Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The different palliative procedures in incurable colorectal cancer are critically reviewed. In regard to the progress in operative and non-operative management the aims and possibilities have to be newly defined. The alternative, colostomy or enteroanastomosis, is unable to satisfy higher demands. This also means a tendency to aggressive resection therapy in colonic and proximal rectal carcinoma as well as combined local surgical and radiological treatment in distal rectal cancer. In emergency cases the minimal intervention necessary has to be planned in preparation for a more radical effort later on. The role of chemotherapy in colorectal cancer is still not precisely defined. In complications where surgical or radiological palliation is hopeless, the limited success of a combined therapy with 5-fluorouracil and MeCCNU seems justified.
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PMID:[Incurable colorectal cancer. Possibilities and limits of differentiated therapy (author's transl)]. 7 Jul 47

In a prospectively randomized study, the effect of adjuvant chemotherapy with 5-FU on survival and recurrence rates was analyzed in 299 evaluable patients with colorectal carcinoma who either underwent a curative or a palliative resection. In the treatment group, chemotherapy consisted of the intravenous administration of 12 mg/kg daily of 5-FU for 4 consecutive days, then 6 mg/kg on alternate days, to the point of toxicity, or to a maximum of five doses, followed by 12mg/kg weekly for 1 year. Some degree of drug toxicity was seen in the majority of patients, was rarely severe, and there have been no drug-related deaths. Analysis of the survival curves and disease-free interval curves reveal definite evidence of drug benefit in two unfavorable subgroups, namely patients with Dukes C tumors and in patients whose tumor was located in the rectum. In the chemotherapy groups, patients who were treated to toxicity (WBC less than 4000 mm3), the disease-free interval was significantly longer than the nonleukopenic patients. We conclude that the addition of 5-FU to the surgical treatment of colorectal carcinoma provides a small, but significant benefit in patients with colorectal cancer in certain unfavorable subgroups, namely patients with Dukes C lesions and patients with rectal carcinoma.
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PMID:Adjuvant chemotherapy in large-bowel cancer: demonstration of effectiveness of single agent chemotherapy in a prospectively controlled,, randomized trial. 8 53

The results of a phase I--II study of a combination chemotherapy with AAFC and ICRF-159 in advanced adenocarcinoma of digestive origin are presented. Myelosuppression was the dose-limiting toxicity with anemia, leukopenia, and thrombocytopenia. The maximum tolerated dose of AAFC in the combination program was 650 mg/m2 I.V. weekly. ICRF-159 was given in a 3-day course every 3 weeks and the dose was escalated from 125 mg/m2 to 500 mg/m2 daily. Bone marrow toxicity was noticied at the first escalation level and all dose levels were similarly toxic. The results of this combination chemotherapy were: two partial responses in 14 patients with gastric cancer; no responses in nine patients with colorectal cancer; no responses in three patients with pancreatic cancer; and no responses in two patients with biliary tree cancer. In conclusion, AAFC and ICRF-159 combination chemotherapy demonstrated a low level of activity in advanced carcinoma of digestive origin. The peculiar hematologic toxicity found at the low-level dose requires further documentation and could make this drug association suitable for a phase II study in leukemia and/or lymphoma.
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PMID:Phase I and II clinical study of anhydro-ara-5-fluorocytosine (AAFC) and ICRF-159 combination in adenocarcinoma of digestive origin. 9 30

Despite many similarities to colorectal cancer in adults, the rare childhood form has some peculiarities. Childhood mortality is greater among Negroes than Caucasians, particularly in boys, reflecting the rising incidence of this tumor in the young Negro population. In addition, the percentage of childhood cases with precancerous diseases (polyposis, colitis) appears greater than in adults. Most striking is the high percentage of mucin-producing tumors in young people with colorectal cancer. The mucoid tumors tend to occur after the age of 10 years, whereas younger children are more likely to develop non-mucoid carcinoma in an adenomatous polyp.
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PMID:Colorectal cancer in children: epidemiologic aspects. 16 47

Nine patients with extensive bilateral hepatic metastases of colorectal cancer were treated with hepatic artery ligation and continuous infusion of 5-fluorouracil (5-FU). Silastic catheters were inserted into the hepatic artery at laparotomy, and continuous perfusion was effected by a Sigmamotor pump. There was no operative mortality or morbidity, and drug toxicity was acceptable. Dosage averaged 10 mg/kg/day and average time of infusion was sixty-three days. Liver function returned to preoperative values within two weeks in all patients, and four patients had improvement of preoperative liver function for three to six months after perfusion. Two patients had palpable regressions that lasted five months or more, and one patient had a slight palpable regression for two months. Five who are dead had a mean survival of 10.4 months after therapy, with a median survival of 11.5 months. Eight of the nine patients had significant clinical improvement following treatment. Seven patients with irresectable primary liver carcinoma were treated with continuous 5-FU infusion. A Silastic catheter was placed at laparotomy into the hepatic artery via the gastroduodenal artery. Ligation of the hepatic artery was not performed. There was no operative mortality or morbidity. Dosage averaged 10 mg/kg/day and the average time of infusion was 140 days. Significant clinical improvement was noted in six of the seven patients although this did not correlate with improvement of hepatic function. All six responding patients are still living (mean survival, 14 months). Prolongation of life with hepatic artery infusion of 5-FU has been significantly better than with any previously reported chemotherapy for this disease.
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PMID:Hepatic artery ligation and 5-fluorouracil infusion for metastatic colon carcinoma and primary hepatoma. 18 29

Linitis plastica denotes a diffuse, intramurally infiltrating, anaplastic carcinoma in a hollow structure resulting in a shrunken organ with thickened walls. Microscopically, linitis plastica is characterized by tumor cells in the presence of inflammatory changes with much fibrosis. Linitis plastica is found most frequently in the stomach where it may produce the classical "leather-bottle stomach". Metastases to the colon are frequent via contiguity along mesenteric fascial planes. Therefore, when linitis plastica carcinoma of the stomach or colon is found, the other organ must also be carefully examined. Although rare, primary linitis plastica carcinoma can occur in the colon where it is often characterized by a long stenotic lesion without irritability, sometimes appearing more like an inflammatory lesion than a carcinoma. While the radiological features are not diagnostic, they are, in many cases, suggestive of this entity. The entire spectrum of linitis plastica is reviewed in relationship to the gastrointestinal tract, synthesizing the pertinent literature, with correlation of clinical, pathophysiological, and specific radiological findings.
CRC Crit Rev Clin Radiol Nucl Med 1976
PMID:Some specific radiological findings and consideration of linitis plastica of the gastrointestinal tract. 18 7

Colorectal carcinoma in the black population of South Africa is very uncommon when compared with incidence among whites. Even in whites the proportion of patients with colorectal carcinoma under 25 years of age is less than 1% (Hardin, 1972). Eight cases of colorectal carcinoma in black patients under 25 years of age are presented. None had any evidence of premalignant lesions of the colon. The prognosis of colorectal carcinoma in young adults is poor in most series and this group of patients was no exception. Reasons for this poor prognosis are mentioned. A more aggressive approach to the early detection and treatment of the lesion in young patients is essential.
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PMID:Colorectal carcinoma in young black patients: a report of eight cases. 20 31

Case records of all patients 30 years of age and under with a proven pathological diagnosis of colorectal cancer at Howard University Hospital between January 1955 and December 1977 were reviewed. Over this 23-year period, 14 cases were documented. All patients were black. This study reaffirms the poor prognosis which accompanies colorectal carcinoma in the young, particularly in those patients with mucinous carcinoma.
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PMID:Colorectal carcinoma in young persons: experience at Howard University Hospital, 1955--1977. 22 63

We report a patient with perianal Paget disease who developed a colorectal carcinoma fifteen years later, complicated by pseudomyxoma peritoneal. While perianal Paget disease is often associated with underlying carcinomas noted at the time of the diagnosis, we suggest that perianal Paget disease may also predispose to the future development of colorectal cancer.
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PMID:Colorectal carcinoma 15 years after the diagnosis of perianal Paget disease. 23 Mar 92

The fiberoptic colonscope represents a significant diagnostic and therapeutic acheivement in the management of colonic disease. Despite some claims to the contrary, it is not universally simple, rapid, thorough, reliable, and inexpensive or without morbidity and mortality. Until these goals are achieved through future refinements, modifications, and new instrumentation, it is strongly recommended that the indications for colonscopy be sharply defined to include the following: (1) Investigation of colonic lesions seen on two successive or one air-contrast barium enema examination. Pedunculated polyps less than 1 cm in diameter can be observed. (2) Preoperative investigation of patients with demonstrable colorectal cancer (to rule out synchronous lesions). (3) Postoperative evaluation after colectomy for carcinoma where the anastomosis is above the reach of a sigmoidoscope. (4) Evaluation of patients with inflammatory bowel disease of the colon. (5) Investigation of persistent occult or gross rectal bleeding when anoscopy, sigmoidoscopy, and barium studies are negative. Patients who represent prohibitive surgical risks because of age or systemic disease should not be considered as candidates for colonoscopy without compelling indications. The decision to biopsy rather than remove or fulgerate a detected lesion must be left to the judgment and experience of the endoscopist. The morbidity that follows polypectomy or fulgeration of sessile lesions less than 0.5 cm in diameter probably exceeds the incidence of carcinoma.
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PMID:A hard look at colonoscopy. 29 91


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