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

Adjuvant postoperative radiation therapy has been suggested for adenocarcinoma of the rectum and sigmoid colon to reduce the incidence of local recurrences. Determination of this incidence is necessary to optimally employ such adjuvant therapies. Ninety-nine patients with adenocarcinoma of the rectum or sigmoid who had surgery from 1976-1984 were reviewed. Follow-up ranged from one to eight years (average 4.1 years). Twenty-three patients had gross unresected residual tumor due to local invasion. Fifteen of the remaining 76 have developed recurrences (20 percent). Two patients (2.6 percent) had local recurrences without concurrent regional or distant metastases. Thus local recurrences rarely are encountered without concurrent regional or distant metastases. Therefore, postoperative radiation therapy to prevent local recurrences is not justified, given the small number of patients potentially benefited. Treatment modalities will need to address regional and distant metastases in addition to local recurrences.
Dis Colon Rectum 1986 May
PMID:Local recurrence of adenocarcinoma of the rectosigmoid. Is postoperative adjuvant radiotherapy justified? 369 56

From 1968 to 1982, 195 patients with invasive cancer of the anal canal were treated (average age, 67 +/- 11 years; range, 38 to 85 years; sex ratio [women/men]: 5/1). Histology revealed: cloacogenic cancer, 20 cases; squamous cancer, poorly differentiated, 30; moderately differentiated, 68; well differentiated, 77. The initial size of the cloacogenic cancers was smaller than the squamous cancers. Invasion less than half the circumference of the canal was 90 and 74 percent, respectively. No patients with cloacogenic cancer presented with positive inguinal nodes; however, there were 22 unilateral and five bilateral positive nodes in the squamous cancers. All 195 patients received radiotherapy as the first treatment. There were no differences among the patients operated on with respect to sterilized operative specimens, postradiotherapy sequelae, perineal recurrences, and/or visceral metastases in the cloacogenic and squamous cancers. Five-year survival was better in cloacogenic (62 percent) than in squamous cancers (56 percent); this difference was not significant, and was related to the initial size of the tumor. The number of patients with no evidence of disease and good anal function was significantly related to the initial size of the tumor, and was independent of the histologic findings.
Dis Colon Rectum 1986 May
PMID:Prognosis of cloacogenic and squamous cancers of the anal canal. 369 57

A prospective study was done on 34 patients using magnetic resonance imaging (MRI) and computed tomography (CT) preoperatively to stage patients with known rectal carcinoma. The study was done to determine the accuracy and clinical usefulness of CT and MRI. The Thoeni staging method was used. Twenty-four of 30 cases were staged correctly by CT. Sixteen of 27 were staged correctly by MRI. CT detected lymph node metastases in six of 15 cases with one false-positive. MRI detected lymph node metastases in two of 15 patients with one false-positive. CT was the preferred examination, and was useful in some cases. These cases included patients with small tumors who were considered for local excision and patients with extensive disease who were candidates for preoperative or intraoperative radiation treatment. MRI demonstrated extensive disease, as did CT in our later cases.
Dis Colon Rectum 1986 Jul
PMID:Preoperative staging of rectal carcinoma by computed tomography and 0.15T magnetic resonance imaging. Preliminary report. 372 Apr 56

Two cases of carcinoma in Crohn's disease of the colon are reported. One patient was a 30-year-old man who had asymptomatic Crohn's ileocolitis resulting in an acute presentation due to toxic dilatation of the colon. This was preceded by a short prodromal period of four weeks, characterized by intermittent diarrhea on the basis of a coloileal tumor fistula. A mucus-secreting adenocarcinoma was present in the sigmoid colon associated with both adjacent and one nearby focus of high-grade mucosal dysplasia. Pelvic wall and abdominal metastases were present, and the patient died two months later. The other patient was a 60-year-old woman who had a nine-year history of biopsy-proven Crohn's proctocolitis. A stricture of the sigmoid colon due to Crohn's disease also harbored an invasive adenocarcinoma. The carcinoma was not evident preoperatively or on initial gross pathologic examination. The presentation and pathology of large intestinal carcinoma in Crohn's colitis are discussed and illustrated.
Dis Colon Rectum 1986 Nov
PMID:Carcinoma in Crohn's disease of the colon. 376 96

A case of hepatomegalia due to multiple metastases of unknown origin to the liver is described. At autopsy the primary tumor, an adenocarcinoid tumor of the appendix, was identified along with multiple metastases to the lymph nodes and widespread peritoneal carcinoidosis. Hepatic metastases from an appendiceal adenocarcinoid tumor has not been described previously. In the liver and lymph nodes the tumor had an insular growth pattern and was composed predominantly of cells of carcinoid type, whereas the carcinoidosis was composed almost entirely of signet-ring cells. It is suggested that differentiation of the metastases of appendiceal adenocarcinoids is modulated by factors in the recipient organ.
Dis Colon Rectum 1987 Feb
PMID:Adenocarcinoid of the appendix presenting with metastases to the liver. 380 15

A case report of a rectal carcinoma metastasizing to the penis is reviewed along with a total of 44 similar cases reported in the world literature. Pertinent arguments are presented in favor of yet another possible route of metastases, namely the perineural route, which has not been considered previously. Cavernosography provides valuable information about the extent of tumor spread; used more often, it would lead to recognition of the rare opportunity when an aggressive surgical approach might achieve prolonged survival.
Dis Colon Rectum 1987 Feb
PMID:Involvement of the penis by rectocolic adenocarcinoma. Report of a case and review of the literature. 380 18

Osseous metastases to the hand are rare. The primary site is usually in the lung, breast, or kidney. Two cases of metastatic tumor in the hand from adenocarcinoma of the colon are reported herein. These patients presented two and four years after initial resections of colonic carcinomas. General aspects of diagnosis, etiology, and management are discussed.
Dis Colon Rectum 1987 Feb
PMID:Metastatic tumors in the hand from adenocarcinoma of the colon. 380 22

Five patients with colorectal cancer and unresectable synchronous liver metastases have survived for over five years at this writing. Four of the five had multiple metastases over both lobes, as diagnosed preoperatively, and the other had multiple metastases in the right lobe not evident preoperatively. The primary foci were excised completely in four patients. For one patient with multiple metastases limited to the right lobe, the postoperative cancer chemotherapy prescribed was intravenous mitomycin C (MMC; 12 mg) and oral ftorafur (a derivative of 5-FU) for a total dose of 291 gm over 63 weeks. The remaining four patients underwent postoperative intra-arterial infusion therapy with the average total dose of 20.5 mg of MMC plus 5600 mg of 5-FU; subsequently, they received protracted chemotherapy with oral ftorafur of 354 gm as an average, with little or no side effects. In these four patients, duration of intra-arterial treatment was an average of 3.2 weeks, and the subsequent oral treatment continued for an average of 85 weeks. Recent hepatic echography and CEA determinations show these patients to be free from intrahepatic metastasis.
Dis Colon Rectum 1985 Aug
PMID:Long-term survivors of colorectal cancer with unresectable hepatic metastases. 392 43

Computed tomography (CT) scan of the pelvis unreliably detects metastases to lymph nodes from rectal carcinoma. Alternative features of tumor spread visualized on pelvic CT scan may aid preoperative evaluation. Two patients in a series had thickened perirectal fascia due to tumor involvement. The perirectal fascia was recently described by others from CT scans of the pelvis. The extent of the perirectal fascia shown on CT scan correlated with descriptions of Waldeyer's fascia that stress its expansive nature enveloping internal iliac vessels and lymphatics. The perirectal fascia and Waldeyer's fascia are proposed to be synonymous, and lymphangitis carcinomatosa is proposed to account for a thickened perirectal/Waldeyer's fascia in rectal carcinoma. The fascial thickening also is found in inflammatory pathology of the rectum (probably due to inflammatory lymphangitis), and fascial thickening on pelvic CT scan is thus not an absolute indicator of carcinoma.
Dis Colon Rectum 1986 Feb
PMID:Thickening of pelvic fascia in carcinoma of the rectum. Perirectal fascia or Waldeyer's fascia? 394 20

In a prospective study of 402 colorectal cancer patients, 133 patients (46 men and 87 women) presented with right colon cancer. There was no significant difference between men and women in right colon cancer incidence. Common presenting features were abdominal pain, weight loss, and anemia. Ninety-one patients underwent resection with curative intent. There were significantly fewer Dukes' A tumors in the right colon cancer series (P less than 0.05). Significantly more women in the right colon cancer group were over 70 years old (P less than 0.05). The findings of peritoneal metastases and poorly differentiated lesions at initial surgery also were associated significantly with women who had right colon cancer (P less than 0.05). This study confirms previous reports of more advanced tumors in the right colon. The need for age, sex, and subsite differences to be taken into account when assessing treatment outcomes or survival is emphasized.
Dis Colon Rectum 1986 Apr
PMID:Age and sex differences in right colon cancer. 394 13


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