: KRAS mutations are frequent in mCRCs while presence of BRAF mutations in these patients is rare. Moreover, associations of KRAS genotypes with non-mucinous adenocarcinoma and depth of invasion (pT3) were remarkable.

다양한 원발성 암의 척추전이 병변의 특징적인 자기공명영상 소견들: 병리학적으로 확인된 병변들의 후향적인 분석 (Characteristic MRI Findings of Spinal Metastases from Various Primary Cancers: Retrospective Study of Pathologically-Confirmed Cases)

  • 안찬식;이영한;김성준;조희우;서진석;송호택
    • Investigative Magnetic Resonance Imaging
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    • 제17권1호
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    • pp.8-18
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    • 2013
  • 목적: 척추전이의 자기공명영상 소견들 중 특정 원발성 암에 특이적인 소견들이 있는지 알아보고자 한다. 대상과 방법: 본 연구에서는 자기공명영상을 시행한 총 169개의 척추전이암 병변들 (56개는 폐암, 29개는 유방암, 20개는 대장암, 17개는 간세포암, 그리고 47개는 위암으로부터 기원)을 후향적으로 분석하였다. 각 병변의 크기, 위치, 침범 정도, 신호강도, 경계, 조영증강 양상, 그리고 골융해/골경화 특성들을 분석하여 원발성 암의 기원에 따라 차이가 있는지 보았다. 결과: 간세포암의 전이 병변들은 대장암을 제외하고는 (P=0.268) 다른 암에 비하여 크기가 유의하게 컸다 (P < 0.05). 경계가 좋은 병변은 폐암과 유방암에서 기원한 경우에서 더 흔히 관찰되었다 (P < 0.01). 간세포암을 제외한 모든 암에서 전이를 할 때 척추의 후부요소보다 척추체를 더 자주 침범하였다(P < 0.02). 대장암과 간세포암은 골외 침범을 더 자주 보였으나 통계학적 의미는 없었다 (P > 0.05). 간세포암과 위암의 전이병변들은 특징적인 조영증강 양상을 보였다. 결론: 일부 자기공명영상 소견들은 척추전이 병변이 어떤 원발성 암에서 기원한 것이지 예측하는 데 도움이 될 수 있다.

Value of FDG PET/Contrast-Enhanced CT in Initial Staging of Colorectal Cancer - Comparison with Contrast-Enhanced CT

  • Kunawudhi, Anchisa;Sereeborwornthanasak, Karun;Promteangtrong, Chetsadaporn;Siripongpreeda, Bunchorn;Vanprom, Saiphet;Chotipanich, Chanisa
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.4071-4075
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    • 2016
  • Background: FDG PET/CT is at an equivocal stage to recommend for staging of colorectal cancer as compared to contrast-enhanced CT (ceCT). This study was intended to evaluate the value of FDG PET/ceCT in colorectal cancer staging as compared to ceCT alone. Materials and Methods: PET/ceCT was performed for 61 colorectal cancer patients who were prospectively enrolled in the study. Three patients were excluded due to loss to follow-up. PET/ceCT findings and ceCT results alone were read separately. The treatment planning was then determined by tumor board consensus. The criteria for T staging were determined by the findings of ceCT. Nodal positive by PET/ceCT imaging was determined by visual analysis of FDG uptake greater than regional background blood pool activity. The diagnostic accuracy of T and N staging was determined only in patients who received surgery without any neoadjuvant treatment. Results: Of 58 patients, there were 40 with colon cancers including sigmoid cancers and 18 with rectal cancers. PET/ceCT in pre-operative staging detected bone metastasis and metastatic inguinal lymph nodes (M1a) that were undepicted on CT in 2 patients (3%), clearly defined 19 equivocal lesions on ceCT in 18 patients (31%) and excluded 6 metastatic lesions diagnosed by ceCT in 6 patients (10%). These resulted in alteration of management plan in 15 out of the 58 cases (26%) i.e. changing from chemotherapy to surgery (4), changing extent of surgery (9) and avoidance of futile surgery (2). Forty four patients underwent surgery within 45 days after PET/CT. The diagnostic accuracy for N staging with PET/ceCT and ceCT alone was 66% and 48% with false positive rates of 24% (6/25) and 76% (19/25) and false negative rates of 47% (9/19) and 21% (4/19), respectively. All of the false negative lymph nodes from PET/ceCT were less than a centimeter in size and located in peri-lesional regions. The diagnostic accuracy for T staging was 82%. The sensitivity of the peri-lesional fat stranding sign in determining T3 stage was 94% and the specificity was 54%. Conclusions: Our study suggested promising roles of PET/ceCT in initial staging of colorectal cancer with better diagnostic accuracy facilitating management planning.

Dendrosomal Curcumin Inhibits Metastatic Potential of Human SW480 Colon Cancer Cells through Down-regulation of Claudin1, Zeb1 and Hef1-1 Gene Expression

  • Esmatabadi, Mohammad Javad Dehghan;Farhangi, Baharak;Safari, Zahra;Kazerooni, Hanif;Shirzad, Hadi;Zolghadr, Fatemeh;Sadeghizadeh, Majid
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2473-2481
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    • 2015
  • Colon cancer is one of the leading causes of cancer-associated death worldwide. The prognosis for advanced colorectal cancers remains dismal, mainly due to the propensity for metastatic progression. Accordingly, there is a need for effective anti-metastasis therapeutic agents. Since a great body of research has indicated anticancer effects for curcumin, we investigated the effects of dendrosomal curcumin (DNC) on cellular migration and adhesion of human SW480 cells and possible molecular mechanisms involved. Different methods were applied in this study including MTT, Scratch and adhesion assays as well as real-time PCR and transwell chamber assays. Based on the results obtained, DNC inhibits metastasis by decreasing Hef 1, Zeb 1 and Claudin 1 mRNA levels and can reduce SW480 cell proliferation with $IC_{50}$values of 15.9, 11.6 and $7.64{\mu}M$ at 24, 48 and 72h post-treatment. Thus it might be considered as a safe formulation for therapeutic purpose in colorectal cancer cases.

난치성 복막암종증의 치료 전략에 대한 고찰 (Treatment Strategy of Intractable Peritoneal Carcinomatosis)

  • 정재규;임윤정
    • Journal of Digestive Cancer Research
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    • 제1권1호
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    • pp.29-35
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    • 2013
  • 복막암종증(Peritoneal carcinomatosis)은 복강내에 암세포가 파종되어 벽쪽 복막과 내장쪽 복막 표면에 악성세포가 축적되는 상태로 정의할 수 있으며, 이것은 암성복수와도 관련 있다. 일반적으로 복막암종증은 원발암의 전이성 암과 유사하게 치료하나 같은 원발암의 다른 장기로의 전이암과는 달리 예후가 좋지 않다. 보존적 치료만 했을 경우 복막암종증 환자의 중앙생존기간은 3-6개월이다. 복막암종증은 예후가 좋지 않고 치료 방법이 제한적이어서 일선에서 치료하는 내과 의사에겐 여전히 어려운 과제이기도 하다. 최근에 이와 관련된 치료 방법이 많이 연구되어 육안적 병소제거술 및 복막절제술(cytoreductive surgery with peritonectomy)과 함께 조기 수술 후 복강내 화학요법(early postoperative intraperitoneal chemotherapy, EPIC) 또는 수술 중 복강내 온열화학요법(hyperthermic intraperitoneal chemotherapy, HIPEC)을 시행하여 생존율을 향상시키고 있다. 본 논문에서는 복막암종증의 전반적인 특징, 증상, 예후 및 진단과 수술적 방법, 항암 화학요법 등의 치료법에 대하여 알아보고자 한다.

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Phase II Study of Pemetrexed as Second or Third Line Combined Chemotherapy in Patients with Colorectal Cancer

  • Wu, Xue-Yan;Huang, Xin-En;You, Shan-Xi;Lu, Yan-Yan;Cao, Jie;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.2019-2022
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    • 2013
  • Purpose: To investigate the safety and efficacy of pemetrexed combined with chemotherapy as second or third line in patients with stage IV colorectal cancer (CRC). Patients and Methods: This trial was conducted to evaluate the effectiveness and safety of pemetrexed given to patients with recurrent or metastatic colorectal carcinoma who previously received 5-FU-based chemotherapy. All patients were required to have a histological diagnosis of colorectal adenocarcinoma with measurable metastatic disease and prior chemotherapy. Patients received pemetrexed at a dose of 500 $mg/m^2$ by 10 minute infusion on day 1, repeated every 21 days. Doses were modified depending on nadir counts. Combined chemotherapy included Oxaliplatin, Irinotecan and cis-platinum. Results: Thirty patients were enrolled and twenty-nine were evaluable for response. One patient did not have repeat radiological testing to determine response because he went off study after only one cycle of treatment for economic reasons. For 29 evaluable patients, 1 partial response, 6 stable disease and 22 progressive disease were recorded. Response rate was 3.45% (1/29). All responses occurred in patients receiving a starting dose of pemetrexed 500 $mg/m^2$. Median time to progression for all eligible patients was 2.5 months. The most common toxicities experienced were mild to moderate fever, hepatic damage, myelosuppression, nausea, vomiting, constipation, abdominal pain, diarrhea, and skin rash. Conclusion: Pemetrexed at 500 $mg/m^2$ given every three weeks combined with chemotherapy is associated with moderate response and good tolerability in patients with stage IV CRC.

Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

  • Wen, Ru-Min;Zhang, Yi-Jing;Ma, Sha;Xu, Ying-Li;Chen, Yan-Su;Li, Hai-Long;Bai, Jin;Zheng, Jun-Nian
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3703-3708
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    • 2015
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whether preoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materials and Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluated retrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. The predictive value of NLR for non-metastatic RCC was analyzed. Results: The NLR of 327 patients was $2.72{\pm}2.25$. NLR <1.7 and NLR ${\geq}1.7$ were classified as low and high NLR groups, respectively. Chi-square test showed that the preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histological subtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. To evaluate the independent prognostic significance of NLR, multivariate COX regression models were applied and identified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019). Conclusions: Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker of poor OS and DFS in patients with non-metastatic RCC.

Treatment of Metastatic Colorectal Cancer With or Without Bevacizumab: Can the Neutrophil/Lymphocyte Ratio Predict the Efficiency of Bevacizumab?

  • Dirican, Ahmet;Varol, Umut;Kucukzeybek, Yuksel;Alacacioglu, Ahmet;Erten, Cigdem;Somali, Isil;Can, Alper;Demir, Lutfiye;Bayoglu, Ibrahim Vedat;Akyol, Murat;Yildiz, Yasar;Koyuncu, Betul;Coban, Eyup;Tarhan, Mustafa Oktay
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4781-4786
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    • 2014
  • Background: The purpose of this study was to analyze the predictive value of neutrophil/lymphocyte ratio (NLR) to better clarify which patient groups will benefit the most from particular treatments like bevacizumab. Materials and Methods: A total of 245 treatment-naive metastatic colorectal cancern (mCRC) patients were retrospectively enrolled and divided into 2 groups: 145 group A patients were treated with chemotherapy in combination with bevacizumab, and 100 group B patients were treated as above without bevacizumab. Results: Group A patients had better median overall survival (OS) and progression-free survival (PFS) (24.0 and 9.0 months) than group B patients (20 and 6.0 months) (p=0.033; p=0.015). In patients with low NLR, OS and PFS were significantly longer in group A patients (27 vs 18 months, p=0.001; 11 vs 7 months, p=0.017). Conclusions: We conclude that NLR, a basal cancer related inflammation marker, is associated with the resistance to bevacizumab-based treatments in mCRC patients.