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

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

Total pelvic exenteration was performed in 31 patients (30 males and 1 female) who had rectal cancers involving adjoining pelvic structures. Twenty-nine patients had primary tumors and two had recurrent diseases after previous abdominoperineal resection. Preoperative irradiation was used in nine patients with fixed tumors. When performing the surgical procedure, we also actively employed lateral node dissection to make the operation more radical. Three patients (one with primary tumor and two with recurrent) underwent the exenteration with partial sacrectomy because of the sacral involvement and they all died of local failure within 15 months. The overall 5-year survival rate was 52 percent for all patients and 56 percent for those who had primary tumors. The results suggest that total pelvic exenteration with lateral node dissection should be performed for locally advanced rectal cancer if the tumor is not completely fixed to the pelvic wall and preoperative irradiation should be used to convert a fixed tumor to a resectable one.
Dis Colon Rectum 1994 Feb
PMID:Total pelvic exenteration for locally advanced rectal carcinoma. 830 39

Records of 487 patients in long-term follow-up after Ro resection of colorectal carcinomas between January 1, 1980 and December 31, 1989 were analyzed. Every patient underwent regular examinations according to a defined schedule after curative resection of colorectal carcinoma. The date of evaluation was June 31, 1991. During a median observation time of 48 months (range, 15-132 months), tumor recurrence was observed in 149 patients (30.6 percent), with 56.4 percent of these suffering from tumor-associated symptoms. As the primary manifestation of tumor recurrence, only distant metastases (DM) were found in 76 patients (51 percent), only local recurrence (LR) in 46 patients (30.9 percent), and both DM and LR in 27 patients (18.1 percent). Patients with rectal carcinoma developed LR more frequently (P < 0.05) (19.5 percent) than patients with colon carcinoma (11.8 percent). The probability of developing distant metastases was not different (P < 0.05) for colon or rectal carcinoma but depended on primary tumor stage (P < 0.05). Only 36 patients (24.2 percent) with recurrence could undergo further curative resection. Fifty patients (33.5 percent) were given palliative therapy, and 63 patients (42.3 percent) were given no oncologic treatment. Only 9 of the 36 patients (6 percent of all recurrence patients) undergoing Ro resection were free of tumor for more than two years. In no case was a third Ro resection possible. The survival time of these patients was increased significantly after Ro resection of tumor recurrence (P = 0.03). Our study suggests that only a very few patients may live longer as a result of regular follow-up programs after curative resection for colorectal carcinoma.
Dis Colon Rectum 1993 Mar
PMID:Does methodic long-term follow-up affect survival after curative resection of colorectal carcinoma? 844 34

Between 1978 and 1990, 23 patients underwent 35 thoracotomies for metastatic colorectal cancer. The pulmonary disease was diagnosed within an interval of 0 to 105 (average, 33.4) months after colon resection. Fifteen patients underwent a single thoracotomy; 12 patients had solitary lesions, and three patients had multiple nodules. Eight patients underwent multiple thoracotomies. The median survival following thoracotomy was 28 months; three-year survival was 45 percent, and five-year survival was 16 percent. Factors that had no significant bearing on survival included origin and stage of the primary tumor and patient age and sex. An interval before thoracotomy of three years had an impact on survival approaching statistical significance (P = 0.17). Patients who underwent multiple thoracotomies had a significantly prolonged survival (P = 0.04). Patients who underwent a single thoracotomy for a solitary lesion had a significantly prolonged survival compared with patients who had a single thoracotomy for multiple metastases. After thoracotomy, 14 patients eventually developed recurrent disease, which was confined to the lung in only four patients. Of these 14 patients, 11 subsequently died of cancer. We conclude that thoracotomy for metastatic disease should be considered when the primary tumor is controlled, the lungs are the only site of metastatic disease, and there is adequate lung reserve to withstand surgery. Survival following thoracotomy may be influenced by the interval before diagnosis, the number of pulmonary nodules, and the number of thoracotomies performed.
Dis Colon Rectum 1993 May
PMID:Thoracotomy for colon and rectal cancer metastases. 848 60

A 26-year-old male presented with a colorectal adenocarcinoma with germ-cell differentiation and an isolated elevation of serum alpha-fetoprotein. He was treated with platinum/etoposide/bleomycin chemotherapy with a decrease in serum alpha-fetoprotein and in the size of the primary tumor. An ongoing tumor-marker response occurred when the patient was switched to concurrent 5-fluorouracil chemotherapy and radiation therapy. The patient underwent a palliative diversion of his rectal cancer 10 months after diagnosis, developed liver metastasis at 12 months, and died 20 months after diagnosis.
Dis Colon Rectum 2003 Dec
PMID:Rectal adenocarcinoma with germ-cell differentiation: report of a case. 1466 99

Only hepatic metastasectomy has been shown to have a therapeutic effect for hepatic metastases of colorectal cancer if the primary tumor can be removed radically according to the 2014 guidelines of the Japanese Society for Cancer of the Colon and Rectum. However, only a few patients with hepatic metastases are candidates for metastasectomy due to tumor factors other than the hepatic metastases. Furthermore, hepatic metastasectomy is frequently judged to be impossible in older patients due to underlying diseases and surgical tolerability. In such cases, therefore, treatment is often difficult. Herein, we report 2 patients with hepatic metastases of colorectal cancer treated with radiofrequency ablation, raising the possibility of local control in the liver.
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PMID:[Two case reports with hepatic metastases of colorectal cancer treated with radiofrequency ablation, raising the possibility of local control in the liver]. 2573 Dec 82


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