Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From the surgical point of view it may be helpful to adopt the following guidelines in the treatment of patients with metastatic or locally recurrent colorectal cancer: 1. A gastroenterologist concerned with oncological patients should initiate adequate resectional treatment of the primary tumor. 2. In case of locoregional recurrences, every diagnostic effort (endoscopy, intraluminal ultrasound, angiogram, CT-scan, MRI) should be made to select patients with limited and resectable disease. 3. In patients with liver metastases amenable to surgical resection it is mandatory to rule out extrahepatic disease preoperatively as far as possible. 4. Prognostic factors deriving from tumor-biological data, extent of recurrent disease, and laboratory findings (CEA) must be taken into consideration when the decision whether to operate is to be made. These arguments should also be used to support non-operative treatment in patients with a type of recurrence that cannot be cured by surgery. 5. Postoperatively, all information (intraoperatively detected extrahepatic disease, tumor infiltrated resection margins, CEA not returning to normal levels) should be combined to classify patients according to whether they carry a high risk for a second tumor recurrence and should thus undergo additional treatment. In a "low-risk situation", further follow-up seems to be adequate.
 ...
PMID:[Reoperation in colorectal carcinoma with curative intention]. 164 13

The following 3 points are important clinical problems to be resolved in the management of cancer: 1. Are there any useful procedures in the diagnosis, treatment or prevention of recurrence or metastasis of cancer? 2. Can the recurrence or metastasis of cancer be predicted? 3. Are there any parameters which reflect the degree or grade of malignancy of cancer? For the diagnosis of recurrence or metastasis, tumor markers and imaging MRI are useful, especially for colorectal cancer. Radical extended resection can lead to good survival even though the tumor recurs. A randomized prospective study of 1011 gastrectomized cancer patients treated with oral OK432 showed significantly good results, especially in n(+) cases with curative resection. Prognostic stratification and risk assessment by computer analysis using Akaike Information Criteria (AIC) showed that cancerous invasion of subserosal veins (Vd) was the most important risk factor for liver metastasis of colorectal cancer. In predicting the recurrence or metastasis of cancer computer analysis by AIC appears to be a useful procedure. DNA ploidy patterns demonstrated by flow cytometry and oncogene analysis of tumor tissue have been reported and discussed as possible indices of the grade of malignancy.
 ...
PMID:[Indices of the malignancy of cancer--is it possible to predict the recurrence or metastasis of cancer?]. 194 54

The results and consequences of intra-operative ultrasonography of the liver were studied in 50 patients who had laparotomy for colorectal cancer. Compared with preoperative imaging techniques like US, CT and MRI, intra-operative US had a higher sensitivity for intrahepatic lesions. Especially in case that adjuvant therapy could have been considered, intra-operative US gave relevant information in 10 patients (20%) by altering the stage of the primary tumour. Four of the 50 patients showed more liver metastases at intra-operative US than detected by preoperative imaging techniques. Resectional therapy of liver metastases could be prevented in these four patients. We advise intra-operative US as routine for all patients undergoing laparotomy for colorectal cancer especially if adjuvant chemotherapy is considered. When surgery is scheduled extensive preoperative liver examination can be avoided if intra-operative US is available.
 ...
PMID:Intra-operative ultrasonography of the liver: a prerequisite for surgery of colorectal cancer? 194 95

Detection of recurrent colorectal carcinoma can be a diagnostic challenge. The authors report a case of a patient who, after resection of his primary colorectal carcinoma, had a recurrence that was not detected by MRI or serial CT examination, but was clearly demonstrated by In-111 labeled CYT-103 scintigraphy. This case demonstrates the use of CYT-103 scintigraphy in detecting recurrent colorectal cancer in a patient, despite results of nondiagnostic MRI or serial CT examinations.
 ...
PMID:Detection of recurrent colorectal carcinoma with In-111 CYT-103 scintigraphy in a patient with nondiagnostic MRI and CT. 784 71

Whatever the technique used for colorectal resection, the carcinologic principles of resection of colorectal cancer must include removal of the cancer with an adequate margin by performing a wide excision of the tumor-bearing area and associated lymphatics. Recent advances in colorectal cancer management concern principally rectal cancer, with new diagnostic tools (i.e. endorectal ultrasound, MRI, CT-scanner), and new surgical procedures (ioff coloanal anastomosis, stapled anastomosis, and local excision) which allow, in most of the cases, a sphincter-saving resection to be performed. Indication of laparoscopic surgery in colorectal cancer remains to be determined. Prognosis of colorectal cancer has not improved for recent years and the 5 year survival rate remains close to 50% after surgical excision. However, recently, adjuvant chemo-and radio-therapy have permitted a significant reduction of local recurrences and an improvement of the overall survival.
 ...
PMID:[Surgery of cancers of the colon and rectum]. 787 61

A prospective study was performed to compare, with a lesion-by-lesion analysis, the sensitivities of high field strength MRI and CT during arterial portography (CTAP) in detecting hepatic metastases from colorectal cancer. Twenty-one patients with liver metastases from colorectal cancer were prospectively investigated by high field strength MRI (1.5 or 2 T) and CTAP. High field strength MRI was performed with pre and post gadopentetate dimeglumine enhanced T1-weighted SE sequences and T2-weighted SE sequences. All patients underwent partial hepatectomy and 37 metastases were surgically and pathologically proved. The metastasis detection rate (sensitivity) was 94% (35 of 37) for CTAP and 78% (29 of 37) for high field strength MRI. The 16% (95% confidence interval: 1-31%) difference in sensitivity between CTAP and high field strength MRI was statistically significant (p < 0.05, McNemar test). The use of gadopentetate dimeglumine did not improve the sensitivity of T1-weighted SE sequences. Since our study demonstrated significant difference in sensitivities between high field strength MRI and CTAP in our group of patients, we can conclude that high field strength MRI cannot replace CTAP in the preoperative evaluation of patients with liver metastases from colorectal cancer. Computed tomography during arterial portography must be considered as the preoperative gold standard.
 ...
PMID:MRI of liver metastases from colorectal cancer vs. CT during arterial portography. 841 43

CT during arterial portography (CTAP) is based on portal enhancement of the liver by infusion of contrast material through the superior mesenteric or splenic artery. This technique provides high degrees of enhancement of the portal vein and intrahepatic vessels, allowing reliable segmental localisation of tumours and accurate assessment of relationships between tumours and intrahepatic vessels. Because of its invasiveness, CTAP must be limited to patients for whom non-invasive preoperative imaging suggests resectable tumour. In the majority of cases, CTAP is performed in patients with hepatic metastases from colorectal cancer, but other types of hepatic tumour (either primary or secondary) and pancreatic tumour may be an indication for CTAP. Visualisation of non-tumorous perfusion defects is a limitation of this technique, but such defects have been well described and have characteristic locations and appearance. In difficult cases, correlation with sonographic, CT and MRI findings helps characterise portal perfusion defects. CTAP is the most sensitive technique for the detection of intrahepatic tumours, and the recent use of spiral technology shows promise in the performance of CTAP. CTAP data can be viewed as multiplanar and three-dimensional reconstructions that allow preoperative planning of the extent of resection and determination of the volume of the remaining liver after resection.
 ...
PMID:CT during arterial portography. 879 5

The accurate and early diagnosis of the tumor in the point of the size, the location, the depth of invasion of other organs or the stages of the recurrent cancer became much more important than before, not only for the selection of the treatment method but also for the decision of the quality of the operation for preserving the function as much as possible for the quality of the life of the patient. The usefulness of positron emission tomography (PET) and immunoscintigraphy by means of 131I or 111In anti-CEA onoclonal antibody for the diagnosis of the recurrent colorectal cancer had been confirmed in clinical use of colorectal cancers. No adverse effect of this monoclonal anti-body of the mouse was seen in this studies. The differential absorption ratio (DAR) was useful indicator in PET-imaging to differentiate the true tumor tissue from the scar tissue or granulation-tissue around the tumor. Even though the imaging, structure of PET is inferior to those of CT or MRI, the imaging of PET reflects the biological character of tumor, itself and makes the more accurate diagnosis possibly by combined use with regular CT and MRI.
 ...
PMID:[Diagnosis of local recurrence of colorectal cancer, using PET and immunoscintigraphy by means of 131I or 111In anti-CEA monoclonal antibody]. 910 44

The risk of relapse of colorectal cancer depends on tumor characteristics such as location and Dukes' stage. Recurrences may be metastatic only (70%), locoregional only (20%) or both (10%). The main objective of postoperative follow-up is to detect recurrent disease as early as possible, in order to allow curative resection. Most relapses are now diagnosed when still asymptomatic. Different imaging methods help to diagnose these recurrences. The CT scan allows to examine the liver, lymph nodes, anastomosis and the pelvic cavity. MRI can bring complementary information in some selected cases. Lastly, percutaneous needle biopsies will be useful to prove the diagnosis. For the detection of distant metastases, chest X-ray, hepatic echography and CT scan examination can be used.
 ...
PMID:[Diagnosis of local recurrences and metastases from colorectal cancers]. 924 87

Hypoxia occurs to a variable extent in a vast majority of rodent and human solid tumors. It results from an inadequate and disorganized tumor vasculature, and hence an impaired oxygen delivery. A probe for the non-invasive detection of tumor hypoxia could find important utility in the selection of patients for therapy with bioreductive agents, anti-angiogenic/anti-vascular therapies and hypoxia-targeted gene therapy. In addition, tumor hypoxia has been shown to predict for treatment outcome following radio- or chemotherapy in human cancers, the underlying mechanism for which may involve hypoxia driving genetic instability and resulting tumor progression. Beyond oncology, utility can also be envisaged in stroke, ischemic heart disease, peripheral vascular disease, arthritis and other disorders. Design, validation, preclinical development and current status of a fluorinated 2-nitroimidazole, N-(2-hydroxy-3,3,3-trifluoropropyl)-2-(2-nitro-l-imidazolyl) acetamide (SR 4554, CRC 94/17), which has been rationally designed for the measurement of tumor hypoxia by magnetic resonance spectroscopy (MRS) and imaging (MRI), are reviewed. Application in positron emission tomography (PET) detection is also proposed. Design goals were: (i) a nitro group with appropriate redox potential for selective reduction and binding in hypoxic tumor cells; (ii) hydrophilic/hydrogen bonding character in the side chain to limit nervous tissue penetration and prevent neurotoxicity; and (iii) three equivalent fluorine atoms to enhance MRS/MRI detection, located in a metabolically stable position. Reduction of SR 4554 by mouse liver microsomes was dependent on oxygen content, with a half-maximal inhibition at 0.48 +/- 0.06%. SR 4554 underwent nitroreduction by hypoxic but not oxic tumor cells in vitro and electron energy loss spectroscopic analysis showed selective retention in the hypoxic regions of multicellular tumor spheroids. Pharmacokinetic design goals were met. In particular, low brain tissue concentrations were seen in contrast to excellent tumor levels, as measured by high performance liquid chromatography. The extent of this restricted entry to brain tumor was surprising given the overall octanol/water partition coefficient and was attributed to the hydrophilic/hydrogen bonding character of the side chain. Quantitative MRS was used to assess the retention of 19F signal in murine tumors and human tumor xenografts. The 19F retention index (FRI; ratio of 19F signal levels at 6 h relative to that at 45 min) ranged from 0.5 to 1.0 and 0.2 to 0.9 for murine tumors and human xenografts respectively. The correlation between SR 4554 retention and pO2 was not a linear one, but when FRI was > 0.5, the % pO2 < or = 5 mmHg was always > 60%, indicating that high FRI was associated with low levels of oxygenation. Finally, whole body 19F-MRI in mice demonstrated that SR 4554 and related metabolites localized mainly in tumor, liver and bladder regions. A selective MRS signal was readily detectable in tumors at doses at least 7-fold lower than those likely to cause toxicity in mice. We conclude that proof of principle is established for the use of SR 4554 as a non-invasive MRS/MRI probe for the detection of tumor hypoxia. Based on these promising studies, SR 4554 has been selected for clinical development.
 ...
PMID:Preclinical development and current status of the fluorinated 2-nitroimidazole hypoxia probe N-(2-hydroxy-3,3,3-trifluoropropyl)-2-(2-nitro-1-imidazolyl) acetamide (SR 4554, CRC 94/17): a non-invasive diagnostic probe for the measurement of tumor hypoxia by magnetic resonance spectroscopy and imaging, and by positron emission tomography. 975 26


1 2 3 4 5 6 7 8 9 10 Next >>