Editorial: Serrated Polyposis: The Last (or Only the Latest - Frontier of Familial Polyposis (Lynch Syndrome/familial/pre-malignant adenomas)

 Wiki:  Sessile serrated adenoma

 In gastroenterology, a sessile serrated adenoma (abbreviated SSA), also known as sessile serrated polyp (abbreviated SSP), is a premalignant flat (or sessile) lesions of the colon, predominantly seen in the cecum and ascending colon.

Editorial: Serrated Polyposis: The Last (or Only the Latest|[quest]|) Frontier of Familial Polyposis|[quest]| : The American Journal of Gastroenterology

The American Journal of Gastroenterology 107, 779-781 (May 2012) | doi:10.1038/ajg.2012.62

Editorial: Serrated Polyposis: The Last (or Only the Latest?) Frontier of Familial Polyposis?

Stephen J Lanspa, Dennis J Ahnen and Henry T Lynch

Abstract

Serrated polyps are thought to be precursors of ~15% of colorectal cancers and clinical criteria for a serrated polyposis (SP) syndrome have been proposed. In this issue of American Journal of Gastroenterology, Win et al. report that family members of individuals who meet the clinical criteria for SP are at increased risk for colorectal and possibly pancreatic cancer. The important data presented by Win et al. strongly support the concept that familial SP exists and help define the patterns of risk in this syndrome. The paper also illustrates the difficulties of trying to define a genetic syndrome on the basis of largely retrospective clinical data and highlights the importance of efforts to define the genetic basis of familial SP and to study these families in a systematic, prospective manner.

abstract: Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer - Segelman - 2012 - British Journal of Surgery - Wiley Online Library

Peritoneal Carcinomatosis (Creighton University) includes a variety of tumors that present with extensive metastasis throughout the peritoneal cavity (inside surface of the abdomen) and can be found with gall bladder, liver, colon, appendix, ovarian, pancreas, mesothelioma, pseudomyxoma peritonei, rectal, small bowel and stomach cancers. It is a broad description in which multiple tumors develop in and line the peritoneal abdominal cavity and linings.

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 Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer - Segelman - 2012 - British Journal of Surgery

Abstract

Background:

This was a population-based cohort study to determine the incidence, prevalence and risk factors for peritoneal carcinomatosis (PC) from colorectal cancer.

Methods:

Prospectively collected data were obtained from the Regional Quality Registry. The Cox proportional hazards regression model was used for multivariable analysis of clinicopathological factors to determine independent predictors of PC.

Results:

All 11 124 patients with colorectal cancer in Stockholm County during 1995–2007 were included and followed until 2010. In total, 924 patients (8·3 per cent) had synchronous or metachronous PC. PC was the first and only localization of metastases in 535 patients (4·8 per cent). The prevalence of synchronous PC was 4·3 per cent (477 of 11 124). The cumulative incidence of metachronous PC was 4·2 per cent (447 of 10 646). Independent predictors for metachronous PC were colonic cancer (hazard ratio (HR) 1·77, 95 per cent confidence interval 1·31 to 2·39; P = 0·002 for right-sided colonic cancer), advanced tumour (T) status (HR 9·98, 3·10 to 32·11; P < 0·001 for T4), advanced node (N) status (HR 7·41, 4·78 to 11·51; P < 0·001 for N2 with fewer than 12 lymph nodes examined), emergency surgery (HR 2·11, 1·66 to 2·69; P < 0·001) and non-radical resection of the primary tumour (HR 2·75, 2·10 to 3·61; P < 0·001 for R2 resection). Patients aged > 70 years had a decreased risk of metachronous PC (HR 0·69, 0·55 to 0·87; P = 0·003).

Conclusion:

PC is common in patients with colorectal cancer and is associated with identifiable risk factors.

Two cases of ovarian metastasis of colon cancer

Ovarian tumors were diagnosed as metastasis from colon cancer. Ovarian metastasis of colon cancer is a relatively rare event, but a long-term survival case has been reported by multimodality therapy including surgery.

abstract: Effect of Misclassified Underlying Cause of Death on Survival Estimates of Colon and Rectal Cancer

Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomised trial : The Lancet Oncology

Background

Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction, but its benefits are uncertain.
We aimed to establish whether colonic stenting has better health outcomes than does emergency surgery.

Why do People get Cancer? « Dr. Robert A. Nagourney – Rational Therapeutics – Blog discusses multiple primaries uterine/colon (Lynch Syndrome)

Note: the article lacks specific drug/chemotherapy intervention information which may be helpful to others

Reports of Serrated polyps of the colon - (references MSI/Lynch Syndrome) Mayo Clinic

Serrated polyps of the colon

Aravind Sugumar and Frank A Sinicrope

Division of Gastroenterology & Hepatology and Division of Oncology, Mayo Clinic and Mayo College of Medicine, 200 First Street SW, Rochester, MN 55905, USA

Corresponding author

F1000 Med Reports2010, 2:89 (doi: 10.3410/M2-89)

Published: 17 Dec 2010

"....Among the more important findings is that SSAs may be the precursor lesions for MSI-H colon cancers. Furthermore, there is evidence that serrated polyps are more likely to be missed during colonoscopy [10,11,22]. As a result, colonoscopic follow-ups for serrated adenomas should be the same as for conventional adenomatous polyps...."

Mechanism of action and toxicities of purgatives used for colonoscopy preparation

Take home message: Although generally safe and effective, colonic purgatives have both acute and permanent toxicities. The safest preparations utilize PEG combined with a balanced electrolyte solution. Limitations of this preparation center on the volume required and poor taste. Alternative formulations are now available; however, those using sodium phosphate have fallen out of favor due to a risk of renal toxicity

Read More: http://informahealthcare.com/doi/abs/10.1517/17425255.2011.542411

Characteristics and survival associated with ovarian cancer diagnosed as first cancer and ovarian cancer diagnosed subsequent to a previous cancer

Abstract

Objective:
To examine the risk of subsequent primary ovarian cancer among women diagnosed previously with cancer (subsequent cohort) and to compare demographic and tumor characteristics affecting overall survival of these women and women diagnosed with first primary ovarian cancer (index cohort).


Methods: 
We identified the two cohorts of women using the 1973-2005 Surveillance, Epidemiology and End Results (SEER) result data. We calculated relative risk of subsequent primary ovarian cancer and estimated 5-year risks of dying (hazard-ratios) after diagnosis of the first or subsequent primary ovarian cancer in the two cohorts, respectively using Cox modeling.


Results:
Women diagnosed with index cancers of the corpus uteri, colon, cervix, and melanoma at age younger than 50 had increased risk of ovarian cancer within 5 years after diagnosis (p<0.05); young breast cancer survivors had continued risk beyond 20 years. In 5-year follow-up survival analysis, the factors associated with a better survival (p<0.05) were similar in both cohorts and included more recent diagnosis; localized or regional disease; age <50 years at diagnosis; and being white versus black. A lower risk of dying from mucinous, endometrioid, or non-epithelial tumors than from serous was seen after 15 months (p<0.01), or after 32 months from diagnosis of the index and subsequent cohorts, respectively. (clear cell??)


Conclusions:
Age, stage, and histology affect ovarian cancer survival. The increased risk of ovarian cancer over time, especially among breast and colon cancer survivors who are less than 50 years of age, suggests common etiologies and necessitates careful surveillance by health care providers and increased survivors awareness through educational efforts.

Marjie - The support of 'family'

"...Margie is in the midst of a battle with colon, ovarian, and uterus cancer, and Saturday was her first time attending...."

Hormone therapy, DNA methylation and colon cancer-- Carcinogenesis

The role of cytoreductive surgery for non-genital tract metastatic tumors to the ovaries.

Abstract


OBJECTIVE: The aim of this study was to investigate prognostic factors of patients with metastases to the ovaries from non-genital organs.
STUDY DESIGN: From September 1994 to December 2006, 158 patients with pathologically confirmed metastatic tumors to the ovaries at Samsung Medical Center (SMC) were included in this study. The data were obtained from the patients' medical records and pathology reports.
RESULTS: The primary tumor origin was mostly stomach (73 cases) and colon (61 cases). Krukenberg tumor (pathologically proven signet ring cell carcinoma) was found in 34 cases: stomach (25), colon (2), appendix (1), and unknown (6). ....However, age, bilateral tumors, chronology of diagnosis and mass size did not affect survival.
CONCLUSION: Cytoreductive surgery and post-operative adjuvant chemotherapy had a beneficial effect on survival in selected patients.

Colon Cancer: Microsatellite instability stymies doctors - Cancer Network

Note: MSI has been/is being studied also in ovarian cancer (w/without Lynch Syndrome genes)

Hereditary Ovarian Cancer: Molecular Genetics, Pathology, Management, and Heterogeneity

Future Prospects: DNA Variants Modify HBOC and LS (Lynch Syndome) Cancer Risk:
What does the future hold with respect to molecular genetics and cancer control in hereditary cancer, inclusive of HBOC and Lynch syndrome?

This projection relates to the truism that cancer-causing mutations do not act in a vacuum, since they are likely to be impacted by additional low-penetrant modifier genes in concert with myriad environmental events.

A personal or family history of breast, colon or ovarian cancer may increase your risk for ovarian cancer

Family history includes both your mother and your father’s sides of the family