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

It has been shown previously that it is difficult for a general practitioner to predict anal vs. colorectal sources of bleeding in patients presenting with rectal bleeding. The aim of the present study was to determine whether there are any aspects of such a patient's history or clinical features that strongly indicate bleeding from a colorectal cancer or polyp. One hundred forty-five consecutive patients, aged 40 years and older, who had complained of rectal bleeding to a general practitioner, were referred to a specialist for full colonic investigation. Among 15 symptoms and clinical features examined, few had any statistically significant association with the source of bleeding. There was an elevated probability of colorectal cancer (21 percent) in patients who had seen blood mixed with feces. Most bowel symptoms and clinical features are not helpful in deciding whether to proceed with full colorectal assessment in patients aged 40 and older who have rectal bleeding of recent onset.
Dis Colon Rectum 1989 Mar
PMID:Rectal bleeding. Do other symptoms aid in diagnosis? 278 96

To assess prognostic factors in patients who develop colorectal cancer before the age of 40 years, a 30-year experience from 1956 through 1985 was reviewed. There were 50 patients ranging in age from 7 to 39 years. Five cases were associated with either ulcerative colitis (2) or familial polyposis (3). The most common presenting symptoms were abdominal pain (66 percent), hematochezia (60 percent), change in bowel habit (41 percent) and weight loss (30 percent). On pathologic staging (N = 44), only 14 of 44 (31 percent) had a Dukes' stage A or B lesion, 20 (45 percent) had Dukes' stage C, and the remaining 10 (23 percent) had distant metastases at the time of surgery. Five-year survival rate was 28 percent with a disease-free survival rate of 18 percent. Median survival was only 28 months. Negative prognostic factors were Dukes' stage C/D (P less than .001), symptom duration of longer than 3 months (P = .01), noncaucasian ancestry (P = .01), and poorly differentiated histology (P = .06). In contrast to older patients with colorectal cancer, only 1 of 30 (3 percent) patients with stage C D disease was disease-free at 5 years. In view of the poor survival rate associated with both delay in diagnosis and the presence of advanced disease, it was concluded that young patients presenting with the symptoms listed above need early, aggressive evaluation for possible colorectal cancer.
Dis Colon Rectum 1989 Oct
PMID:Colorectal cancer in patients younger than 40 years of age. 279 69

Thirty-nine patients (age 40 years and younger) with rectal cancer treated at the Mount Sinai Hospital between 1967 and 1985 were studied. Their mean age was 34 years (range, 21 to 40). A positive family history for colorectal cancer was found in six patients (15 percent). Fifty percent of patients under age 30 had metastatic disease at diagnosis. Twenty-seven patients (69 percent) had potentially curative resections. Of these, 17 (63 percent) had lymph-node metastasis. This rate is twice as high as in a group of 315 patients with rectal cancer over age 40 (31 percent). The overall five-year survival for young patients having curative resection was 53 percent. Noncolorectal cancer occurred in three patients in this series and six patients also had first-degree relatives with noncolorectal cancer. Young patients with rectal cancer appear to belong to a high-risk cancer group which often seems to have a genetic pattern of predisposition.
Dis Colon Rectum 1989 Jun
PMID:Clinical significance of rectal cancer in young patients. 279 82

A retrospective study was conducted on 519 patients undergoing curative resection for colorectal carcinoma between 1969 and 1980. Recurrence was diagnosed in 214 patients (41.2 percent), 179 of whom (34.5 percent) had received blood transfusions and 35 of whom (6.7 percent) had not (P less than .001). Exclusion of the right-sided colonic tumors still showed that recurrence was more common in transfused than nontransfused patients (135 [47.2 percent] vs. 25 [22.5 percent]; P less than .001). Recurrence in patients transfused only during surgery (N = 201) was higher than in nontransfused patients (P less than .001) and, similarly, all patients transfused during surgery (N = 297) had an increased risk (P less than .001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P less than .02), but this was not the case in those treated by sphincter-saving resection (P = .2). Hierarchical log linear analysis of all dependent factors (Dukes' stage, histologic grade, age, sex, site, elective, or emergency procedure) showed that Dukes' stage and blood transfusion had the most significant effects on the development of recurrence (chi 2 = 54.04, df = 6, P less than .0001 and chi 2 = 13.93, df = 3, P less than .003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.
Dis Colon Rectum 1989 Nov
PMID:Perioperative blood transfusion increases the risk of recurrence in colorectal cancer. 280 27

Cancer research has been productive in developing new knowledge on the role of diet in cancer. It is clear from epidemiologic observations that diet is the principal factor in the cause of colorectal cancer in most people. Therefore, a significant reduction in incidence is possible in countries where the disease is common. The ingestion of excessive amounts of fat appears to be the major factor that promotes cancer development. Animal studies confirm this and have recently shown that the sources of fat vary in the degree of their promotional effect. Fiber is generally considered to inhibit cancer but it is now clear that only some types of fiber are effective. These include whole grain cereals, and fruit and vegetables containing large amounts of uronic acid. In addition to fiber, a number of micronutrients, chemicals, and drugs have been found to be effective inhibitors. It is clear that the basic information concerning dietary changes that can reduce colorectal cancer incidence in this country has been uncovered. Additional information is needed about specific details of dietary guidelines. These include identification of the best mixture of sources of fat and how to incorporate such a mixture in the diet. Substances in foods need to be identified that, when included in the diet, help to lower cancer risk. People at high risk may require an additional supplement of inhibitors. New epidemiologic studies and human intervention trials should provide the necessary information to design dietary guidelines that are more specific than current ones.
Dis Colon Rectum 1987 Oct
PMID:Prospects for the prevention of colorectal cancer. 282 Jun 70

Metastasis from colorectal carcinoma occurs by either lymphatic or hematogenous spread. The pattern of metastasis in patients with colorectal malignancy has been characterized by numerous clinical, surgical, and autopsy studies. The most common sites of colorectal metastasis are the liver and lung. Only two previous instances of colorectal carcinoma metastatic to skeletal muscle have been reported. The present report documents the third case of colorectal cancer metastatic to skeletal muscle and reviews the typical pattern of distant metastasis from colorectal carcinoma.
Dis Colon Rectum 1987 Oct
PMID:Colon carcinoma metastatic to the thigh--an unusual site of metastasis. Report of a case. 282 Jun 73

The epithelial expression of carbohydrate antigen, stage-specific embryonic antigen 1 (SSEA-1) was examined immunohistochemically in noncancerous specimens from patients with familial polyposis coli, and compared with the colorectal epithelia from patients with sporadic colorectal cancer. In mucosa remote from carcinoma of sporadic cases, SSEA-1 was expressed only faintly in the lower crypts. In mucosa adjacent to carcinoma of sporadic cases, SSEA-1 was expressed not only in the lower crypts but also in the upper crypts. These results corresponded to those observed in the authors' previous study. In the flat mucosa of familial polyposis coli cases, SSEA-1 was detected not only in the lower crypts, but also in both upper crypts and the surface epithelium in contrast with the flat mucosa of sporadic cases. The staining pattern in the upper crypts of the flat mucosa of familial polyposis coli cases was very similar to that of the mucosa adjacent to carcinoma of sporadic cases, but was stronger and more diffuse in the surface epithelium. In microscopic adenomas, SSEA-1 was expressed diffusely. These results demonstrate that the flat mucosa of patients with familial polyposis coli shows preneoplastic changes similar to those in the mucosa adjacent to carcinoma of sporadic cases, and that SSEA-1 is related to adenoma formation in the early stage of carcinogenesis in the colorectum. In addition, the results suggest that immunohistochemical studies of flat mucosa may be useful for the early detection of high-risk individuals in a familial polyposis coli family.
Dis Colon Rectum 1987 Jun
PMID:The expression of stage-specific embryonic antigen 1 in the noncancerous colorectal epithelia of familial polyposis coli. 288 60

A retrospective review of 922 colorectal cancer patients was undertaken to determine whether the nonuniform anatomic distribution of colorectal cancer was influenced by age and/or sex. The mean age of patients with right colon lesions (71.2 years) was significantly higher than for either patients with left colon lesions (68.2 years) or rectal lesions (65.6 years). Further analysis disclosed that patients with proximal tumors were older than patients with distal tumors primarily because of the later presentation of females with cecal or ascending colon cancers. Comparison of the anatomic distribution of tumors in patient groups above and below the age of 70 revealed that right colon cancers accounted for a greater percentage of colorectal tumors in the older patient group than in the younger patient group. These findings support the roles played by both age and sex in influencing colorectal cancer location. Furthermore, these data provide a plausible explanation for the increasing incidence of proximal colonic lesions.
Dis Colon Rectum 1989 Feb
PMID:Age and sex distribution of patients with colorectal cancer. 275 64

Pathologic (Dukes) and clinicopathologic staging systems (Australian and TNM) are all used for the staging of colorectal cancer. Many modifications of the systems, with different standards of evidence, are currently used for a variety of purposes. It is not yet possible to readily exchange data from one staging system to another because of the lack of uniform anatomic and pathologic subdivisions. It would also be an advantage if staging systems more confidently predicted potential for cure. It is proposed that the TNM based system be modified to satisfy these requirements. Modifications identify common ground between the various systems, use prognostic variables shown to be significant by multivariate analyses, and introduce an abbreviated form of tumor grading. Grading improves prediction of cure and allows standardization of the composition of stages and substages because distant metastatic potential is shown to be related to the presence of high grade. The modifications are considered necessary and appropriate for epidemiologic and clinical studies.
Dis Colon Rectum 1989 Apr
PMID:International colorectal carcinoma staging and grading. 292 68

The purpose of this article was to review the effectiveness of follow-up in patients with colorectal cancer submitted to curative treatment. A comprehensive follow-up involves rational initial management of the primary tumor, knowledge of prognostic factors, selection of the patient to be followed, determination of the time for follow-up, use of the most appropriate tests for early diagnosis of recurrence, and eventual curative treatment. The updated answers to all these questions are given through an extensive review of the world literature and confronted with the authors' experience of eight years of follow-up in a series of 170 colorectal cancer patients treated for cure. Although the future might be more promising, past world experience suggests only a few patients could be saved. It is concluded that there is no place for incomplete and disperse screening tests, and only comprehensive, intensive, and very well-coordinated follow-up programs should be undertaken if better results are hoped to be achieved.
Dis Colon Rectum 1988 Aug
PMID:Colorectal cancer. The bases for a comprehensive follow-up. 304 4


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