Stage III Colon Cancer Susquehanna Cancer Center Warren L Robinson, MD, FACP May 9, 2007
|
|
- Debra McKenzie
- 6 years ago
- Views:
Transcription
1 Stage III Colon Cancer Susquehanna Cancer Center Warren L Robinson, MD, FACP May 9, 27 Stage III Colon Cancer Susquehanna Cancer Center
2 Colorectal cancer is the third most common cancer in the United States with an estimated life-time risk of 6%. 1 It affects males and females equally and is the second most common cause of cancer death. 2 Although highly curable when diagnosed in early stages, the 5 year overall survival is only 62%. One approach to improve survival has been the development of systemic adjuvant chemotherapy. As late as 1984 the Gastrointestinal Tumor Study Group reported no survival advantage with adjuvant chemotherapy or immunotherapy for patients with Dukes stage B2, C1 or C2 colon cancer. 3 However, in 1989 the North Central Cancer Treatment Group reversed this understanding with its seminal report of adjuvant Levamisole and Fluorouracil demonstrating a borderline improvement in survival for patients with stage C disease. 4 A statistically significant improvement in overall survival with adjuvant chemotherapy in node positive colon cancer emerged in a subsequent report 5 and has been confirmed by others. 6 Today systemic adjuvant chemotherapy is an established standard of care for patients with node positive colon cancer. The Commission on Cancer embarked on an assessment of the utilization of adjuvant chemotherapy in node positive colon cancer patients through its Cancer Program Practice Profile Reports (CP3R) as a measure of quality of cancer care at its approved programs. This report details an analysis of all analytic cases of stage III colon cancer seen at the Susquehanna Cancer Center between 1997 and 21. Results A total of 12 patients with Stage III colon cancer were observed during this time period averaging 2 new cases per year. Their demographics are displayed in Table 1. Male and female cases were Table 1 Demographics Total Cases 12 Average per Year 2 Male: Female 52: Caucasian: African-American 99:3 Age: Median (range) (yrs) 71(-88) Male 68(-87) Female 74(45-88) divided equally. The predominately Caucasian distribution likely reflects the population of this region. The median age at diagnosis was 71 years, 68 years for males and 74 years for females. 92% were over age years and 67% over 65 years. Table 2 displays the distribution of primary sites among these 12 Stage III patients. Overall, 46% patients presented with cecal or right colon lesions while % had left colon or distal lesions. However, % of male cases involved Table 2 Primary Location Total Male Female Cecum Ascending Hepatic Flex Transverse Splenic Flex Descending 3 3 Sigmoid NOS the distal colon compared to only 18% for females. Whereas the disease
3 involved the proximal colon in 76% of our female patients compared to only 36% for male patients. Involvement of the flexures and transverse colon were relatively consistent with 2% overall, 21% males and 18% females. Complete surgical resection was deemed to have been achieved in 96% of cases. The predominate surgical procedure was a limited colectomy in 94% of cases. Subtotal and total colectomies were each performed in 3% of patients. The lymph node evaluation is given in Table 3. Table 3 Lymph Node Analysis Total: Median (range) 8 (1-38) < 12 72% > 12 26% Not assessable 2% Positive: Median (range) 2 (1-21) leucovoran was employed in 99% of patients treated. Only one patient received 5-Fluorouracil plus levamisole during this period. Table 5 ChemoRx Contraindications Contraindication Number Perioperative death 2 Poor performance status 2 Dementia 2 Renal failure, dementia 1 Renal & heart failure 1 Heart failure 1 Heart Failure, COPD 1 Non-healing wound 1 Overall survival of this group of Stage III patients is depicted in Figure 1 comparing patients at this center with those reported to the State and National Registries. 76% of patients were symptomatic at the time of diagnosis. Abdominal pain, rectal bleeding, anemia, and change in bowel habit were the most frequent symptoms. 24 patients were identified through screening, 18 by stool hemoccult testing and 6 by colonoscopy. Table 4 displays the percentage of patients identified by screening by year. Figure 1 Overall Survival Five Ye a r Obse rve d Surviva l Ra te s State of PA National Cancer DataBase** ** 1999 is most recent data available from NCDB Table 4 Screened vs. Symptomatic (%) Year Screened Symptomatic Adjuvant chemotherapy was recommended to 89% of these Stage III patients and received by 81%. 8% of patients refused chemotherapy. 11% were deemed not to be suitable candidates for chemotherapy (Table 5). The regimen of 5-Fluorouracil and Figure 2 compares survival by sex. At all follow up intervals males in this group of patients achieved greater survival than females. Figure 2 Survival by Sex Susquehanna Hea lth Five Yea r Observe d Surviva l Female vs Male Female Male
4 Figures 3-6 depict survival comparisons by various grouping. Those patients identified by screening had similar survival to those who were symptomatic. Patients with more than 12 nodes identified in the specimen and those with less than 4 positive nodes had superior survival. Those patients who received treatment lived longer than those who did not receive treatment. Figure 6 Survival by Treatment Five Year Observed Survival Rates Treatment vs Refused vs Contraindicated Discussion Contraindicated Refused Treatment Received Figure 3 Survival by Detection Method Five Year Obse rved Suriva l Rates Screening vs Symptomatic Screening Symptomatic 2 1 Figure 4 Survival by Total Nodes Five Year Observed Survival Rates Nodes Examined Nodes 12 Examined Nodes < 12 Examined 2 1 Figure 5 Survival by Positive Nodes Five Year Observed Survival Rates Positive Nodes Colon cancer is recognized to be a major health problem. Despite declining incidence and mortality rates in recent years, this disease remains the third most common malignancy among men and women and the second most frequent cause of cancer death. Patients presenting to this community cancer center have demographics similar to those reported to State and National registries. As expected the incidence was equal in males and females. 92% of our patients were over yrs and 67% greater than 65 yrs approximates Pennsylvania State data with 9% over yrs and 75% over 65 yrs. Our Stage III patients described in this review do demonstrate some differences from those patients reported in clinical trials. In general our patients were significantly older as shown in Table positive nodes 4 or more positive nodes Table 6 Age Distribution 2 1 Study Median(yrs) This report 71(-88) 92%> 67%>65 GITSG(3) 84%> 56%>61 NCCTG(5) 61(18-84) NSABP(6) 54%< 45%>
5 This age difference did not appear to adversely impact survival or the use of adjuvant chemotherapy in our patients. Among our patients overall 46% presented with right colon lesions compared to % distal and 2% at the flexures or transverse colon. Mortel 5 reported 33% proximal, 43% distal and 17% flexure or transverse sites. Wolmark 6 noted 42% right colon and 55% left colon or rectosigmoid tumors among his cases. This more proximal distribution of colon tumors among our patients is even more notable in our female patients who had 64% right sided, 18% flexure or transverse, and only 15% distal cancers. This pattern may have implications for screening strategies among patients in this area. The vast majority of our patients were symptomatic at the time of diagnosis. Although it is recognized that screening tests have limitations, this observation more like reflects the general consensus of under utilization of screening tests for colorectal cancer. 7 During the later years of this study the percent of patients identified by screening increased from a baseline of 18% to 42% in the final year. Interestingly, 21 was the first year of a concerted effort by the Lycoming County Colorectal Cancer Task Force to increase the use of screening through physician education programs and community awareness. Stage at diagnosis remains the single most important prognostic factor for colorectal cancer. 8 The survival of our unselected Stage III colon cancer patients compares favorably with State and National reference data. The number of lymph node metastases has been identified as affecting prognosis and in 26 is used to substage these patients. The 5 yr overall survival of our patients with less than 4 lymph node metastases was % compared to % for 4 or more lymph nodes involved. The number of lymph nodes recovered in the surgical specimen has also been demonstrated to have prognostic significance. 9 Among our cases the 5 year overall survival was 58% for 12 or greater nodes examined versus % for less than 12 nodes examined. These results are similar to those of Johnson et al 1 who observed a 5 year survival of 73% for Stage IIIB and 58% for Stage IIIC patients with more than 12 nodes examined as opposed to 55% and 35% respectively for three or fewer nodes examined. The Commission on Cancer has adopted the description of 12 or more nodes in the pathology report as the criteria for its next CP3R colorectal quality care project. Only 26% of our cases would have met this criterion. The median of 8 lymph nodes recovered in the specimens of our patients is not far below the reported U.S. average of Older studies reported the survival among women to be superior to men while later studies could not confirm an impact of sex on survival. 8 In our small group of patients males enjoyed greater survival at every interval. Nonetheless, sex is not generally recognized as a significant prognostic factor in this disease. Although surgery remains the principal modality with curative potential for colon cancer, adjuvant chemotherapy has been clearly demonstrated to improve survival of patients with node positive colon cancer. 12 The use of adjuvant chemotherapy is felt to be one
6 of the main reasons the 5 yr survival has improved from % in the 19 s to 62% in the 199 s and has become a well recognized standard of care. 11% of our patients were deemed to be poor candidates for adjuvant chemotherapy due to comorbid conditions. All other patients at our center determined to be suitable for adjuvant chemotherapy were offered chemotherapy. 91% of that group of patients received treatment. This degree of adjuvant chemotherapy utilization significantly exceeds the report of Potosky for the SEER program 13 in which 9% of patients under 55 yrs, 65% of patients yrs and % of patients over 75 yrs received adjuvant chemotherapy. The % 5 year survival observed in our treated patients matches that of reported trials of adjuvant chemotherapy. Patients with Stage III colon cancer managed at the Susquehanna Cancer Center are generally older and more often present with proximal lesions than typically reported in clinical trials. They receive surgical and adjuvant therapy which rivals best practices. Their 5 year survival matches State and National reference standards. As we move forward an effort should be made to increase the number of lymph nodes examined in the surgical specimen. Refinements in adjuvant therapy may further enhance survival, but diagnosis at an earlier stage with better prognosis through screening remains a major public health priority.
7 1. Bromer MQ & Weinberg DS: Screening for Colorectal Cancer-Now and the Near Future. Semin Oncol 32:3-1, Jemal A et al: Cancer Statistics 27. CA Cancer J Clin 57:43-66, Gastrointestinal Tumor Study Group: Adjuvant Therapy of Colon Cancer Results of a Prospectively Randomized Trial. NEJM 31: , Laurie JA, Moertel CG, Fleming TR, et al: Surgical Adjuvant Therapy of Large-Bowel Carcinoma: An Evaluation of Levamisole and the Combination of Levamisole and Fluorouracil. JCO 7: , Moertel CG et al: Levamisole and Fluorouracil For Adjuvant Therapy of Resected Colon Carcinoma. NEJM 322: , Wolmark N et al: The Benefit of Leucovorin-modulated Fluorouracil as Postoperative Adjuvant Therapy for Primary Colon Cancer: Results From National Surgical Adjuvant Breast and Bowel Project Protocol C-3. JCO 11: , Lymphadenectomy: Results of a Secondary Analysis of a Large Scale Adjuvant Trial. Ann Surg 235: , Johnson PM et al: Increasing Negative Lymph Node Count Is Independently Associated With Improved Long-Term Survival in Stage IIIB and IIIC Colon Cancer. J Clin Oncol 24; , Schrag D et al: Adjuvant Chemotherapy Use for Medicare Beneficiaries with Stage II Colon Cancer. J Clin Oncol 2:3999-5, Sun W, Haller DG: Adjuvant Therapy of Colon Cancer. Semin Oncol 32:95-12, Potosky AL et al: Age, Sex and Racial Differences in the Use of Standard Adjuvant Therapy for Colorectal Cancer. J Clin Oncol 2: , Etzioni DA et al: A Population- Based Study of Colorectal Cancer Test Use. Cancer 11; , Skibber JM, Minsky BD, Hoff PM: Cancer of the Colon, Chapter 33.7 in Devita Cancer: Principles and Practice of Oncology, 6 th edition, 21, pp Prandi M et al: Prognostic Evaluation of Stage B Colon Cancer Patients is Improved by an Adequate
COLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE
COLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE PROFESSOR OF SURGERY & DIRECTOR, PROFESSIONAL DEVELOPMENT CENTRE J I N N A H S I N D H M E D I C A L U N I V E R S I T Y faisal.siddiqui@jsmu.edu.pk
More informationTHE RESULTS OF A NATIONAL INstitutes
ORIGINAL CONTRIBUTION Adjuvant Chemotherapy for Stage III Colon Cancer Implications of Race/Ethnicity, Age, and Differentiation J. Milburn Jessup, MD Andrew Stewart, MS Frederick L. Greene, MD Bruce D.
More informationFactors associated with delayed time to adjuvant chemotherapy in stage iii colon cancer
Curr Oncol, Vol. 21, pp. 181-186 doi: http://dx.doi.org/10.3747/co.21.1963 DELAYED TIME TO ADJUVANT CHEMOTHERAPY ORIGINAL ARTICLE Factors associated with delayed time to adjuvant chemotherapy in stage
More informationCurrent Status of Adjuvant Therapy for Colorectal Cancer
Review Article [1] May 01, 2004 By Michael J. O connell, MD [2] Adjuvant therapy with chemotherapy and/or radiation therapy in addition to surgery improves outcome for patients with high-risk carcinomas
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationAdjuvant therapies for large bowel cancer Wasantha Rathnayake, MD
LEADING ARTICLE Adjuvant therapies for large bowel cancer Wasantha Rathnayake, MD Consultant Clinical Oncologist, National Cancer Institute, Maharagama, Sri Lanka. Key words: Large bowel; Cancer; Adjuvant
More informationTrends and Comparative Effectiveness in Treatment of Stage IV Colorectal Adenocarcinoma
Trends and Comparative Effectiveness in Treatment of Stage IV Colorectal Adenocarcinoma Taylor S. Riall, MD, PhD CERCIT Workshop October 19, 2012 Department of Surgery Center for Comparative Effectiveness
More informationEfficacy and Toxicity of Adjuvant Chemotherapy in Elderly Patients with Colon Carcinoma
1931 Efficacy and Toxicity of Adjuvant Chemotherapy in Elderly Patients with Colon Carcinoma A 10-Year Experience of the Geisinger Medical Center Farid Fata, M.D. 1 Ayoub Mirza, M.D. 2 G. Craig Wood, M.S.
More informationAdjuvant Chemotherapy for Patients with Resected Dukes C and High-risk B2 Colon Cancer with Fluorouracil and Levamisole
733 Adjuvant Chemotherapy for Patients with Resected Dukes C and High-risk B2 Colon Cancer with Fluorouracil and Levamisole E Au,*FAMS, M Med (Int Med), MRCP, P T Ang,**FAMS, FACP, FRCP (Edin), F Seow-Choen,***FAMS,
More informationCarcinoembryonic Antigen
Other Names/Abbreviations CEA 190.26 - Carcinoembryonic Antigen Carcinoembryonic antigen (CEA) is a protein polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring
More informationAdjuvant therapy in older adults: controversies and challenges - Colorectal cancer -
International Society of Geriatric Oncology Lisbon October 23 rd 25t h 2014 Adjuvant therapy in older adults: controversies and challenges - Colorectal cancer - Claus-Henning Köhne Klinik für Onkologie
More informationComparative Efficacy of Adjuvant Chemotherapy in Patients With Dukes B Versus Dukes C Colon Cancer: Results From
Comparative Efficacy of Adjuvant Chemotherapy in Patients With Dukes B Versus Dukes C Colon Cancer: Results From Four National Surgical Adjuvant Breast and Bowel Project Adjuvant Studies (C-01, C-02, C-03,
More informationCase Conference. Craig Morgenthal Department of Surgery Long Island College Hospital
Case Conference Craig Morgenthal Department of Surgery Long Island College Hospital Neoadjuvant versus Adjuvant Radiation Therapy in Rectal Carcinoma Epidemiology American Cancer Society statistics for
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal drainage, after hepatic resection, 159 160 Ablation, radiofrequency, for hepatocellular carcinoma, 160 161 Adenocarcinoma, pancreatic.
More information2009 Cancer Committee
2009 Cancer Committee Colon Cancer Study Stages I-lV Joseph Carmichael, M.D. Alicia Stark, RHIT Jeff Robinson Table of Cont ent s Table of Contents... 1 Colon Cancer Facts.. 2 CoxHealth Cancer Committee
More informationNorthwestern University, Division of Hematology/Oncology, Chicago, Illinois, USA. Key Words. Colon cancer Stage II Adjuvant chemotherapy
The Oncologist Dialogues in Oncology Adjuvant Therapy in Stage II Colon Cancer: Current Approaches LISA BADDI, AL BENSON III Northwestern University, Division of Hematology/Oncology, Chicago, Illinois,
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adenocarcinoma, pancreatic ductal, laparoscopic distal pancreatectomy for, 61 Adrenal cortical carcinoma, laparoscopic adrenalectomy for, 114
More informationPhysician Follow-Up and Guideline Adherence in Post- Treatment Surveillance of Colorectal Cancer
Physician Follow-Up and Guideline Adherence in Post- Treatment Surveillance of Colorectal Cancer Gabriela M. Vargas, MD Kristin M. Sheffield, PhD, Abhishek Parmar, MD, Yimei Han, MS, Kimberly M. Brown,
More informationNeoplastic Colon Polyps. Joyce Au SUNY Downstate Grand Rounds, October 18, 2012
Neoplastic Colon Polyps Joyce Au SUNY Downstate Grand Rounds, October 18, 2012 CASE 55M with Hepatitis C, COPD (FEV1=45%), s/p vasectomy, knee surgery Meds: albuterol, flunisolide, mometasone, tiotropium
More informationLaparoscopic Resection Of Colon & Rectal Cancers. R Sim Centre for Advanced Laparoscopic Surgery, TTSH
Laparoscopic Resection Of Colon & Rectal Cancers R Sim Centre for Advanced Laparoscopic Surgery, TTSH Feasibility and safety Adequacy - same radical surgery as open op. Efficacy short term benefits and
More informationLocally Advanced Colon Cancer. Feiran Lou MD. MS. Richmond University Medical Center Department of Surgery
Locally Advanced Colon Cancer Feiran Lou MD. MS. Richmond University Medical Center Department of Surgery Case 34 yo man presented with severe RLQ abdominal pain X 24 hrs. No nausea/vomiting/fever. + flatus.
More informationORIGINAL ARTICLE. Colon Cancer and Low Lymph Node Count. James W. Jakub, MD; Greg Russell, MS; Cindy L. Tillman, CTR; Craig Lariscy, MD
ORIGINAL ARTICLE Colon Cancer and Low Lymph Node Count Who Is to Blame? James W. Jakub, MD; Greg Russell, MS; Cindy L. Tillman, CTR; Craig Lariscy, MD Objective: To identify the factors that contribute
More informationSurgical Management of Advanced Stage Colon Cancer. Nathan Huber, MD 6/11/14
Surgical Management of Advanced Stage Colon Cancer Nathan Huber, MD 6/11/14 Colon Cancer Overview Approximately 50,000 attributable deaths per year Colorectal cancer is the 3 rd most common cause of cancer-related
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GASTROINTESTINAL RECTAL CANCER GI Site Group Rectal Cancer Authors: Dr. Jennifer Knox, Dr. Mairead McNamara 1. INTRODUCTION 3 2. SCREENING AND
More informationNon-Anthracycline Adjuvant Therapy: When to Use?
Northwestern University Feinberg School of Medicine Non-Anthracycline Adjuvant Therapy: When to Use? William J. Gradishar MD Betsy Bramsen Professor of Breast Oncology Director, Maggie Daley Center for
More informationFinancial Disclosure. Team. Race-based Socioeconomic and Treatment Disparities in Adolescents and Young Adults with Stage II-III Rectal Cancer
Race-based Socioeconomic and Treatment Disparities in Adolescents and Young Adults with Stage II-III Rectal Cancer Melanie Goldfarb MD, MSc, FACS, FACE John Wayne Cancer Institute at PSJHC, Santa Monica,
More informationPeritoneal Involvement in Stage II Colon Cancer
Anatomic Pathology / PERITONEAL INVOLVEMENT IN STAGE II COLON CANCER Peritoneal Involvement in Stage II Colon Cancer A.M. Lennon, MB, MRCPI, H.E. Mulcahy, MD, MRCPI, J.M.P. Hyland, MCh, FRCS, FRCSI, C.
More informationDisclosures. Colorectal Cancer Update GAFP November Risk Assessment. Colon and Rectal Cancer The Challenge. Issues in Colon and Rectal Cancer
Disclosures Colorectal Cancer Update GAFP November 2006 Robert C. Hermann, MD Georgia Center for Oncology Research and Education Northwest Georgia Oncology Centers, PC WellStar Health System Marietta,
More informationThe impact of operation center and the prognostic factors on the outcome of patients with stage II and stage III colorectal cancer
Turkish Journal of Cancer Volume 38, No. 4, 28 175 The impact of operation center and the prognostic factors on the outcome of patients with stage II and stage III colorectal cancer ABDULLAH BÜYÜKÇELİK
More informationFollow this and additional works at: Part of the Neoplasms Commons
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2015 Will the Addition of Oxaliplatin to 5-Fluorouracil
More informationFinancial Disclosure. Learning Objectives. Review and Impact of the NCDB PUF. Moderator: Sandra Wong, MD, MS, FACS, FASCO
Review and Impact of the NCDB PUF Moderator: Sandra Wong, MD, MS, FACS, FASCO Financial Disclosure I do not have personal financial relationships with any commercial interests Learning Objectives At the
More informationDifference in the recurrence rate between right- and left-sided colon cancer: a 17-year experience at a single institution
Surg Today (2014) 44:1685 1691 DOI 10.1007/s00595-013-0748-5 ORIGINAL ARTICLE Difference in the recurrence rate between right- and left-sided colon cancer: a 17-year experience at a single institution
More informationHow much colon should be resected?
Colon Cancer Surgical Standard of Care and Operative Techniques Madhulika G. Varma MD Professor and Chief Section of Colorectal Surgery University of California, San Francisco How much colon should be
More informationCOLON AND RECTAL CANCER
COLON AND RECTAL CANCER Mark Sun, MD Clinical Associate Professor of Surgery University of Minnesota No disclosures Objectives 1) Understand the epidemiology, management, and prognosis of colon and rectal
More informationRadiation Therapy for Resectable Colon Cancer
Review Article [1] February 01, 2006 By Brian G. Czito, MD [2], Johanna C. Bendell, MD [3], and Christopher G. Willett, MD [4] Colon cancer is a major public health problem. The primary treatment is resection.
More informationColon, or Colorectal, Cancer Information
Colon, or Colorectal, Cancer Information Definition Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Other types of cancer can affect
More informationEvaluation and Treatment of Colorectal Cancer in Yazd - Iran
Evaluation and Treatment of Colorectal Cancer in Yazd - Iran 1 Ali Akbar Salari, 2 Mansour Moghimi, 3 Hamid Reza Dehghan, 4 Hedayat Karimi. 1 Department of Surgery, Shahid Sadoughi University of Medical
More information2.2 Improved survival of colon cancer due to improved treatment and detection: a nationwide population-based study in the Netherlands
2.2 Improved survival of colon cancer due to improved treatment and detection: a nationwide population-based study in the Netherlands 1989-2006 L.N. van Steenbergen M.A.G. Elferink P. Krijnen V.E.P.P.
More informationShore Medical Center Site-Specific Study: Colorectal Cancer 2013
Shore Medical Center Site-Specific Study: Colorectal Cancer Shore Medical Center Site-Specific Study: Colorectal Cancer The following report is the result of a collaborative effort of four physician members
More informationGreater Baltimore Medical Center Sandra & Malcolm Berman Cancer Institute
2008 ANNUAL REPORT Greater Baltimore Medical Center Sandra & Malcolm Berman Cancer Institute Cancer Registry Report The Cancer Data Management System/ Cancer Registry collects data on all types of cancer
More informationManagement of colorectal cancer liver metastases
Management of colorectal cancer liver metastases Aliakbarian M. M.D. Assistant professor of surgery Organ Transplant & Hepatopancreatobiliary Surgeon SUBJECTS The importance of surgical resection in colorectal
More informationSurgical Management of Metastatic Colon Cancer: analysis of the Surveillance, Epidemiology and End Results (SEER) database
Surgical Management of Metastatic Colon Cancer: analysis of the Surveillance, Epidemiology and End Results (SEER) database Hadi Khan, MD 1, Adam J. Olszewski, MD 2 and Ponnandai S. Somasundar, MD 1 1 Department
More informationManagement of Perforated Colon Cancers
Management of Perforated Colon Cancers Introduction Colon and rectal cancers are the most common gastrointestinal cancers. They are 3 rd most common and 2 nd most common causes of cancer deaths among men
More informationPatient Presentation. 32 y.o. female complains of lower abdominal mass CEA = 433, CA125 = 201
Patient Presentation 32 y.o. female complains of lower abdominal mass CEA = 433, CA125 = 201 CT shows: Thickening of the right hemidiaphragm CT shows: Fluid in the right paracolic sulcus CT shows: Large
More informationCLINICAL MEDICAL POLICY
CLINICAL MEDICAL POLICY Policy Name: Avastin (bevacizumab) Policy Number: MP-030-MD-DE Responsible Department(s): Medical Management; Clinical Pharmacy Provider Notice Date: 10/01/2017 Original Effective
More informationCOLON AND RECTAL CANCER
No disclosures COLON AND RECTAL CANCER Mark Sun, MD Clinical Assistant Professor of Surgery University of Minnesota Colon and Rectal Cancer Statistics Overall Incidence 2016 134,490 new cases 8.0% of all
More informationLOINC. Clinical information. RCPA code. Record if different to report header Operating surgeon name and contact details. Absent.
Complete as narrative or use the structured format below 55752-0 17.02.28593 Clinical information 22027-7 17.02.30001 Record if different to report header Operating surgeon name and contact details 52101004
More informationA916: rectum: adenocarcinoma
General facts of colorectal cancer The colon has cecum, ascending, transverse, descending and sigmoid colon sections. Cancer can start in any of the r sections or in the rectum. The wall of each of these
More informationAge and factors associated with access and time to postoperative adjuvant chemotherapy in colon cancer: a French epidemiological study
Original Article Age and factors associated with access and time to postoperative adjuvant chemotherapy in colon cancer: a French epidemiological study Jean Capsec 1, Carole Lefebvre 1, Fabienne Chupé
More information!"#$ Oncology Outcomes Report
!"#$ Oncology Outcomes Report The Cleveland Clinic Florida Cancer Institute is dedicated to the comprehensive care of patients with cancer. Oncologists collaborate with a variety of physicians across multiple
More informationCASE STUDIES IN COLORECTAL CANCER: A ROUNDTABLE DISCUSSION
CASE STUDIES IN COLORECTAL CANCER: A ROUNDTABLE DISCUSSION PROVIDED AS AN EDUCATIONAL SERVICE BY THE INSTITUTE FOR CONTINUING HEALTHCARE EDUCATION SUPPORTED BY AN EDUCATIONAL GRANT FROM GENENTECH LEARNING
More informationCOLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE
COLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE Guideline Authors: Todd S. Crocenzi, M.D.; Mark Whiteford, M.D.; Matthew Solhjem, M.D.; Carlo Bifulco, M.D.; Melissa Li, M.D.; Christopher Cai, M.D.;
More informationRazvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationTreatment of Locally Advanced Rectal Cancer: Current Concepts
Treatment of Locally Advanced Rectal Cancer: Current Concepts James J. Stark, MD, FACP Medical Director, Cancer Program and Palliative Care Maryview Medical Center Professor of Medicine, EVMS Case Presentation
More informationMeasure Description. Denominator Statement
CMS ID/CMS QCDR ID: CAP 18 Title: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Primary or Metastatic
More informationColorectal Cancer Epidemiology and Clinical Study in Misan: Past, Present and Future
Vol 4, Dec, 2018 P 4-12 www.imaqpress.com Orginal Article Colorectal Cancer Epidemiology and Clinical Study in Misan: Past, Present and Future Hayder Saadoon Qasim Alhilfi 1 *, Khalid Obiad MohsinAlmohammadawi
More informationEARLY DETECTION OF COLORECTAL CANCER. Epidemiology of CRC
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationKomplette Mesokolische Exzision (CME) Ergebnisse und Ausblicke
Komplette Mesokolische Exzision (CME) Ergebnisse und Ausblicke Werner Hohenberger Chirurgische Universitätsklinik Erlangen Friedrich-Alexander-Universität Erlangen-Nürnberg Colon Cancer Cancer related
More information11/21/13 CEA: 1.7 WNL
Case Scenario 1 A 70 year-old white male presented to his primary care physician with a recent history of rectal bleeding. He was referred for imaging and a colonoscopy and was found to have adenocarcinoma.
More informationRamya Thota 1, Xiang Fang 2, Shanmuga Subbiah 3. Introduction
Original Article Clinicopathological features and survival outcomes of primary signet ring cell and mucinous adenocarcinoma of colon: retrospective analysis of VACCR database Ramya Thota 1, Xiang Fang
More informationColorectal Cancer: Lumping or Splitting? Jimmy J. Hwang, MD FACP Levine Cancer Institute Carolinas HealthCare System Charlotte, NC
Colorectal Cancer: Lumping or Splitting? Jimmy J. Hwang, MD FACP Levine Cancer Institute Carolinas HealthCare System Charlotte, NC 2 Epidemiology Colorectal Cancer is the 2 nd Leading Cause of Cancer-related
More information2007 ANNUAL SITE STUDY HODGKIN S LYMPHOMA
2007 ANNUAL SITE STUDY HODGKIN S LYMPHOMA SUSQUEHANNA HEALTH David B. Nagel, M.D. April 11, 2008 Hodgkin s lymphoma was first described by Thomas Hodgkin in 1832. It remained an incurable malignancy until
More informationAfter primary tumor treatment, 30% of patients with malignant
ESTS METASTASECTOMY SUPPLEMENT Alberto Oliaro, MD, Pier L. Filosso, MD, Maria C. Bruna, MD, Claudio Mossetti, MD, and Enrico Ruffini, MD Abstract: After primary tumor treatment, 30% of patients with malignant
More informationOncologic Outcomes of Stage IIIA Colon Cancer for Different Chemotherapeutic Regimens
Original Article Journal of the Korean Society of J Korean Soc Coloproctol 2012;28(5):259-264 http://dx.doi.org/10.3393/jksc.2012.28.5.259 pissn 2093-7822 eissn 2093-7830 Oncologic Outcomes of Stage IIIA
More informationColorectal Cancer Structured Pathology Reporting Proforma DD MM YYYY
Colorectal Cancer Structured Pathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Date of birth DD MM YYYY S1.02 Clinical details
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Kaminski MF, Regula J, Kraszewska E, et al. Quality indicators
More informationCOLORECTAL CANCER SCREENING
COLORECTAL CANCER SCREENING APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? STANDARD OF CARE NCQA ACCEPTED CODES DOCUMENTATION REQUIREMENTS What documentation
More informationColorectal Cancer Demographics and Survival in a London Cancer Network
Cancer Research Journal 2017; 5(2): 14-19 http://www.sciencepublishinggroup.com/j/crj doi: 10.11648/j.crj.20170502.12 ISSN: 2330-8192 (Print); ISSN: 2330-8214 (Online) Colorectal Cancer Demographics and
More informationThe New CP 3 R Application And Revisions To Standard 4.6 Integration Of The NCDB With The Accreditation Process
The New CP 3 R Application And Revisions To Standard 4.6 Integration Of The NCDB With The Accreditation Process Wednesday, April 29, 2009 at 11 AM Central M. Asa Carter, CTR Manager, Approvals and Standards
More informationFollow up The way ahead. John Griffith
Follow up The way ahead John Griffith Key Emerging Principles Risk stratified pathways of care Personalised care plan and treatment summary with a hand held record Information and education Remote monitoring
More informationDOES LOCATION MATTER IN COLORECTAL CANCER: LEFT VS RIGHT?
DOES LOCATION MATTER IN COLORECTAL CANCER: LEFT VS RIGHT? By: Dr. Dominik Modest, Medical Department III, Hospital of the University of Munich, Germany Dr. Andrea Sartore-Bianchi, Niguarda Cancer Center,
More informationThe impact of lymph node examination on survival of stage II colorectal cancer patients: Are 12 nodes adequate?
Formosan Journal of Surgery (2011) 44, 176e180 Available online at www.sciencedirect.com journal homepage: www.e-fjs.com ORIGINAL ARTICLE The impact of lymph node examination on survival of stage II colorectal
More informationColorectal Cancer at the MemorialCare Todd Cancer Institute at Long Beach Memorial
Colorectal Cancer at the MemorialCare Todd Cancer Institute at Long Beach Memorial ANNUAL REPOR T (562) 933-0900 MemorialCare.org/TCI 2810 Long Beach Blvd. Long Beach, CA 90806 #3 Colorectal cancer is
More informationVariables Impacting Lymph Node Recovery in Colectomy Resection Specimens Removed for Colorectal Adenocarcinoma
Send Orders for Reprints to reprints@benthamscience.net The Open Pathology Journal, 2013, 7, 1-6 1 Open Access Variables Impacting Lymph Node Recovery in Colectomy Resection Specimens Removed for Colorectal
More informationEarlier stages of colorectal cancer detected with immunochemical faecal occult blood tests
O R I G I N A L A R T I C L E Earlier stages of colorectal cancer detected with immunochemical faecal occult blood tests L.G.M. van Rossum 1*, A.F. van Rijn 2, I.P. van Munster 3, J.B.M.J. Jansen 1, P.
More informationTumor location impact in stage II and III colon cancer: epidemiological and outcome evaluation
Original Article Tumor location impact in stage II and III colon cancer: epidemiological and outcome evaluation Nesrine Mejri, Manel Dridi, Houda El Benna, Soumaya Labidi, Nouha Daoud, Hamouda Boussen
More informationColorectal Cancer Awareness: Wiping Out This Disease. Cedrek L. McFadden, MD, FACS, FASCRS
Colorectal Cancer Awareness: Wiping Out This Disease Cedrek L. McFadden, MD, FACS, FASCRS Colorectal Cancer: Statistics ~135,000 estimated new cases 2016 ~50,000 estimated deaths in 2016 (2 nd leading
More informationMultiple localized metachronous recurrences in a patient of colon cancer and therapeutic controversies in stage II colon cancer
Case Report Multiple localized metachronous recurrences in a patient of colon cancer and therapeutic controversies in stage II colon cancer Vijai Simha, Rakesh Kapoor, Saniya Sharma Post Graduate Institute
More informationLymph node ratio as a prognostic factor in stage III colon cancer
Lymph node ratio as a prognostic factor in stage III colon cancer Emad Sadaka, Alaa Maria and Mohamed El-Shebiney. Clinical Oncology department, Faculty of Medicine, Tanta University, Egypt alaamaria1@hotmail.com
More informationTable S2 Study group sample sizes for CEA, CYFRA21-1 and CA125 determinations.
Supplementary Data Table S Clinico-pathological data associated with malignant and benign cases Primary site Early stage Late stage Caecum 3 (5%) 4 (20%) (5%) Ascending colon 6 (30%) 2 (0%) 0 (0%) Transverse
More informationADJUVANT CHEMOTHERAPY...
Colorectal Pathway Board: Non-Surgical Oncology Guidelines October 2015 Organization» Table of Contents ADJUVANT CHEMOTHERAPY... 2 DUKES C/ TNM STAGE 3... 2 DUKES B/ TNM STAGE 2... 3 LOCALLY ADVANCED
More informationDepartment of Surgery, Aizu Central Hospital, Fukushima
Case Reports Resection of Asynchronous Quadruple Advanced Colonic Carcinomas Followed by Reconstruction with Ileal Interposition between the Transverse Colon and Rectum Sho Mineta 1, Kimiyoshi Shimanuki
More informationPancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts)
Pancreas Quizzes Quiz 1 1. The pancreas produces hormones. Which type of hormone producing organ is the pancreas? a. Endocrine b. Exocrine c. Both A and B d. Neither A or B 2. Endocrine indicates hormones
More informationOriginal article. Introduction. Patients and methods
Original article Annals of Oncology 16: 767 772, 2005 doi:10.1093/annonc/mdi159 Published online 7 April 2005 Adjuvant treatment for elderly patients with stage III colon cancer in the southern Netherlands
More informationPreoperative Data Colorectal Cancer Database
Preoperative Data Please place patient label here Patient Information Patient s Last Name First Middle Initial UR MH MP Birth Date Sex Post Code / / M F ECOG (see codes below) Date of Diagnosis Consultant
More informationCancer Programs Practice Profile Reports (CP 3 R) Rapid Quality Reporting System (RQRS)
O COLON MEASURE SPECIFICATIONS Cancer Programs Practice Profile Reports (CP 3 R) Rapid Quality Reporting System (RQRS) Introduction The Commission on Cancer s (CoC) National Cancer Data Base (NCDB) staff
More informationPeng Gao, Yong-xi Song, Zhen-ning Wang *, Ying-ying Xu, Lin-lin Tong, Jing-xu Sun, Miao Yu and Hui-mian Xu
Gao et al. BMC Cancer 2013, 13:123 RESEARCH ARTICLE Open Access Is the prediction of prognosis not improved by the seventh edition of the TNM classification for colorectal cancer? Analysis of the surveilla006ece,
More informationANNUAL REPORT. Figure 2 displays the distribution of the number of these diagnoses in 2013 by age (along the X axis) and by gender.
One ANNUAL REPORT Colorectal Cancer Colorectal cancer affects 14, Americans annually, making it the fourth most frequently diagnosed cancer in the US. It is also the second leading cause of cancer death
More informationColorectal Carcinoma Presentation and Management
COLORECTAL THE IRAQI POSTGRADUATE CARCINOMA MEDICAL JOURNAL VOL.8, NO.3, 29 Colorectal Carcinoma Presentation and Management Talib A.Majid, Wasem Muhamed Shakir, Aqeel Shakir Mahmmod ABSTRACT BACKGROUND:
More informationPharmacologyonline 1: (2010)
THE EFFECT OF USING COMBINATION CHEMOTHERAPY IN COLORECTAL CANCER IN INDIA: A SINGLE INSTITUTE SURVEY Adiga Sachidananda*, Meena Kumari K**, Bairy KL***, Mohan Babu A**, Vadiraja BM+, Vidyasagar MS++ *Associate
More informationC-stage in Colon Cancer: Implications of Carcinoembryonic Antigen Biomarker in Staging, Prognosis, and Management
DOI: 10.1093/jnci/djr078 Advance Access publication on March 18, 2011. The Author 2011. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
More informationColorectal Cancer in Upper Egypt, Does Age Make A Difference in Survival?
Med. J. Cairo Univ., Vol. 78, No. 2, March: 145-150, 2010 www.medicaljournalofcairouniversity.com Colorectal Cancer in Upper Egypt, Does Age Make A Difference in Survival? HODA H. EISA, M.D. The Department
More informationAnnual Report. Cape Cod Hospital and Falmouth Hospital Regional Cancer Network Expert physicians. Quality hospitals. Superior care.
Annual Report Cape Cod Hospital and Falmouth Hospital Regional Cancer Network 2013 Expert physicians. Quality hospitals. Superior care. Cape Cod Hospital s Davenport- Mugar Hematology/Oncology Center and
More informationThe CREST Trial. Funded by Cancer Research UK and developed by the National Cancer Research Institute
The CREST Trial A randomised phase III study of stenting as a bridge to surgery in obstructing colorectal cancer. Results of the UK ColoRectal Endoscopic Stenting Trial (CREST). Funded by Cancer Research
More informationWhether regional lymph nodes evaluation should be equally required for both right and left colon cancer
/, Vol. 7, No. 37 Whether regional lymph nodes evaluation should be equally required for both right and left colon cancer Xu Guan 1,*, Wei Chen 2,*, Zheng Liu 3,*, Zheng Jiang 3, Hanqing Hu 1, Zhixun Zhao
More informationreceive adjuvant chemotherapy
Women with high h risk early stage endometrial cancer should receive adjuvant chemotherapy Michael Friedlander The Prince of Wales Cancer Centre and Royal Hospital for Women The Prince of Wales Cancer
More informationColon Screening in 2014 Offering Patients a Choice. Clark A Harrison MD The Nevada Colon Cancer Partnership
Colon Screening in 2014 Offering Patients a Choice Clark A Harrison MD The Nevada Colon Cancer Partnership Objectives 1. Understand the incidence and mortality rates for CRC in the US. 2. Understand risk
More informationCigdem Benlice, Ipek Sapci, T. Bora Cengiz, Luca Stocchi, Michael Valente, Tracy Hull, Scott R. Steele, Emre Gorgun 07/23/2018
Does preoperative oral antibiotic or mechanical bowel preparation increase Clostridium difficile colitis after colon surgery? An assessment from ACS-NSQIP procedure-targeted database Cigdem Benlice, Ipek
More informationOutcomes and Toxicity in African-American and Caucasian Patients in a Randomized Adjuvant Chemotherapy Trial for Colon Cancer
Outcomes and Toxicity in African-American and Caucasian Patients in a Randomized Adjuvant Chemotherapy Trial for Colon Cancer A. David McCollum, Paul J. Catalano, Daniel G. Haller, Robert J. Mayer, John
More information