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

Tumors of the colon and rectum belong to the most frequent malignant diseases in the German Federal Republic. Only operative therapy ensures an optimal rate of success. In metastasizing and advanced local tumors, additional chemotherapy and radiotherapy should be taken into consideration. Also, preoperative radiotherapy may improve the chances of a cure in rectal carcinoma. An exact classification of the tumor is essential for a reliable prognosis. The Dukes tumor classification, still frequently used today, is inadequate for clinical application. Since the UICC has withdrawn the proposed classification for tumors of the colon and rectum, the Heidelberg proposed classification is presented, which is based on the degree of infiltration of the primary tumor and on the degree of metastatic dissemination.
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PMID:[Possibilities for operative therapy of carcinoma of the large intestine (author's transl)]. 6 66

Sixty-nine patients have been followed prospectively after curative resection of Dukes-Kirklin B-2 or C colorectal cancer. Serial plasma samples were studied in selected patients to determine changes in circulating immune complex concentrations (CIC) following primary tumor resection, and to compare serial plasma CIC and carcinoembryonic antigen (CEA) levels. CIC was determined in an average of seven serial samples per patient by inhibition of antibody-dependent cell-mediated cytotoxicity (ADCC). CEA assays were performed by the Hanson Z-gel method. Two distinct patterns of serial CIC have emerged. In seven patients with no known tumor recurrences, serial CEA levels and CIC oscillated regularly and were inversely related. In seven of eight patients whose tumors recurred, both CEA and CIC rose together. In three patients with elevated plasma CEA levels due to inflammatory bowel disease, serial Ag-Ab complex concentrations did not vary, nor did separated Ag or Ab fractions inhibit ADCC. These data suggest that, in patients following curative resection of colorectal cancer, serial changes in circulating immune complexes may discriminate between transient CEA elevations which occur despite no known tumor recurrence and tumor recurrence which is beyond the capacity of adequate host antitumor defense.
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PMID:Circulating immune complexes in patients following clinically curative resection of colorectal cancer. 20 63

The results of histopathologic study and the preoperative circulating carcinoembryonic antigen levels were correlated with each other and with the postoperative clinical course in 45 surgically treated patients with cancer of the colon. Histopathologic evaluation of the tumor included the depth of bowel wall involvement according to the Dukes classification, the histologic differentiation of cells on the basis of Broders' grades of malignancy, evidence of lymphocyte and plasma cell infiltration within and surrounding the primary tumor, and evidence of blood vessel, lymphatic, and perineural invasion. All these parameters, including the serum carcinoembryonic antigen level, had prognostic value. Low serum carcinoembryonic antigen levels in patients with colonic cancer suggested tumor localized within the bowel wall; the highest values were found in patients with tumors that had spread beyond the bowel wall. An inverse correlation was noted between the degree of tumor differentiation and carcinoembryonic antigen levels in the same patient. Carcinoembryonic antigen levels tended to be elevated when blood vessel, lymphatic, and perineural invasion was present. An inverse correlation was also noted between the preoperative carcinoembryonic antigen level and the degree of lymphocyte and plasma cell infiltration in the primary tumor. Round cell infiltration was interpreted as an indication of the host's immune response against the tumor. Thus, on the basis of clinical follow-up of the patients it is concluded that all morphologic parameters evaluated have prognostic value, that preoperative serum carcinoembryonic antigen levels have prognostic value, that all prognostic parameters correlate with each other appropriately, and that the combined parameters are more reliable than any single one alone.
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PMID:Prognostic factors in colon carcinoma: correlation of serum carcinoembryonic antigen level and tumor histopathology. 111 84

Three different systems in staging colorectal cancer (TNM3, ACPS, TNM4/Dukes) have been compared in 318 patients treated at some stage of their disease at Berne University Hospital. Simultaneously, the role of some prognostic factors for survival and relapse has been analyzed. The estimated 5 years' survival rate for all patients is 42%. After complete removal of the tumor 49% of patients relapsed. In a multivariate analysis the stage, age above 80 years and the site of the primary tumor have an influence on survival and relapse. Blood transfusions had no effect on either in this analysis. The concordance of the three staging systems is good and the resultant survival curves are similar. TNM3 puts some patients with a bad prognosis into stage I. ACPS classifies patients with residual tumor after surgery with patients with distal metastasis. It has no further advantages over TNM4. TNM4 seems at present to be the best staging system. It incorporates the advantages of the well-known Dukes classification and, with possible refinements, has the qualities to be used as a standard method.
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PMID:[Staging and prognosis of colorectal carcinoma]. 141 93

Between 1982 and 1990, 2388 bronchoscopic examinations were carried out in patients with cancer in our hospital. A diagnosis of endobronchial metastasis was established in 30 patients (2.09%), with the following primary tumors in descending order of frequency: breast, large bowel, melanoma, neuroblastoma, leiomyosarcoma and endometrial. Despite the rarity of endobronchial metastases secondary to colon adenocarcinoma, we were able to study 3 cases from our Center. In one case the diagnosis of endobronchial metastasis was simultaneous with that of the primary tumor, and in the other 2 this metastatic complication occurred 16 and 42 months, after the original diagnosis. When this complication occurred, the stage of the disease was advanced in all 3 cases: 2 were Dukes' stage C and one stage D. Although this metastatic location usually implies a very negative prognosis as regards life expectancy, it did not seem to significantly reduce the latter in our patients.
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PMID:Endobronchial metastases in colorectal adenocarcinoma. 146 85

Correlative studies of MRI and pathologic specimens were done in 35 patients with rectal cancer. The MR manifestations of the primary tumor and its invasion into the surrounding structures were investigated with reference to the staging of rectal cancer. Prone positioning and the procedure of hypotonic air-distension of rectum was the method of choice to depict the primary tumor and tumor invasion. The spin-echo (SE)pulse sequence with TR/TE: 500/32 ms (T1-weighted image) was selected to show the anatomical structures in the pelvis and tumor spread in the surrounding fatty space and lymph node metastasis. Owing to the reduced contrast between tumor invasion and fatty tissue and decreasing signal intensity on multi-echo T2-weighted images the long repetiting time (TR) pulse sequence could not provide significant contribution in tumor staging. The MR appearance of rectal carcinoma was categorized as polypoidnodular, cauliflowermassive and protuberant-ring types. Ulceration was often seen in the latter two types. Peripheral invasion often manifested as spotty-nodular, sawtoothed-wavy and tumefied shape with medium signal intensity on T1-weighted images. The presence of a lump of small nodes, round or oval nodules within 2 cm from the rectal wall or nodular mass in the perirectal fatty space could be considered as possible lymph node metastasis. Following the modified Dukes Staging System of rectal cancer proposed by Astler-Coller all patients were staged preoperatively and correlated with surgical specimens. The accuracy of staging was 74.3%, compatible with the results of studies published.
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PMID:[Value of MR imaging in the staging of rectal carcinoma]. 157 12

The development of hepatic metastases in 344 patients with colorectal carcinoma was examined for correlation with the presence of both venous invasion by the primary tumor and basement membranes in the tumor tissue. The former was detected by Victoria blue and hematoxylin-eosin staining and the latter by antilaminin antibody. A significant difference in the incidence of venous invasion was noted between patients with and those without liver metastasis at surgery. Basement membrane deposition was found in half of all cases of well differentiated adenocarcinoma, which was significantly high compared with other tumor types. This was more distinct in metastatic foci in the liver and lymph nodes than in the primary lesion, but less marked in intravascular tumor tissue. Basement membrane deposition was seen more frequently in Dukes' A tumors than in B tumors, although this was not statistically significant. No relationship was found between basement membrane laminin positivity and five-year survival, nor was there any correlation between the incidence of liver metastasis and tumor histologic type. Venous invasion was considered to be intimately related to the development of liver metastasis. Deposition of laminin-positive basement membrane was dependent on the grade of tumor differentiation, whereas it had no direct relation to the development of liver metastasis.
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PMID:Development of liver metastasis in colorectal carcinoma. With special reference to venous invasion and basement membrane laminin. 171 35

Pretreatment levels of phosphohexose isomerase (PHI) were above the cutoff limit of 107 IU/l in 41% of patients with benign intestinal diseases and in 46% of patients with colorectal cancer. Sensitivity of PHI was related to the presence of distant metastasis and the location of the primary tumor. Patients with rectal tumors presented a lower sensitivity than patients with colonic tumors. Pretreatment levels of PHI had prognostic value and patients with elevated levels of this enzyme showed a shorter disease-free interval in comparison with those patients with normal PHI activities. However, the prognostic significance of PHI was not independent of Dukes' classification. The present study indicates that PHI is not useful in the follow-up of patients with colorectal cancer after curative surgery because of its low sensitivity in the diagnosis of recurrences (47%) and its low specificity in patients without evidence of disease (76%).
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PMID:Serum phosphohexose isomerase activities in patients with colorectal cancer. 179 10

DNA ploidy patterns in 11 poorly differentiated adenocarcinomas of the colorectum were examined by flow cytometry using paraffin-embedded specimens. Measurements of DNA content were made of the superficial (Sup) half and deeper (Deep) half of the primary tumors in all cases, and of lymph node metastases in five cases. All the primary tumors showed invasion beyond the muscularis propria of the colorectum. Aneuploidy or polyploidy in either Sup or Deep of the primary tumor was found in six of the 11 (54.5%) tumors. Out of the six aneuploid tumors, five were in Dukes' stage C with distant metastases at the time of operation, and four died within one year of surgery. Conversely, out of five diploid tumors, none had distant metastases at the time of operation and two survived for longer than three years after surgery. The DNA ploidy pattern of Deep differed from that of Sup in four out of six aneuploid tumors, and two showed aneuploidy in Sup and diploidy in Deep. All the lymph node metastases in the five tumors had a diploid pattern, although three had aneuploid patterns in the primary tumors. The findings suggest the DNA ploidy pattern of a primary tumor to be correlated with the degree of metastasis at the time of operation or prognosis, but the population of tumor cells having different DNA contents may be apt to change between Sup and Deep in aneuploid tumor.
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PMID:Flow cytometric DNA analysis of poorly differentiated adenocarcinoma of the colorectum. 180 45

A retrospective study of 325 consecutive patients suffering colorectal adenocarcinoma, allowed in 141, the determination of the influence of blood transfusion upon the risk of recurrence/metastases over a minimum observation period of 6 months. Of 29 patients not receiving blood transfusion, 6 were subjected to recurrence/metastases. Of 112 patients receiving blood transfusion, 45 suffered recurrence/metastases. No significant difference in the risk of developing recurrence/metastases was seen when the primary tumor was Dukes' class A and C. When the primary tumor was Dukes' class B, a significantly higher risk of recurrence/metastases was seen in the group receiving blood transfusion. A constrained use of blood transfusion in connection with colorectal surgery is recommended until definitive immunological studies determined the influence of blood transfusion upon the risk of recurrence/metastases.
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PMID:The influence of blood transfusions upon the recurrence rate of colorectal cancer. 182 43


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