The impact of primary tumor sidedness on survival in early‐onset colorectal cancer by stage: A National Veterans Affairs retrospective analysis

Azar, Ibrahim; Masalmeh, Nada Al; Esfandiarifard, Saghi; Virk, Gurjiwan; Kiwan, Wissam; Shields, Anthony F.; Mehdi, Syed; Philip, Philip A.

doi:10.1002/cam4.3757

Cited by 16 publications

(8 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were many factors that could affect the prognosis of CRC patients including tumor stage, BMI, T2DM, age and complications [ 3 , 21 – 24 ]. In this study, tumor stage and complications were independent predictors of CRC patients which was similar with previous studies [ 3 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis

et al. 2022

View full text Add to dashboard Cite

Purpose The purpose of the current study is to analyze the difference of short-term and oncologic outcomes between younger and older colorectal cancer (CRC) patients who underwent primary CRC surgery using a propensity score matching (PSM) analysis. Methods We retrospectively collected CRC patients who underwent primary surgery in a single clinical database from Jan 2011 to Jan 2020. The short-term and oncologic outcomes were compared between younger aged group and older aged group. Results A total of 4599 patients were included in this study, and there were 4196 patients in older aged group and 403 patients in younger aged group. After 1:1 ratio PSM, there were 401 patients in each group. No significant difference was found in terms of baseline information after PSM (p>0.05). Younger aged group had larger retrieved lymph nodes before (p<0.001) and after PSM (p=0.001) than older aged group. In multivariate analysis, younger age was an independent predictor of better overall survival (OS) (p<0.001, HR=2.303, 95% CI=1.658-3.199) and disease-free survival (DFS) (p=0.008, HR=1.425, 95% CI=1.098-1.850). In terms of different tumor stage after PSM, younger aged group had better OS than older group in stage II (p<0.001) and stage IV (p=0.028) CRC, and younger aged group had better DFS than older group in stage II (p=0.016) CRC. Conclusion Younger CRC patients had larger retrieved lymph nodes and better prognosis than older CRC patients after primary CRC surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In modeling studies, “adherence” to screening is 100%, which is inconsistent with real-world practices. Furthermore, the rise in early-onset CRC has been largely driven by an increase in rectal cancer, and our study demonstrated that younger patients had the highest rate of having tumors that could be seen on a flexible sigmoidoscopy [ 20 ]. Among newly screen eligible patients aged 45–49 years, the rate of CRC screening is low, at 11.6% from January 2019 to August 2021 after guideline changes to include younger patients [ 21 ], and even this could be an overestimate because some of the tests could have been performed for diagnostic purposes in patients with symptoms.…”

Section: Discussionmentioning

confidence: 99%

Screening Implications for Distribution of Colorectal Cancer Subsite by Age and Role of Flexible Sigmoidoscopy

Lin,

Hein,

Liu

et al. 2024

Cancers

View full text Add to dashboard Cite

Objectives: The effectiveness of colonoscopy to reduce colorectal cancer (CRC) mortality is extrapolated from cohort studies in the absence of randomized controlled trial (RCT) data, whereas flexible sigmoidoscopy is supported by RCT data and may be easier to implement in practice. We characterized the anatomic distribution of CRC to determine the proportion that is visible with sigmoidoscopy. Methods: Patients with a primary diagnosis of colorectal adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results program (2000–2020). Tumors from the rectum to the descending colon were categorized as visible by sigmoidoscopy, whereas more proximal tumors required colonoscopy. Differential prognosis between tumor locations, stratified by age groups and stage, was assessed using the overall restricted mean survival time (RMST) at 2, 5, and 10 years. Results: Among 309,466 patients, 58% had tumors visible by sigmoidoscopy, including 73% of those under age 50 (OR 2.10, 95% CI 2.03–2.16 age < 45, OR 2.20, 95% CI 2.13–2.27 age 45–49 versus age ≥ 50). Male sex (OR 1.54, 95% CI 1.51–1.56) and Asian or Pacific Islander race (OR 1.60, 95% CI 1.56–1.64) were also positively associated with tumors visualizable by sigmoidoscopy. Across age groups, for local disease, RMST was comparable for tumors visible versus not visible on sigmoidoscopy. For regional and metastatic cancer, patients with tumors visible by sigmoidoscopy had improved RMST versus those with more proximal tumors. Conclusions: 58% of CRC arises in locations visible by flexible sigmoidoscopy. Flexible sigmoidoscopy should be considered as a viable option for CRC screening, particularly in younger patients unwilling or unable to undergo colonoscopy.

show abstract

“…In general, considering the prognosis, there is a consensus that patients with right-side tumors have worse prognosis 22 , 23 . However, sidedness also influences the incidence and the impact of signaling pathways in the survival of CRC patients 24 , while this effect seems to be dependent on the genetic status of main driver genes, like KRAS and TP53.…”

Section: Discussionmentioning

confidence: 99%

Laterality influence on gene expression of DNA damage repair in colorectal cancer

Oliveira-Silveira,

Filippi-Chiela,

Saffi

2023

Sci Rep

View full text Add to dashboard Cite

Colorectal carcinoma (CRC) is the third most common malignancy worldwide, and second in number of deaths in the world. The molecular pathogenesis of CRC is heterogeneous and can affect several genes. Moreover, genomic instability is recognized as an important part of CRC carcinogenesis and is tightly connected to DNA damage response. DNA damage repair (DDR) pathways are intrinsically associated with cancer development and establishment. Traditionally, CRC is considered as one coherent disease, however, new evidence shows that left and right-sided CRC present differences observed in clinical settings, as well as in pre-clinical studies. Therefore, this study aimed to investigate the impact of DDR transcriptional profiles on survival in different sublocations of the colon and rectum using Cox regression, survival analysis and differential gene expression. Right side colon (RSC) has DDR genes’ expression associated only with higher risk of death, while left side colon (LSC) and Rectum have most genes’ expression associated with lower risk. The pattern is the same with survival analysis. All significant DDR genes had lower expression associated with better survival in RSC, as opposed to LSC and Rectum. Our results demonstrate that RSC is distinctively different from LSC and Rectum. LSC and Rectum have similar DDR expression profiles.

show abstract

The impact of primary tumor sidedness on survival in early‐onset colorectal cancer by stage: A National Veterans Affairs retrospective analysis

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 16 publications

References 47 publications

The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis

The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis

Screening Implications for Distribution of Colorectal Cancer Subsite by Age and Role of Flexible Sigmoidoscopy

Laterality influence on gene expression of DNA damage repair in colorectal cancer

Contact Info

Product

Resources

About