Colon Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Colon Cancer, including details on causes, treatment, symptoms.

Revised TN categorization for colon cancer based on national survival outcomes data.

Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart AK

Mayo Clinic Cancer Center-Scottsdale, Radiation Oncology, 13400 East Shea Blvd, Scottsdale, AZ 85259, USA. gunderson.leonard@mayo.edu

PURPOSE: The sixth edition of American Joint Committee on Cancer (AJCC) Cancer Staging Manual for colon cancer subdivided stage II into IIA (T3N0) and IIB (T4N0) and stage III into IIIA (T1-2N1M0), IIIB (T3-4N1M0), and IIIC (anyTN2M0). Subsequent analyses supported revised substaging of stage III because of improved survival for T1-2N2 versus T3-4N2 and T4N1 survival was more similar to T3-4N2 than to T3N1. The AJCC Hindgut Taskforce sought population-based validation that depth of invasion and nodal status interact to affect survival. PATIENTS AND METHODS: Surveillance, Epidemiology, and End Results (SEER) population-based data from January 1992 to December 2004 for 109,953 colon cancer patients were compared with National Cancer Data Base (NCDB) data on 134,206 patients. T4N0 cancers were stratified by tumors that perforate visceral peritoneum (T4a) versus tumors that invade or are adherent to adjacent organs or structures (T4b). N1 and N2 were stratified by number of involved positive lymph nodes (N+): N1a/N1b (1 v 2-3), N2a/N2b (4 to 6 v > or = 7). Five-year observed and relative survival data were obtained for each TN category. RESULTS: SEER rectal cancer analyses confirm that T1-2N2 cancers have better prognosis than T3-4N2,T4bN1 have similar prognosis to T4N2, T1-2N1 have similar prognosis to T2N0/T3N0, and T1-2N2ahave similar prognosis to T2N0/T3N0 (T1N2a) or T4aN0 (T2N2a). Prognosis for T4a lesions is betterthan T4b by N category. The number of positive nodes affects prognosis. CONCLUSION: This SEER population-based colon cancer analysis is highly consistent with rectal cancer pooled analysis and SEER rectal cancer analyses, supporting the shift of T1-2N2 lesions from IIIC to IIIA/IIIB, shifting T4bN1 from IIIB to IIIC, subdividing T4/N1/N2, and revising substaging of stages II/III. Survival outcomes by TN category for colon and rectal cancer are strikingly similar.

Published 8 January 2010 in J Clin Oncol, 28(2): 264-71.
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Articles on Colon Cancer published 8 January 2010:

Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon.   J Clin Oncol, 28(2): 272-8.

PURPOSE: The plane of surgery in colonic cancer has been linked to patient outcome although the optimal extent of mesenteric resection is still unclear. Surgeons in Erlangen, Germany, routinely perform complete mesocolic excision (CME) with central vascular ligation (CVL) and report 5-year survivals of higher than 89%. We aimed to further investigate the importance of CME and CVL surgery for colonic cancer by comparison with a series of standard specimens. METHODS: The fresh photographs of 49 ... [Abstract] [Full-text]

Articles on Colon Cancer published 24 December 2009:

Variation in colonoscopic technique and adenoma detection rates at an academic gastroenterology unit.   Dig Dis Sci, 55(1): 166-71.

The purpose of this research is to evaluate the quality of colonoscopy at an academic institution with a focus on factors influencing withdrawal times and adenoma detection rates. Procedural data and pathologic results of 550 consecutive screening colonoscopies in average risks patients (mean [+/-SD] age, 57 +/- 7.6, 44% male) completed by ten academic gastroenterologists were reviewed. Per individual gastroenterologist, the adenoma detection rates ranged widely from 0.09 to 0.82 adenomas per ... [Abstract] [Full-text]

Articles on Colon Cancer published 21 December 2009:

Cytogenetic characterization and cell cycle analysis of three human colon adenocarcinoma cell lines: comparison between two- and three-dimensional cell culture systems.   Cancer Invest, 28(1): 7-12.

The aim of the study was to investigate whether changes in the pattern of gene copy number and cell cycle were present passing from the two- to the three-dimensional cell culture system. We used three human colon adenocarcinoma cell lines grown two- and three-dimensionally. We analyzed morphology, karyotype, chromosomal gain and losses, and cell cycle. In three-dimensional cell cultures the growth is delayed and arrested in G1 phase without specific rearrangements in the three-dimensional ... [Abstract] [Full-text]

Articles on Colon Cancer published 18 December 2009:

Nodal staging score: a tool to assess adequate staging of node-negative colon cancer.   J Clin Oncol, 27(36): 6166-71.

PURPOSE: Adequate nodal staging of colon cancer has been defined as pathologic examination of at least 12 lymph nodes. We sought to refine this definition by quantifying the likelihood that a pathologically node-negative patient has, indeed, no positive nodes. PATIENTS AND METHODS: Patients with stage I-III adenocarcinoma of the colon between 1994 and 2005 and had at least one lymph node pathologically examined were identified from the Surveillance, Epidemiology and End Results (SEER) database ... [Abstract] [Full-text]

Articles on Colon Cancer published 17 December 2009:

Adhesions and incisional hernias following laparoscopic versus open surgery for colorectal cancer in the CLASICC trial.   Br J Surg, 97(1): 70-8.

BACKGROUND: This study investigated adhesive intestinal obstruction (AIO) and incisional hernia (IH) in patients undergoing laparoscopically assisted and open surgery for colorectal cancer. METHODS: In a case-note review of patients randomized to the Medical Research Council's Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer (CLASICC) trial, primary and key secondary endpoints were AIO and IH admission rates respectively. RESULTS: Of 411 patients, 11 were admitted for AIO: ... [Abstract] [Full-text]

Radiation- and chemoinduced multidrug resistance in colon carcinoma cells.   Strahlenther Onkol, 185(12): 815-20.

BACKGROUND AND PURPOSE: Radiation can induce multidrug resistance (MDR) and thus interfere with simultaneous or subsequent chemotherapy. In SW620 colon carcinoma cells, the interrelation of various biological endpoints of MDR was analyzed and the potential of fractionated irradiation and chemoselection to evoke MDR was compared. MATERIAL AND METHODS: To induce/select an MDR phenotype, SW620 were exposed to either 27 Gy in 1.8-Gy daily fractions or to 50% inhibiting concentrations of doxorubicin ... [Abstract] [Full-text]

Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection.   Br J Surg, 97(1): 86-91.

BACKGROUND: A retrospective analysis of age-related postoperative morbidity in the Australia and New Zealand prospective randomized controlled trial comparing laparoscopic and open resection for right- and left-sided colonic cancer is presented. METHODS: A total of 592 eligible patients were entered and studied from 1998 to 2005. RESULTS: Data from 294 patients who underwent laparoscopic and 298 who had open colonic resection were analysed; 266 patients were aged less than 70 years and 326 were ... [Abstract] [Full-text]

A novel pro-apoptotic function of RACK1: suppression of Src activity in the intrinsic and Akt pathways.   Oncogene, 28(50): 4421-33.

Earlier we showed that RACK1 regulates growth of human colon cells by suppressing Src activity at G(1) and mitotic checkpoints. Here, we show that RACK1 also induces apoptosis of the cells, partly by inhibiting Src. In the intrinsic pathway, RACK1 inhibits expression of anti-apoptotic Bcl-2 and Bcl-X(L), induces expression of pro-apoptotic Bim, targets Bim and Bax to the mitochondria, induces oligomerization of Bax (which requires Bim and inhibition of Src), depolarizes mitochondria membranes, ... [Abstract] [Full-text]

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