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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-three consecutive specimens of resected rectal carcinomas, 16 abdominoperineal and 27 anterior resections, were examined for distal intramural spread. Thirty-four of the resections were considered curative and nine palliative. Eighteen carcinomas (42 percent) showed no distal spread, and 14 (33 percent) showed very limited distal spread (0-5 mm). In the remaining cases, 11 (25 percent) had distal spread of more than 5 mm and eight of more than 10 mm. The eight carcinomas with distal spread of greater than 10 mm were advanced Dukes' C tumors. Only three were considered curable. All potentially curable carcinomas would have been resected adequately with a distal margin of only 1.5 cm except one signet-ring carcinoma with extensive lymph node metastases located in the lower rectum.
Dis Colon Rectum 1986 Apr
PMID:Distal intramural spread of rectal carcinomas. 394 22

The more common patterns of dissemination and recurrence of colonic cancer are known and well-documented. In contrast, extravisceral, distant soft tissue metastases are comparatively rare. Therefore, these metastases are not subject to meaningful generalizations, with the exception that they are often associated with widespread metastatic disease. This report describes the first case of carcinoma of the colon metastatic to the skeletal muscle of the contralateral buttock and the sciatic nerve without concurrent evidence of pelvic or distant metastases. Curative resection was not possible because of involvement of the proximal sciatic nerve.
Dis Colon Rectum 1985 Feb
PMID:Isolated metachronous metastases to soft tissues of the buttock from a colonic adenocarcinoma. 397 5

Intra-abdominal operations result in profound immunodepression during a period when tumor cells are released into the systemic and portal circulations. This combination may augment tumor metastases. The authors have developed a model in which rat colon carcinoma cells transplanted into the portal vein consistently induce hepatic metastases by four weeks, and death within nine weeks. Additionally, the authors have shown that perioperative treatment with levamisole significantly reduces the incidence of metastases. This study tested whether maleic anhydride-divinyl ether-2 (MVE-2), a known immunostimulant, would produce similar effects. Rats pretreated with MVE-2 the day before and day of tumor implantation developed fewer metastases (34 percent of animals treated with MVE-2, compared with 5 percent of animals not treated with MVE-2 had less than or equal to two liver metastases). Eighteen percent of MVE-2-treated rats developed no hepatic metastases. Comparison of median liver weights between the MVE-2-treated group and the nontreated, tumor-bearing group was significant (P = 0.03) and the MVE-2-treated animals had significantly prolonged survival (P = 0.04). The authors conclude that the perioperative period is critical for the implantation and growth of metastases and that perioperative immunostimulation may be a factor in decreasing the incidence of metastases. This model may have relevance to the adjuvant treatment of human colonic cancer.
Dis Colon Rectum 1985 Apr
PMID:Reduced incidence of rat colon cancer metastases by perioperative immunostimulation with maleic anhydride-divinyl ether-2 (MVE-2). 397 21

Skin metastasis from colorectal carcinoma without evidence of visceral metastases is exceedingly rare. However, it must be considered whenever a new skin growth appears in a patient with a history of carcinoma. A diagnostic biopsy is mandatory as the appearance of these metastases is not distinctive.
Dis Colon Rectum 1985 Jul
PMID:Subcutaneous metastases without visceral metastases from an adenocarcinoma of the rectum. 401 15

From 1962 to 1982, 27 patients with pulmonary metastases as the only site of recurrent colorectal carcinoma underwent pulmonary resection at Roswell Park Memorial Institute. Only five of these patients had symptomatic pulmonary lesions. No postoperative mortality occurred. The median survival after pulmonary resection was 27 months. Five patients are alive presently without recurrent colorectal cancer and two patients are alive with recurrent pulmonary metastases. Patients with solitary lesions had a better survival than patients with multiple lesions. The major sites of recurrence following thoracotomy were the lungs and liver.
Dis Colon Rectum 1985 Aug
PMID:Surgical resection of pulmonary metastases from colorectal adenocarcinoma. 401 19

A controversy exists as to the correct therapeutic approach to colorectal polyps that contain malignancy and are removed colonoscopically. This paper presents our experience in the management of such polyps. Between 1977 and 1983, a total of 117 patients underwent colonoscopic polypectomy for 178 adenomas. Nine adenomas from nine patients showed carcinomatous invasion across the line of muscularis mucosae. None of these carcinomas was poorly differentiated and in all but two cases there was histologic evidence of complete excision. Seven patients whose adenomas containing foci of malignant changes were treated by polypectomy alone are alive without recurrence at periods from six months to over five years (mean, 40 months). The two patients in whom endoscopic removal of cancerous adenomas was found to be either doubtfully complete or incomplete, had further surgical treatment; both are alive and well after one and five years, respectively. Nine other patients whose adenomas containing malignant changes were considered unsuitable for colonoscopic polypectomy, underwent surgical resection and in none was regional lymph node or distant metastases found at laparotomy. In conclusion, our results of local endoscopic excision for adenomas containing malignant changes suggest a conservative approach to such polyps and this policy is supported by the finding that, in none of our operated patients was there any evidence of metastatic disease.
Dis Colon Rectum 1985 Sep
PMID:A conservative approach to adenomas containing invasive carcinoma removed colonoscopically. 405 10

Squamous cell carcinoma of the colorectum is a rare pathologic curiosity. Since the first report by Schmidtman in 1919, only 69 cases have been reported in the English medical literature. The mean age at presentation is 52 years, and the disease presents itself equally in men and women. The rectum accounts for slightly less than one half of all cases. Survival appears to correlate with nodal status and findings of visceral metastases at presentation. Most tumors can be identified easily by physical examination and/or barium enema. Therapy is limited largely to surgical resection, although attempts at irradiation and chemotherapy have been made. At this time, the etiology of this disease process is unknown, but a likely explanation revolves around replacement of damaged epithelium by cells which undergo anaplasia due to repeated trauma. In addition to this review of the literature, the authors wish to add one additional report of a patient treated successfully by a multimodality approach.
Dis Colon Rectum 1985 Dec
PMID:Primary squamous carcinoma of the rectum. Report of a case and review of the literature. 406 61

Cases are reviewed of 12 patients who had abdominoperineal resections for cancer recurrence subsequent to anterior resection. Although this procedure is technically more difficult, we experienced no mortality or significant morbidity, and the postoperative hospital stay was similar to that of patients who received an abdominoperineal resection as a primary procedure. Although we have no long-term cures, at least significant palliation can be achieved in selected patients who have no evidence of distant metastases.
Dis Colon Rectum
PMID:Abdominoperineal resection for recurrent cancer following anterior resection. 616 97

The results of palliative operative management of 338 patients with rectal carcinoma managed by one of the authors are presented. Postoperative mortality was higher for patients undergoing palliative resection (11.7 per cent) than colostomy bypass (5.3 per cent) or diagnostic laparotomy (6.8 per cent). Cancer specific survival following palliative resection was significantly (P less than 0.001) longer than that following colostomy bypass or diagnostic laparotomy for tumor Stages D1 (local visceral involvement) and D2 (distant metastases). However, in patients with liver or peritoneal metastases alone, cancer specific survival did not differ significantly after the operations of resection or colostomy bypass. The failure to demonstrate improved survival after resection of the primary tumor in these latter two groups with distant metastases indicates the dominant role of volume of tumor tissue present in these situations. The results suggest that longer survival following palliative resection reflects a bias of patient selection towards more favorable cases.
Dis Colon Rectum
PMID:Palliative operative management in rectal carcinoma. 617 44

Progress in regional arterial infusion therapy for metastatic cancer confined to the liver from colorectal primary and in systemic chemotherapy for widespread disease has been limited. Despite considerable search for effective antitumor agents, only few drugs have been shown to have efficacy to warrant additional evaluation alone or in multidrug regimens. Despite high response rates reported with regional therapy and some of the systemic chemotherapy regimens, significant prolongation of the overall survival on these treatment programs remains to be documented. Although chemotherapy for advanced large bowel cancer is only moderately effective at present, patients do obtain substantial benefit occasionally. Thus, chemotherapy should be attempted and there should be trials of new treatment regimens to find effective treatments for these patients.
Dis Colon Rectum 1983 May
PMID:Regional and systemic chemotherapy for advanced colorectal cancer. A review. 622 13


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