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

The laboratory and radiologic tests that give useful information in colon and rectal cancer patients over and above that obtained by routine work-up and surgical exploration of the abdomen have not been defined previously. An analysis of surgically occult metastases was used to discover which test would assist in the management of these patients. Occult metastases for radiologic tests were those occurring within one year after resection of the primary tumor; for CEA they were metastases occurring at any time following surgery. Full lung tomography, liver/spleen scan, computerized tomogram of the abdomen, intravenous pyelogram, bone scan, and postoperative baseline CEA greater than 2.5 ng/ml were analyzed. The postoperative baseline CEA was the most sensitive test detecting occult metastases in 57 per cent (12 out of 21) of a high risk patient population. Both postoperative baseline CEA and computerized tomograms of the abdomen had high positive predictive values of 71 and 67 per cent. The negative predictive percentage of computerized tomograms of the abdomen (18 per cent) was lower than that of CEA (21 per cent). In comparing these tests in individual patients with occult recurrence, postoperative CEA and computerized tomograms of the abdomen were seen to be complementary in that approximately 90 per cent of occult metastases were detected when both examinations were used. Computerized tomogram of the abdomen and postoperative baseline CEA are useful in patients with primary colorectal cancer as part of their routine work-up.
Dis Colon Rectum 1984 Dec
PMID:Prospective studies of laboratory and radiologic tests in the management of colon and rectal cancer patients: I. Selection of useful preoperative tests through an analysis of surgically occult metastases. 649 21

Regional lymph nodes of the rectum are not demonstrable by pedal lymphoscintigraphy. We have evaluated the technique of rectal lymphoscintigraphy, using a technique similar to that which has been used in the assessment of lymph nodes in breast and prostatic cancer. Thirty-five patients were studied: ten normal subjects and 25 patients with rectal cancer. In normal subjects, the lymph nodes accompanying the superior hemorrhoidal artery and the inferior mesenteric artery are demonstrable in succession; after three hours the aortic lymph nodes are demonstrable. The 25 patients with rectal cancer underwent resection of their primary tumor and the stage was defined according to Dukes (1932). In five patients (stage A) no alteration was demonstrable. In 11 patients (stage B) the demonstration of regional lymph nodes was delayed vs. the control group. In nine cases (stage C) the demonstration of regional lymph nodes was delayed and defective versus the control group.
Dis Colon Rectum 1984 Jun
PMID:Rectal lymphoscintigraphy. 673 61

This review was undertaken in an attempt to accumulate and critically evaluate all evidence that suggests that special techniques may alter survival rates of patients undergoing surgery for large-bowel cancer. Data suggesting reduced survival with a distal margin of resection less than 5 cm in patients undergoing anterior resection were found to be inconsistent. En bloc removal of the primary tumor and an adhesed adjacent structure seemed important, for 30 to 60 per cent survival has been reported using this approach, and adhesions were found to contain malignant cells at the interface of the primary tumor and adjacent structure in 40 to 100 per cent of patients. No statistically significant differences in survival rates were found in studies comparing conservative segmental bowel resection with radical hemicolectomy. This was true for colonic as well as rectal resections; while patient morbidity was not markedly increased for radical colectomy, it was found to be much greater with radical rectal resections. No data to support the use of "no-touch techniques" could be uncovered. Data to support the use of techniques for control of intraluminal tumor cells were sparse; however, because these maneuvers cost the patient little in terms of added morbidity, they should be used. Important aspects of the techniques for large-bowel surgery need to be investigated by prospective controlled clinical trials.
Dis Colon Rectum 1982 Sep
PMID:Influence of surgical techniques on survival in patients with colorectal cancer. 674 55

External beam megavoltage radiation therapy was used as primary treatment for 123 patients with rectal adenocarcinoma. Surgery was undertaken for some patients who had residual tumor. The overall five-year survival rate was 21 per cent. When patients were separated into those who presented with clinically mobile and those with clinically fixed rectal tumor masses, the survival rates were 38 per cent and 2 per cent, respectively. The primary tumor was controlled by radiation alone in 21 of 56 (38 per cent) patients who had mobile tumors but in only six of 67 (9 per cent) patients who had fixed tumors. Further investigation of high-dose primary radiation, with surgery reserved for patients with residual rectal carcinoma, may allow reduction of the number of patients who require abdominoperineal resection.
Dis Colon Rectum 1983 Jan
PMID:Radical external beam radiation therapy for adenocarcinoma of the rectum. 682 58

This paper reviews the clinical characteristics of a group of patients in whom unsuspected primary adenocarcinoma of the colon presented with signs and symptoms of a primary ovarian neoplasia. In most patients, the ovaries were removed, the correct diagnosis was established at a later time, and a second surgery for resection of the primary adenocarcinoma of the colon was then performed. Preoperative use of colonoscopy or barium-enema examination would have helped. We compared these patients to a group of patients with similar clinical characteristics, but in whom the ovarian metastases were clinically apparent months after the resection of a primary colorectal cancer. We found that, in both groups, age of the patients, anatomic distribution of the primary tumor, histologic differentiation, serosal or mesenteric lymph node tumor involvement, and timing of the oophorectomy in relationship to removal of the primary colorectal tumor did not affect the overall survival. Once ovarian metastases were documented, patients died regardless of treatment, approximately 16 1/2 months after the diagnosis.
Dis Colon Rectum 1983 Jun
PMID:Adenocarcinoma of the colon masquerading as primary ovarian neoplasia. An analysis of ten cases. 685 97

A patient with epithelioid leiomyosarcoma of the transverse colon presented clinically with a metastatic left axillary mass, destructive lesion of the glenoid cavity and head of the left humerus, and metastases to the apical region of the left lung and right paravertebral area of the mid-back. The primary tumor was detected eight months after the presentation of metastatic disease.
Dis Colon Rectum 1983 Sep
PMID:Epithelioid leiomyosarcoma (malignant leiomyoblastoma) of the colon. 687 94

A retrospective analysis was undertaken of 51 patients with primary anal canal carcinoma who were treated by radiation therapy, with surgery being reserved for those with residual carcinoma. The five-year uncorrected survival rate was 59 per cent, and the corrected survival rate was 71 per cent. The primary tumor was controlled by radiation alone in 29 of 51 patients (57 per cent) and by subsequent radical surgery in eight of ten patients. Abnormal lymph nodes were controlled by radiation alone in eight of 11 patients. Only three of 29 patients required surgery for complications associated with radiation in the absence of persistent tumor. Seventy-seven per cent (23 of 30) of long-term survivors did not require colostomy and retained anal continence. It is concluded that modern radiation therapy techniques are well tolerated and are an effective method of treating carcinoma of the anal canal.
Dis Colon Rectum
PMID:Primary radiation therapy in the treatment of anal canal carcinoma. 717 46

Colorectal cancer recurs within the operative field in 10-20 per cent of patients undergoing potentially curative surgery. In certain subgroups, the recurrence rate is 20-50 per cent. There are some data to suggest either preoperative or postoperative radiation therapy as an adjuvant to potentially curative surgery can reduce the local operative failure rate. However, since radiation therapy has significant side effects, patient selection to maximize the therapeutic ratio is important. This report defines the criteria at the Massachusetts General Hospital for selection of patients with colorectal cancer for adjuvant radiation therapy, defines radiation therapy-surgery sequencing alternatives used, and describes techniques to reduce radiation side effects. Over a period of three and a half years, 196 patients received adjuvant radiation therapy: 51 patients received either moderate or low dose preoperative radiation therapy to rectal or rectosigmoid cancers, and 161 patients received postoperative radiation therapy to the pelvis or extrapelvic colonic tumor-lymph node beds. Some patients who received low-dose preoperative radiation therapy also received moderate-dose postoperative radiation therapy. We prefer moderate-dose postoperative radiation therapy as the approach most likely to decrease the local recurrence rate with minimal interference with surgical procedures and late small-bowel complications. Patients who received postoperative radiation therapy were those without distant metastases, whose primary tumor pathology revealed macroscopic or extensive microscopic transmural tumor penetration into extraperitoneal tissues. Careful case selection, multiple field techniques, the use of reperitonealization, omental flaps, and retroversion of the uterus into the pelvis were combined with postoperative small-bowel x-rays, bladder distention, and lateral portals to minimize radiation damage to normal structures.
Dis Colon Rectum
PMID:Selective use of adjuvant radiation therapy in resectable colorectal adenocarcinoma. 723 31

Since the adhesive interaction between tumor cells and host cells, or extracellular matrix (ECM), presumably plays a crucial role in metastatic formation, we used synthetic or recombinant polypeptide analogues, poly (RGD), CH-271 or SCM-chitin-RGDS based on Arg-Gly-Asp (RGD) sequence. Poly (RGD) effectively inhibited the experimental lung and liver metastasis when coinjected i.v. with different types of tumors. In a spontaneous lung metastasis model using B16-BL6 melanoma, multiple administrations of this polypeptide, before or after surgical excision of the primary tumor, resulted in significant inhibition of tumor metastasis. The mechanism responsible for the inhibition is partly associated with the ability to interfere with cell functions such as adhesiveness, motility, and invasiveness in the process of metastasis. CH-271 fusion polypeptide was much more effective in inhibiting lung or liver metastasis of tumors than cell-binding domain (C-274) or heparin-binding domain (H-271) polypeptides. SCM-chitin-RGDS conjugate significantly reduced the number of tumor colonies in the lungs by coinjection with Colon 26 carcinoma as compared with either RGDS or SCM-chitin alone. Since the polypeptides derived from cell adhesion molecules showed no toxicity to the host, they may provide a promising approach for the control of cancer metastasis.
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PMID:[Inhibition of tumor metastasis by synthetic peptide analogues of cell-adhesive RGD sequence of fibronectin]. 763 3

The effects of an oral administration of BLP, a preparation of viable Lactobacillus casei YIT 9018, upon tumor growth and the mitogenic responses of splenocytes from tumor-bearing mice were studied. BALB/c mice were insufficiently pre-immunized by resecting a Colon 26 tumor mass (primary tumor) grown for 5 days intradermally. Thereafter, mice were rechallenged by injecting Colon 26 tumor (secondary tumor) into the hind footpad. The secondary tumor grew progressively in control mice, but was markedly suppressed by oral administration with BLP at a dose of 100 or 200 mg/kg/day for 7 consecutive days. The suppression was a primary tumor-specific response. Viable L. casei, not heat-killed L. casei, could suppress the secondary tumor. Although the lymphoproliferative responses of splenocytes from the secondary tumor-bearing mice with T-cell mitogens (concanavalin A and phytohaemagglutinin) and cytokines (interleukin-1 and interleukin-2) were lower than those of normal mice, this suppression of mitogenic responses under tumor-bearing conditions was abolished by oral administration with BLP. Thus we concluded that oral BLP potentiated systemic immune responses that modified T-cell functions in tumor-bearing mice.
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PMID:Effects of oral administration of Lactobacillus casei on antitumor responses induced by tumor resection in mice. 815 May 53


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