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

Type 4 gastric cancer has a poor prognosis compared with other types of advanced gastric cancer because of the high incidence of peritoneal metastasis which causes intestinal obstruction, hydronephrosis, or obstructive jaundice. Surgical treatment is often only palliative, and systematic chemotherapy is considered to be important for long survival. S-1 showed a higher response rate for undifferentiated-type adenocarcinoma, and S-1 alone or its combination regimens demonstrated greater anti-tumor effects and longer survival time for gastric linitis plastica compared with conventional 5-FU regimens in our historical control study (response rate: S-1/non S-1 57.9%/27.9%, p<0.01; MST: S-1/non S-1 402 days/213 days, p<0.01). S-1 regimens may also improve the survival in patients with type 4 gastric cancer in neoadjuvant or adjuvant settings, but further prospective studies are warranted to prove its significance. Paclitaxel also has a high response rate for undifferentiated-type adenocarcinoma, and can be expected to show high efficacy for peritoneal dissemination. Irinotecan should not be administered in case of intestinal obstruction because its toxicity may be increased. However,survival of patients with type 4 gastric cancer may improve with the availability of active agents like S-1, taxanes, irinotecan as reported in colorectal cancer. Therefore,irinotecan should be administered carefully before intestinal obstruction occurs.
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PMID:[Therapeutic strategy for type 4 gastric cancer from the clinical oncologist standpoint]. 1763 32

Results of treatment of 150 patients with colorectal cancer complicated with obturation intestinal obstruction are analyzed. Rational health care organization has permitted to increase operability and respectability of tumor to 96 and 87% accordingly compared with 73 and 57.5% at control group. Primary anastomosis in study group was used at 68% patients, rate of insufficiency was 4%. Postoperative lethality in study group was 13%, in control group - 23%. Rate of postoperative complications was 21 and 36.5% accordingly. It is concluded that rational organizational approach permits to improve immediate results of treatment of these patients.
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PMID:[Treatment of the patients with complications of colon malignant tumors]. 1769 Jun 33

The recent improved survival in advanced colorectal cancer, owing in a large part to advances in adjuvant treatment, has mainly been reported in studies of younger patient groups. Less is known about outcome in elderly patients, the fastest growing cohort of cancer patients. The antimetabolite capecitabine used sequentially or concomitantly with the topoisomerase 1 inhibitor irinotecan or the DNA cross linking agent oxaliplatin are now considered to be the standard first line chemotherapy regime. The role of surgery in advanced colorectal cancer in the elderly is restricted to the relief of bowel obstruction and where appropriate resection of hepatic metastasis. Advanced chronological age has not been shown to be a contraindication to the consideration of these interventions. Indeed, chronological age alone does not provide sufficient guidance when considering the appropriateness of any palliative treatment regime in the elderly.
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PMID:Treatment of advanced colorectal cancer in the elderly. 1800 66

This study aimed to determine the incidence of adhesive small bowel obstruction (SBO) after primary colorectal cancer surgery and the outcomes of conservative management using gastrointestinal tubes in such cases. Between October 2000 and December 2005, 2,586 primary colorectal cancer patients underwent consecutive operations and were followed up completely for a median of 38 months. During the follow-up periods, 119 patients with 130 consecutive cases of adhesive SBO underwent conservative management using nasogastric tubes and long intestinal tubes. The overall adhesive SBO rate was 5.0% in 38 months of follow-up, and the observed incidence rate was 0.0013 per patient-month. Of the 130 cases, 104 cases (80%) were successfully treated by conservative management, and the symptoms of SBO were resolved by the sixth day (range 1 to 22). Twenty-six cases (20%) underwent surgery because of lack of clinical improvement (17) or signs of strangulation (9). The high success rate indicates that initial conservative management with intestinal decompression using gastrointestinal tubes is recommended for patients with adhesive SBO after primary colorectal cancer surgery.
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PMID:Conservative management of adhesive small bowel obstructions in patients previously operated on for primary colorectal cancer. 1806 Apr 66

A 74-year-old woman was referred to our hospital with complaints of constipation and abdominal distention caused by a sigmoid colon tumor. After examination, she was diagnosed as sigmoid colon cancer with multiple liver metastases. To prevent bowel obstruction, a sigmoid colon resection was performed. On postoperative days 15, S-1 was started, and she was discharged on postoperative day 26. Each course consisted of daily oral administration S-1 for 4 weeks followed by 2 drug-free weeks. However, because of grade 2 anorexia in the 1st course, the treatment plan was changed to administration for 2 weeks and withdrawal for 1 week. After 7 courses of treatment, computed tomography revealed that the liver metastases were remarkably reduced. Although she experienced an adverse event involving a cutaneous symptom of grade 2, the treatment was continued under ambulatory management. After eight courses, elevation of tumor marker and metastasis at the right femur were found, and she died of the cancer 12 months after the operation. S-1 is expected to be an effective agent for the treatment of advanced colorectal cancer.
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PMID:[A case of sigmoid colon cancer with multiple liver metastases responding to S-1]. 1828 73

Surgery, chemotherapy and radiotherapy have been the mainstay of colorectal cancer treatment. There is however current intense research on traditional Chinese medicine (TCM) as novel or additional treatment methods for colorectal cancer. This article reviews the current use of TCM in colorectal cancer so as to increase the awareness of colorectal surgeons. The pathogenesis of colorectal cancer according to TCM is discussed. TCM has been used successfully during the perioperative period to relieve intestinal obstruction, reduce postoperative ileus and reduce urinary retention after rectal surgery. Good results have been reported in the treatment of the complications of chemotherapy and radiation enterocolitis. Favourable results have also been shown in the use of TCM either alone or in combination with chemotherapy to treat advanced colorectal cancer. Molecular studies have shown some TCM compounds to reduce tumour cell proliferation and induce apoptosis. Although the reported results of TCM have been exciting thus far, problems of lack of consensus on treatment regimes and questions on the reliability, validity and applicability of published studies prevent its widespread use. There is now an urgent need for colorectal surgeons to work with TCM physicians in the continuing research on this 6,000-year-old art so as to realize its full potential for our patients.
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PMID:The role of traditional Chinese medicine in colorectal cancer treatment. 1851 6

Purpose: American Society of Clinical Oncology (ASCO) guidelines define high-risk prognostic features (HRFs) in stage II colon cancer and recommend limiting adjuvant chemotherapy to patients with HRFs. We evaluated the extent to which HRFs influenced decisions on adjuvant chemotherapy before and after publication of the guidelines. Patients and Methods: We reviewed data from 100 consecutive patients with stage II colon cancer resected between January 2000 and June 2007. Practice pattern in the pre-guideline era (2000 through 2004) was compared with the postguideline era (2005-2007). Results: The median age of the cohort was 65.8 years. A total of 60 patients had >/= 1 HRF. Overall, 38% of the patients with HRFs did not receive chemotherapy; 37.5% without HRFs did. Seventy-one percent of the patients given adjuvant chemotherapy had HRFs versus 48% of the patients not given chemotherapy. There was no association between the presence/absence of HRFs and chemotherapy (P = .25). The association between number of HRFs per individual and chemotherapy was significant (P = .0255). Bowel obstruction and T4 disease were the only individual HRFs significantly associated with chemotherapy (P = .0059 and .0294, respectively). A significant drop in use of chemotherapy for all patients occurred after publication of the guidelines, but this was caused mostly by a drop in treatment for patients with HRFs from 80% to 36% (P = .001). Conclusion: Decisions for or against adjuvant chemotherapy did not adhere completely to ASCO guidelines. Publication of the guidelines led to a significant drop in appropriate use of adjuvant chemotherapy in high-risk patients.
Clin Colorectal Cancer 2009 Mar
PMID:Pattern of Use of Adjuvant Chemotherapy for Stage II Colon Cancer: A Single-Institution Experience. 1942 2

Inflammatory bowel disease (IBD) is a disorder driven by immune dysregulation, characterized by a relapsing-remitting pattern which is punctuated by flares associated with abdominal pain and bloody diarrhea. Management in general is guided by potent immunosuppressive regimens, often with equally potent associated toxicities. Treatment of refractory disease has been revolutionized by biologic therapies. Surgery remains an important part of the overall treatment plan, especially in patients presenting with acute mechanical complications and for prophylactic total colectomy in certain patients at high risk for colorectal cancer (CRC). IBD is associated with a host of intestinal disease-related complications such as intestinal stricture and fistula formation, small bowel obstruction, toxic megacolon, CRC and malnutrition. In addition to these complications there exist a myriad of extraintestinal manifestations that affect almost every organ system, such as primary sclerosing cholangitis, ankylosing spondylitis, pyoderma gangrenosum and uveitis.
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PMID:Inflammatory bowel disease: complications and extraintestinal manifestations. 1943 44

A 73-year-old man was referred to our hospital with complaints of constipation and defecation caused by a sigmoid colon tumor. After examination, he was diagnosed as sigmoid colon cancer with lung metastasis, peritoneal dissemination and early gastric cancer. To prevent bowel obstruction, a sigmoid colon resection was performed. On postoperative day 20, S-1 (100 mg/body for 4 weeks followed by 2 drug-free weeks) treatment was started. After 13 courses of treatment, gastrointestinal fiberscope revealed that the gastric cancer was remarkably reduced, and after 16 courses, computed tomography revealed that the lung metastasis was remarkably reduced. Although after 12 courses, elevation of bilirubin, the treatment could be possible to continued on a lowered dose of S-1 from 100 mg to 80 mg/body. Twenty-four months after the operation, good control of cancer has been maintained, and the treatment is continuing. S-1 treatment was proved effective for double cancer of the advanced colorectal cancer and the gastric cancer.
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PMID:[A case of double cancer of sigmoid colon cancer with lung metastases, peritoneal dissemination and early gastric cancer responding to S-1]. 1962 Aug 12

There has been an ample interest in delivery of therapeutic molecules using live cells. Oral delivery has been stipulated as best way to deliver live cells to humans for therapy. Colon, in particular, is a part of gastrointestinal (GI) tract that has been proposed to be an oral targeted site. The main objective of these oral therapy procedures is to deliver live cells not only to treat diseases like colorectal cancer, inflammatory bowel disease, and other GI tract diseases like intestinal obstruction and gastritis, but also to deliver therapeutic molecules for overall therapy in various diseases such as renal failure, coronary heart disease, hypertension, and others. This review provides a comprehensive summary of recent advancement in colon targeted live bacterial cell biotherapeutics. Current status of bacterial cell therapy, principles of artificial cells and its potentials in oral delivery of live bacterial cell biotherapeutics for clinical applications as well as biotherapeutic future perspectives are also discussed in our review.
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PMID:Colon-targeted delivery of live bacterial cell biotherapeutics including microencapsulated live bacterial cells. 1970 68


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