bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of recurrence by microsatellite instability in colorectal cancer.
Authors: Kim Chang-gon , Ahn Joong Bae , Jung Minkyu , Beom Seung Hoon , Kim Joo Hoon , Heo Su Jin , Kim Ji Hyung , Shin Sang Joon 
Published: February 2017

501 Background: Although colorectal cancer (CRC) with microsatellite instability (MSI) has a more favorable prognosis than microsatellite stable (MSS) CRC, patterns of recurrence has not been precisely investigated. We aim to explore patterns of recurrence and prognosis of CRC with MSI-H (high-frequency MSI) in comparison to MSI-L (low-frequency of MSI)/MSS. Methods: Patients with stage I-III colorectal cancer who received complete surgical resection were included using retrospective cohort of Yonsei Cancer Center. Patients were categorized to MSI status (MSI-H vs. MSS-L/MSS). Patterns of recurrence, disease free survival (DFS) and overall survival (time from diagnosis to death as OS1 and time from recurrence to death as OS2) between two groups were compared. Results: A total of 2944 patients were evaluated. Of all, 263 patients (8.9%) has MSI-H tumor. Patients with MSI-L/MSS tumor experienced more systemic recurrence events than patients with MSI-H tumor (13.1% vs. 4.6%). In patients who experienced recurrence, MSI-H tumor has tendency toward young age, proximal location and poorly differentiated histology. MSI-H tumor is more likely to recur as peritoneal metastasis (33.3% vs. 8.0%, p-value 0.002) and lymph node metastasis (25.0% vs. 7.7%, p-value 0.033). In contrast, MSI-L/MSS tumor is more likely to recur as lung metastasis (37.1% vs. 0.0%, p-value 0,008). There was no difference in DFS [hazard ratio (HR) = 0.753, p-value 0.241] and OS1 [HR = 1.486, p-value 0.203]. However, OS2 was marginally inferior in MSI-H tumor [HR = 1.779, p-value 0.064]. Conclusions: Patterns of recurrence in MSI-H CRC is different from that of MSI-L/MSS and modification of surveillance strategy in MSI-H CRC should be considered. In addition, prognosis of recurred MSI-H CRC is not superior than MSI-L/MSS and prognostic value of MSI in this circumstance should be evaluated using larger sample size.
Perioperative chemotherapy using FOLFOX with panitumumab for locally advanced rectal cancer: Phase II trial.
Authors: Ota Mitsuyoshi , Watanabe Jun , Ishibe Atsushi , Suwa Hirokazu , Momiyama Masashi , Ichikawa Yasushi , Kunisaki Chikara , Endo Itaru 
Published: February 2017

502 Background: Neoadjuvant chemotherapy for locally advanced rectal cancer is required to achieve tumor reduction when skipping routine use of preoperative radiation therapy. It is known that EGFR inhibitor has impact on early tumor shrinkage in metastatic colorectal cancer. We evaluated the effect of preoperative infusional fluorouracil, leucovolin, and oxaliplatin (FOLFOX) with panitumumab. Methods: Forty-three patients with clinical stage III rectal cancer without invasion to other organs were enrolled in this multicenter phase II trial. All patients had KRAS wild tumors confirmed by biopsy. Patients received six cycles of FOLFOX with panitumumab. Reduction rate of primary tumor was measured by T2 weighted sagittal image of magnetic resonance imaging. Excluding patients whose disease progressed after the six cycles, total mesorectal excision was performed two weeks after neoadjuvant chemotherapy. After surgery, adjuvant chemotherapy with six cycles of FOLFOX without panitumumab was planned before diverting stoma closure. The primary outcome was the response rate of the primary lesion. Results: Between January 2012 and December 2014, 42 out of 43 patients completed preoperative chemotherapy; one patient did not complete the regimen due to grade III neutropenia. There was no progressive disease in the 42 patients and response rate was 69.8% in this series. Average reduction rate of the primary lesion was 47.6%. All of the 43 participants had R0 resections without mortality or severe complications. Pathological complete response rate to chemotherapy was 7.0% (3 of 43). Thirty-eight out of 43 patients started adjuvant chemotherapy and 32 patients completed the regimen. Grade 3 or worse peripheral neuropathy was not seen during neoadjuvant chemotherapy and seen in 2.6% (1 of 38) during adjuvant chemotherapy. Conclusions: Periopative chemotherapy using FOLFOX with panitumumab seemed to have two advantages; one is tumor reduction which enables skipping neoadjuvant radiation therapy, the other is safely administering a larger dose of chemotherapy than adjuvant only in locally advanced rectal cancer. Additional impact of EGFR inhibitor should be followed in long term results. Clinical trial information: UMIN000006039.
Prevalence of metabolic syndrome in older (50 years and older) vs younger (less than 50 years) patients with colorectal cancer diagnosed in a safety net hospital system.
Authors: Sharma Ashish , Chan Johanna , Trang Tony , Suarez Milena Gould 
Published: February 2017

512 Background: Colorectal cancer (CRC) incidence has declined overall with screening, though incidence in patients younger than 50 years has increased. Younger patients present with more aggressive and advanced stage CRC. Potential mechanisms are sporadic, genetics, and environmental (alcohol, smoking, metabolic syndrome). Metabolic syndrome (MetS) is an established risk factor for CRC. We examined the prevalence of MetS in younger patients ( < 50 yrs) compared with older patients ( ≥ 50 yrs) with CRC in a safety net hospital population. Methods: IRB-approved retrospective chart review of all patients diagnosed with CRC in the Harris County Hospital District cancer registry from Jan 2008 to Dec 2013. Data was collected for patient characteristics and metabolic syndrome to compare 2 patient groups: < 50 yr (younger) and ≥ 50 yr (older). MetS was defined using 2005 AHA/NHLBI criteria as ≥ 3 of the following components: abdominal obesity (waist circumference > 102 cm in men, > 88 cm in women), serum triglycerides (TG) ( > 150 mg/dL), serum HDL ( < 40 mg/dL in men and < 50 mg/dL in women), BP > 130/85 mmHg, fasting glucose/diabetes ( ≥ 100 mg/dL). Per WHO criteria, BMI > 30 was used as surrogate for waist circumference. Descriptive statistics were performed using t-test for continuous variables and Chi-square / Fisher’s exact test for categorical variables. Results: 625 cases of CRC diagnosed showed median age of 56.5 years and 54.7% female patients. The majority (77.76%) of cases occurred in the older group. Overall, 208/625 patients (33.28%) had MetS. Average BMI overall was 27.33. Prevalence of MetS was 38.27% vs 23% (older vs younger; p = 0.0001). In older compared with younger patients, average BMI 26.13 vs 25.05 (p = 0.02), obesity 25.92% vs 35.87% (p = 0.05), BP > 130/85 mmHg 56.3% vs 31.6% (p = 0.001), low HDL 41.7% vs 31.9% (p = 0.02), TG > 150 34.7 % vs 22.3 % (p = 0.02) and diabetes 36.2% vs 11.5% (p = 0.001). Conclusions: Overall prevalence of MetS in our patient cohort was similar to that of general population (which approximates 34%). Prevalence of MetS was higher in older patients with CRC than in younger patients, though this may reflect the natural history of MetS.
Efficacy of panitumumab (pmab) vs. cetuximab (cmab) in patients (pts) with wild-type (WT) KRAS exon 2 metastatic colorectal cancer (mCRC) treated with prior bevacizumab (bev): Results from ASPECCT.
Authors: Peeters Marc , Kim Tae Won , Li Jin , Cascinu Stefano , Ruff Paul , Suresh Attili Venkatasatya , Thomas Anne , Tjulandin Sergei , Guan Xuesong , Hoang Tien , Hei Yong Jiang , Price Timothy Jay 
Published: February 2017

519 Background: The phase 3 ASPECCT trial of pts with chemorefractory WT KRAS exon 2 mCRC demonstrated that pmab was noninferior to cmab for overall survival (OS). A previous subgroup analysis of hazard ratios (HRs) suggested that pts who had received prior bev (any line, at any point before study start) in the pmab arm may have had better outcomes vs pts in the cmab arm (Price, 2014). Methods: Pts were randomized 1:1 to receive pmab or cmab. The subset of pts who had received prior bev were analyzed based on the final analysis of ASPECCT. Results: 999 pts were randomized and treated: 499 pmab and 500 cmab. The prior bev subset included 126 pts in the pmab arm (25%) and 132 pts in the cmab arm (26%). Pts in the pmab arm had longer median OS and progression-free survival (PFS) and higher objective response rates (ORR) compared with pts in the cmab arm. Results are shown (table). After adjustment for baseline covariates including ECOG performance status, number of metastatic sites, and baseline LDH, OS HR was 0.65 (95%CI=0.49-0.85) with pmab vs cmab in pts who had received prior bev. Pts in the pmab and cmab arms who did not receive prior bev had similar OS, PFS, and ORR. Post-progression antitumor therapy was similar between the pmab (47%) and cmab arms (52%) in pts who received prior bev. Conclusions: In ASPECCT, pts with WT KRASexon 2 mCRC who received prior bev-containing regimens may have derived greater benefit with pmab versus cmab monotherapy. Clinical trial information: NCT01001377. [Table: see text]
Assessing distress in patients with gastrointestinal tumors during radiotherapy.
Authors: Hollant Laeticia , Single Megan Paige , Gaines Katherine , Smart Bridget , Habboush Jacob , Kaleem Tasneem , Tzou Katherine S. , Ko Stephen , Biers Heather , Day Atiya , Miller Robert Clell 
Published: February 2017

524 Background: Psychosocial distress during radiotherapy (RT) for gastrointestinal tumors is poorly characterized. Since 2012, patients receiving RT in our clinic have been prospectively screened for causes of distress. The results of our screening were reviewed in order to elucidate concerns of GI cancer patients and to delineate patterns within patient reported distress (PRD). Methods: Patients treated with RT at our institution receive a 30 question PRD survey that also includes a linear analog measure of overall distress at the start and during RT. The PRD survey asks patients to rate forms of distress on a scale of 1 to 5 (5 being the most distressed). The survey also asks patients to rate overall distress according to the National Comprehensive Cancer Network (NCCN) Distress Thermometer on a scale 0 to 10. The reported results were retrospectively reviewed in patients receiving definitive RT for GI cancers from 04/02/2012 to 08/05/2015. Results: PRD surveys were completed by 113 patients, 55 (48.7%) male and 58 (51.3%) female. Median age was 65 years (range 28 to 93). The most common tumor histology was adenocarcinoma, 67 (59.3%). 105 patients (93.0%) received chemotherapy and 66 (58.4%) underwent surgery. Overall, NCCN distress thermometer results ranged from 0 to 10, with a median of 4.3. The mean distress scores for the top five complaints ranged from 1.27 to 2.63. Top distresses were “How will I feel during treatment” (2.63), “Fatigue” (2.45), “Pain that affects daily functioning” (2.35), “Out of pocket medical costs” (2.31), and “Sleep difficulties” (2.31). The least concerning complaints were “Housing during treatment” (1.27), “A loved one relying on me for their physical care” (1.30), “Spirituality” (1.33),“Family communication about my illness”(1.37), and “Transportation” (1.38). Conclusions: Patients’ major concerns were aligned with daily quality of life, such as fatigue, pain and insomnia. Highest reported distress was linked with the process of RT and side effects associated with treatment. Medical expenses were also perceived as a burden. Medical providers should identify psychosocial stressors during RT in order to effectively communicate and provide resources to improve quality of life.
How often does the patient repeat screening colonoscopy? A study for personalized recommendation of screening colonoscopy interval.
Authors: Kim Eun Sun , Chun Hoon Jai , Jeen Yoon Tae , Keum Bora , Choi Hyuk Soon 
Published: February 2017

527 Background: Colorectal cancer (CRC) is the third most common cancer and the second most frequent cause of cancer death of female and fourth most of male in South Korea. Most CRCs develop through the adenoma–carcinoma sequence, which allows for screening and prevention of CRCs by screening colonoscopic examination and polypectomy. However, there have been limited data on personalized optimal time interval of next surveillance colonoscopic examination. The aim of our study is to recommend personalized interval by analysis of various clinical factors obtained by health care examination. Methods: We enrolled the patients who underwent two times more voluntary, complete screening colonoscopy at health care unit of Korea University Medical Center Anam Hospital from July 1, 2004 to July 31, 2010. The clustering analysis using the partitioning around medoids algorithm and Hierarchial cluster were conducted including the 32 clinical, geographic and laboratory data. For each cluster, we then performed survival analysis that provides the probability of having polyps according to the number of days until next colonoscopy. Results: Totally 8,332 patients underwent screening colonoscopy, among them 625 patients performed repeat colonoscopy exam. 625 patients divided four clusters by clustering analysis. Adenoma detection at first screening colonoscopy was the most potent risk factor of develop of adenoma at next screening. Male gender, triglyceride (>134 mg/dL), and age (>56 years old) were significant factor for decision of the personalized interval of next screening colonoscopy. For example, male patient, who had adenoma at fist screening, the predicted risk of adenoma is 50% after 25 months. Conclusions: Our study can provide personalized time interval of next screening colonoscopy according to patients’ individual clinical data. Further study are necessary for validation our results.
Rate of implementation of universal testing for Lynch Syndrome in a county hospital system.
Authors: Sharma Ashish , Chan Johanna , Trang Tony , Suarez Milena Gould 
Published: February 2017

533 Background: Lynch Syndrome (LS) is the most common cause of inherited colorectal cancer (CRC). Universal testing is recommended as a cost effective strategy for screening for LS in all patients with CRC diagnosed < 70 years of age. This has shown to be beneficial in clinical decision making and cancer surveillance of both the patient and at risk relatives. According to a study in 2012, 71% of NCI institutions were performing universal testing versus 15%-36% of programs in the community. The aim of our study was to determine the outcomes of Universal Testing for LS in CRC in a County Hospital System. Methods: IRB-approved retrospective chart review of all patients diagnosed with colorectal cancer from cancer registry at Harris County Hospital District from March 2010 to Dec 2013. Patients between 18-70 yr were included. We collected data on patient characteristics, universal testing [immunohistochemistry (IHC) at our institution], and LS diagnosis (confirmed with germline testing for mismatch repair gene) in our patient cohort diagnosed with CRC. Descriptive statistics were performed using t-test for continuous variables. Results: Overall, 430 patients had CRC diagnosis in our study period, and 54 years was median age of diagnosis. IHC was performed in 359/430 (83.4%) CRC cases. IHC was positive in overall 26/430 (6%) cases of CRC. LS was confirmed in 9/430 (2%) CRC cases. IHC was more often positive with CRC diagnosed in patients younger than 50 years than in patients 50 years or older (7.91% vs 3.09%; p = 0.04). Conclusions: Universal testing for screening of LS amongst patients with CRC can result in significant rates of detection. In this study we have shown that this is possible in a largely safety-net setting.
Predictors of recurrence in stage I/II colorectal cancer: Analysis of a single institution’s experience for over 24 years.
Authors: Gonzalez Velez Miguel , Duma Narjust , Sanchez Larysa Jessica , Undamatla Ramya , Ruiz Mino Jose , Gutierrez Martin 
Published: February 2017

534 Background: Surgical resection remains a mainstay of treatment for localized colorectal cancer (CRC). However, up to 35% of patients (pts) develop recurrence with a significant decrease in overall survival. The aim of this study was to evaluate clinical characteristics and specific predictors of recurrence for stage I/II CRC Methods: We performed a retrospective analysis of 2310 pts diagnosed with stage I/II CRC at our institution between 1990 and 2013, with a minimum follow up of 24 months. Tumor characteristics and recurrence data were studied. Cox regression was used for statistical analysis. Results: Of the 2310 pts, recurrence was identified in 276 (12%) pts, of which 88 (32%) pts had early recurrence ( < 1 year). Median time of recurrence was 625 days. 210 (76%) pts had local recurrence while 66 (24%) pts had distal recurrence, with liver being the main site of distant metastasis. Males had a higher recurrence rate than females (16% vs. 7%, p < 0.0001). When comparing recurrence pts (R) with non-recurrence (NR) pts, Hispanics were more prevalent in the R group (13% vs 8%, p < 0.01). R pts were more likely to have rectal and poorly differentiated tumors (33% vs. 13%, p < 0.0001; 23% vs. 14%, p < 0.0001, respectively). Mucinous adenocarcinomas were more prevalent in the R group (16% vs. 9%, p < 0.0005). In multivariate analysis: male sex (OR: 1.24, 95% CI: 1.21-1.56, p < 0.001), rectal tumors (OR: 4.2, 95% CI: 3.14-5.06, p < 0.001), tumor size (OR: 2.55, 95% CI: 1.31-4-51, p < 0.01), and positive margins (OR: 3.6, 95% CI: 2.13-5.21, p < 0.04) were independent predictors for recurrence. K-ras (+) status was a predictor of recurrence by univariate analysis. Age, race, and histologic grade were not predictors of recurrence. Pts with early recurrence had a lower median overall survival compared to pts that developed recurrence after 1 year, 37 months (95% CI: 26.6-49.6) vs. 59 months (95% CI: 42.4-74.3), p < 0.04. Conclusions: Pts with recurrence were more likely to have rectal and poorly differentiated tumors. Poorer survival was observed in pts with early recurrence. These findings could serve as important prognostic information and may help identify the pts that would benefit from aggressive surveillance after treatment.
Genotype-phenotype correlation of gastric cancer in familial adenomatous polyposis.
Authors: Ito Tatsuhiro , Iwaizumi Moriya , Tao Hong , Osawa Satoshi , Kurachi Kiyotaka , Hamaya Yasushi , Takagaki Kosuke , Furuta Takahisa , Sugimoto Ken , Sugimura Haruhiko , Maekawa Masato 
Published: February 2017

535 Background: Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary colorectal tumor syndrome characterized by the formation of a number of adenomatous polyps throughout the entire colon. Clinically, a precise family history together with surveillance of the colon as well as extra-colonic organs for people at risk is important to prevent cancer progression because of an almost 100% lifetime risk of colorectal cancer if the colon is not removed. Although there are fascinating correlations between the location of the APC mutation and the clinical phenotype, none has reported about genotype-phenotype correlation of gastric cancer in FAP, which occupies 2.1-4.2% in East Asia. Methods: Peripheral blood samples were obtained from 29 probands that was clinically diagnosed with FAP and DNA was extracted from the peripheral blood. All the coding exons of APC and their boundary regions were amplified using PCR and were directly sequenced. For large deletion/insertion analysis, an MLPA was performed using MLPA kit (P043 APC, MRC-Holland). Using results from the APC mutation analysis, we examined correlation between location of APCgermline mutation and clinical phenotype including gastric cancer. Results: Among 16 probands (3 cases were severe FAP, 12 cases classical FAP, and one case attenuated FAP) that were identified APC germline mutation, correlation between density of colonic adenomatous polypsosis and distribution of the APC mutation donated the same tendency of previous report. Among the 16 probands, 11 had fundic gland polyposis (FGPs) of the stomach and three had gastric adenocarcinoma (one case with FGPs and others without FGPs). Interestingly, all the three cases did not have severe adenomatous polyposis of the colon and their APC mutations were distributed at the location that is reported to be correlated with attenuated FAP. Conclusions: Patients with gastric cancer in FAP clinically have a tendency of having non-severe adenomatous polyposis of the colon and their location of APC mutation may be correlated to the hot spot location of attenuated FAP, suggesting that patient with non-severe colonic adenomatous polyp should have upper GI screening for gastric cancer prevention.
Thromboembolism incidence in patients with gastrointestinal tract cancer receiving chemotherapy: A single-institutional retrospective cohort analysis.
Authors: Oba Ayane , Nakamura Michio , Murai Taichi , Matsuda Chika , Itaya Kazufumi , Koike Yuta , Endo Ayana , Tsukuda Yoko , Ono Yuji , Kudo Takahiko , Nagasaka Atsushi , Nishikawa Shuji 
Published: February 2017

541 Background: Although cancer and its treatments are well-recognized risk factors for thromboembolism (TE), such as venous and pulmonary TE, there are very few data of the incidence of cancer associated TE in the Asian population. So we conducted a retrospective cohort study to investigate the TE incidence of gastrointestinal tract cancer (GTC) patients (pts) receiving chemotherapy in a Japanese community hospital’s daily practice setting. Methods: All the patients received chemotherapy for GTC in our hospital from January 2008 to May 2015 were identified through medical records review extracted by our hospital data warehouse. We analyzed the incidences of TE by reviewing all the reports of contrast-enhanced computed tomography performed on each patient during chemotherapy and identified the association between several clinicopathological factors and TE incidence using chi-square tests and logistic regression. Results: Five hundred fourteen Japanese GTC pts were analyzed on this study. Patient characteristics were as follows; male/female 317/197, median age 69.1 (range 21.1 - 89.1), Gastric (GC)/Colorectal cancer (CRC) pts 213/301, non-adjuvant (non-Adj)/adjuvant (Adj) setting 314/200, tumor-bearing (TB)/non-TB pts 344/170, multiple primary (MP)/single primary (SP) pts 29/485. The incident rate with TE in GC and CRC pts was 10.3 % (n = 22) and 16.6 % (n = 50), respectively. In relation to the status of malignancy, the incidence of TE was 16.6 % (n = 52) and 10.0 % (n = 20) in non-Adj and Adj setting (p = 0.0367), 16.9 % (n = 59) and 7.9 % (n = 13) in TB and non-TB pts (p = 0.007), 31.0 % (n = 9) and 13.0 % (n = 63) in MP and SP pts (p = 0.007), respectively. Conclusions: We found that there were significantly higher incidences of TE in non-Adj, TB, and MP compared with Adj, non-TB, and SP pts, respectively. Although the ethnic differences of the TE incidence rate between Caucasian and Asian population were reported, the incidence of Asian population received cancer chemotherapy remains unclear yet. So further accumulation of data are necessary to establish a Guideline for Asian to prevent and manage TE occurred during cancer chemotherapy such as ESMO or ASCO guidelines. Clinical trial information: UMIN000018912.