Influence of the Primary Tumor Location on the Pattern of Synchronous Metastatic Spread in Patients with Stage IV Colorectal Carcinoma, According to the 8 th Edition of the AJCC Staging System

Alexandrescu, Sorin; Anastase, Diana Teodora; Grigorie, Răzvan; Zlate, C.; Andrei, Ștefan; Costea, Radu; Gramaticu, Iulia; Croitoru, Adina; Popescu, Irinel

doi:10.15403/jgld-2688

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…As a routine method for clinical diagnosis, the AJCC staging system is widely used in the decision-making and monitoring of ccRCC ( Alexandrescu et al, 2020 ). However, due to the limitation of ccRCC clinical heterogeneity, the AJCC systems have not been able to guide treatment with complete precision ( Suss et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a novel necroptosis-related score to improve the outcomes of clear cell renal cell carcinoma

et al. 2022

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Necroptosis has been indicated as a key regulator of tumor progression. However, the prognostic regulatory role of necroptosis in clear cell renal cell carcinoma (ccRCC) needs to be further investigated. In this study, necroptosis-related subtypes were identified by mining the public cohort (n = 530) obtained from The Cancer Genome Atlas. By applying Principal Component Analysis (PCA), the necroptosis-related scores (N-Score) were developed to assess the prognosis procession of ccRCC. The results were further validated by an external clinical cohort (n = 116) obtained from the First Affiliated Hospital of Wenzhou Medical University. It has been found that N-Score could precisely distinguish the prognostic outcomes of patients as an independent risk factor (Hazard ratio = 4.990, 95% confidence interval (CI) = 2.007–12.403, p < 0.001). In addition, changes in N-Score were associated with differences in tumor mutational burden as well as immune infiltration characterization. Moreover, higher N-Scores were also correlated significantly molecular drug sensitivity and stronger immune checkpoint activity. Notably, the prognosis of ccRCC could be effectively guided by combining the N-Scores and external clinical indicators. In conclusion, N-Scores could be served as a robust and effective biomarker to improve the prognosis outcomes and targeted therapy of ccRCC.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a novel necroptosis-related score to improve the outcomes of clear cell renal cell carcinoma

et al. 2022

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“…Similarly, in a population-based cohort study of 7,930 patients with synchronous PM, patients with rightsided colon cancer were less often suitable candidates for CRS-HIPEC [30]. Patients with synchronous metastatic right-sided colorectal cancer more often had PM with or without other metastatic sites (M1c) [31]. Left-sided colon cancers more frequently metastasize to lung and liver [32,33].…”

Section: Discussionmentioning

confidence: 99%

Differences in the distribution of peritoneal metastases in right- versus left-sided colon cancer on MRI

et al. 2021

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Purpose Right-sided colon tumors with peritoneal metastases (PM) are associated with a poorer prognosis than left-sided tumors. We hypothesized that a different pattern of spread could be characterized with abdominopelvic MRI. The objective of this study was to explore the spread of PM in relation to the primary tumor location on MRI. Methods This is a retrospective cohort study of patients with PM from colon cancer referred to be considered for CRS-HIPEC at a single tertiary referral center. Patients with colon cancer were eligible if they had undergone an abdominopelvic MRI scan following a clinical diagnosis of PM. The frequency of affected PCI regions on MRI (MRI-PCI) was assessed and compared between tumor sidedness. Results One hundred eighteen patients were included with a median age of 65 (IQR: 56-72). 46% percent were male. The median MRI-PCI was 10 (IQR: 5-16) and 8 (IQR: 4-11) for right-and left-sided tumors, respectively (p = 0.39), and the median number of affected regions was 4 (IQR: 2-7 for right-sided and IQR 2-5 for left-sided tumors). PM was most frequently found close to the primary tumor. The odds ratio of patients with PM of left sided to be affected with PM in the upper abdominal regions was 0.42 (95% CI: 0.20-0.90) and with PM on the small bowels or mesentery was 0.42 (95% CI: 0.19-0.92) over a patient with PM of right-sided colon cancer. Conclusion MRI can help to assess the spread of PM in colonic cancer. In right-sided tumors, the small bowel and upper abdominal regions are more frequently affected.

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“…For CRC, synchronous PSM is encountered in 6–7% of patients and almost half of them have peritoneal-only metastases [ 18 ]. Furthermore, the risk for metachronous PSM can be as high as 6% [ 19 ].…”

Section: Surgical Options For Psm From Colorectal Carcinoma (Crc)mentioning

confidence: 99%

Surgical Options for Peritoneal Surface Metastases from Digestive Malignancies—A Comprehensive Review

2023

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The peritoneum is a common site for the dissemination of digestive malignancies, particularly gastric, colorectal, appendix, or pancreatic cancer. Other tumors such as cholangiocarcinomas, digestive neuroendocrine tumors, or gastrointestinal stromal tumors (GIST) may also associate with peritoneal surface metastases (PSM). Peritoneal dissemination is proven to worsen the prognosis of these patients. Cytoreductive surgery (CRS), along with systemic chemotherapy, have been shown to constitute a survival benefit in selected patients with PSM. Furthermore, the association of CRS with hyperthermic intraperitoneal chemotherapy (HIPEC) seems to significantly improve the prognosis of patients with certain types of digestive malignancies associated with PSM. However, the benefit of CRS with HIPEC is still controversial, especially due to the significant morbidity associated with this procedure. According to the results of the PRODIGE 7 trial, CRS for PSM from colorectal cancer (CRC) achieved overall survival (OS) rates higher than 40 months, but the addition of oxaliplatin-based HIPEC failed to improve the long-term outcomes. Furthermore, the PROPHYLOCHIP and COLOPEC trials failed to demonstrate the effectiveness of oxaliplatin-based HIPEC for preventing peritoneal metastases development in high-risk patients operated for CRC. In this review, we discuss the limitations of these studies and the reasons why these results are not sufficient to refute this technique, until future well-designed trials evaluate the impact of different HIPEC regimens. In contrast, in pseudomyxoma peritonei, CRS plus HIPEC represents the gold standard therapy, which is able to achieve 10-year OS rates ranging between 70 and 80%. For patients with PSM from gastric carcinoma, CRS plus HIPEC achieved median OS rates higher than 40 months after complete cytoreduction in patients with a peritoneal cancer index (PCI) ≤6. However, the data have not yet been validated in randomized clinical trials. In this review, we discuss the controversies regarding the most efficient drugs that should be used for HIPEC and the duration of the procedure. We also discuss the current evidence and controversies related to the benefit of CRS (and HIPEC) in patients with PSM from other digestive malignancies. Although it is a palliative treatment, pressurized intraperitoneal aerosolized chemotherapy (PIPAC) significantly increases OS in patients with unresectable PSM from gastric cancer and represents a promising approach for patients with PSM from other digestive cancers.

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Influence of the Primary Tumor Location on the Pattern of Synchronous Metastatic Spread in Patients with Stage IV Colorectal Carcinoma, According to the 8 th Edition of the AJCC Staging System

Cited by 4 publications

References 29 publications

Development and validation of a novel necroptosis-related score to improve the outcomes of clear cell renal cell carcinoma

Development and validation of a novel necroptosis-related score to improve the outcomes of clear cell renal cell carcinoma

Differences in the distribution of peritoneal metastases in right- versus left-sided colon cancer on MRI

Surgical Options for Peritoneal Surface Metastases from Digestive Malignancies—A Comprehensive Review

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