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 47,337 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Limited data are available concerning resting metabolic expenditure (RME) in cancer patients and the effect of RME by varying glucose intake. This study describes the measurements on 21 patients with colorectal cancer while fasting and with incremental levels of standard TPN-glucose system by central vein. Following an overnight fast, the measured mean +/- SEM percent difference from the predicted RME for the male group was 4.13 +/- 1.67% and the female group, 2.09 +/- 2.09%. The overall mean percent difference of 2.95 +/- 1.45 suggests that colorectal cancer does not cause an increase in energy expenditure. Hepatic metastases in 11 of the patients did not influence RME. The data from the 21 patients indicate a statistically significant increase in RME with TPN compared to postabsorptive states in females of 37%, in males 21.88%, and combined of 29.88%. Progressively greater increases in RME were seen when calories provided incrementally exceeded the basal RME. Carbohydrate loading in excess of the patient's calorie need, as indicated by the respiratory quotient (RQ) greater than 1.0, results in fat synthesis and other energy-costing processes. The basal RME demonstrates that these cancer patients are not hypercatabolic, but do respond to high-level force-feeding with markedly increased metabolic expenditures.
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PMID:Energy requirements for cancer patients and the effect of total parenteral nutrition. 312 61

The results of treatment of 1115 patients with colorectal cancer, from one hospital, are presented. The mean age of the patients was 67.24 (+/- 0.35 SEM) years and there were the same number of male and female patients. Forty per cent of patients were admitted as an emergency, and 67% of the tumours were in the rectum or sigmoid colon. 46.7% of the patients were considered to have undergone a 'curative' resection. Six per cent of the tumours were Dukes' Stage A lesions; 37% were Stage B and 57% Stage C. Twenty-six per cent had liver metastases. The overall hospital mortality was 21.5% and the operative mortality 14%. One-third of the patients admitted as an emergency died during their first admission. The overall 5-year survival was 25.8%; those with Dukes' Stage A tumours had a 5-year survival of 82.1%, Stage B 53.6% and Stage C 12.8%. The sex, site of tumour or duration of symptoms had no effect on prognosis.
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PMID:The results of 1115 patients with colorectal cancer treated over an 8-year period in a single hospital. 400 69

A retrospective study was performed on 966 patients with histologically verified nasopharyngeal carcinomas. The follow-up rate was 93.6% over a minimum period of five years. The actuarial and relapse-free survivals were 82% and 49% at one year, 64% and 43% at two years, 43% and 33% at five years, and 36% and 22% at ten years, respectively. None of the patients with distant metastases when initially evaluated survived more than four years following the initiation of radiotherapy and chemotherapy. After the initial radiotherapy was completed, 200 (22.2%) of 900 patients had distant metastases, bone metastases being the most frequent; and 226 (25.1%) patients had locoregional recurrence. There is no statistical correlation found between locoregional recurrence and distant metastases. In patients without recurrence, the rate of subsequent distant metastases is found to be much more heavily influenced by the initial N stage (trend X2 P less than 0.001) than the initial T-stage (trend X2 0.05 greater than P greater than 0.02). Of patients with metastases, the survival time of those with liver metastases was found to be the shortest, 5.4 +/- 0.5 months (mean +/- SEM). Since three quarters of both distant metastases and recurrence developed within two years of the initial radiotherapy, it is highly recommended for patients to be examined monthly during this period. Aggressive retreatment may lead to palliation should recurrence and/or distant metastases be found. Adjuvant chemotherapy is recommended to the patients with T4, N2 or N3 disease following completion of the initial radiotherapy.
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PMID:Nasopharyngeal carcinoma in Taiwan. Clinical manifestations and results of therapy. 619 May 47

Administration of 98% ethanol destroys tissues by coagulative necrosis. In the rat bearing 1,2-dimethylhydrazine-induced colonic carcinoma which has spread to the liver, direct injection of 0.1-0.2 ml ethanol into each of the hepatic metastases at the time of total colectomy afforded a significant survival advantage relative to colectomy alone (20.1 +/- 0.2 vs 12.8 +/- 0.2 months of age, mean +/- SEM, n = 20, p < 0.01 by the Mann-Whitney U test). A pilot study was, therefore, carried out (2 women and 4 men, age range 43 to 71 years--mean 56) to examine the clinical significance of these observations in patients with multiple hepatic metastases from carcinoma of the sigmoid colon. The tumour was resected then all palpable hepatic secondaries were injected with 1-1.5 ml of 98% ethanol. Two weeks post-operatively and thereafter once every two months any hepatic lesions detected ultrasonically were similarly treated percutaneously. All the patients tolerated this treatment without any observed distress or adverse effects. Their mean survival measured from the time of tumour resection until death from any cause was 20 months (range 17 to 26 months). The survival gain afforded by chemonecrosis in addition to its simplicity and safety deserves further consideration to assess the exact role of this method in the treatment of liver metastases from colonic cancer.
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PMID:Pilot study on alcohol-induced chemonecrosis of hepatic metastases from colonic cancer. A new approach for percutaneous localized dynamic destruction of the hepatic spread. 826 Apr 33

Injection of ethyl alcohol in high concentrations into tissues produces coagulative necrosis. The benefits of direct injection of 98% ethanol into hepatic metastases from 1,2-dimethylhydrazine (DMH)-induced colonic cancer was investigated in groups of 20 Sprague-Dawley rats of either sex. At 10 weeks of age, rats were subcutaneously injected every week with 10 mg/kg DMH for 28 weeks. They were then housed for 3 months. At the end of this period all the animals had developed colonic carcinoma with multiple hepatic metastases. Total colectomy and the fashioning of an ileostomy coupled with direct injection of 0.1-0.2 ml of ethanol into each of the hepatic metastases, after mobilizing the liver by dividing its fascial attachments to facilitate easier tumour detection by inspection and palpation, afforded a significant survival advantage relative to colectomy alone (20.1 +/- 0.2 months of age, vs, 12.8 +/- 0.2 months of age, mean +/- SEM, n = 20, p < 0.01 by the Mann-Whitney U test). The clinical implications of these observations were, therefore, examined in a pilot study carried out on 6 patients (2 women and 4 men with an age range of 43-71 years, mean 56) who had adenocarcinoma of the sigmoid colon with multiple hepatic secondaries. The colonic tumour was resected and an end-to-end anastomosis effected, then all palpable hepatic metastases were slowly injected with 1-1.5 ml of 98% ethanol. Two weeks post-operatively and thereafter once every 2 months any hepatic lesions detected ultrasonically were similarly treated percutaneously. This treatment produced no adverse effects of any significance. None of the patients died during the first post-operative year. Death was due to disease spread in all the patients. The mean survival measured from the time of tumour resection until death from any cause was 20 months (range 17-26 months). It thus appears that chemonecrosis for the treatment of liver metastases from colonic cancer is a simple and safe therapeutic modality which offers a survival gain.
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PMID:Chemonecrosis for localized dynamic destruction of hepatic metastases of colonic cancer. A new approach. 842 95

The high incidence of hepatocellular carcinoma (HCC) in cirrhosis, where previous studies have indicated a severe reduction in several antioxidant vitamin factors, prompted us to compare plasma liposoluble vitamins with tocopherol content in healthy and neoplastic liver tissue in humans. This, with a view to a more positive preventive dietary approach, given the conflicting results obtained by liposoluble vitamin dietary supplementation in different malignancies. Eleven patients with cirrhosis, 18 patients affected by cirrhosis with HCC, and 10 patients with liver metastases (LM) from digestive tract adenocarcinomas were compared with controls who had undergone perlaparoscopic cholecistectomy. Plasma alpha- and beta-carotene, retinol and tocopherol, together with liver tocopherol, from both nonmalignant portions and malignant nodules of the same organ, were determined by high-performance liquid chromatography following a well-assessed technique. The results confirm a trend towards a reduction in circulating carotenoids and tocopherol in cirrhosis and in patients affected by cirrhosis with HCC. Tocopherol content in liver tissue is significantly decreased in cirrhosis (0.26 + 0.03 micromol/g prot., mean + SEM, P < .001) and in cirrhotic areas of the HCC group (0.31 + 0.02, P < .002), with respect to its content in liver specimens of healthy controls (0.46 + 0.03) and in healthy areas of the same organ in patients with LM (0.41 + 0.03). Tocopherol concentration is further reduced by 50% in malignant liver nodules of HCC, with respect to surrounding cirrhotic tissue, whereas in metastatic liver nodules from digestive neoplasms the tocopherol content is almost twice that of healthy surrounding areas. This unpredictable tocopherol behavior in liver specimens, of secondary as opposed to primary malignancies of the liver, affords further insight into the conflicting effects of liposoluble vitamins employed in the chemopreventive treatment of different malignant diseases, where hepatic tocopherol concentration show opposite trends: halved in primary HCC and doubled in LM of digestive adenocarcinomas, with respect to healthy controls.
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PMID:Hepatic tocopherol content in primary hepatocellular carcinoma and liver metastases. 921 53

The presence of the carcinoembryonic antigen (CEA) gene and CEA expression in the liver was tested to identify their possible roles in the liver metastasis of colorectal carcinoma. The CEA gene in the liver was identified by amplifying the CEA-specific N-terminal domain exon with digoxigenin-dUTP labeling in 16 colorectal carcinomas with liver metastases. Next, CEA expression was tested by immunostaining using the anti-CEA monoclonal antibody (T84.66, ATCC). Liver tissues from 13 stomach cancer patients and 12 colorectal cancer patients without liver metastasis were also tested as control groups. Three grades (<25%, 25-50%, and 50%< or =) were given according to the proportion of positive cells. The CEA gene was amplified in the metastatic tumor cells of the liver (2.6 +/- 0.2, mean grade +/- SEM) and their surrounding hepatocytes (1.5 +/- 0.2) in all cases. CEA expression was found in all metastatic tumor cells and 14 cases of the surrounding hepatocytes. Among the control groups, the CEA gene of the hepatocytes was found in 9 cases each of the colorectal and the stomach cancers that did not exhibit CEA expression. The level of serum CEA was related with the numbers and volume of liver metastases, but not with CEA expression in tumor cells and surrounding hepatocytes. The CEA gene in the metastatic tumor cells, not in the hepatocytes, was closely associated with CEA expression in the surrounding hepatocytes (p<0.01). Although the precise mechanism of CEA gene regulation in hepatocytes remains to be proven, the CEA gene in the metastatic tumor of the liver seems to affect CEA expression in the surrounding hepatocytes facilitating liver metastasis in colorectal carcinoma.
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PMID:Carcinoembryonic antigen gene and carcinoembryonic antigen expression in the liver metastasis of colorectal carcinoma. 1034 Apr 66

Little is known about the risk of metachronous liver metastases following laparoscopic resection for gastrointestinal malignancies. The effect of CO(2) pneumoperitoneum on the growth of established liver micrometastases was investigated in a rabbit model. Male Japanese white rabbits weighing 2.8 to 3.3 kg were randomized to three groups (n = 15 per group) 3 days following intraportal inoculation of a tumor suspension containing 5 x 10(4) cells of VX(2) cancer. In the pneumoperitoneum group, insufflation with CO(2) was maintained at a pressure of 10 mmHg for 30 minutes. In the laparotomy group the abdominal cavity remained open through a 45 mm midline incision for 30 minutes; in the control group no treatment other than anesthesia was performed. Cancer nodules on the liver surface were compared among the three groups on day 17. There was no difference in the number of cancer nodules among the groups (p = 0. 72). A significant difference in the total area of cancer nodules (mean +/- SEM) was found only between the pneumoperitoneum group (696.0 +/- 177.0 mm(2)) and the control group (247.2 +/- 60.7 mm(2)) (p < 0.05). The frequency of cancer nodules larger than 3.0 mm in maximal diameter tended to be highest in the pneumoperitoneum group (p = 0.053). These results suggests that CO(2) pneumoperitoneum may promote the growth of established liver micrometastases in this animal model.
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PMID:Effect of CO(2) pneumoperitoneum on growth of liver micrometastases in a rabbit model. 1086 49

We previously reported on the safety and efficacy of laparoscopic radiofrequency thermal ablation (RFA) for treating hepatic neuroendocrine metastases. The aim of this study is to report our 5-year RFA experience in the treatment of these challenging group of patients. Of the 222 patients with 803 liver primary and secondary tumors undergoing laparoscopic RFA between January 1996 and August 2001, a total of 34 patients with 234 tumors had neuroendocrine liver metastases. There were 25 men and 9 women with a mean +/- SEM age of 52 +/- 2 years who underwent 42 ablations. Primary tumor types included carcinoid tumor in 18 patients, medullary thyroid cancer in 7, secreting islet cell tumor in 5, and nonsecreting islet cell tumor in 4. There was no mortality, and the morbidity was 5%. The mean hospital stay was 1.1 days. Symptoms were ameliorated in 95%, with significant or complete symptom control in 80% of the patients for a mean of 10+ months (range 6-24 months). All patients were followed for a mean +/- SEM of 1.6 +/- 0.2 years (range 1.0-5.4 years). During this period new liver lesions developed in 28% of patients, new extrahepatic disease in 25%, and local liver recurrence in 13%; existing liver lesions progressed in 13%. Overall 41% of patients showed no progression of their cancer. Nine patients (27%) died. Mean +/- SEM survivals after diagnosis of primary disease, detection of liver metastases, and performance of RFA were 5.5 +/- 0.8 years, 3.0 +/- 0.3 years, and 1.6 +/- 0.2 years, respectively. Sixty-five percent of the patients demonstrated a partial or significant decrease in their tumor markers during follow-up. In conclusion, RFA provides excellent local tumor control with overnight hospitalization and low morbidity in the treatment of liver metastases from neuroendocrine tumors. It is a useful modality in the management of these challenging group of patients.
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PMID:Laparoscopic radiofrequency ablation of neuroendocrine liver metastases. 1201 79