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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Skin tests (ST) in 1332 patients are associated with increased morbidity from sepsis. Patients with normal skin tests had a 7% major sepsis rate and 2% mortality rate. Thirty-six per cent of anergic (A) patients and 21% of relatively anergic (RA) patients died; 52% of A patients and 34% of RA patients had sepsis. These data include all patients studied and represent their worst skin test. Two studies were done. The first was a retrospective evaluation of effect of surgery upon 49 anergic patients with biliary tract disease, colon cancer, bowel obstruction, hypovolemia and visceral abscesses. The patients did not receive total parenteral nutrition (TPN). The data show that surgery without TPN can reverse the anergic state and did so in 84% of patients reported. The second study was a prospective, double-blind, randomized trial of the effect of levamisole on skin tests, neutrophil chemotaxis (CTX), sepsis and mortality iin 39 preoperative anergic patients. Major sepsis was significantly increased in placebo group (p less than 0.05). Mortality, minor sepsis, restoration of skin tests and chemotaxis were somewhat better in levamisole patients but not statistically so. These studies show that in addition to TPN, surgery and immunorestorative drugs are viable approaches to the management of selected anergic patients.
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PMID:Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. 11 27

From 1957 to 1973, 656 patients with carcinoma of the entire colon, excluding those with carcinoma of the rectum, were reviewed with the aid of a computer. Of 457 patients, 69.7 per cent were observed for a minimum of five years. Sixty-five per cent of the lesions were located in the cecum or sigmoid colon. In patients with type A lesion, the five year plus survival rate was 71.15 per cent while, in patients with type D lesions, the five year plus survival rate was zero per cent. Patients who presented with intestinal obstruction had a significantly lower five year survival rate. Roentgenographic visualization of the cecum was significantly less accurate in demonstrating carcinoma when compared with that of the sigmoid colon. An emergency surgical procedure had a significantly higher operative mortality than did elective procedures. In both groups of patients undergoing emergency and elective operations, primary resection and anastomosis led to similar operative mortality rates, although staged procedures resulted in the lowest operative mortality in both groups. In the group of patients who had elective operations, resection an primary anastomosis led to a significantly lower wound infection and fistula rate when compared with the group of patients who had emergency procedures. In comparison with other series, no improvement in survival was illustrated in patients with carcinoma of the colon. The use of new modalities of adjuvant therapy, such as radiotherapy or chemotherapy, or both, actually should be evaluated.
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PMID:A multiparametric computer analysis of carcinoma of the colon. 99 16

The use of home parenteral nutrition (HPN) in patients with inoperable malignant bowel obstruction (IMBO) is controversial. The efficacy, safety, and indications for HPN in these patients is uncertain, and its benefit is difficult to demonstrate. The records of 17 patients (9, ovarian cancer; 4, colon cancer; 4, other) with IMBO receiving HPN managed by the Nutrition Support Team (NST) at Yale-New Haven Hospital from 1980 to 1989 were reviewed. Median survival was 53 days and was longest in the two patients with appendiceal carcinomatosis (208 and 159 days), intermediate in patients with colon cancer (median 90 days), and shortest in patients with ovarian cancer (median 39 days). Survival was unrelated to age or sex. All patients died of their underlying disease; 82% of deaths occurred at home. Only one treatment-related complication requiring readmission occurred. Fourteen patients and their families (82%) perceived their therapy as highly beneficial or beneficial. The NST agreed with this assessment in 11 patients but did not share this perception in three patients. These three patients had a short duration of HPN (less than 25 days) or minimal rehabilitation. It is concluded that HPN for patients with IMBO is associated with a low complication rate, may be most beneficial for those patients with gastrointestinal tract primary tumors, and is usually perceived by patients and care providers as beneficial. HPN has palliative benefit and facilitates compassionate home care for carefully selected patients with IMBO.
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PMID:Home parenteral nutrition for patients with inoperable malignant bowel obstruction. 155 21

A rare case of primary linitis plastica carcinoma of the colon seen in a 44 year old Japanese man is described herein. The patient had a complete obstruction of the descending colon and was treated with a loop colostomy followed shortly afterward by a left hemicolectomy. At the time of the second operation, the entire thickness of the colonic wall was found to be infiltrated by cancer cells, however, the other intraabdominal organs were free of cancerous involvement. The histopathological diagnosis made at this time was primary linitis plastica carcinoma of the descending colon. Nine months later, the patient developed an intestinal obstruction and relaparotomy revealed diffuse peritoneal dissemination. Two years after the first operation, upper GI films and a gastrofiberscopic examination revealed gastric involvement. The patient died 28 months after his initial operation, and autopsy revealed widespread metastases in the peritoneal surface, paraaortic lymph nodes, small intestine, remaining colon and stomach.
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PMID:Primary linitis plastica of the descending colon: a case report. 216 May 54

The mechanism of bowel obstruction in colorectal cancer is likely to involve interactions between tumour cells, host fibroblasts and the extracellular matrix. The role of fibroblast-mediated matrix reorganisation in malignant structures of the large bowel was examined in an in vitro collagen matrix model in which tumour cells and fibroblasts were cultured under serum-free conditions. Colon cancer cells secreted a factor(s) which enhanced the ability of colon fibroblasts to contrast a collagen matrix without an associated mitogenic response by the fibroblasts. Within uncontracted collagen gels marked elongation of fibroblast cell processes was observed in the presence of the tumour-derived factor(s). We propose that matrix reorganisation by host fibroblasts in the wall of the human colon is responsible, at least in part, for malignant large bowel obstruction.
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PMID:The role of colon fibroblasts in malignant large bowel obstruction--an experimental in vitro model. 222 73

The early detection and management of recurrence following curative resection for colorectal carcinoma can prolong survival. However, at the present time there is no consensus on the appropriate follow-up protocol for such patients. This investigation was undertaken to determine which tests and procedures are most useful in detecting recurrence and the frequency with which they should be employed. Another purpose of this study was to identify those patients at high risk for recurrence. Sixty-five patients who underwent curative resection of adenocarcinoma of the colon and rectum were followed for at least two years or until recurrence. Thirty were classified as Duke's A carcinoma of the colon, 18 were Duke's B, and 17 were Duke's C. Mean follow-up was 44.9 months. The follow-up regimen consisted of clinical exam, liver function tests, carcinoembryonic antigen (CEA) level, and chest x-ray every three months for the first two years postoperatively and every six months thereafter, and colonoscopy or barium enema and proctoscopy every six months for the first two years postoperatively and every year thereafter. Seventeen patients (26%) had a recurrence; 24% per cent of these developed within one year, 65 per cent developed within two years, 82 per cent developed within three years, and 94 per cent developed within four years of resection. Recurrence was detected by CEA in eight patients, chest x-ray in five, endoscopy in three, and laparotomy for small-bowel obstruction in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postoperative surveillance of patients with carcinoma of the colon and rectum. 229 7

This study presents a review of 519 of 553 unselected patients with carcinoma of the caecum presenting in the Plymouth Health District between 1975 and 1987. A large proportion of the patients were elderly and the median age increased throughout the study period to 76 years. One third of cases presented as an emergency and a small number was discovered at autopsy. Bowel obstruction accounted for over half the emergencies and chronic anaemia for half the elective cases. At presentation many tumours were advanced and only 5% were Dukes' A. One quarter of patients had synchronous tumours. Resection was performed in most cases, and this was attempted even in the presence of local invasion and liver metastases. Morbidity following resection was low and only six anastomotic leaks were clinically apparent. The mortality rate following resection was 2.6% and was higher for emergency procedures. The age-adjusted 5-year survival rate was 37% and rose to 64% for those undergoing 'curative' surgery. These results suggest that future improvements in the management of right colon cancer may lie with early referral and diagnosis. This study further highlights the importance of good perioperative care in the increasingly elderly patient.
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PMID:Carcinoma of the caecum. 235 83

From 1978 through 1986, 183 women with cervical carcinomas underwent pretreatment extraperitoneal surgical staging followed by definitive radiation therapy. Overall 10-year actuarial relapse-free and survival rates were both 64%. There were a 20.2% overall incidence and 31.6% actuarial incidence of patients with subsequent abdominal surgery. Of the 47 total surgical procedures, most frequent were 15 repairs of radiation-related bowel injury (11 patients), 11 colostomies for tumor-related obstruction or fistula and 10 explorations for possible exenteration. Only one exenteration could be performed. Other operations consisted of 5 hysterectomies, 3 negative explorations for suspected recurrence, 1 cholecystectomy, 1 small bowel obstruction following surgical staging, and 1 sigmoid resection for colon cancer. Seven patients had multiple operations. Logistic analysis revealed cervix size, pelvic node status, periaortic lymph node status, and thin physique to be significant predictors of overall recurrence, while cervix size was the only significant predictor of exploration for exenteration. Tumor-related colostomies and radiation complications tended to occur in lower and higher clinical stages, respectively. There was a trend toward greater survival in patients with surgery for radiation complications.
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PMID:Surgical intervention following multimodality therapy for advanced cervical cancer. 238 32

Results of operation for obstructing carcinomatosis of gastrointestinal (GI), pancreatic, or biliary origin were reviewed to assess relief of symptoms, management of re-obstruction, and duration of hospitalization. A retrospective review (1977 to 1986) identified 89 patients, 59 (66%) of whom had tumors originating in the colon, and 19 (21%) in the stomach. Normal bowel function was restored for a median of 102 days in 66 patients (74%) and all but four (94%) were discharged. Forty-one (46%) patients remained unobstructed until death. Twenty-three (26%) were not relieved by operation and died a median of 33 days later (P less than .005). Forty-eight (81.4%) of the 59 colon cancer patients and ten (52.6%) of 19 with gastric cancer (P less than .05) were benefited by the operation, although comparison of duration of function was less striking (P less than .1). In-hospital mortality was 13% and complications occurred in 44%. Obstruction recurred in 38% of those relieved by the initial operation. Normal bowel function was restored in six (46%) of 13 patients undergoing a second laparotomy (median, 158 days) and in six of 13 (46%) treated with nasogastric suction. Obstruction recurred again in four of the latter six patients (median, 39 days). Hospitalization averaged 31 days (median, 25 days) for the first procedure and 41 days (median, 39 days) for patients operated for recurrent obstruction. These results justify laparotomy for intestinal obstruction in known or suspected carcinomatosis, particularly of colonic origin, if performance status is compatible with a reasonable quality of life.
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PMID:Results of surgery for obstructing carcinomatosis of gastrointestinal, pancreatic, or biliary origin. 291 33

Cefsulodin (CFS), a new antipseudomonal cephalosporin, shows a potent antibacterial activity against Pseudomonas aeruginosa and some Gram-positive bacteria, whereas it shows low activity against many Gram-negative rods. Against clinical isolates of P. aeruginosa, CFS was about 10 times more active than sulbenicillin and carbenicillin, and had a similar activity to gentamicin and dibekacin. The CFS was administered by an intravenous bolus injection at a dose of 1 g to each of 14 patients operated for acute peritonitis with drainage or radical mastectomy with drainage to treat breast cancer. These cases included 3 of localized peritonitis due to perforative appendicitis, 3 of diffuse peritonitis due to perforative duodenal ulcer, 2 of panperitonitis due to intestinal obstruction and perforative sigmoid colon cancer, 4 of subacute cholangitis, localized peritonitis T-tube choledochal drainage due to choledocholithiasis, and 2 of breast cancer. Materials from drain exudate were taken at intervals with sterilized paper discs and CFS concentrations were determined by the paper disc bioassay method with P. aeruginosa NCTC 10490 as the test organism. Serum concentrations of CFS just after injection reached 135.4 +/- 66.1 micrograms/ml, and they were 2.7 +/- 1.5 micrograms/ml at 6 hours after injection. Concentrations in purulent exudates of patients with acute peritonitis increased quickly after intravenous bolus injections, and reached maximum levels relatively early after injection in cases 2 to 3 days after operation. In cases 10 to 13 days after operation, CFS levels were comparatively low and reached to peak levels at 4 to 5 hours after injection. Levels of CFS in purulent exudate tended to increase in proportion to the severity of symptoms, as did CFS levels in appendix wall. Pseudomonas spp. were not isolated in this study, but MICs of CFS were mostly around 1.56 to 3.13 micrograms/ml when clinically isolated Pseudomonas spp. were present at 10(6) cells/ml. Levels of CFS in infected exudate were higher than the above MIC values against Pseudomonas spp. Therefore, CFS were a useful drug for the chemotherapy against pseudomonal infections.
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PMID:[Cefsulodin concentration in exudates from drainage of patients with acute peritonitis following intravenous administration]. 309 29


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