Managing HR tech transformation in a rapidly-growing business HRjobs: What makes the HR role in Vietnam so distinct?
J Cancer ; 5 4: How to cite this article: Several variables factor into the ultimate outcome of these patients, including the extent of disease, tumor biology, and patient co-morbidities. Additionally, the time from initial treatment to the development of recurrence is strongly associated with overall survival, particularly in patients who recur within one year of their surgical resection.
Current post-resection surveillance strategies involve physical examination, laboratory, endoscopic and imaging studies utilizing various high and low-intensity protocols. Ultimately, the goal is to detect recurrence as early as possible, and ideally in the asymptomatic localized phase, to allow initiation of treatment that may still result in cure.
While current strategies have been effective, several efforts are evolving to improve our ability to identify recurrent disease at its earliest phase. Our aim with this article is to briefly review the options available and, more importantly, examine emerging and future options to assist in the early detection of colon and rectal cancer recurrence.
Colorectal cancer, recurrence, biomarkers. It is well known that most recurrences occur within 5 years. The current recommendations for follow-up include routine visits with laboratory evaluation every months for the first 2 years then every 6 months for 2 years then annuallyCT scan every 6 months for the first few years, and a colonoscopy within 12 months of the resection.
Patients should be offered another colonoscopy after 3 years if the examination is normal. Further surveillance depends on the results of the examination, imaging, labs and endoscopy; however, if that examination is normal, the patients may undergo routine examination annually and endoscopic surveillance every 5 years.
The aim of this article is to inform readers of novel and evolving concepts regarding early detection of tumor recurrence. Predicting Tumor Recurrence Regardless of the adequacy of resection and the use of adjuvant therapy, recurrence remains a major problem.
While debate regarding the ideal surveillance strategy i. One of the ways this can be achieved is by improving the ability to predict those that will recur, which could lead to more focused or intensive follow-up. To aid in this process, several patient and disease-related factors have been identified that can help better predict the risk of recurrence, including depth of invasion, number of nodes involved, site of disease, obstruction, perforation, resection margins, and pathologic grade.
Predictive Nomograms Nomograms are prediction stemming from hundreds of patients who present with the same condition. Using the characteristics of these patients, the individual can determine their relative risk.
Online provides a model to predict the risk of recurrence as well as the potential benefit of adjuvant chemotherapy. It is based upon several clinical parameters such as tumor size and number of positive nodes. The nomogram was developed, validated, and compared with the American Joint Committee on Cancer fifth and sixth editions with a concordance rate of 0.
Unique to this system, the model goes beyond simple TNM staging by combining interactions amongst known variables i. BBNs have been shown to improve prognostic estimates and to guide clinical decision-making and counseling for appropriate treatment and follow-up surveillance testing for several different tumors including colorectal cancer.
When compared with the AJCC staging system alone, they showed superior sensitivity and specificity in estimating mortality. Genetic Components of Recurrence Markers that can reliably predict the likelihood of recurrence or responsiveness to chemotherapy would be particularly helpful in Stage II or node-negative colorectal cancer for clinical decision-making regarding both treatment and follow-up.
Current pathological staging fails to predict recurrence accurately in many patients undergoing curative surgery for localized colorectal cancer. Even less data exists for predicting prognosis and recurrence.
Studies on CRC have been poorly reproducible, possibly because CRC is composed of distinct molecular entities that may develop through multiple pathways on the basis of different molecular features. Pretreatment CEA levels are useful for prediction of prognosis, and postoperative serial assays of CEA level provide an opportunity for early detection of recurrent disease by following trends and basing additional diagnostic testing on early elevations.
Consistent elevation in CEA is a concerning sign of disease recurrence and it remains the only widely used serum tumor marker that has been shown to correlate sufficiently with colorectal tumor activity to be used reliably during follow-up.
Amri and colleagues questioned whether preoperative continuous CEA values could be used as a predictor of disease-free survival, recurrence, and overall survival, in surgical colon cancer cases. Specifically, CEA levels were measured at different intervals up to the point of colorectal cancer resection.
They showed that using CEA levels continuously had no relationship with metastatic recurrence and a weak association with the overall risk of metastatic disease and death. MSI also shows some of the most promising data related to colon cancer recurrence.
Patients with MSI-high colon cancers, defined as those with multiple insertion or deletion mutations in at least 2 of 5 loci of DNA, rarely develop distant metastasis and have a longer overall survival OS than stage-matched microsatellite stable i.
Another future use could involve the use of specific testing based on MSI status. MACC1 promotes tumor cell motility and invasion, which would then theoretically lead to local-regional and systemic dissemination of the disease.
These observations have been extended also to other cancer types, including lung adenocarcinomas, hepatocellular carcinomas, gastric carcinomas, and ovarian tumors.
This reinforces the notion that MACC1 is a pure prognostic indicator that could be exploited to inform rational therapeutic decisions after surgical intervention. In regards to rectal cancer, Kawamura et al. Specifically, MACC1 was associated with reduced relapse-free survival when cutoff values above 0.
Plastin3 Tumor cells can be shed and found to be circulating within the peripheral circulatory system.
These are termed circulating tumor cells CTCs.HR transformation. Author: Sarah Welfare Summary. HR transformation is the process of implementing change to the way in which the organisation as a whole delivers HR.
Human resources transformation refers to the massive restructuring of corporate human resources (HR) departments that took place in the decade or so after Before that, the staff in HR. According to KPMG’s HR Transformation Survey, 50% felt that intelligent automation will drive significant changes for the business and believed process automation will have a notable impact on the HR operating model.
I got this list of best-selling HBR articles through our library. I am planning read (and in some cases re-read) the articles and post a summary. Yahoo Lifestyle is your source for style, beauty, and wellness, including health, inspiring stories, and the latest fashion trends.
How to cite this article: Walker AS, Johnson EK, Maykel JA, Stojadinovic A, Nissan A, Brucher B, Champagne BJ, Steele SR.
Future Directions for the Early Detection of Colorectal Cancer Recurrence.