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5. Defining Benchmarks for Pelvic Exenteration Surgery: A Multicentre Analysis of Patients with Locally Advanced and Recurrent Rectal Cancer

Author

Brown, Kilian G. M., Solomon, Michael J., Koh, Cherry E., Sutton, Paul A., Aguiar, Samuel, Jr, Bezerra, Tiago S., Clouston, Hamish W., Desouza, Ashwin, Dozois, Eric J., Ersryd, Amanda L., Frizelle, Frank, Funder, Jonas A., Garcia-Aguilar, Julio, Garfinkle, Richard, Glyn, Tamara, Heriot, Alexander, Kanemitsu, Yukihide, Kong, Chia Y., Kristensen, Helle Ø, Malakorn, Songphol, Mens, David M., Nilsson, Per J., Palmer, Gabriella J., Pappou, Emmanouil, Quinn, Martha, Quyn, Aaron J., Sahakitrungruang, Chucheep, Saklani, Avanish, Solbakken, Arne M., Tiernan, Jim P., Verhoef, Cornelis, and Steffens, Daniel

Published
2024
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9. Impact of microsatellite status in early-onset colonic cancer.

Author

Zaborowski, Alexandra M, Adamina, Ahmed Abdile Michel, Aigner, Felix, d'Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Bach, Sam Atallah Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Collinson, Rowan, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Figueiredo, Nuno, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah D, Salido, Andrea Jiménez, Jiménez-Toscano, Marta, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, Kennelly, Rory, Khrykov, Gleb, Kocian, Peter, Koh, Cherry, and Kok, Neils

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Genetic Testing, Digestive Diseases, Genetics, Clinical Research, Colo-Rectal Cancer, Aetiology, 2.1 Biological and endogenous factors, Colonic Neoplasms, Colorectal Neoplasms, Humans, Microsatellite Instability, Microsatellite Repeats, Mutation, Prognosis, Proto-Oncogene Proteins B-raf, Proto-Oncogene Proteins p21(ras), REACCT Collaborative, Medical and Health Sciences, Surgery, Clinical sciences
Abstract

BackgroundThe molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status.MethodsAnonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated.ResultsA total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively).ConclusionPatients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.

Published
2022

18. Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Author

Collaborative, REACCT, O’Connell, Lauren V, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d’Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Bach, Sam Atallah Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Collinson, Rowan, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliott, Brodie, Emile, Sameh, Espin-Basany, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Figueiredo, Nuno, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah D, Salido, Andrea Jiménez, Jiménez-Toscano, Marta, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, Kennelly, Rory, Khrykov, Gleb, Kocian, Petr, and Koh, Cherry

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Rehabilitation, Cancer, Clinical Research, Digestive Diseases, Good Health and Well Being, REACCT Collaborative, early onset rectal cancer, functional outcome, patient reported outcome, rectal cancer, young rectal cancer, Clinical sciences, Oncology and carcinogenesis
Abstract

BackgroundImpairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (

Published
2022

19. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer

Author

Collaborative, REACCT, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d’Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Atallah, Sam, Bach, Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Bebington, Brendan, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Boutall, Adam, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Figueiredo, Nuno, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Gong, Jianping, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hoffmeister, Michael, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah Dorna, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, and Kennelly, Rory

Subjects
Aging, Nutrition, Digestive Diseases, Cancer, Colo-Rectal Cancer, Genetics, Clinical Research, Prevention, 2.1 Biological and endogenous factors, Aetiology, Good Health and Well Being, Adult, Age of Onset, Colorectal Neoplasms, Humans, Incidence, Middle Aged, Risk Factors, REACCT Collaborative
Abstract

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Published
2021

20. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

Author

REACCT Collaborative, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d'Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Atallah, Sam, Bach, Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Bebington, Brendan, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Boutall, Adam, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D'Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Figueiredo, Nuno, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Gong, Jianping, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hoffmeister, Michael, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah Dorna, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, and Kennelly, Rory

Subjects
REACCT Collaborative
Abstract

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Published
2021

29. An epigenetic signature of advanced colorectal cancer metastasis

Author

Rodger, Euan J., Gimenez, Gregory, Ajithkumar, Priyadarshana, Stockwell, Peter A., Almomani, Suzan, Bowden, Sarah A., Leichter, Anna L., Ahn, Antonio, Pattison, Sharon, McCall, John L., Schmeier, Sebastian, Frizelle, Frank A., Eccles, Michael R., Purcell, Rachel V., and Chatterjee, Aniruddha

Published
2023
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37. Comparing outcomes and cost in surgery versus watch & wait surveillance of patients with rectal cancer post neoadjuvant long course chemoradiotherapy.

Author

Crean, Rory, Glyn, Tamara, McCombie, Andrew, and Frizelle, Frank

Subjects
RECTAL cancer, CHEMORADIOTHERAPY, CANCER patients, ELECTRONIC health records, ACCOUNTING methods, OVERALL survival
Abstract

Background: Watch and wait (W&W) in complete clinical responders after neoadjuvant chemoradiotherapy has increasingly robust data supporting its oncological safety. Recently, studies have assessed the real‐world costs of this strategy compared to surgical resection. Our aim was to compare our oncological safety and costs associated with operative and surveillance strategies to international literature. Methods: Data were retrospectively collected and analysed via electronic health records from March 2014 to March 2021 in Christchurch, New Zealand. Two cohorts were created based on intention to treat. All hospital events were recorded and costed, as well as oncologic outcomes. Our primary endpoints were the cumulative cost of both strategies, 3‐year survival rate, and disease‐free survival. Results: Forty‐eight patients were identified who had rectal cancers resected (OT) with a yPT0N0 pathology, and 42 who were on the wait‐and‐watch (W&W) audit after having a clinical complete response. After exclusions, we identified 38 OT and 23 W&W patients; the W&W group were more co‐morbid (P = 0.05), had worse functional status (P = 0.008), higher BMI (P = 0.34) and more favourable clinical tumour staging (P = 0.01). The operative treatment (OT) group (n = 38) had more acute admissions (34% versus 13% in W&W, P = 0.08, OR 0.29). There was a 35.7% (n = 8 of 23) local recurrence in W&W and none in the OT group (P ≤ 0.001), with successful salvage in the W&W with local recurrence in 71.5% (n = 5 of 7). Three‐year distant metastasis‐free rate was 97.3% in the OT group and 90.9% in W&W (p = 0.05). Overall survival was 100% (W&W) and 94.7% (OT); (P = 0.019). Care in the OT group cost more than W&W, accounting for local regrowth management; $NZ70,759.56 versus $NZ47,905.52 (P = 0.014). Conclusion: This study found better oncological outcomes in the OT group, whilst the W&W group had reduced morbidity and acute bed days. The cost of wait and watch was approximately two‐thirds that of operative treatment, even accounting for salvage procedures for local regrowth. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Diverticulitis: An Update From the Age Old Paradigm

Author

Hawkins, Alexander T., Wise, Paul E., Chan, Tiffany, Lee, Janet T., Glyn, Tamara, Wood, Verity, Eglinton, Timothy, Frizelle, Frank, Khan, Adil, Hall, Jason, Ilyas, M.I. Mohammed, Michailidou, Maria, Nfonsam, Valentine N., Cowan, Michelle L., Williams, Jennifer, Steele, Scott R., Alavi, Karim, Ellis, C. Tyler, Collins, Danielle, Winter, Des C., Zaghiyan, Karen, Gallo, Gaetano, Carvello, Michele, Spinelli, Antonino, and Lightner, Amy L.

Published
2020
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