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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical, laboratory, and pathologic data of 310 patients who had curative resections were prospectively collected and analyzed in a multiple stepwise regression model. Although several factors (i.e., venous invasion) were of importance in univariate analysis, the following conclusions reflect the outcome and relative importance of the regression analysis only. Blood loss as an initial symptom and duration of symptoms were associated with a better prognosis. Location of the primary tumor, age, and sex did not appear to have prognostic value. Observations during operation such as palpable lymph nodes, fixity to adjacent organs, and tumor spill were related to a diminished tumor-free survival. Laboratory data (hemoglobin, leukocytes, ESR, GGTP, SGOT, SGPT, LDH, total protein, CEA) were tested for their potential prognostic values. Only a preoperative low protein level or an elevated CEA level were associated with an increased risk of death due to recurrent tumor. The histopathologic features (stage and grade), with the exception of venous invasion, were of relative importance in the determination of prognosis. The aforementioned variables can be included in a prognostic index on the base of which high-risk groups suitable for adjuvant studies can be identified.
Dis Colon Rectum 1988 Jan
PMID:Regression analysis of prognostic factors in colorectal cancer after curative resections. 336 23

Between 1981 and 1985, 44 patients with advanced metastatic carcinoma of the liver were treated with deep microwave hyperthermia (HT) in five medical centers in the US. This HT was given with a BSD-1000 Annular Phased Array (BSD Medical Corporation, Salt Lake City, Utah). Of the 44 patients treated, 18 (41%) were in poor general condition and scored less than 60 on the Karnofsky scale. In 50% upper abdominal pain was a major presenting symptom. Prior chemotherapy (CT) had been given in 12 (27%) patients, while 10 (23%) had received prior radiotherapy (RT). Colon (73%) was the most frequent site of the primary tumor, and adenocarcinoma (79%) was the most frequent histological diagnosis. A total of 150 HT treatments were given, with an average of 3.4. HT alone was administered to 12 (27%), HT-RT to 15 (34%), HT-CT to 13 (30%) and HT-RT-CT to four (9%). Therapeutic temperature was reached in 28 (64%) patients. The majority (66%) tolerated treatment well. Due to the poor general condition of over one-third of the patients, prior therapy in 50% and the presence of advanced tumor in all, it is not surprising to see a response rate of only 36%. The response rate was 53% among patients receiving RT in addition to HT and 46% in patients who had therapeutic temperature. Survival ranged from less than 1 to 63 months, with an average of 11 months. Relief of pain was observed in 8 of 22 patients who presented with this symptom. HT can be safely delivered to patients with metastatic tumor to the liver.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Deep microwave hyperthermia for metastatic tumors of the liver. 337 58

Routine preoperative intravenous pyelography was performed in a series of 105 consecutive male patients with rectal or rectosigmoid carcinomas who were totally free of urinary symptoms. Abnormal findings were present in 26 percent of those patients. Postoperative intravenous pyelograms were performed in 61 patients. Twenty-one percent of patients with negative preoperative intravenous pyelograms and 42 percent of patients with positive preoperative intravenous pyelograms had abnormal findings in the postoperative intravenous pyelograms. Preoperative cystoscopy was performed in 52 patients. Thirty-one percent of patients with negative preoperative intravenous pyelograms and 76 percent of patients with positive preoperative intravenous pyelograms had abnormal cystoscopic findings. The overwhelming majority of cystoscopic findings in patients with negative preoperative intravenous pyelograms were not related to the primary tumor. The findings of this prospective study suggest that routine preoperative intravenous pyelography is indicated in patients with rectosigmoid or rectal tumors without symptoms related to the urinary tract. Postoperative intravenous pyelography is indicated only in patients with positive preoperative intravenous pyelograms. Preoperative cystoscopy is indicated when the preoperative intravenous pyelogram is positive and especially if intravenous pyelography findings are suggestive of bladder-wall defect or extrinsic pressure.
Dis Colon Rectum 1987 Oct
PMID:The value of routine preoperative urologic evaluation in patients with colorectal carcinoma. 365 88

A 75-year-old woman presented with rapidly progressive intestinal and general symptoms including diarrhea, melena, weight loss, back pain, and lassitude. Endoscopy revealed multiple intestinal polyps which, microscopically, consisted of metastatic tumor deposits composed predominantly of spindle-shaped tumor cells. The primary tumor, a mixed spindle-cell and clear-cell carcinoma, was later identified in the kidney at autopsy. The patient had a cholecystectomy 13 years previously.
Dis Colon Rectum 1986 Nov
PMID:Metastatic spindle-cell renal carcinoma presenting as multiple intestinal polyps. 376 93

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

Since 1978, 41 patients (12 percent of all restorative operations) have undergone peranal coloanal reconstruction following anterior resection (LAR) for cancers of the midrectum. Twenty-seven patients (66 percent) were men and 14 patients (34 percent) were women (mean, 58.8 years). The mean distance of the primary tumor from the anal verge was 6.7 cm and 50 percent of the primary tumors were considered highly mobile. In 29 patients, a hand-sewn anastomosis was performed between the colon and the dentate line. In the 12 most recent patients, the anastomosis was performed using a circular stapling instrument. A diverting colostomy should be employed in all cases and is closed approximately three months later. There has been no operative mortality. Morbidity included anastomotic separation (two patients), minor anastomotic defects (three patients), pelvic sepsis (two patients), and bacteremia of unknown origin (two patients). Where fecal diversion was employed, there were no instances of anastomotic leak. Two patients with hemorrhage were returned to the operating room. Thirty-seven of the 41 patients underwent curative resections. Thirty-three percent of the patients had Dukes' C lesions. With a median follow-up of 31 months for the curative resections, 73 percent remain free of disease. Sixty-four percent of evaluable patients have either excellent or good anorectal function nine to 12 months after colostomy closure. Of 26 operations performed by one surgeon, 22 patients (85 percent) are currently evaluable. Nineteen (86 percent) of the 22 have normal or near-normal bowel function. Four guidelines for performing a functionally successful operation are presented. Coloanal reconstruction following LAR, were pull-through operations were previously required, is an excellent sphincter-preserving operation. The functional results one year after the operation are gratifying, with the majority of patients leading an active life with normal bowel function.
Dis Colon Rectum 1985 Aug
PMID:Peranal coloanal anastomosis following low anterior resection for rectal carcinoma. 389 52

A case of adenocarcinoma of the rectum occurring 17 years after pelvic irradiation for squamous carcinoma of the cervix is reported. Earlier colonic resection had shown localized colitis cystica profunda in a radiation-induced colonic stricture. Colorectal cancer is an infrequent sequel to radiotherapy, which may occur many years after treatment of the primary tumor. Prolonged follow-up of these patients is essential.
Dis Colon Rectum 1985 Feb
PMID:Adenocarcinoma and colitis cystica profunda in a radiation-induced colonic stricture. 397 7

This retrospective study analysed the relationship of tumor size to regional and systemic metastasis and to survival according to stage of disease. Colon cancers (391 cases) that were treated surgically at M. D. Anderson Hospital from 1955 to 1975 were reviewed. Staging of disease was based on the Astler-Coller modification of Dukes' staging classification. The mean diameters (cm +/- s.e.m.) of Dukes' B1, B2, C2 and D tumors were 4.47 +/- 0.34 (n = 46), 6.61 +/- 0.29 (n = 147), 5.39 +/- 0.23 (n = 71) and 5.78 +/- 0.24 (n = 120), respectively. The mean diameter of Dukes' B2 tumors was significantly greater than C2 (P less than 0.001) and D (P less than 0.05) tumors. Within stage B and C, size of the primary tumor showed no relationship to five year adjusted survival. Our findings suggest that colon carcinoma metastasis and survival are independent of tumor size. Because tumor burden does not account for distant disease, specific tumor cell phenotypes and biological processes are probably more important in determining metastatic disease.
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PMID:Absence of a relationship of size of primary colon carcinoma with metastasis and survival. 405 45

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

Adjuvant pelvic radiation is intended to reduce the incidence of pelvic tumor recurrence and improve the survival rates of patients who have "curative" resections for adenocarcinoma of the rectum. The results of trials of preoperative radiation of up to 2500 cGy in two weeks have been disappointing. However, studies with preoperative or postoperative radiation doses of 4500 cGy in five weeks or more suggest that the risk of pelvic recurrence can be reduced to 15 per cent or less, although follow-up in most studies is too brief to allow any comment on changes in survival rates. These promising results need to be confirmed, since most were not obtained in appropriately controlled studies. Although these higher radiation doses do appear to be safe when attention is paid to surgical and radiotherapy techniques, this also needs to be confirmed with larger numbers of patients and longer follow-up. While the studies suggest that higher radiation doses are more effective than lower doses, there is no agreement on whether radiation should be directed to the region of the primary tumor only, or also to the pelvic lymph nodes, nor whether radiation should be given before or after surgery. Although the use of adjuvant pelvic radiation is becoming more widespread, these and other questions need to be answered before adjuvant radiation can be considered standard therapy.
Dis Colon Rectum 1984 Dec
PMID:Adjuvant radiation therapy for rectal adenocarcinoma. 638 53


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