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

The complete autopsies of 145 patients dying of colorectal cancer are reviewed. Isolated local or distant metastases are infrequent, compared to disseminated disease. Solitary local recurrences are most common after resection of rectal tumors. Right colon tumors spread to local and distant sites in 90% of autopsies, and to distant sites alone in 10%. Rectal tumors spread locally only in 25% of cases, to distant site alone in 25%, and to both in 50%. Regardless of the origin of the primary tumor, the liver is the most common site of metastasis, followed by the regional lymph nodes and the lungs. Two-thirds of the patients with right colon lesions died of liver metastases, and three-quarters of those with rectal tumors succumbed to disseminated disease. The current curative and palliative treatment of recurrent colorectal cancer in clinical medicine by surgery, radiotherapy, and chemotherapy is reviewed. It is suggested that an understanding of the anatomic patterns of cancer recurrence will increase in importance as advances in the modalities of treatment are made,
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PMID:The clinical correlation of an autopsy study of recurrent colorectal cancer. 44 5

The relationship between blood transfusion, disease-free survival, and other potential prognostic factors was prospectively studied in 339 consecutive patients with colorectal cancer. Admission and discharge hematocrit, Dukes' stage, and blood loss were significantly related to both blood transfusion and disease-free survival. Using Cox proportional hazards model, however, the association of transfusion with disease-free survival was significant (p = 0.0196) after controlling for age, sex, blood loss, procedure, tumor differentiation, stage, admission hematocrit, duration of surgery, length of the specimen, and tumor size. Dukes' stage (p < 0.0001) and blood transfusion (p < 0.0001) were the only variables independently related to disease-free survival. Forty per cent (44) of the 110 patients who received transfusions developed cancer recurrence, compared with 22% (50) of the 229 patients who did not receive blood (p < 0.0001). Five-year disease-free survival of the transfused patients was 57%, compared with 77% for nontransfused patients. Patients who developed recurrence received an average of twice as much blood as patients without recurrence (1.26 versus 0.61 units, p = 0.0128). Perioperative blood transfusion is a significant independent prognostic factor for colorectal cancer.
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PMID:The association of perioperative blood transfusion with colorectal cancer recurrence. 146 16

A method of superimposing computed tomography (CT) and immunoscintigraphic (IS) single photon emission tomography (SPET) slices is presented and has been applied to 10 patients with suspected cancer recurrence. IS was performed with carcinoembryonic antigen (CEA)-specific indium-111 monoclonal antibodies (MoAbs) in 5 patients with colorectal cancer, and with OC125 111In-MoAbs in 5 patients with ovarian cancer. All patients had an abnormal CT image result in the pelvis, which was interpreted 5 times as recurrence, once as doubtful and four times as scar fibrosis. Recurrence was subsequently proven in all patients. Bone scintigraphy (BS) SPET was recorded at the same time as IS. No special technique was used during BS, IS or CT acquisition. CT images were fed into a computer using a CCD camera. Using the internal anatomical landmarks provided by the pelvic bone structures seen on CT and BS, an operator had to select corresponding fiducial points, which were used by the software to register the images. The final results were CT-BS and CT-IS superimposed images. CT-BS images were used for quality control. In all patients, the inspection of CT-BS and CT-IS showed that the registration process is accurate and assists in the co-interpretation of CT and IS images.
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PMID:Superimposition of computed tomography and single photon emission tomography immunoscintigraphic images in the pelvis: validation in patients with colorectal or ovarian carcinoma recurrence. 157 83

Argyrophil nucleolar organiser regions (AgNORs) are increased in a variety of malignant cells compared with normal cells, and a recent study has claimed that AgNORs have prognostic value in colorectal cancer. We have studied the AgNOR counts in tumours from 95 colonic resections performed in 94 patients in whom a minimum 5 year follow-up was available. In 71 pathological specimens adjacent normal mucosa was also examined. There was a significant difference between AgNORs per cell in normal mucosa (median 1.46, range 1.10-1.80) compared with tumour cells (median 1.92, range 1.42-2.95, P less than 0.001). There were no significant differences in average AgNORs per cell between tumours in each Dukes' stage or category of differentiation. The average AgNORs per cell in tumours of patients surviving disease-free for 5 years was the same as that in tumours of patients dying of colonic cancer recurrence. We conclude that AgNORs have no prognostic value in colorectal cancer and are not correlated with Dukes' staging or differentiation of the tumour.
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PMID:The prognostic value of argyrophil nucleolar organiser regions (AgNORs) in colorectal cancer. 173 91

We developed a predictive scale for cancer recurrence by conducting a multivariate analysis (Hayashi's discriminant analysis of qualitative data) on clinicopathologic indicators in 207 patients with Dukes' B or C colorectal cancer who underwent curative resection at our institution. Seven indicators were found to have prognostic value. Nodal status, which was divided into five categories according to the level and number of positive nodes, had the highest coefficient as a predictor of recurrence. The correlation ratio between the group showing recurrence and that showing non-recurrence was 0.49, with 74% discrimination success rate. Liver or lung metastases were more accurately discriminated than local or peritoneal failure. We assessed the accuracy of this predictive scale in 110 patients with Dukes' B or C colorectal cancer who had been surgically treated at another institution (National Cancer Center, Tokyo), and determined it to be 68%. We think that this scale using multivariate analysis for the prediction of cancer recurrence has significant clinical application in the selection of more effective postoperative adjuvant chemotherapy. It is concluded that the present predictive scale is clinically useful, but that the inclusion of other indicators such as immunohistological ones is required to increase its predictive precision.
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PMID:[Multivariate analysis for the prediction of recurrence in colorectal cancer]. 194 56

An experimental follow-up plan based on immunoscintigraphy was evaluated in 48 patients, who had undergone resection for colorectal cancer. The results were compared with those concerning other 317 patients submitted to a traditional follow-up (physical examination, blood analysis, endoscopy, ultrasonography, CT scan, barium enema, etc.). Immunoscintigraphy was performed with Iodine 131--or Indium 111--labeled anti-CEA and-19.9 monoclonal antibody, using a gamma-detecting probe (GDP) enabling to perform radioimmunodetections. In addition, radioimmunoguided surgery was performed in two cases of highly suspected recurrence, and radioimmunoguided endoscopy was made in two cases of suspected recurrence after anterior resection for tumor of the rectum. Our gamma-detecting probe differs from the other ones because of its collimator which enables to detect all the radioisotopes that are used for external scanning and because of its particular shape that enables to perform endoscopic radioimmuno detections. The experimental follow-up plan showed cancer recurrence in 27% of the patients vs. 13% of extensive instrumental investigations. Radioimmunoguided surgery appears to provide a higher level of radicality. The same GDP used for intraoperative immunoscintigraphies seems to be effective in the endoscopic study of the pelvis after anterior resection, a clinical occurrence which can hardly be investigated by means of other instrumental diagnostic procedures.
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PMID:[Radioimmunoscintigraphy with monoclonal antibodies in recurrences and metastases of colorectal tumors]. 227 52

Correlation between preoperative CEA levels in draining venous blood (d CEA) and draining-peripheral (d-p) CEA gradient, and postoperative survival of 94 patients with colorectal cancer patients was examined. The positive rates of d CEA and d-p CEA gradient greater than 5 ng/ml (55.9% and 37.2%) in 59 alive patients were significantly (p less than 0.05) lower than those (77.1% and 57.1%) in 35 patients died of cancer recurrence within 4 years. Survival curve of the patients with positive d CEA and d-p CEA gradient were significantly (p less than 0.01) lower than those of the patients with negative d CEA and d-p CEA gradient. Survival curve of the patients with d-p CEA gradient greater than 10 ng/ml was significantly (p less than 0.001) lower than that of the gradient less than 10 ng/ml, and 4-year survival rates were 37.5% in the former patients and 68.3% in the latter patients. These results suggest that d CEA and d-p CEA gradient may be used as prognostic indicators of colorectal cancer patients. Clinically, the patients with positive d-p CEA gradient greater than 10 ng/ml are necessary to be treated as patients having very poor prognosis.
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PMID:[CEA levels of draining venous blood and draining-peripheral CEA gradient in colorectal cancer patients: correlation with postoperative survival]. 238 21

Retrospective studies of the relationship between perioperative blood transfusion and colorectal cancer recurrence are reviewed. Perioperative blood transfusion was associated with preoperative anemia, operations for rectal carcinoma, presence of tumor in the right colon, prolonged procedures, and copious blood loss. Control for variables related to blood transfusion and potentially affecting disease recurrence--blood loss, duration of surgery, and magnitude of the procedure--was notably absent from the majority of studies. None of the negative studies had sufficient numbers of both transfused and untransfused patients to reject the hypothesis that blood transfusion is associated with cancer recurrence with statistical validity. No concensus emerged regarding the significance of blood transfusion for the patient with colorectal cancer, and no recommendations concerning the use of blood are justified on the basis of these studies.
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PMID:Perioperative blood transfusion and colorectal cancer recurrence: a review. 305 36

Of 668 Rochester, Minnesota residents with colon or rectal cancer diagnosed from 1940 through 1979, 400 (60%) were operated on for cure and had a known disease stage. The influence of patient sex, age, and decade of diagnosis, disease stage, grade, site, and size, and the presence of obstruction or perforation were examined as prognostic factors for death, death from colorectal cancer, and cancer recurrence. In this population-based inception cohort, overall survival was independently associated with male sex (P = 0.0002), older age (P less than 0.001), and more advanced disease stage (P less than 0.001). Death due to colon cancer, on the other hand, was associated with disease stage (P less than 0.0001), more advanced grade (P = 0.016), and the presence of obstruction (P = 0.003). One hundred seven (27%) patients had a recurrence of their colon cancer. Seventy-one percent of recurrences were evident within the first 2 years and 91% by 5 years. Recurrence was associated with disease stage (P less than 0.0001), grade (P = 0.006), and the presence of perforation (P = 0.012).
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PMID:Predictors of survival after curative resection of carcinoma of the colon and rectum. 344 Feb 38

Blood transfusions are associated with phenomena attributable to immune suppression. Since perioperative blood transfusion is associated with early cancer recurrence in patients with malignancies, we prospectively studied T-cell subsets and natural killer cytotoxicity in patients undergoing potentially curative surgery for colorectal cancer. Preoperative total peripheral lymphocyte number was significantly (P = 0.0191) depressed in patients who were subsequently transfused, but returned to normal by follow-up 1 to 3 months after surgery. Natural killer cytotoxicity declined significantly (P less than 0.05) at follow-up in patients who were not transfused. These results do not explain the association of blood transfusion with cancer recurrence observed in colorectal cancer patients. Blood transfusion in this study was followed by increased numbers of peripheral lymphocytes and higher natural killer cytotoxicity.
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PMID:Lymphocyte subsets, natural killer cytotoxicity, and perioperative blood transfusion for elective colorectal cancer surgery. 348 69


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