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

This study explores the relationships between tumor size and regional lymph node involvement in patients with Dukes' B and C colorectal cancer in the randomized prospective clinical trials of the NSABP. Six-hundred and seventy patients with colon cancer and 236 patients with carcinoma of the rectum were available for analysis. Utilizing cumulative frequency distributions of tumor diameter and tumor volume, comparisons were carried out between Dukes' B and C lesions. The results indicate that there was no correlation between the longest diameter of the primary tumor and the status of regional lymph nodes for either colon or rectal cancer. Moreover, this lack of association was evident throughout the distribution. When tumor volume was analyzed, Dukes' B tumors proved to be consistently larger than Dukes' C lesions. This inverse relationship was statistically significant for carcinoma of the rectum. These findings underscore the unique biological behavior of colorectal cancer and emphasize the function of the current generation of randomized prospective trials in providing natural history information.
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PMID:Tumor size and regional lymph node metastasis in colorectal cancer. A preliminary analysis from the NSABP clinical trials. 633 99

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.
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PMID:Rectal lymphoscintigraphy. 673 61

Ninety-two patients with Dukes' class C colonic carcinoma, divided equally into those who survived 5 years or more and those surviving less than 5 years after resection for cure, underwent evaluation of multiple histopathologic characteristics of the primary tumor and the uninvolved regional lymph nodes. These characteristics were analyzed by the chi-square test for correlation with survival. A statistically significant correlation (P less than 0.05) in the group who survived 5 years or more was observed for Broders' grades 1 and 2, tumor not involving serosa, and a pushing tumor margin. Of the 14 patients who had a pushing tumor margin and tumor not involving serosa, 12 (86%) survived 5 years or more. Seven patients had an infiltrating tumor margin and peritumor venous invasion, and of this group, only one (14%) survived 5 years or more. Histopathologic characteristics of host immune reaction at the tumor or in the uninvolved regional lymph nodes did not correlate with survival.
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PMID:Correlation of histopathologic characteristics of primary tumor and uninvolved regional lymph nodes in Dukes' class C colonic carcinoma with prognosis. 735 51

This study explores the patterns of recurrence after "curative" operation for colorectal cancer. For an 11-year period, 1960-1971, 281 evaluable patients were resected at the Peter Bent Brigham Hospital. Crude five-year survival in these patients was 49%, but only 10% of those with recurrence lived five years. A total of 69 patients relapsed during their lifetime and 34 additional patients were found to have metastases at death. The initial site of metastases were regional in 23 patients (33%) and distant in 32 (46%). Simultaneous regional and distant metastases were found in 13 (19%) for a total of 65% of patients having initial distant metastases. Approximate recurrence rates by site were: 30% for sigmoid and rectum, 20% for right colon, and 10% for transverse and left colon. Tumor size was a significant determinant of recurrence but did not select for regional or distant sites. Recurrence by Astler-Coller modification of the Dukes-Kirklin classification revealed 10% for A + B1, 33% for B2, 35% for C1, and 50% for C2. More than half of the patients with distant metastases (18/32) had solely hepatic metastases yet the total incidence of liver metastases as the initial site was only 8% of the total. In general, the site of the primary cancer was the most important determinant of the type of recurrence; the stage and site of the primary tumor were most predictive for eventual relapse.
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PMID:Patterns of recurrence following curative resection of adenocarcinoma of the colon and rectum. 738 40

The aim of this study was to evaluate the relationship between DNA ploidy, proliferative activity and other prognostic factors and the survival of patients with colorectal cancer. 45 patients were prospectively investigated for 6 years. Fresh multiple samples for flow cytometric analysis of DNA content were collected during surgical resection of primary tumor. A 42% frequency of aneuploidy was observed with a median DNA index value of 1.54. The proliferative activity (%S+G2M cells) was higher in the aneuploid cell sub-population (28.6%) compared to the diploid counterpart (22.7%)(p = 0.05). No significant relationship between DNA ploidy and tumor site, Dukes' stage, histological type, grading age or sex was observed. No correlation between DNA ploidy and survival was demonstrated, including in the analysis of patient subsets according to stage. No additive prognostic information was obtained from a breakdown analysis as a function of DI values, percentages of aneuploid cells and proliferative activity. This study suggests that flow cytometric content analysis lacks prognostic value in colorectal carcinoma.
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PMID:Flow cytometric analysis of DNA ploidy and cell proliferation activity in colorectal carcinoma. 857 32

197 cases of distant metastases from colorectal cancer (Dukes A, B, C) were diagnosed in 664 patients after curative resection of the primary tumor. Extrahepatic progress could be excluded in 98 of 142 patients with liver metastases. These 98 patients were allocated to surgical treatment (n = 17), intraarterial chemotherapy (n = 24), transarterial chemoembolization (n = 20), systemic chemotherapy (n = 10) and syptomatic therapy (n = 27) depending on the extent and localization of the disease within the liver and the patients' general condition. Curative success in 12 of 17 patients with a 5-year survival of 47% was achieved by the careful selection of patients for surgical treatment. Prolonged median survival after systemic chemotherapy (13 months), intraarterial chemotherapy (11 months) and transarterial chemoembolization of hepatic metastases (12 months) compared with the survival of patients with a symptomatic treatment only (median 11 months) could not be demonstrated, in spite o local therapeutic effects (intraarterial chemotherapy response rate 42%, transarterial chemoembolization morphologic response 82%). Effective postoperative diagnostic screening determines the percentage of potential curative surgical treatment; nonsurgical approaches failed to demonstrate prolonged survival.
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PMID:Treatment of liver metastases from colorectal cancer. 870 52

A 36-year-old man was diagnosed as a case of mucinous adenocarcinoma of the rectum, Dukes' C. Pathologic examination revealed abundant signet-ring cells in the tumor. He did not receive adjuvant radiotherapy or chemotherapy after resection of the tumor. Two years later, a 3 x 5 cm mass over the right palatine tonsil was found with associated right neck lymphadenopathy. Right tonsillectomy was performed. Metastatic mucinous adenocarcinoma of the tonsil with abundant signet-ring cells similar to the primary tumor of the rectum was found. Signet-ring cell carcinoma of the rectum with tonsillar metastasis is extremely rare. No case has been reported in the English literature. To the best of our knowledge, this is the first case of signet-ring cell carcinoma of the rectum with tonsillar metastasis. The relevant literature on metastatic tonsillar tumors is reviewed.
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PMID:Signet-ring cell carcinoma of the rectum with tonsillar metastasis: a case report. 894 Jul 94

In order to confirm the presence of cancer cells in mesenteric venous blood and to examine their relationship with the occurrence of liver metastases, we attempted to detect K-ras codon 12 point mutations in perioperative mesenteric blood using enriched polymerase chain reaction and single-strand conformation polymorphism (PCR-SSCP) analysis in 25 patients with primary colorectal tumors carrying K-ras point mutations. Among these patients, three with synchronous liver metastases were included. The same K-ras point mutation (substitution of GAT for GGT) was detected in both the blood and the primary tumor in a Dukes' C patient. We confirmed this result by colony hybridization and estimated the tumor-to-normal cell ratio to be 1:400. This patient has no liver metastases two years after surgery and her carcinoembryonic antigen (CEA) level remains normal. We demonstrated that considerable numbers of cancer cells can be found in mesenteric venous blood during colorectal cancer surgery. However, their potential role in the formation of liver metastases remains unclear.
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PMID:Detection of K-ras point mutations in mesenteric venous blood from colorectal cancer patients by enriched polymerase chain reaction and single-strand conformation polymorphism analysis. 900 46

In both the primary tumor and associated lymph-node metastases of 40 cases of Dukes' C colorectal adenocarcinomas, exons 5 to 9 of the p53 tumor-suppressor gene were examined by PCR amplification and single-strand-conformation-polymorphism(SSCP) analysis. Mobility shifts indicating p53 mutations, which were confirmed by direct sequencing, were identified in 14 primary cancers (35%) and in 19 of the 40 lymph-node metastases (48%). In 12 cases (30%), the p53-mutation status in the primary cancer and its lymph-node metastases was identical. This result is compatible with the hypothesis that when a p53 mutation occurs before the establishment of lymph-node metastasis, it subsequently persists in the metastatic nodes. In 7 cases (18%), p53 mutations were identified in lymph-node metastases that were not concordant with the p53 status in the primary tumor. This finding can be explained by assuming that (1) p53 heterogeneity existing in the primary tumor is not reflected in all metastases and/or (2) new p53 mutations may occur during the development of metastatic lesions.
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PMID:Genetic diversity at the p53 locus between primary human colorectal adenocarcinomas and their lymph-node metastases. 909 48

Among the different investigated biomarkers, cell proliferation has provided valuable information on the clinical outcome of patients with malignant tumors. In the present study, we analyzed the potential relevance of fractional incorporation (FI) of a nucleotide precursor (3H-thymidine, 3H-dT) into DNA of tumor cells, determined on the primary tumor, on long-term clinical outcome of a series of patients with colorectal cancer. Determination of 3H-dT FI was carried out on fresh tumor material obtained at surgery as part of the clinical management of the primary tumor in 28 patients with colorectal cancer. Analysis of the relation between the FI and clinico-pathological characteristics of the tumor showed a trend of an inverse relation between the biomarker and Dukes' stage and no relation with tumor site. At 6 year follow-up, alive patients had a statistically significant higher median FI value (2.4%; range: 1.1-6.5%) than dead patients (1%; range: 0.3-4.5%) (p=0.02). Owing to the simplicity of this inexpensive methodology, the preliminary results of our study would indicate the potential of FI, a metabolic-kinetic parameter, to give prognostic information in colorectal cancer patients.
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PMID:Nucleotide fractional incorporation: a simple metabolic feature potentially related to clinical outcome in colorectal cancer patients. 1008 57


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