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Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The overall five year survival of patients with colorectal cancer is excellent compared with other major visceral malignancies. This is attributable to effect surgical treatment, yet the death rate per 100,000 population has improved little in recent decades, stimulating a search for adjuvant treatment modalities until a better understanding of etiology and pathogenesis results in prevention of earlier diagnosis. Combination of the known cancerocidal effect of ionizing radiation and surgical excision has been used sporadically for over six decades, but only recently has this combined modality therapy been studied in a scientific manner. Numerous variables such as source of radiation, total tumor dose, dose-time factors, location of portals of treatment, size and shape of radiation fields, and the radiation-surgery sequence are now being studied. Current information leaves little doubt of the effectiveness of this combined modality therapy in selected patients. Controlled clinical trials must continue in order to obtain more solid data, which hopefully will eventually result in substantially improved survival.
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PMID:Adjuvant radiation therapy in colon cancer. 39 43

It is fair to say that so far, and with few exceptions, the application of enzymology to clinical oncology has been disappointing. This is certainly true with regard to cancer screening and diagnosis. It is unlikely that any single enzyme or isoenzyme will emerge as a sufficiently sensitive or specific indicator of cancer, and it would seem more profitable to focus on multivariate or pattern analysis of several enzymes and other measurable body fluid constituents. Another suggested approach would be to establish the normal enzyme levels for individuals and then follow them for changes which might signal the development of a neoplasm. Finally, Weber's concept of key enzymes as the phenotypic markers of neoplasia and targets of chemotherapy would appear to open a new avenue for enzymology in clinical oncology.
CRC Crit Rev Clin Lab Sci 1978
PMID:Clinical enzymology in cancer. 40 68

Preoperative radiotherapy in colorectal carcinoma invalidates surgical staging and delays performing the surgical resection. Postoperative radiotherapy does neither. From October 1972, to December 1975, 40 patients at high risk for local recurrence (B2 and C) received postoperative radiotherapy. Lesions that were located in the rectum, rectosigmoid and low sigmoid colon were given 4600 rads in four and a half weeks through an inverted T-shaped field which encompassed the pelvic and paraortic nodes. Patients with tumors located above mid-sigmoid were treated to the entire abdominal cavity by the moving strip technique. Of 19 patients with rectal and rectosigmoid lesions, 14 (74%) are alive without evidence of disease. Two had local recurrence in the treated area. Of 21 patients with lesions above the mid-sigmoid, four have failed locally, while 11 (52%) are alive without evidence of disease. One of these 40 patients died to radiation enteritis. Although the follow up period is short, the results suggest that a moderate dose of radiation may prevent local recurrence in patients with locally advanced colorectal cancer.
Cancer 1977 Jul
PMID:Elective postoperative radiotherapy for locally advanced colorectal cancer. A preliminary report. 40 77

Ninety-nine black colorectal cancer patients and 280 matched controls from hospitals and multiphasic health checkup clinics were interviewed about past dietary habits and other traits. The colon cancer cases tended to report less frequent use of foods with at least 0.5% fiber content than did their controls. This relationship, though small, showed a consistent dose-response gradient, appeared in both case-hospital control and case-multiphasic health checkup control comparisons, and could not be accounted for by the effects of other variables. Colon and rectosigmoid junction cancer patients tended to have eaten foods with at least 5% saturated fat somewhat more often than controls. When consumption of these two groups of foods was considered in combination, significantly more colon cancer patients than controls reported a high saturated fat foods-low fibrous foods eating pattern, as opposed to a low saturated fat foods-high fibrous foods diet. Statistically significant excesses of the following traits were also reported by the colorectal cancer patients: prolonged cigar smoking in men, nulliparity in women, and history of colorectal polyps.
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PMID:A case-control study of relationships of diet and other traits to colorectal cancer in American blacks. 42 52

One hundred ninety-eight patients with 211 cancers of the colon and rectum underwent elective resection at the University of Vermont College of Medicine during the five year period 1971 through 1975. Analysis of this series demonstrated that 35 per cent of all cancers were located in the cecum and ascending colon, that a similar percentage were classified as Dukes' A cancers, that a synchronous cancer was present in 5.5 per cent of the patients and that diagnosis by rectal examination and sigmoidscopy was possible in only 32 per cent of the patients. Comparison of these results with published data during the past thirty years indicate that there is an increasing incidence of carcinoma of the right colon with an associated decrease in the incidence of carcinoma of the sigmoid colon and rectum. It is recommended that patients be screened by examination of the stool for occult blood rather than by rectal examination and sigmoidoscopy so that these proximal lesions can be diagnosed at an earlier stage. Preoperative evaluation of patients with distal colorectal cancer should include double contrast barium enema examinations and colonscopy to rule out synchronous right-sided lesions.
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PMID:Increasing incidence of right-sided lesions in colorectal cancer. 42 1

The survival rate in 709 patients with chronic inflammatory bowel disease (CIBD) was calculated by the log rank test. There were 297 patients with Crohn's disease (CD) and 412 patients with ulcerative colitis (UC). In both diseases there was a survival rate of about 94% in the first year of observation against an expected rate of 99.5% in a general population matched for sex and age. This was because a large number of patients were severely ill at their first admission and required immediate or early surgery. During the subsequent 11 years the death rate in CIBD was higher (two to three times) than in the general population. After 12 years the survival rate was about 77% in both CD and UC. The difference was statistically insignificant. There was no significant difference in the sex ratio. The cancer rate was low. No gastrointestinal cancer occurred among patients with CD. Colorectal cancer was found in four patients with UC, three of whom presented with cancer on their first admission. It is concluded that recurrence and reoperation for recurrence in Crohn's disease have not impaired the prognosis compared to ulcerative colitis in this series.
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PMID:Survival rate in Crohn's disease and ulcerative colitis. 43 45

Plasma carcinoembryonic antigen (CEA) in nanograms per milliliter was assayed in 149 patients with benign and 567 patients with malignant disease. Elevated CEA level (greater than 5.0) was a good indicator of malignant disease but a poor screening test for cancer because of the high false-negative rate. Degree of elevation of plasma CEA level correlated with incidence of metastatic disease in patients with colorectal, gastric, and breast carcinomas, but no correlation was seen between CEA levels and status of lymph nodes in patients with localized disease. Patients with localized colorectal cancer, but elevated CEA levels before resection, had a 2.1-fold increase in the incidence of recurrence; however, this added to the prognostic value of Dukes' staging only when the CEA level remained elevated postoperatively. In 87% of patients with colorectal cancer, the CEA level was elevated at the time of recurrence, but a therapeutic value of reexploration for unexplained CEA level elevation was not confirmed.
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PMID:Clinical value of carcinoembryonic antigen: diagnosis, prognosis, and follow-up of patients with cancer. 44 49

The acute changes in concentrations of key blood metabolites and liver function tests were measured following intravenous infusion of Corynebacterium parvum in 9 healthy patients who had recently undergone resection of a colorectal cancer. The following results were obtained: 1) Blood glucose, lactate and ketone body concentrations significantly increased over a 5 hour study period; 2) blood alanine fell during the same period; 3) plasma bilirubin, GOT and urea were significantly elevated 24 hours after C. parvum 4) plasma albumin and cholesterol concentrations were significantly lower 24 hours after C. parvum. These changes are similar to the alterations in hepatic metabolism previously described in clinical bacterial infections, and indicate parenchymal cell damage and reduced synthetic activity. They are potentially important in relation to the treatment of cancer with combined modalities where drug metabolism or excretion may be affected.
Cancer 1979 Apr
PMID:Metabolic changes following the intravenous infusion of Corynebacterium parvum in man. 44 33

A retrospective study of 267 patients with ulcerative colitis admitted to The Mount Sinai Hospital during the period 1960--1976 revealed 26 (9.7%) with adenocarcinoma of the colon. Twenty-one cases of colorectal cancer were observed among 158 patients with universal colitis (13%), and 5 occurred among 109 patients with left-sided disease (5%). Patients with left-sided disease tended to develop cancer at least a decade later than patients with universal disease. The median duration from onset of colitis to diagnosis of cancer was 20 yr for those with universal colitis, and 32 yr for those with left-sided colitis. The decade incidence of colorectal carcinoma increased from 0.4% in the first decade to 7.4% in the second, 15.9% in the third, and 52.6% in the fourth decade of follow-up. The estimated cumulative probability of developing cancer reached 34% at 30 yr and 64% at 40 yr. Cancer risk was positively correlated with duration and anatomic extent of colitis, but did not appear to be increased by early age at onset of disease.
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PMID:Cancer in universal and left-sided ulcerative colitis: factors determining risk. 44 42

Immunoreactive CEA (IR-CEA) in feces or sera from 20 volunteers and 20 patients with colorectal cancer were measured before and at various intervals after surgery by a radioimmunoassay utilizing a "one step sandwich method." Elevated fecal IR-CEA level was observed in 17 of 20 patients with colorectal cancer; elevated serum CEA levels were observed in only 7 of all patients. There could not be found any correlation between fecal IR-CEA levels and Dukes' classification; there was but a little correlation between serum and fecal IR-CEA levels. In 8 of 14 patients treated by surgery, fecal IR-CEA levels obviously dropped, but in 2 patients with hepatic metastasis they were found rising in spite of colon tumor removal. It was speculated from these data that high values of fecal CEA depend on mass production of CEA by cancer cells. From these observations, it appears that fecal IR-CEA level presents a more ideal diagnostic competency in colorectal cancer than serum CEA level.
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PMID:Immunoreactive carcinoembryonic antigen [CEA] levels in feces from colorectal cancer patients. 44 27


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