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Colorectal Cancer in Young and Elderly Patients

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Berut M., Mik M., Kędzia-Berut R., Kujawski R., Trzciński R., Dziki Ł., Dziki A.
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vol. 85
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issue 8
446-451
EN
The aim of the study was to answer the question whether there are differences in the progression of the disease and its morphology, dependent of the patient’s age, as well as show colorectal cancer differences between young and elderly patients. Material and methods. During the period between 2009 and 2011, 747 patients with rectal carcinoma, and 478 with colon cancer underwent surgery at the Department of General and Colorectal Surgery. The study group comprised patients under the age of 40 years (56 patients) and >80 years (90 patients). The following were subject to analysis: gender, tumor location, percentage of radical and palliative procedures, clinical and histopathological staging, as well the differences in the morphology of the tumor. The χ2 test and Yates’ correction were used for statistical analysis. p<0.05 was considered as statistically significant. Results. A higher incidence of rectal carcinoma was observed in younger patients (p=0.004). Amongst the younger patients 30.3% were diagnosed with stage III cancer, while 35.7% with stage IV. In case of elderly patients 30.6% were diagnosed with stage III cancer, while 30.7% with stage IV. In 53.3% of young patients, local lymph node metastases were observed, while in the elderly 41.8%. No statistically significant difference was observed, considering the total number of lymph nodes metastases. However, in case of stage N2, results were unfavorable for young patients 31.8% vs 17% in case of the elderly. Mucogenic adenocarcinoma incidence was similar in both groups. In case of patients< 40 years we observed a higher incidence of poorly differentiated tumors, as compared to the elderly patients (>80 years). Conclusions. 1. It is necessary to create appropriate prevention programs for young community, and improvement of public awareness in this age group. 2. Colorectal cancer (CRC) in young patients is often recognized in advanced stage. 3. A high percentage of unresectable tumors in group of elderly patients shows that CRC is still diagnosed too late in Poland.
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Expression of the PLS3 Gene in Circulating Cells in Patients with Colorectal Cancer

84%
Kujawski R., Przybyłowska-Sygut K., Mik M., Lewandowski M., Trzciński R., Berut M., Dziki Ł., Majsterek I., Dziki A.
Polish Journal of Surgery
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2015
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vol. 87
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issue 2
59-64
EN
Circulating tumor cells (CTC) are cells in circulating blood that have the antigen and gene features of tumor cells of a specific type. Since they can be potentially used in diagnostics and monitoring of treatment of many tumors, they have been attracting attention of researchers worldwide. Plastin-3 (PL S3) is one of such markers of CTC. The aim of the study was to assess expression of PL S3 in CTC in patients with colorectal cancer, to conduct a statistical analysis and to demonstrate a link between expression of PL S3 and progress of the disease, level of CEA and Ca19-9 markers, gender and age of the patients. Material and methods. A group of 85 patients of the Department of General and Colorectal Surgery of the Medical University in Łódź were enrolled in this study. Circulating tumor cells were isolated from whole blood of patients with colorectal cancer and an analysis of PL S3 gene expression in CTC was conducted. The next step was to conduct a statistical analysis and to demonstrate a link between expression of PL S3 in patients’ CTC and progress of the disease, level of CEA and Ca19-9 markers, gender and age of the patients. Results. PL S3 is a marker which can be potentially used in prediction and monitoring of colorectal cancer. A link between expression of PL S3 in CTC of patients with colorectal cancer and metastasis to lymph nodes has been demonstrated. It may be of key importance how PL S3 could impact the qualification to supplementary cancer treatment in patients with stage II colorectal cancer. A link between expression of PL S3 gene in CTC and gender requires further in-depth studies. It is beyond doubt that PL S3 must be further investigated to determine its role in diagnostics, prediction, treatment and monitoring of treatment of colorectal cancer
3
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Preliminary Results of the First Quality Assurance Project in Rectal Cancer in Poland

84%
Mroczkowski P., Hać S., Mik M., Berut M., Dziki Ł., Kube R., Śledziński Z., Lippert H., Dziki A.
Polish Journal of Surgery
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2011
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vol. 83
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issue 3
144-149
EN
When compared with other EU countries, Poland is in the last place in terms of efficacy of rectal cancer treatment. In order to remedy this situation, in 2008 Polish centres were given the opportunity to participate in an international programme for evaluating the treatment efficacy.The aim of the study was to present the results obtained during the first two years of research.Material and methods. The study protocol covered 71 questions concerning demographic data, diagnostics, risk factors, peri- and post-operative complications, histopathology, and treatment plan at discharge. The patient and unit data were kept confidential.Results. From 1 January 2008 to 30 December 2009, there were 709 patients recorded, of which 55.9% were males. At least one risk factor was found in approx. 3/4 of patients, while approx. 1/3 of patients were classified to group 3 and 4 according to ASA. The mean distance of the tumour from the anal margin was 8.5 cm; approx. 70% of patients were in the clinical stages cT3 and cT4; metastases were observed in 18.8%. Transrectal endoscopic ultrasonography (TREUS) was performed in 23.7% of patients, magnetic resonance imaging (MRI) in 2.5% and computed tomography (CT) scan - in 48.1%. In close to half of the patients, anterior or low anterior resection of the rectum was performed, and abdominoperineal resection in 1/4 of the patients. Anastomotic leakage was seen in 3.8% of patients, while 1.8% died during hospitalisation.Conclusions. It should be strived after that all the centres undertaking the treatment of rectal cancer should participate in the quality assurance programme. This should enable the achievement of good therapeutic results in patients with rectal cancer treated in Polish centres.
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