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https://www.readbyqxmd.com/read/28515248/systemic-management-of-colorectal-cancer
#1
Wells A Messersmith
Advances have been made in the systemic treatment of colorectal cancer, with approximately 12 chemotherapy or biologic agents approved for use as a single agent or in a combination. However, numerous gaps in our understanding of the disease remain, such as the lack of benefit with biologics in the adjuvant setting, the absence of biomarkers for most systemic therapies, and the reason why left-sided and right-sided tumors behave differently. At the 22nd NCCN Annual Conference, Dr. Wells A. Messersmith presented several impactful updates to the 2017 NCCN Clinical Practice Guidelines in Oncology for Colon Cancer and reviewed the outcomes with a host of therapies used for both early-stage and metastatic disease...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28503720/contribution-of-germline-mutations-in-cancer-predisposition-genes-to-tumor-etiology-in-young-women-diagnosed-with-invasive-breast-cancer
#2
Seth K Rummel, Leann Lovejoy, Craig D Shriver, Rachel E Ellsworth
PURPOSE: Although breast cancer in young women accounts for <10% of diagnoses annually, tumors in young patients exhibit more aggressive characteristics and higher mortality rates. Determination of the frequency of germline mutations in cancer predisposition genes is needed to improve the understanding of breast cancer etiology in young women. METHODS: All female patients enrolled in the Clinical Breast Cancer Project between 2001 and 2015 and diagnosed with invasive breast cancer before age 40 were included in this study...
May 13, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28487466/the-national-cancer-institute-community-cancer-centers-program-ncccp-sustaining-quality-and-reducing-disparities-in-guideline-concordant-breast-and-colon-cancer-care
#3
Pamela Spain, Stephanie Teixeira-Poit, Michael T Halpern, Kathleen Castro, Irene Prabhu Das, Brenda Adjei, Rebecca Lewis, Steven B Clauser
BACKGROUND: The National Cancer Institute Community Cancer Centers Program (NCCCP) pilot was designed to improve quality of cancer care and reduce disparities at community hospitals. The NCCCP's primary intervention was the implementation of the Commission on Cancer Rapid Quality Reporting System (RQRS). The RQRS is a hospital-based data collection and evaluation system allowing near real-time assessment of selected breast and colon cancer quality of care measures. Building on previous NCCCP analyses, this study examined whether improvements in quality cancer care within NCCCP hospitals early in the program were sustained and whether improvements were notable for minority or underserved populations...
May 9, 2017: Oncologist
https://www.readbyqxmd.com/read/28474459/use-of-guideline-recommended-adjuvant-therapies-and-survival-outcomes-for-people-with-colorectal-cancer-at-tertiary-referral-hospitals-in-south-australia
#4
Pamela Adelson, Kellie Fusco, Christos Karapetis, David Wattchow, Rohit Joshi, Timothy Price, Greg Sharplin, David Roder
RATIONALE, AIMS AND OBJECTIVES: Adjuvant care for colorectal cancer (CRC) has increased over the past 3 decades in South Australia (SA) in accordance with national treatment guidelines. This study explores the (1) receipt of adjuvant therapy for CRC in SA as related to national guideline recommendations, with a focus on stage C colon and stage B and C rectal cancer; (2) timing of these adjuvant therapies in relation to surgery; and (3) comparative survival outcomes. METHODS: Data from the SA Clinical Cancer Registry from 4 tertiary referral hospitals for 2000 to 2010 were examined...
May 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28473079/acr-appropriateness-criteria-%C3%A2-pretreatment%C3%A2-staging-of-colorectal-cancer
#5
Kathryn J Fowler, Harmeet Kaur, Brooks D Cash, Barry W Feig, Kenneth L Gage, Evelyn M Garcia, Amy K Hara, Joseph M Herman, David H Kim, Drew L Lambert, Angela D Levy, Christine M Peterson, Christopher D Scheirey, William Small, Martin P Smith, Tasneem Lalani, Laura R Carucci
Colorectal cancers are common tumors in the United States and appropriate imaging is essential to direct appropriate care. Staging and treatment differs between tumors arising in the colon versus the rectum. Local staging for colon cancer is less integral to directing therapy given radical resection is often standard. Surgical options for rectal carcinoma are more varied and rely on accurate assessment of the sphincter, circumferential resection margins, and peritoneal reflection. These important anatomic landmarks are best appreciated on high-resolution imaging with transrectal ultrasound or MRI...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28471838/risk-of-colorectal-cancer-and-associated-mortality-in-hiv-a-systematic-review-and-meta-analysis
#6
Tyler J O'Neill, Joseph Djiometio Nguemo, Anne-Marie Tynan, Ann N Burchell, Tony Antoniou
BACKGROUND: As people with HIV live longer, the numbers of colorectal cancer cases are expected to increase. We sought to compare colorectal cancer incidence and cause-specific mortality among people living with and without HIV. DESIGN: Systematic review and meta-analysis. METHODS: We searched five electronic databases to 28 June 2016 for primary studies reporting standardized incidence ratios (SIR), standardized mortality ratios (SMR)/hazard ratios or data sufficient for estimating these summary measures...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28470365/objective-assessment-of-minimally-invasive-total-mesorectal-excision-performance-a-systematic-review
#7
REVIEW
N J Curtis, J Davids, J D Foster, N K Francis
INTRODUCTION: Laparoscopy is widely used in colorectal practice, but recent trial results have questioned its use in rectal cancer resections. Patient outcomes are directly linked to the quality of total mesorectal excision (TME) specimen. Objective assessment of intraoperative performance could help ensure competence and delivery of optimal outcomes. Objective tools may also contribute to TME intervention trials, but their nature, structure and utilisation is unknown. AIM: To systemically review the available literature to report on the available tools for the objective assessment of minimally invasive TME operative performance and their use within multicentre laparoscopic TME randomised controlled trials...
April 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28450390/british-society-of-gastroenterology-position-statement-on-serrated-polyps-in-the-colon-and-rectum
#8
James E East, Wendy S Atkin, Adrian C Bateman, Susan K Clark, Sunil Dolwani, Shara N Ket, Simon J Leedham, Perminder S Phull, Matt D Rutter, Neil A Shepherd, Ian Tomlinson, Colin J Rees
Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline...
April 27, 2017: Gut
https://www.readbyqxmd.com/read/28438706/towards-generalizable-entity-centric-clinical-coreference-resolution
#9
Timothy Miller, Dmitriy Dligach, Steven Bethard, Chen Lin, Guergana Savova
OBJECTIVE: This work investigates the problem of clinical coreference resolution in a model that explicitly tracks entities, and aims to measure the performance of that model in both traditional in-domain train/test splits and cross-domain experiments that measure the generalizability of learned models. METHODS: The two methods we compare are a baseline mention-pair coreference system that operates over pairs of mentions with best-first conflict resolution and a mention-synchronous system that incrementally builds coreference chains...
April 21, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28414996/a-case-of-multiple-synchronous-quadruple-cancers-of-the-stomach-sigmoid-colon-rectum-and-pancreas
#10
Atsushi Nanashima, Tetsuro Tominaga, Takashi Nonaka, Kouki Wakata, Masaki Kunizaki, Shuichi Tobinaga, Yorihisa Sumida, Shigekazu Hidaka, Naoe Kinoshita, Terumitsu Sawai, Takeshi Nagayasu
INTRODUCTION: Multiple primary neoplasms are relatively rare, but their incidence has increased because of aging and improvements in diagnostic imaging. PRESENTATION OF CASE: A 67-year-old man presented with epigastric pain. On upper gastrointestinal endoscopy, an ulcer was seen at the gastric angle, and biopsy showed moderately differentiated adenocarcinoma (AC). Colonoscopy demonstrated a 15-mm lesion in the sigmoid colon and a submucosal lesion in the lower rectum...
April 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28404754/therapeutic-response-of-metastatic-colorectal-cancer-harboring-a-kras-missense-mutation-after-combination-chemotherapy-with-the-egfr-inhibitor-panitumumab
#11
Emil Lou, Donna D'Souza, Andrew C Nelson
Over the past decade, subset analyses of retrospective and prospective clinical studies have determined that KRAS-mutated metastatic colorectal cancers do not respond effectively to inhibition of epidermal growth factor receptor (EGFR) with the EGFR-targeting monoclonal antibodies cetuximab or panitumumab. Within the past few years, the scope of tested variants in the KRAS oncogene has expanded significantly, and testing of all RAS family genes has become more widely available in clinical laboratories. Expert consensus guidelines have recommended not using EGFR inhibitors in patients with KRAS-mutated tumors...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28399381/adjuvant-chemotherapy-for-stage-ii-colon-cancer-a-clinical-dilemma
#12
Joseph Kannarkatt, Joe Joseph, Peter C Kurniali, Anas Al-Janadi, Borys Hrinczenko
The decision to treat a patient with stage II colon cancer with adjuvant chemotherapy can be challenging. Although the benefit of treatment is clear in most patients with stage III disease, the decision to provide chemotherapy after surgical resection in stage II disease must be made on an individual basis. Several trials have demonstrated the small but absolute benefits of receiving adjuvant chemotherapy for stage II colon cancer for disease-free survival and overall survival. In an attempt to better understand the role of chemotherapy, several studies were performed that identified high-risk characteristics that can be used prognostically and predictively to aid in the clinical decision making process...
April 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#13
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28349281/japanese-society-for-cancer-of-the-colon-and-rectum-jsccr-guidelines-2016-for-the-treatment-of-colorectal-cancer
#14
Toshiaki Watanabe, Kei Muro, Yoichi Ajioka, Yojiro Hashiguchi, Yoshinori Ito, Yutaka Saito, Tetsuya Hamaguchi, Hideyuki Ishida, Megumi Ishiguro, Soichiro Ishihara, Yukihide Kanemitsu, Hiroshi Kawano, Yusuke Kinugasa, Norihiro Kokudo, Keiko Murofushi, Takako Nakajima, Shiro Oka, Yoshiharu Sakai, Akihito Tsuji, Keisuke Uehara, Hideki Ueno, Kentaro Yamazaki, Masahiro Yoshida, Takayuki Yoshino, Narikazu Boku, Takahiro Fujimori, Michio Itabashi, Nobuo Koinuma, Takayuki Morita, Genichi Nishimura, Yuh Sakata, Yasuhiro Shimada, Keiichi Takahashi, Shinji Tanaka, Osamu Tsuruta, Toshiharu Yamaguchi, Naohiko Yamaguchi, Toshiaki Tanaka, Kenjiro Kotake, Kenichi Sugihara
Japanese mortality due to colorectal cancer is on the rise, surpassing 49,000 in 2015. Many new treatment methods have been developed during recent decades. The Japanese Society for Cancer of the Colon and Rectum Guidelines 2016 for the treatment of colorectal cancer (JSCCR Guidelines 2016) were prepared to show standard treatment strategies for colorectal cancer, to eliminate disparities among institutions in terms of treatment, to eliminate unnecessary treatment and insufficient treatment, and to deepen mutual understanding between health-care professionals and patients by making these Guidelines available to the general public...
March 27, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28283864/lower-gastrointestinal-neuroendocrine-neoplasms-associated-with-hereditary-cancer-syndromes-a-case-series
#15
Trilokesh D Kidambi, Christina Pedley, Amie Blanco, Emily K Bergsland, Jonathan P Terdiman
Lower gastrointestinal (GI) neuroendocrine neoplasms (NENs) of the colon and rectum are uncommon and not traditionally associated with hereditary GI cancer syndromes. However, with widespread implementation of colorectal cancer screening programs, lower GI NENs are being identified with increasing frequency. We report the first case series of six patients with lower GI NENs who were diagnosed with hereditary GI cancer syndromes by germline testing. Two patients presented with poorly differentiated rectal neuroendocrine carcinoma (NECs) with colonic polyposis and were found to have Familial Adenomatous Polyposis and MYH-Associated Polyposis, respectively...
March 10, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28275037/colon-cancer-version-1-2017-nccn-clinical-practice-guidelines-in-oncology
#16
Al B Benson, Alan P Venook, Lynette Cederquist, Emily Chan, Yi-Jen Chen, Harry S Cooper, Dustin Deming, Paul F Engstrom, Peter C Enzinger, Alessandro Fichera, Jean L Grem, Axel Grothey, Howard S Hochster, Sarah Hoffe, Steven Hunt, Ahmed Kamel, Natalie Kirilcuk, Smitha Krishnamurthi, Wells A Messersmith, Mary F Mulcahy, James D Murphy, Steven Nurkin, Leonard Saltz, Sunil Sharma, David Shibata, John M Skibber, Constantinos T Sofocleous, Elena M Stoffel, Eden Stotsky-Himelfarb, Christopher G Willett, Christina S Wu, Kristina M Gregory, Deborah Freedman-Cass
This portion of the NCCN Guidelines for Colon Cancer focuses on the use of systemic therapy in metastatic disease. Considerations for treatment selection among 32 different monotherapies and combination regimens in up to 7 lines of therapy have included treatment history, extent of disease, goals of treatment, the efficacy and toxicity profiles of the regimens, KRAS/NRAS mutational status, and patient comorbidities and preferences. Location of the primary tumor, the BRAF mutation status, and tumor microsatellite stability should also be considered in treatment decisions...
March 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28270730/lymph-node-evaluation-for-colon-cancer-in-routine-clinical-practice-a-population-based-study
#17
J C Del Paggio, S Nanji, X Wei, P H MacDonald, C M Booth
BACKGROUND: Guidelines recommend that 12 or more lymph nodes (lns) be evaluated during surgical resection of colon cancer. Here, we report ln yield and its association with survival in routine practice. METHODS: Electronic records of treatment were linked to the population-based Ontario Cancer Registry to identify all patients with colon cancer treated during 2002-2008. The study population (n = 5508) included a 25% random sample of patients with stage ii or iii disease...
February 2017: Current Oncology
https://www.readbyqxmd.com/read/28237645/nonelective-colon-cancer-resection-a-continued-public-health-concern
#18
Christopher T Aquina, Adan Z Becerra, Zhaomin Xu, Francis P Boscoe, Maria J Schymura, Katia Noyes, John R T Monson, Fergal J Fleming
BACKGROUND: Little is known regarding recent trends in the rate of nonelective colon cancer resection in the United States and its impact on both short-term and long-term outcomes. METHODS: The New York State Cancer Registry and Statewide Planning & Research Cooperative System identified stage I-III colon cancer resections from 2004-2011. Propensity-matched analyses assessed differences in short-term adverse outcomes and 5-year disease-specific and overall survival between elective and nonelective colon cancer operations...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28210747/extent-of-field-change-in-colorectal-cancers-with-braf-mutation
#19
Aaron Poh, Heidi Sian Ying Chang, Kok Yang Tan, Xin Xiu Sam, Avery Khoo, Shoa Nian Choo, Min En Nga, Wei Keat Wan
INTRODUCTION: Sporadic colorectal cancers with BRAF mutations constitute two distinct subgroups of colorectal cancers. Recent studies have linked the presence of the BRAF mutation to a familial inheritance pattern. This was a proof-of-concept study that aimed to examine: (a) the extent of field change in sporadic colorectal cancers with BRAF mutation; and (b) the extent of resection margins required and the pattern of DNA mismatch repair protein loss in these tumours. METHODS: Eight microsatellite instability-high (MSI-H) tumours with positive BRAF mutation from an existing histopathological database were selected for BRAF mutation and mismatch repair protein analysis...
February 17, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28194526/long-term-outcomes-after-treatment-for-t1-colorectal-carcinoma-a-multicenter-retrospective-cohort-study-of-hiroshima-gi-endoscopy-research-group
#20
Yuzuru Tamaru, Shiro Oka, Shinji Tanaka, Shinji Nagata, Yuko Hiraga, Toshio Kuwai, Akira Furudoi, Tadamasa Tamura, Masaki Kunihiro, Hideharu Okanobu, Koichi Nakadoi, Hiroyuki Kanao, Makoto Higashiyama, Koji Arihiro, Kazuya Kuraoka, Fumio Shimamoto, Kazuaki Chayama
BACKGROUND: We aimed to clarify the long-term outcomes of patients with T1 colorectal carcinoma (CRC) after endoscopic resection (ER) and surgical resection. METHODS: We examined T1 CRC patients treated during 1992-2008 and who had ≥5 years of follow-up. Patients who did not meet the curative criteria after ER according to the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines were defined as "non-endoscopically curable" and classified into three groups: ER alone (Group A: 121 patients), additional surgery after ER (Group B: 238 patients), and surgical resection alone (Group C: 342 patients)...
February 13, 2017: Journal of Gastroenterology
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