Analysis of the anatomic subsites, gender and age in unresectable advanced colorectal carcinomas in Tochigi, Japan suggests a shift in location towards the right side colon in elderly patients treated with cetuximab

Tanaka,Toshio; Ichikawa,Kazuhito; Maruoka,Takashi; Tomita,Shigeki; Ueda,Hirofumi; Yamaguchi,Takeshi; Shida,Yosuke; Kato,Hiroyuki; Nagata,Hitoshi; Kubota,Keiichi; Akimoto,Naohiko; Sakamoto,Chouitsu; Imura,Johji; Arita,Munefumi; Tanaka,Hiroyuki; Okamoto,Yosuke; Igarashi,Yoshinori; Fujimori,Takahiro

doi:10.3892/mco.2013.62

March-April 2013 Volume 1 Issue 2

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March-April 2013 Volume 1 Issue 2

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Article

Analysis of the anatomic subsites, gender and age in unresectable advanced colorectal carcinomas in Tochigi, Japan suggests a shift in location towards the right side colon in elderly patients treated with cetuximab

Authors:
- Toshio Tanaka
- Kazuhito Ichikawa
- Takashi Maruoka
- Shigeki Tomita
- Hirofumi Ueda
- Takeshi Yamaguchi
- Yosuke Shida
- Hiroyuki Kato
- Hitoshi Nagata
- Keiichi Kubota
- Naohiko Akimoto
- Chouitsu Sakamoto
- Johji Imura
- Munefumi Arita
- Hiroyuki Tanaka
- Yosuke Okamoto
- Yoshinori Igarashi
- Takahiro Fujimori
View Affiliations / Copyright

Affiliations: Department of Surgical and Molecular Pathology, Dokkyo Medical University School of Medicine, Shimotsuga-Gun, Tochigi 321-0293, Japan, First Department of Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-Gun, Tochigi 321-0293, Japan, Second Department of Surgery, Dokkyo Medical University School of Medicine, Shimotsuga-Gun, Tochigi 321-0293, Japan, Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8603, Japan, Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Toyama 930-0194, Japan, Department of Surgery, Jichi Medical University School of Medicine, Shimotsuke, Tochigi 329-0498, Japan, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University, Omori Medical Center, Ota-ku, Tokyo 143-8541, Japan
Pages: 291-296
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Published online on: January 10, 2013

https://doi.org/10.3892/mco.2013.62
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Abstract

Colorectal cancer is a frequently occurring cancer whose incidence has shown a marked increase in recent years. Additionally, an increase in right side colon in elderly patients has been identified. Therefore, a clinicopathological study was conducted in 49 patients with unresectable advanced colorectal carcinomas to elucidate the association of clinicopathological characteristics and K-ras mutation. Of the 49 patients included in this study, 24 were aged <60 years with a male/female (M/F) ratio of 16/8 and 25 patients were aged ≥60 years with a M/F ratio of 16/9. Of the patients aged ≥65 years, 15 patients were enrolled as controls and the M/F ratio was 9/6. Results revealed that with regard to the subsite of cancer, unresectable advanced colorectal carcinomas developed in the right‑sided colon in 13 patients, left‑sided colon in 19 patients and rectum in 17 patients. Right‑sided colon carcinomas were commonly identified in the elderly patients aged ≥65 years, with a marked tendency in the female patients (P=0.024). Immunostaining was performed for the epidermal growth factor receptor (EGFR) antibody in 40 patients to determine whether the K‑ras gene would yield positive results. The mutant K‑ras gene was identified in 8 patients (20%) and the frequency was lower compared with that of the normal colorectal carcinomas. Anti‑EGFR antibody (cetuximab) is considered to be a molecularly targeted agent for unresectable advanced colorectal carcinomas. The increase in incidence of right‑sided colon carcinomas as well as the increase in the number of patients presenting with colorectal carcinomas means this issue should be addressed. Sessile serrated adenoma/polyp (SSA/P) with b‑raf mutation and CIMP (CpG island methylator phenotype) abnormality as a precursor lesion of right‑sided colon carcinoma is common and since cetuximab refractory wild‑type K‑ras/mutant b‑raf colorectal carcinoma may increase in elderly patients and patients with right‑sided colon carcinoma, a simultaneous examination for the K‑ras and b‑raf gene abnormalities for the treatment of colorectal cancer using anti‑EGFR antibody (cetuximab) is crucial. In addition, the multidisciplinary assessments regarding the effect of such treatments is likely to be determined based on cumulative results, such as the duration of patient survival.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Analysis of the anatomic subsites, gender and age in unresectable advanced colorectal carcinomas in Tochigi, Japan suggests a shift in location towards the right side colon in elderly patients treated with cetuximab

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