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Hashimoto S, Nonaka T, Tominaga T, Shiraishi T, Noda K, Ono R, Hisanaga M, Takeshita H, Fukuoka H, Fukuoka KT, Tanaka K, Kunizaki M, Sawai T, Matsumoto K. Surgical risk and cause of death among octogenarian and nonagenarian patients with colorectal cancer: a Japanese multicenter study. Jpn J Clin Oncol 2025; 55:341-348. [PMID: 39657071 DOI: 10.1093/jjco/hyae171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 12/02/2024] [Indexed: 12/17/2024] Open
Abstract
BACKGROUND The number of elderly people undergoing surgery for colorectal cancer has been increasing. We examine prognosis, including risks of surgery by age and cancer- and noncancer-related deaths. METHODS This study retrospectively reviewed 1830 patients who underwent curative resection colorectal surgery. Patients were divided into oldest-old (>85 years old, n = 49), elderly (75-84 years old, n = 637), and young (<75 years old, n = 1144) patient groups. RESULTS Physical status was poorer (P < .001), postoperative complications were more frequent (49.0% vs. 20.9% vs. 18.4%; P < .001), and adjuvant chemotherapy was less frequent (0% vs. 44.3% vs. 83.5%; P < .001) as patients got older. Multivariate analysis revealed oldest-old [odds ratio (OR) 4.373, 95% confidence interval (CI) 2.362-8.110; P < .001] as independent predictors of postoperative complications. Elderly patients [hazard ratio (HR) 2.494, 95%CI 1.707-3.642; P < .001], oldest-old patients (HR 5.969, 95%CI 3.229-11.035; P < .001), poor physical status (HR 2.546, 95%CI 1.694-3.827; P < .001), and postoperative complications (HR 1.805, 95%CI 1.252-2.602; P = .001) were predictive factors for noncancer-specific survival. CONCLUSIONS Elderly patients had many complications and a higher risk of dying from other causes. Surgical risk and general condition must be considered when deciding the appropriateness of surgery and adjuvant therapy.
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Affiliation(s)
- Shintaro Hashimoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Nonaka
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Tetsuro Tominaga
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Toshio Shiraishi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Keisuke Noda
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Rika Ono
- Department of Surgery, Sasebo City General Hospital, 9-3 Hirasemachi, Nagasaki, 857-8511, Japan
| | - Makoto Hisanaga
- Department of Surgery, Sasebo City General Hospital, 9-3 Hirasemachi, Nagasaki, 857-8511, Japan
| | - Hiroaki Takeshita
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Omura, Nagasaki, 856-8562, Japan
| | - Hidetoshi Fukuoka
- Department of Surgery, Isahaya General Hospital, 24-1 Isahaya, Nagasaki, 854-8501, Japan
| | - Kazuo To Fukuoka
- Department of Surgery, Ureshino Medical Center, 4760-1 Ko, Ureshinomachi, Oaza, Shimojuku, Ureshino, Saga, 843-0393, Japan
| | - Kenji Tanaka
- Department of Surgery, Saiseikai Nagasaki Hospital, 2-5-1 Katafuchi, Nagasaki, 850-0003, Japan
| | - Masaki Kunizaki
- Department of Surgery, Saseno Chuo Hospital, 15 Yamatocho, Sasebo, 857-1195, Japan
| | - Terumitsu Sawai
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Keitaro Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Ramli SR, Azhar ZI, Raman S, Yusof SN, Mohamad M. Spatial patterns of colorectal cancer survival rates in Malaysia, 2013-2018. Cancer Causes Control 2025; 36:389-397. [PMID: 39652251 DOI: 10.1007/s10552-024-01945-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 11/25/2024] [Indexed: 04/10/2025]
Abstract
BACKGROUND Large geographical variations in colorectal cancer (CRC) survival rates have been reported across regions. Poorer survival rates were mainly found in socioeconomically deprived areas, highly dense areas, and areas lacking healthcare accessibility. The objective of this study was to identify, compare, and contrast the spatial patterns of 5-year CRC-specific survival rates and identify high-priority areas by districts in Malaysia. METHODS This retrospective cohort study utilized secondary data from the National Cancer Registry. CRC patients (ICD10 C18-21) diagnosed between 2013 and 2018 were selected. Patient addresses were geocoded into districts and states via geospatial data from the National Geospatial Centre, whereas district population density data were gathered from the Population Census of Malaysia. Kaplan‒Meier survival analysis and log-rank test were conducted to determine and compare the 5-year CRC-specific survival rates, and the spatial distribution of CRC survival by district was determined via ArcGIS software. RESULTS A total of 18,513 CRC patients were registered from 143 districts, with 10,819 deaths occurring during follow-up. The national 5-year CRC-specific survival rate was 42%, with median survival time of 36 months (95% CI: 34.46, 37.54). The eastern region (Kelantan, Terengganu, and Pahang) had the lowest survival (38.0%). Among the 143 districts, eighty-one (56.6%) reported survival rates below the national average while thirty-six (25.2%) were identified as high-priority districts. CONCLUSION The differences in CRC survival rates were evident according to geographical location. Area-based targeted interventions to improve CRC detection, management, and access to healthcare are imperative to address cancer survival disparities and help effectively allocate resources.
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Affiliation(s)
- Siti Ramizah Ramli
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Zahir Izuan Azhar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Sukumaran Raman
- National Cancer Registry Department, National Cancer Institute, Ministry of Health, Putrajaya, Malaysia
| | - Siti Norbayah Yusof
- National Cancer Registry Department, National Cancer Institute, Ministry of Health, Putrajaya, Malaysia
| | - Mariam Mohamad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia.
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Jalan Hospital, Sungai Buloh Campus, 47000, Sungai Buloh, Selangor, Malaysia.
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Fwelo P, Adekunle TE, Adekunle TB, Garza ER, Huang E, Lawrence WR, Ewing AP. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med 2025; 14:e70612. [PMID: 40040375 PMCID: PMC11880620 DOI: 10.1002/cam4.70612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 12/06/2024] [Accepted: 01/04/2025] [Indexed: 03/06/2025] Open
Abstract
INTRODUCTION Non-Hispanic Black (Black) colorectal cancer (CRC) patients have a higher risk of mortality than most other racial/ethnic groups. Limited studies examine the contribution of socioeconomic (SES), clinicopathologic, or treatment variations to mortality disparities. This retrospective cohort investigation examined the extent to which SES, clinicopathologic, and treatment factors explain racial/ethnic differences in CRC mortality. METHODS We studied 146,515 individuals, 18+ years old, with a confirmed diagnosis of CRC within 2010-2017, identified from the Surveillance, Epidemiology, and End Results (SEER) database. We performed Cox regression analyses to examine the association of race and ethnicity, surgery type, and tumor site with all-cause mortality and CRC-specific mortality. We then performed mediation analysis to quantify the extent to which mortality differences were mediated by SES, clinicopathologic, and treatment factors. RESULTS Black patients had a significantly higher hazard of all-cause mortality than non-Hispanic White (White) patients. The White versus Black patients' comparison demonstrated that variations in SES and clinicopathologic factors significantly explained 46.63% (indirect effect HR: 0.92, 95% CI 0.91-0.93) and 10.87% (indirect effect HR: 0.98, 95% CI 0.97-0.99) of the excess all-cause mortality among Black patients, respectively. The Hispanic versus Black comparisons identified SES as the most influential mediator, explaining 19.68% of the excess all-cause mortality. The proportions mediating for CRC-specific mortality showed comparable outcomes to all-cause mortality. CONCLUSION Black patients had a greater risk for all-cause mortality and CRC-specific mortality attributed to SES and clinicopathologic variations compared to other racial/ethnic groups. Future studies should investigate equity in healthcare through interventions addressing SES-related disparities.
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Affiliation(s)
- Pierre Fwelo
- Department of Epidemiology, Human Genetics and Environmental SciencesUTHealth School of Public HealthHoustonTexasUSA
| | - Toluwani E. Adekunle
- Department of Psychology, Public Health ProgramCalvin University School of HealthGrand RapidsMichiganUSA
| | - Tiwaladeoluwa B. Adekunle
- Center for Education in Health Sciences, Institute for Public Health and MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Ella R. Garza
- Department of Epidemiology, Human Genetics and Environmental SciencesUTHealth School of Public HealthHoustonTexasUSA
| | - Emily Huang
- Department of Surgery, College of MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Wayne R. Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer InstituteNational Institutes of HealthRockvilleMarylandUSA
| | - Aldenise P. Ewing
- Division of Epidemiology, College of Public HealthThe Ohio State UniversityColumbusOhioUSA
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Li W, Liu Y. Development and validation of a risk predictive nomogram for colon cancer-specific mortality: a competing risk model based on the SEER database. Discov Oncol 2024; 15:621. [PMID: 39503842 PMCID: PMC11541964 DOI: 10.1007/s12672-024-01498-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 11/01/2024] [Indexed: 11/09/2024] Open
Abstract
BACKGROUND Utilizing the SEER database, we developed a competing risk model along with a nomogram designed for the early identification of colon cancer-specific mortality (CSM) risk. METHODS Clinical and pathological information, along with other significant data, were obtained from the SEER database. Patients were randomly divided into a training set and a validation set. We investigated the independent factors affecting CSM among colon cancer patients using univariate and multivariate analyses within a competing risk framework, ultimately developing a predictive tool for CSM in colon cancer. RESULTS Involving 40,261 individuals diagnosed with colon cancer, our study included 10,397 deaths directly due to the disease and an additional 5,828 from other causes. We used a competing risk model to predict cancer-specific mortality (CSM) in these patients. For the training dataset, the model's area under the curve (AUC) for predicting 1-, 3-, and 5-year cancer-specific survival (CSS) was 0.835 (95% confidence interval [CI] 0.826 to 0.844), 0.849 (95% CI 0.843 to 0.855), and 0.843 (95% CI 0.836 to 0.850), respectively. In the validation group, the AUC values for the same time periods were 0.846 (95% CI 0.833 to 0.860), 0.853 (95% CI 0.843 to 0.862), and 0.846 (95% CI 0.835 to 0.856), respectively. In comparison, traditional survival analysis yielded higher cumulative CSM rates over time than those provided by our competing risk approach. CONCLUSION We created a competitive risk assessment model along with a predictive tool designed to estimate CSM in patients with colon cancer. This nomogram demonstrates high accuracy and reliability, aiding medical professionals in making clinical decisions and developing patient follow-up plans.
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Affiliation(s)
- Wei Li
- Department of Oncology, Shuyang Hospital, The Affiliated Shuyang Hospital of Xuzhou Medical University, No. 9 Yingbin Avenue, Shucheng Town, Shuyang County, Suqian, 223600, Jiangsu, China.
| | - Yiting Liu
- Department of Oncology, Shuyang Hospital, The Affiliated Shuyang Hospital of Xuzhou Medical University, No. 9 Yingbin Avenue, Shucheng Town, Shuyang County, Suqian, 223600, Jiangsu, China
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Tan JY, Shen SH. Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer: A real-world population-based study. World J Cardiol 2024; 16:458-468. [PMID: 39221191 PMCID: PMC11362806 DOI: 10.4330/wjc.v16.i8.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/24/2024] [Accepted: 08/06/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer (CRC). Cardiovascular disease (CVD)-specific mortality is the second-most frequent cause of death. The risk factors for CVD-specific mortality among older patients with CRC are still poorly understood.
AIM To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.
METHODS The data on older patients diagnosed with CRC were retrieved from The Surveillance, Epidemiology, and End Results database from 2004 to 2015. The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.
RESULTS A total of 141251 eligible patients with CRC were enrolled, of which 41459 patients died of CRC and 12651 patients died of CVD. The age at diagnosis, sex, marital status, year of diagnosis, surgery, and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC. We used these variables to develop a model to predict CVD-specific mortality. The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations. The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734, respectively.
CONCLUSION The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC. This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.
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Affiliation(s)
- Jia-Yu Tan
- Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250000, Shandong Province, China
| | - Shuo-Hao Shen
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250000, Shandong Province, China
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Aynalem ZB, Adal AB, Ayele TF, Bayeh GM, Yeshiwas AG, Dessie TM, Tsega TD. Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis. BMC Cancer 2024; 24:821. [PMID: 38987683 PMCID: PMC11234545 DOI: 10.1186/s12885-024-12597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia. METHODS PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics. RESULTS After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors. CONCLUSION In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
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Affiliation(s)
- Zewdu Bishaw Aynalem
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Abebaw Bires Adal
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Temesgien Fentahun Ayele
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Almaw Genet Yeshiwas
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tadesse Miretie Dessie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Adam R, Badrudin D, Chiche L, Bucur P, Scatton O, Granger V, Ducreux M, Cillo U, Cauchy F, Lesurtel M, Mabrut JY, Verslype C, Coubeau L, Hardwigsen J, Boleslawski E, Muscari F, Jeddou H, Pezet D, Heyd B, Lucidi V, Geboes K, Lerut J, Majno P, Grimaldi L, Boukhedouni N, Piedvache C, Gelli M, Levi F, Lewin M. Safety and feasibility of chemotherapy followed by liver transplantation for patients with definitely unresectable colorectal liver metastases: insights from the TransMet randomised clinical trial. EClinicalMedicine 2024; 72:102608. [PMID: 38721015 PMCID: PMC11077272 DOI: 10.1016/j.eclinm.2024.102608] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/17/2024] [Accepted: 04/05/2024] [Indexed: 06/03/2025] Open
Abstract
BACKGROUND Despite the increasing efficacy of chemotherapy (C), the 5-year survival rate for patients with unresectable colorectal liver metastases (CLM) remains around 10%. Liver transplantation (LT) might offer a curative approach for patients with liver-only disease, yet its superior efficacy compared to C alone remains to be demonstrated. METHODS The TransMet randomised multicentre clinical trial (NCT02597348) compares the curative potential of C followed by LT versus C alone in patients with unresectable CLM despite stable or responding disease on C. Patient eligibility criteria proposed by local tumour boards had to be validated by an independent committee via monthly videoconferences. Outcomes reported here are from a non-specified interim analysis. These include the eligibility of patients to be transplanted for non resectable colorectal liver metastases, as well as the feasibility and the safety of liver transplantation in this indication. FINDINGS From February 2016 to July 2021, 94 (60%) of 157 patients from 20 centres in 3 countries submitted to the validation committee, were randomised. Reasons for ineligibility were mainly tumour progression in 50 (32%) or potential resectability in 13 (8%). The median delay to LT after randomisation was 51 (IQR 30-65) days. Nine of 47 patients (19%, 95% CI: 9-33) allocated to the LT arm failed to undergo transplantation because of intercurrent disease progression. Three of the 38 transplanted patients (8%) were re-transplanted, one of whom (3%) died post-operatively from multi-organ failure. INTERPRETATION The selection process of potential candidates for curative intent LT for unresectable CLM in the TransMet trial highlighted the critical role of an independent multidisciplinary validation committee. After stringent selection, the feasibility of LT was 81%, as 19% had disease progression while on the waiting list. These patients should be given high priority for organ allocation to avoid dropout from the transplant strategy. FUNDING No source of support or funding from any author to disclose for this work. The trial was supported by the Assistance Publique - Hôpitaux de Paris (AP-HP).
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Affiliation(s)
- René Adam
- AP-HP Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
| | - David Badrudin
- AP-HP Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
- Université De Montréal, Département de Chirurgie, Montréal, Canada
| | | | | | | | | | | | | | | | - Mickael Lesurtel
- Department of Digestive Surgery & Liver Transplantation, Croix Rousse University Hospital, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery & Liver Transplantation, Croix Rousse University Hospital, Hospices Civils de Lyon, University of Lyon, Lyon, France
| | | | | | | | | | | | | | - Denis Pezet
- CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | | | | | - Pietro Majno
- Università Della Svizzera Italiana, Lugano, Switzerland
| | | | | | | | | | - Francis Levi
- AP-HP Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
| | - Maïté Lewin
- AP-HP Hôpital Paul Brousse, Université Paris-Saclay, Villejuif, France
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Rahmati S, Moeinafshar A, Rezaei N. The multifaceted role of extracellular vesicles (EVs) in colorectal cancer: metastasis, immune suppression, therapy resistance, and autophagy crosstalk. J Transl Med 2024; 22:452. [PMID: 38741166 PMCID: PMC11092134 DOI: 10.1186/s12967-024-05267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Extracellular vesicles (EVs) are lipid bilayer structures released by all cells and widely distributed in all biological fluids. EVs are implicated in diverse physiopathological processes by orchestrating cell-cell communication. Colorectal cancer (CRC) is one of the most common cancers worldwide, with metastasis being the leading cause of mortality in CRC patients. EVs contribute significantly to the advancement and spread of CRC by transferring their cargo, which includes lipids, proteins, RNAs, and DNAs, to neighboring or distant cells. Besides, they can serve as non-invasive diagnostic and prognostic biomarkers for early detection of CRC or be harnessed as effective carriers for delivering therapeutic agents. Autophagy is an essential cellular process that serves to remove damaged proteins and organelles by lysosomal degradation to maintain cellular homeostasis. Autophagy and EV release are coordinately activated in tumor cells and share common factors and regulatory mechanisms. Although the significance of autophagy and EVs in cancer is well established, the exact mechanism of their interplay in tumor development is obscure. This review focuses on examining the specific functions of EVs in various aspects of CRC, including progression, metastasis, immune regulation, and therapy resistance. Further, we overview emerging discoveries relevant to autophagy and EVs crosstalk in CRC.
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Affiliation(s)
- Soheil Rahmati
- Student Research Committee, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Aysan Moeinafshar
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, Tehran, 14194, Iran.
- Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Hang D, Du M, Wang L, Wang K, Fang Z, Khandpur N, Rossato SL, Steele EM, Chan AT, Hu FB, Meyerhardt JA, Mozaffarian D, Ogino S, Sun Q, Wong JB, Zhang FF, Song M. Ultra-processed food consumption and mortality among patients with stages I-III colorectal cancer: a prospective cohort study. EClinicalMedicine 2024; 71:102572. [PMID: 38572081 PMCID: PMC10990709 DOI: 10.1016/j.eclinm.2024.102572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/24/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Background Ultra-processed foods (UPFs) are emerging as a risk factor for colorectal cancer (CRC), yet how post-diagnostic UPF intake may impact CRC prognosis remains unexplored. Methods Data collected from food frequency questionnaires were used to estimate intakes of total UPFs and UPF subgroups (serving/d) at least 6 months but less than 4 years post-diagnosis among 2498 patients diagnosed with stages I-III CRC within the Nurses' Health Study and Health Professionals Follow-up Study during 1980-2016. Hazard ratios (HR) and 95% confidence intervals (CIs) of all-cause, CRC- and cardiovascular disease (CVD)-specific mortality in association with UPF consumption were estimated using an inverse probability weighted multivariable Cox proportional hazards regression model, adjusted for confounders. Findings The mean (SD) age of patients at diagnosis was 68.5 (9.4) years. A total of 1661 deaths were documented, including 321 from CRC and 335 from CVD. Compared to those in the lowest quintile (median = 3.6 servings/d), patients in the highest quintile (median = 10 servings/d) of post-diagnostic UPF intake had higher CVD mortality (HR = 1.65, 95% CI = 1.13-2.40) but not CRC or all-cause mortality. Among UPF subgroups, higher consumption of fats/condiments/sauces was associated with a higher risk of CVD-specific mortality (highest vs. lowest quintile of intake, HR = 1.96, 95% CI = 1.41-2.73), and higher intake of ice cream/sherbet was associated with an increased risk of CRC-specific mortality (highest vs. lowest quintile, HR = 1.86, 95% CI: 1.33-2.61). No statistically significant association was found between UPF subgroups and overall mortality. Interpretation Higher post-diagnostic intake of total UPFs and fats/condiments/sauces in CRC survivors is associated with higher CVD mortality, and higher ice cream/sherbet intake is linked to higher CRC mortality. Funding US National Institutes of Health and the American Cancer Society.
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Affiliation(s)
- Dong Hang
- Department of Epidemiology, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mengxi Du
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lu Wang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kai Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhe Fang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Human Nutrition and Health, Wageningen University, Netherlands
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Sinara Laurini Rossato
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Geography, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | - Eurídice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition (NUPENS), Faculty of Public Health, University of São Paulo, Brazil
| | - Andrew T. Chan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jeffrey A. Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts School of Medicine and Division of Cardiology, Tufts Medical Center, Boston, MA, USA
| | - Shuji Ogino
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Nutrition, Harvard Medical School, Boston, MA, USA
- Tokyo Medical and Dental University (Institute of Science Tokyo), Tokyo, Japan
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - John B. Wong
- Division of Clinical Decision Making, Tufts Medical Center, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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10
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Lin Y, Li H, Wu H, Li S, Abakumov MA, Chekhonin VP, Peltzer K, Abbas KS, Makatsariya AD, Liu Z, Zhang J, Xue Y, Zhang C. Age-related Disparities in Pan-Cancer Mortality and Causes of Death: Analysis of Surveillance, Epidemiology, and End Results (SEER) Data. J Cancer 2024; 15:1613-1623. [PMID: 38370383 PMCID: PMC10869975 DOI: 10.7150/jca.91758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/07/2024] [Indexed: 02/20/2024] Open
Abstract
Comprehensive analysis of mortality and causes of death (COD) in cancers was of importance to conduct intervention strategies. The current study aimed to investigate the mortality rate and COD among cancers, and to explore the disparities between age. Initially, cancer patients diagnosed between 2010 and 2019 from the surveillance, epidemiology, and end results (SEER) database were extracted. Then, frequencies and percentage of deaths, and mortality rate in different age groups were calculated. Meanwhile, age distribution of different COD across tumor types was illustrated while the standardized mortality ratios (SMR) stratified by age were calculated and visualized. A total of 2,670,403 death records were included and digestive system cancer (688,953 death cases) was the most common primary cancer type. The mortality rate increased by 5.6% annually in total death, 4.0% in cancer-specific death and 10.9% in non-cancer cause. As for cancer-specific death, the age distribution varied among different primary tumor types due to prone age and prognosis of cancer. The top five non-cancer causes in patients older than 50 were cardiovascular and cerebrovascular disease, other causes, COPD and associated conditions, diabetes as well as Alzheimer. The SMRs of these causes were higher among younger patients and gradually dropped in older age groups. Mortality and COD of cancer patients were heterogeneous in age group due to primary tumor types, prone age and prognosis of cancer. Our study conducted that non-cancer COD was a critical part in clinical practice as well as cancer-specific death. Individualized treatment and clinical intervention should be made after fully considering of the risk factor for death in different diagnosis ages and tumor types.
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Affiliation(s)
- Yile Lin
- Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Huiyang Li
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin, China
| | - Haixiao Wu
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Shu Li
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Public Service Management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Maxim A Abakumov
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- National University of Science and Technology (MISIS), Moscow, Russia
- Department of Medical Nanobiotechnology, N.I Pirogov Russian National Research Medical University, Moscow, Russia
| | - Vladimir P Chekhonin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Medical Nanobiotechnology, N.I Pirogov Russian National Research Medical University, Moscow, Russia
| | - Karl Peltzer
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Research & Innovation, University of Limpopo, Sovenga, Limpopo, South Africa
| | - Kirellos Said Abbas
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Alexander D Makatsariya
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health, Sechenov University, Moscow, Russia
| | - Zheng Liu
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Orthopaedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jin Zhang
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yuan Xue
- Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Zhang
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Department of Medical Nanobiotechnology, N.I Pirogov Russian National Research Medical University, Moscow, Russia
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11
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Xia Y, Lu S, Huo C, Fan L, Lin M, Huang J. Non cancer causes of death after gallbladder cancer diagnosis: a population-based analysis. Sci Rep 2023; 13:13746. [PMID: 37612302 PMCID: PMC10447554 DOI: 10.1038/s41598-023-40134-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/05/2023] [Indexed: 08/25/2023] Open
Abstract
Mortality from non cancer causes in patients with gallbladder cancer (GBC) still unclear. This study evaluated the causes and risk factors of non cancer death during different follow-up periods after GBC diagnosis. Non cancer causes of death for GBC patients diagnosed between 2000 and 2017 in Surveillance, Epidemiology and End Results database were analyzed and standardized mortality rates (SMR) for each non cancer death were calculated. Predictors for non cancer death were identified through multivariate competing risk analysis. A total 11,927 GBC patients were identified for further analysis, 9393 died during follow up. The largest proportion of non cancer deaths occurred > 3 years after diagnosis (39.4%). Most common non cancer cause were cardiovascular disease (43.3%), followed by other cause of death (34.4%) and infectious diseases (8.6%). Compared with US general population, GBC patients has higher risk of death from disease of heart (SMR, 1.58; 95%CI, 1.41-1.75), septicemia (SMR,3.21; 95%CI, 2.27-4.40), diabetes mellitus (SMR,1.97; 95%CI, 1.43-2.63), alone with other causes. Non cancer causes accounted for a significant proportion of deaths during the follow-up period after GBC diagnosis. The risk of non cancer death is higher in GBC patients than in the general population. Our study provides comprehensive assessment of death from non cancer cause in GBC patients, which has important implications for health management in GBC patients.
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Affiliation(s)
- Yang Xia
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Shuangshuang Lu
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Chunyan Huo
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Li Fan
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Min Lin
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
| | - Jin Huang
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
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12
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Patel BY, Bhome R, Liu DSK, Giovannetti E, Merali N, Primrose JN, Mirnezami AH, Rockall TA, Annels N, Frampton AE. Cancer cell-derived extracellular vesicles activate hepatic stellate cells in colorectal cancer. Expert Rev Mol Diagn 2023; 23:843-849. [PMID: 37599564 DOI: 10.1080/14737159.2023.2246893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
Colorectal cancer (CRC) is the 2nd leading cause of cancer-related deaths worldwide, primarily due to the development of metastatic disease. The liver is the most frequently affected site. The metastatic cascade relies on a complex interaction between the immune system, tumor, and distant organs. Communication between the tumor and the metastatic site can be mediated by tumor-derived extracellular vesicles (EVs) and their cargo. The mechanisms underlying this process are starting to be understood through research that has rapidly expanded over the past 15 years. One crucial aspect is the remodeling of the microenvironment at the site of metastasis, which is essential for the formation of a premetastatic niche and the subsequent establishment of metastatic deposits. In the evaluated study, the authors use cellular experiments and a mouse model to investigate how tumour derived extracellular vesicles and their microRNA contents interact with hepatic stellate cells (HSCs). They demonstrate how this may lead to remodelling of the microenvironment and the formation of colorectal liver metastasis using their experimental model. In this mini review, we examine the current evidence surrounding tumour derived EVs and their effect on the tumour microenvironment to highlight potential areas for future research in CRC and other malignancies.
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Affiliation(s)
- Bhavik Y Patel
- Section of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
- Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, UK
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Guildford, UK
| | - Rahul Bhome
- Cancer Sciences, University of Southampton, Southampton, UK
| | - Daniel S K Liu
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Elisa Giovannetti
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Pharmacology Lab, Fondazione Pisana per La Scienza, San Giuliano, Italy
| | - Nabeel Merali
- Section of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
- Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, UK
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Guildford, UK
| | - John N Primrose
- Department of Surgery, University of Southampton, Southampton, UK
| | - Alex H Mirnezami
- Department of Surgery, University of Southampton, Southampton, UK
| | - Timothy A Rockall
- Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, UK
| | - Nicola Annels
- Section of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
| | - Adam E Frampton
- Section of Oncology, Dept. of Clinical & Experimental Medicine, University of Surrey, Guildford, Surrey, UK
- Minimal Access Therapy Training Unit (MATTU), Leggett Building, University of Surrey, Guildford, UK
- Department of Hepato-Pancreato-Biliary (HPB) Surgery, Royal Surrey County Hospital, Guildford, UK
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13
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Chen Y, He L, Lu X, Tang Y, Luo G, Chen Y, Wu C, Liang Q, Xu X. Causes of death among early-onset colorectal cancer population in the United States: a large population-based study. Front Oncol 2023; 13:1094493. [PMID: 37168371 PMCID: PMC10166590 DOI: 10.3389/fonc.2023.1094493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/30/2023] [Indexed: 05/13/2023] Open
Abstract
Background Early-onset colorectal cancer (EOCRC) has an alarmingly increasing trend and arouses increasing attention. Causes of death in EOCRC population remain unclear. Methods Data of EOCRC patients (1975-2018) were extracted from the Surveillance, Epidemiology, and End Results database. Distribution of death was calculated, and death risk of each cause was compared with the general population by calculating standard mortality ratios (SMRs) at different follow-up time. Univariate and multivariate Cox regression models were utilized to identify independent prognostic factors for overall survival (OS). Results The study included 36,013 patients, among whom 9,998 (27.7%) patients died of colorectal cancer (CRC) and 6,305 (17.5%) patients died of non-CRC causes. CRC death accounted for a high proportion of 74.8%-90.7% death cases within 10 years, while non-CRC death (especially cardiocerebrovascular disease death) was the major cause of death after 10 years. Non-cancer death had the highest SMR in EOCRC population within the first year after cancer diagnosis. Kidney disease [SMR = 2.10; 95% confidence interval (CI), 1.65-2.64] and infection (SMR = 1.92; 95% CI, 1.48-2.46) were two high-risk causes of death. Age at diagnosis, race, sex, year of diagnosis, grade, SEER stage, and surgery were independent prognostic factors for OS. Conclusion Most of EOCRC patients died of CRC within 10-year follow-up, while most of patients died of non-CRC causes after 10 years. Within the first year after cancer diagnosis, patients had high non-CRC death risk compared to the general population. Our findings help to guide risk monitoring and management for US EOCRC patients.
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Affiliation(s)
- Yuerong Chen
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lanping He
- Department of Gastroenterology, Fogang County People’s Hospital, Fogang, China
| | - Xiu Lu
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuqun Tang
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guanshui Luo
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yuji Chen
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Chaosheng Wu
- Minimally Invasive Tumor Therapies Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qihua Liang
- Center of Digestive Endoscopology, The Second People’s Hospital of Luoding City, Luoding, China
| | - Xiuhong Xu
- Department of Acupuncture and Massage Rehabilitation, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
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14
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Nso N, Nyabera A, Nassar M, Mbome Y, Emmanuel K, Alshamam M, Sumbly V, Guzman L, Shaukat T, Bhangal R, Ojong GA, Radparvar F, Rizzo V, Munira MS. Incidence and risk factors of cardiovascular mortality in patients with gastrointestinal adenocarcinoma. PLoS One 2023; 18:e0262013. [PMID: 36706093 PMCID: PMC9882755 DOI: 10.1371/journal.pone.0262013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 12/15/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Gastrointestinal (GI) cancers are common and fatal. Improved cancer-directed therapies, with thier substantial role in improving cancer-specific survival, may increase non-cancer mortality-including cardiovascular mortality-in these patients. AIM To identify the risk factors of cardiovascular mortality in GI adenocarcinoma patients. METHODS Data of GI adenocarcinoma patients were gathered from the Surveillance, Epidemiology, and End Results database. We used Pearson's chi-square test to assess the relationships between categorical variables. We used the Kaplan-Meyer test in the univariate analysis and Cox regression test for the multivariate analysis. RESULTS Among 556,350 included patients, 275,118 (49.6%) died due to adenocarcinoma, 64,079 (11.5%) died due to cardiovascular causes, and 83,161 (14.9%) died due to other causes. Higher rates of cardiovascular mortality were found in patients ≥ 50 years (HR, 8.476; 95% CI, 7.91-9.083), separated (HR, 1.27; 95% CI, 1.184-1.361) and widowed (HR, 1.867; 95% CI, 1.812-1.924), patients with gastric (HR, 1.18; 95% CI, 1.1-1.265) or colorectal AC (HR, 1.123; 95% CI, 1.053-1.198), and patients not undergone surgery (HR, 2.04; 95% CI, 1.958-2.126). Lower risk patients include females (HR, 0.729; 95% CI, 0.717-0.742), blacks (HR, 0.95; 95% CI, 0.924-0.978), married (HR, 0.77; 95% CI, 0.749-0.792), divorced (HR, 0.841; 95% CI, 0.807-0.877), patients with pancreatic AC (HR, 0.83; 95% CI, 0.757-0.91), and patients treated with chemotherapy (HR, 0.416; 95% CI, 0.406-0.427). CONCLUSIONS Risk factors for cardiovascular mortality in GI adenocarcinoma include advanced age, males, whites, separated and widowed, gastric or colorectal adenocarcinoma, advanced grade or advanced stage of the disease, no chemotherapy, and no surgery. Married and divorced, and patients with pancreatic adenocarcinoma have a lower risk.
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Affiliation(s)
- Nso Nso
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Akwe Nyabera
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Mahmoud Nassar
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Yolanda Mbome
- Department of Medicine, Richmond University Medical center, Staten Island, NY, United States of America
| | - Kelechi Emmanuel
- Department of Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA, United States of America
| | - Mohsen Alshamam
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Vickram Sumbly
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Laura Guzman
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Tanveer Shaukat
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Rubal Bhangal
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Gilbert Ako Ojong
- Department of Medicine, La Magna Health/United Regional Hospital, Wichita Falls, Texas, United States of America
| | - Farshid Radparvar
- Division of Cardiology, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Vincent Rizzo
- Department of Medicine, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
| | - Most Sirajum Munira
- Division of Cardiology, Icahn School of Medicine at Mount Sinai / NYC H&H Queens, New York, NY, United States of America
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15
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Tarta C, Marian M, Capitanio M, Faur FI, Duta C, Diaconescu R, Oprescu-Macovei AM, Totolici B, Dobrescu A. The Challenges of Colorectal Cancer Surgery during the COVID-19 Pandemic in Romania: A Three-Year Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14320. [PMID: 36361200 PMCID: PMC9658781 DOI: 10.3390/ijerph192114320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
The predictions on the influence of the SARS-CoV-2 pandemic on access to medical services in Romania predicted a 35% drop in oncological hospitalizations in 2020 compared to the previous decade, raising the hypothesis that patients with colorectal cancer can become indirect victims of the ongoing pandemic. Therefore, the aim of the current research was to observe how the COVID-19 pandemic influenced colorectal cancer surgery in Romania, to determine the level of addressability towards specialized care, to compare the cancer staging between the pandemic and pre-pandemic periods, and to observe the risk factors for disease progression. This retrospective study was spread over three years, respectively, from March 2019 to March 2022, and included a total of 198 patients with a history of colorectal cancer surgery. It was decided to perform a parallel comparison of 2019, 2020, and 2021 to observe any significant changes during the pandemic. Our clinic encountered a significant decrease in all interventions during the pandemic; although the number of CRC surgeries remained constant, the cases were more difficult, with significantly more patients presenting in emergency situations, from 31.3% in 2019 to 50.0% in 2020 and 57.1% in 2021. Thus, the number of elective surgeries decreased significantly. The proportion of TNM (tumor-node-metastasis) staging was, however, statistically significant between the pre-pandemic and pandemic period. In 2019, 13.3% of patients had stage IIa, compared with 28.8% in 2020 and 13.1% in 2021. Similarly, the proportion of very advanced colorectal cancer was higher during the pandemic period of 2020 and 2021 (12.0% in 2019 vs. 12.5% in 2020 and 25.0% in 2021), which was represented by a significantly higher proportion of patients with bowel perforation. Patients with an advanced TNM stage had a 6.28-fold increased risk of disease progression, followed by lymphovascular invasion (HR = 5.19). However, the COVID-19 pandemic, represented by admission years 2020 and 2021, did not pose a significant risk for disease progression and mortality. In-hospital mortality during the pandemic also did not change significantly. After the pandemic restrictions have been lifted, it would be advisable to conduct a widespread colorectal cancer screening campaign in order to identify any instances of the disease that went undetected during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Cristi Tarta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Marian
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Capitanio
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Flaviu Ionut Faur
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Duta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan Diaconescu
- Department of Gastroenterology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Anca Monica Oprescu-Macovei
- Department of Gastroenterology, Emergency Hospital “Prof. Dr. Agripa Ionescu”, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Bogdan Totolici
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Amadeus Dobrescu
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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16
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Xu Y, Abdelazeem B, Abbas KS, Lin Y, Wu H, Zhou F, Peltzer K, Chekhonin VP, Li S, Li H, Ma W, Zhang C. Non-cancer Causes of Death Following Initial Synchronous Bone Metastasis in Cancer Patients. Front Med (Lausanne) 2022; 9:899544. [PMID: 35721072 PMCID: PMC9201113 DOI: 10.3389/fmed.2022.899544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the non-cancer causes of death (COD) in cancer patients with synchronous bone metastasis (BM) that is based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods The retrospective cohort study included malignant cancer patients with synchronous BM diagnosed from 2010 to 2018 in the SEER database. The frequencies and proportion of non-cancer COD were calculated and analyzed in different genders, ages, and races subgroups. Results A total of 97,997 patients were deceased and included into the current study and 6,782 patients were died of non-cancer causes with a male predominance (N = 4,515, 66.6%). Around half of deaths (N = 3,254, 48.0%) occurred within 6 months after diagnosis while 721 patients were deceased after 3 years. Lung and bronchus cancer, prostate cancer, breast cancer, kidney and renal pelvis cancer, and liver cancer were proved to be the top five cancer types resulting in non-cancer caused death. Cardiovascular and cerebrovascular diseases were the leading non-cancer cause of death (N = 2,618), followed by COPD and associated conditions (N = 553) and septicemia, infectious and parasitic diseases (N = 544). Sub-analyses stratified by gender, age and race were performed and the similar results with slightly difference were observed. Conclusions Cardiovascular and cerebrovascular diseases were the main non-cancer cause of death in cancer patients with synchronous BM. Other non-cancer causes included COPD, septicemia, infectious and parasitic diseases, and so on. These findings should be considered by physicians. Physicians can counsel cancer patients with BM regarding survivorship with death causes screening and focus on prevention of non-cancer deaths.
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Affiliation(s)
- Yao Xu
- Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Basel Abdelazeem
- McLaren Health Care, Flint, MI, United States
- Department of Internal Medicine, Michigan State University, East Lansing, MI, United States
| | | | - Yile Lin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
| | - Haixiao Wu
- Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Fei Zhou
- Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Vladimir P. Chekhonin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- N. P. Serbsky National Medical Research Centre of Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Shu Li
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Public Service Management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huiyang Li
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjuan Ma
- Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- *Correspondence: Wenjuan Ma
| | - Chao Zhang
- Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Chao Zhang
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New Challenges in Surgical Approaches for Colorectal Cancer during the COVID-19 Pandemic. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
(1) Background: The COVID-19 pandemic put a great burden on national healthcare systems, causing delays and disruptions in the medical care of non-COVID-19 patients. This paper aims to analyze the COVID-19 pandemic impact upon the quality of care in colorectal surgery. (2) Materials and Methods: We performed a retrospective study on the colorectal cancer cases operated in the Fourth Department of General Surgery, Emergency Hospital Bucharest Romania, over the period March 2020–February 2021 (pandemic group) vs. March 2019–February 2020 (non-pandemic group). (3) Results: The number of patients in the pandemic group decreased by 70% (36 vs. 118 patients), with lower accessibility from rural areas (11.1% vs. 37.2%, p = 0.035). Most cases in the pandemic group were emergencies (69% vs. 37.3%, p = 0.009), admitted for bowel obstruction (63.8% vs. 27.9%, p = 0.008). There was no in-hospital COVID-19 infection in patients operated for colorectal cancer. The 30-day mortality was significantly higher in the pandemic group (25% vs. 6.7%, p = 0.017), mostly due to septic shock (36.1% vs. 5%, p = 0.0001). (4) Conclusions: Colorectal cancer surgery may be performed safely during the COVID-19 pandemic, with strict adherence to the SARS-CoV-2 prevention protocols. However, the significant increase in colorectal cancers in the emergency was associated with worse outcomes and higher mortality during the COVID-19 pandemic.
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Wang Q, Zeng Z, Nan J, Zheng Y, Liu H. Cause of Death Among Patients With Thyroid Cancer: A Population-Based Study. Front Oncol 2022; 12:852347. [PMID: 35359353 PMCID: PMC8964038 DOI: 10.3389/fonc.2022.852347] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022] Open
Abstract
Background Over the last decades, the number of patients diagnosed with thyroid carcinoma has been increasing, highlighting the importance of comprehensively evaluating causes of death among these patients. This study aimed to comprehensively characterize the risk of death and causes of death in patients with thyroid carcinoma. Methods A total of 183,641 patients diagnosed with an index thyroid tumor were identified from the Surveillance, Epidemiology, and End Result database (1975-2016). Standardized mortality rates (SMRs) for non-cancer deaths were calculated to evaluate mortality risk and to compare mortality risks with the cancer-free US population. Cumulative mortality rates were calculated to explore the factors associated with higher risk of deaths. Results There were 22,386 deaths recorded during follow-up, of which only 31.0% were due to thyroid cancer and 46.4% due to non-cancer causes. Non-cancer mortality risk among patients with thyroid cancer was nearly 1.6-fold (SMR=1.59) that of the general population. Cardiovascular diseases were the leading cause of non-cancer deaths, accounting for 21.3% of all deaths in thyroid cancer patients. Non-cancer causes were the dominant cause of death in thyroid cancer survivors as of the third year post-diagnosis. We found that males with thyroid cancer had a higher risk of all-cause mortality compared with females. The risk of suicide was highest in the first post-diagnostic year (<1 year: SMR=1.51). The long-term risk of Alzheimer's disease was notably increased in thyroid cancer patients (>5 years: SMR=8.27). Conclusion Non-cancer comorbidities have become the major risks of death in patients with thyroid tumor in the US, as opposed to death from the tumor itself. Clinicians and researchers should be aware of these risk trends in order to conduct timely intervention strategies.
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Affiliation(s)
- Qian Wang
- Department of General Practice, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhen Zeng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junjie Nan
- Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yongqiang Zheng
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Huanbing Liu
- Department of General Practice, The First Affiliated Hospital of Nanchang University, Nanchang, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
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