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C-stage was an independent prognostic factor for colon cancer. The results support routine preoperative CEA testing and C-staging upon diagnosis of colon cancer and the inclusion of C-stage in the conventional TNM staging of colon cancer.

Purpose A major limitation of studies reporting a lower prevalence rate of human papilloma virus (HPV) in African American (AA) oropharyngeal cancer (OPSCC) patients than Caucasian Americans (CA), with corresponding worse outcomes, was adequate representation of HPV positive AA patients. This study examined survival outcomes in HPV positive and HPV negative AA with OPSCC Experimental Design The study cohort of 121 primary OPSCC had 42% AA. Variables of interest included age, race, gender, HPV status, stage, marital status, smoking, treatment, and date of diagnosis. Results CA are more likely to be HPV positive (OR=3.28, p=0.035), as are younger age (age <50 OR=7.14, p=0.023 compared to age >65) or being married (OR=3.44, p= 0.016). HPV positivity and being unmarried were associated with being late stage (OR=3.10, p=0.047 and OR=3.23, p=0.038, respectively). HPV negative patients had 2.7 times the risk of death as HPV positive patients (p=0.004). Overall, the HPV-race groups differed (log-rank p<0.001), with significantly worse survival for HPV negative AA vs 1) HPV positive AA (HR=3.44, p=0.0012); 2) HPV positive CA (HR=3.11, p=<0.049); and 3) HPV negative CA (HR=2.21, p=0.049). Conclusions HPV has a substantial impact on overall survival in AA OPSCC. Among AA OPSCC, HPV positive patients had better survival than HPV negative. HPV negative AA also did worse than both, HPV positive CA and HPV negative CA. This study adds to the mounting evidence of HPV as a racially-linked sexual behavior life style risk factor impacting survival outcomes for both AA and CA OPSCC patients.

Background-Outpatient cardiac rehabilitation (CR) decreases mortality rates but is underutilized. Current median time from hospital discharge to enrollment is 35 days. We hypothesized that an appointment within 10 days would improve attendance at CR orientation. Methods and Results-At hospital discharge, 148 patients with a nonsurgical qualifying diagnosis for CR were randomized to receive a CR orientation appointment either within 10 days (early) or at 35 days (standard). The primary end point was attendance at CR orientation. Secondary outcome measures were attendance at ≥1 exercise session, the total number of exercise sessions attended, completion of CR, and change in exercise training workload while in CR. Average age was 60±12 years; 56% of participants were male and 49% were black, with balanced baseline characteristics between groups. Median time (95% confidence interval) to orientation was 8.5 (7-13) versus 42 (35 to NA [not applicable]) days for the early and standard appointment groups, respectively (P<0.001). Attendance rates at the orientation session were 77% (57/74) versus 59% (44/74) in the early and standard appointment groups, respectively, which demonstrates a significant 18% absolute and 56% relative improvement (relative risk, 1.56; 95% confidence interval, 1.03-2.37; P=0.022). The number needed to treat was 5.7. There was no difference (P>0.05) in any of the secondary outcome measures, but statistical power for these end points was low. Safety analysis demonstrated no difference between groups in CR-related adverse events. Conclusions-Early