Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using a one-step silver nitrate staining technique, routinely processed tumour tissues of 49 carcinomas of the colon were investigated to demonstrate silver-stained nucleoli (Ag-nus) and argyrophilic proteins associated with the so-called nucleolar organizer regions (Ag-NORs). Patients with attempted curative resections and tumour stages Dukes' A, B, C1 and C2, with an uneventful follow-up period of at least 48 months (N = 17), showed a statistically significant (P = 0.0001) lower mean number of scattered Ag-NORs (3.04; SD: 1.08) compared to patients who developed metastases during their follow-up period (N = 15; 5.40; SD: 1.28), as well as to patients who underwent palliative surgical treatment (N = 17; 4.48; SD: 1.67). Mean numbers of scattered Ag-NORs per nucleus and staging of the tumour were strongly related (P = 0.0001) to cancer-specific survival. The results indicate that the evaluation of silver-stained particles according to their different distribution patterns is of great value with regard to the clinical outcome of colonic carcinoma and may even allow a more accurate prognostic assessment of these patients than the WHO grading system, UICC staging system, the so-called Jass-scoring system, and Dukes' classification.
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PMID:Silver stained nucleolar organizer region proteins (Ag-NORs) as a predictor of prognosis in colonic cancer. 223 Nov 91

The postoperative course of 64 patients resected with EEA stapler because of their midrectal cancer have been followed. 13 (20.3%) local tumor recurrence have been observed in the first 24 postoperative months. 5 patients could be rectum exstirpated at the reexploration, only colostomy was performed in 8 cases. All the inoperabel patients have died in a year, but 3 of the exstirpated ones overlived this time. A direct connection have been observed between the Dukes stadium and the differentiation of the tumor, the distance of the distal resection line from the lower end of the tumor and the probability of the local recurrence. No connection has been found between the distance of the tumor from the linea dentata and the local tumor recurrence. On the basis of the oncological observations the deep rectal resection can be performed only by tumors in stadium Dukes A and B, if the tumor is well differentiated, there are no signs for local propagation or lymph node metastases, and more then 2 cm distal distance can be kept by the resection from the lower and of the tumor. In all other cases the rectum exstirpation must be the method of choice.
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PMID:[Causes and management of local tumor recurrence after low resection of the rectum]. 223 17

Twenty-eight patients with colon carcinoma (excluding the recto-sigmoid region) underwent preoperative staging with computed tomography (CT). The CT had a sensitivity and a specificity of 60 and 67% for detection of extramural invasion, 75% sensitivity and specificity for lymph node metastases and a sensitivity of 87% and specificity of 95% for liver metastases. Compared with the modified Dukes classification, CT correctly staged 50% of the patients with Dukes A lesions; 40% with Dukes B; 75% with Dukes C and 85% with Dukes D lesions. The data presented in this study showed that CT has limitations in the sensitivity and accuracy of staging local colonic carcinoma. However, we recommend its use for patients who are clinically suspected of having extensive disease.
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PMID:Preoperative CT staging of colon carcinoma (excluding the recto-sigmoid region). 225 38

Three hundred and thirty one patients with cancer of the rectum and rectosigmoid junction, operated on during the period 1968-1985 are here examined. The study shows the prognostic value and the impact that stage, histopathological grade, number and location of nodal metastases, morphology of the primary tumour, occurrence of obstruction, perforation, and haemorrhage have on the natural history of the tumour. Stage and histopathologic grading resulted as the most outstanding prognostic parameters also because they are correlated to the presence, number, and location of nodal metastases as well as occurrence of obstruction, perforation and haemorrhage. The study concludes that: a) stage according to the Dukes-Gabriel classification still has a reliable prognostic predictivity, since it faithfully reflects major anatomic situations observed in rectal cancer; b) Dukes' stage C cases should be considered as a non-homogeneous group with a distinct biological behaviour depending on the number and site of the lymph nodes involved; c) intraoperative staging of the tumour, if possible, should guide the excision extent on a curative aim, where the term means a prospective evaluation based on statistical data correlating stage and survival.
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PMID:Carcinoma of the rectum: factors influencing the prognosis. 228 41

Total, free, and acetylated polyamine concentrations were measured simultaneously in colon tissue, serum, and urine of 50 patients with histologically proven colorectal cancer, 40 patients with nonmalignant gastrointestinal diseases, and 30 healthy volunteers. Compared with histologically unaffected colon tissue, concentrations were significantly (P less than 0.001) higher for putrescine, elevated for cadaverine, and nearly identical for spermidine and spermine in colon carcinoma, whereas N1-acetylated and N8-acetylated spermidine were detectable in cancer tissue only. Serum and urine concentrations of all polyamines except total cadaverine and spermine in serum and free spermine in urine were significantly elevated compared with healthy controls and highest sensitivity for colon cancer was found for total spermidine (89.15%) in serum and acetylputrescine (84.5%), total putrescine (84.0%), N1-acetylspermidine (79.3%), and total spermidine (92.1%) in urine. However, nonmalignant gastrointestinal diseases partly showed similar elevations which resulted in a low specificity for polyamines in colorectal cancer. Therefore, polyamines are of little value only as diagnostic markers in colorectal carcinoma. Since polyamine concentrations in serum and urine normalized in patients after curative operation while they were further elevated in patients with proven tumor relapse or metastases, these substances might play a clinical role in predicting therapeutic success or indicating relapse of the tumor. Although a significant dependency of polyamine concentrations in serum or urine to Dukes' classification, tumor localization, CEA, CA 19-9, or CA 125 did not exist, a significant linear correlation was found for tumor size.
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PMID:Polyamines in colorectal cancer. Evaluation of polyamine concentrations in the colon tissue, serum, and urine of 50 patients with colorectal cancer. 229 64

Immunohistochemical study may be used for detecting micrometastases by their expression of tumor-associated antigens. In 48 specimens of colorectal cancer from 47 patients, 49 of 249 lymph nodes (median, five per patient; range, 2-11) examined by light microscopic study contained tumor deposits. Sections of all lymph nodes were also examined by immunohistochemical study for carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) expression using the indirect immunoperoxidase staining method. All 49 lymph node metastases (100%) from 20 patients stained positively for CEA and 45 (92%) expressed EMA. Of the 200 lymph nodes without metastases on light microscopic examination, anti-CEA revealed a single micrometastasis in a patient staged as Dukes' B. No additional metastases were detected with anti-EMA. In this series of patients immunohistochemical study has, therefore, influenced the histologic staging in only one patient (2%) and thus does not offer a significant benefit over conventional histologic staging.
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PMID:Detection of occult nodal metastases in patients with colorectal carcinoma. 229 65

DNA ploidy patterns were studied by flow cytometry in nuclear suspensions from 149 paraffin-embedded colorectal adenocarcinomas. The DNA ploidy of rectal tumours was not significantly different from that of colonic tumours. Patients with DNA diploid tumours had a significant survival advantage compared with patients with non-diploid tumours, but DNA ploidy did not confer any significant additional prognostic information when tumour site, Dukes's stage, the invasiveness of the tumour, and the number of lymph node metastases were adjusted for in a proportional hazards regression analysis (Cox). It is concluded that DNA ploidy does not contribute significantly to the explanation of why patients with rectal cancer have a poorer prognosis than those with colonic cancer.
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PMID:DNA ploidy, tumour site, and prognosis in colorectal cancer. A flow cytometric study of paraffin-embedded tissue. 230 11

While hepatic resection of metastatic colorectal carcinoma is accepted as effective in selected patients, resection of metastases to other solid organs has not gained wide acceptance. We retrospectively reviewed the records of 49 patients who had resection of isolated pulmonary (18 patients) and hepatic (31 patients) metastases from the large bowel, comparing disease-free survival and overall survival. Tumor parameters analyzed included Dukes' stage, deoxyribonucleic acid (DNA) flow cytometry, and number of metastases. Dukes' B and diploid tumors had longer disease-free survival and overall survival than did Dukes' C and aneuploid tumors, though the difference was not significant. Patients with a single lung metastasis had a significantly longer disease-free survival (P = .02) than did patients with multiple metastases. Mean and median survival were longer in patients with lung metastases. Five-year actuarial survival was 19% for patients with liver metastases and 47% for patients with lung metastases. Resection of isolated pulmonary metastases from the large intestine results in survival comparable to or better than resection of hepatic metastases. An aggressive surgical approach is warranted in patients with isolated resectable pulmonary metastases of colorectal carcinoma.
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PMID:Improved survival after pulmonary resection of metastatic colorectal carcinoma. 231

Cecal carcinoma has been associated with a poorer prognosis than other colon carcinomas because of the presumed longstanding obscure symptoms. In a combined study of three Dutch hospitals, a total of 166 patients with cecal carcinoma were evaluated after right hemicolectomy. Special emphasis was placed on clinical symptoms related to advanced tumor growth, e.g., pain, anemia, and palpable mass. These factors and clinicopathological staging were evaluated with aid of the Cox regression model. Ninety percent of the resected specimens contained a Dukes' B or C carcinoma. Only 5% were found to have widespread metastatic disease. Overall 5 year survival rate was found to be 0.57. No statistically significant relation to pain or palpable mass was found. Anemia, however, was related to a better survival, especially in patients with a Dukes' B carcinoma. Clinicopathological staging according to Dukes' is closely related to survival. It is concluded that carcinoma of the cecum behaves similarly to other colon malignancies.
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PMID:Cecal carcinoma: a different colon malignancy? 237 Aug

Perioperative blood transfusion has been reported to adversely affect survival in cancer patients, but the evidence is inconclusive and may be an epiphenomenon. From the Large Bowel Cancer Project, 961 patients who underwent curative resection and left hospital alive have been reviewed to compare the effect of perioperative blood transfusion on outcome; 591 patients (61%) had been given a blood transfusion while 370 (39%) had not been transfused. Some clinical variables were equally distributed between the two groups; ie age, sex, obstruction, perforation, tumour differentiation. Three other variables known to influence patient prognosis were not equally distributed, ie tumour site, Dukes' stage and tumour mobility. Patients with tumours of the rectum and rectosigmoid, with Dukes' stage C lesions and with some degree of tumour fixation were more likely to have received blood transfusions. Using the logrank method of multivariate analysis to allow for differences in distribution of all those variables known to affect prognosis, there was no survival disadvantage for those patients who had received perioperative blood transfusion. Furthermore, there were no overall differences between the two groups of patients in their risk of developing local tumour recurrence or distant metastases. The distribution of metastases differed: in the 'transfused' group only 37% of distant metastases were found in the liver, while 71% were found in this site in the 'not transfused' group (chi 2 = 18.46, d.f. = 1, P less than 0.001). By contrast, there was a larger proportion of patients with lung metastases in the transfused group (27% vs 11%) (chi 2 = 5.59, d.f. = 1, P less than 0.05). Therefore, these data do not support the concept of an overall deleterious effect of blood transfusion on patient survival, but suggest that blood given in the perioperative period may change the biology of the metastatic process.
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PMID:Large bowel cancer: the effect of perioperative blood transfusion on outcome. 240 65


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