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

From 1977-1984, 56 patients with colon cancer adherent to other organs were operated. Twenty-three patients (41%) underwent palliative treatment without resection. The mean survival in this group was 6 months. In this retrospective study the results were analysed of 33 patients (59%) who underwent a resection with curative intent. Pathological staging was based on the Dukes, Astler & Coller classification. The 4-year survival rate was as follows: Dukes B 47%, Dukes C 29%, Dukes D 0%. The 4-year survival rate for the whole group was 33%. The postoperative morbidity and mortality were 6% and 3% respectively. Colon cancer with involvement of adjacent structures should not be regarded as an incurable Dukes D cancer: extended resection is indicated.
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PMID:[Surgical therapy of colon carcinoma with local invasion: a useful treatment?]. 247 46

From 1978 to 1985, 297 patients were entered in a double-blind randomized trial comparing levamisole to placebo as adjuvant therapy of Dukes' C carcinoma of the colon. Therapy consisted of from two to five tablets of 50 mg levamisole (or placebo) twice a week, depending on bodyweight for 1 year. Levamisole was generally well tolerated, with only four reversible cases of agranulocytosis reported among 129 patients. The trial failed to show a benefit of levamisole on disease-free survival (P = 0.53) or on survival (P = 0.35). There was no difference between the two treatment groups in terms of number of disease relapses, sites of relapse, or time to relapse. The proportion of patients still alive at 5 years was 51 per cent (standard error, 5.5 per cent) in the levamisole group versus 39 per cent (standard error, 5.4 per cent) in the placebo group.
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PMID:Adjuvant therapy of poor prognosis colon cancer with levamisole: results of an EORTC double-blind randomized clinical trial. 265 12

To gain a better understanding of the biologic development of rectal adenocarcinomas, the authors evaluated the level of ras gene protein product (p21) in the available material of 74 Dukes' B adenocarcinomas, 64 Dukes' C adenocarcinomas, and 60 lymph-node metastases resected at the University of Chicago Medical Center between 1965 and 1981. Pathologic slides and archival paraffin blocks were retrieved for confirmation of the original diagnosis and measurement of p21 content. P21 titers were obtained using the RAP-5 monoclonal antibody in a semiquantitative immunohistochemical assay. Titer was expressed as the highest dilution giving definitive staining using the avidin-biotin peroxidase method. The analysis indicated that a higher percentage of Dukes' stage C rectal adenocarcinomas had high (greater than or equal to 1:40,000) p21 titers than Dukes' B adenocarcinomas (68.8 vs. 51.4 percent, respectively, P less than 0.05). In view of recent data suggesting that ras oncogene expression confers invasive and metastatic capabilities to NIH 3T3 cells, the authors believe this study offers evidence that overexpression of ras oncogene with overproduction of p21 protein product may be an important prerequisite for the acquisition of metastatic capabilities in the early stages of colon cancer.
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PMID:Ras oncogene and the acquisition of metastasizing properties by rectal adenocarcinoma. 266 52

Seventy-four patients with Dukes' B2 through C3 colon or rectal cancer were entered into a prospectively randomized, controlled trial of active specific immunotherapy (ASI) with an autologous tumor cell-BCG vaccine. Primary tumors were dissociated enzymatically and cryopreserved by techniques that maintain cell viability. Patients were randomized into groups treated by resection alone (control) or resection plus ASI. All patients with rectal cancer received 5,040 rads of pelvic irradiation post-operatively. With a median follow-up of 56 mo, there is a moderately significant difference in the distribution of time-to-recurrence (P = .037) and a comparably significant difference in the distributions of time-to-death (P = .031); both comparisons favor the ASI group. Most of the difference was due to the subgroup with colon cancer. With such small numbers of patients, we cannot conclude that ASI is of proven therapeutic benefit. The results are sufficiently encouraging that the trial is continuing and a national multi-institutional prospectively randomized trial is being conducted.
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PMID:Active immunotherapy in colorectal cancer. 268 33

The value of adjuvant therapy for colon and rectal cancer has been studied extensively in clinical trials. Data from earlier trials suggested some potential benefit for rectal cancer patients but minimal if any benefit for patients with Dukes' B2, B3 or C colon cancer. More recent data demonstrate that combined irradiation plus chemotherapy is useful in rectal cancer and that postoperative chemotherapy may have a small benefit as adjuvant treatment in patients with adenocarcinoma of the colon. Whether the recently reported statistically significant results in the adjuvant therapy of colon cancer are clinically significant is still being debated. A number of clinical trials evaluating biological response modifiers, regional chemotherapy, and tumor vaccines are either still under way or in the process of evaluation. The results of these trials may significantly enhance the therapeutic options available to clinicians managing patients with resected large bowel cancer.
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PMID:Adjuvant therapy of colorectal cancer: where do we stand? 264 12

Forty-five patients with obstructing carcinoma of the colon and rectum were compared with 176 patients with nonobstructing tumor diagnosed over a 10-year period. The age and sex distribution did not differ between the two groups. The site of greatest risk for obstruction was the splenic flexure and descending colon (50%); median survival in these patients was one-half that for other sites. In the obstructed group no patient had Dukes' stage A vs. 9.6% in the nonobstructed patients, and 22% of the obstructed patients had Dukes' D vs. 14% of the nonobstructed patients. The 5-year survival in Dukes' A was 82%, while no survivors were found for Dukes' D. The crude 5-year survival rate was 22.4% in the obstructed patients and 49.1% in the nonobstructed patients; in-hospital mortality was 22.4% and 6.8%, respectively, and the adjusted actuarial survival was 39% vs. 64%, respectively. Curative resection was performed in 68% of the obstructed and 83% of the nonobstructed patients. The adjusted actuarial 5-year survival rates for these patients were 53% and 76%, respectively. The criteria for the tumor grade tested in this study, which included differentiation of the tumor cells, size, and the presence of perforation, did not influence the survival. Twenty-one patients underwent primary resection, 15 had stage resection, and 9 had diversion procedures. The in-hospital mortality rates were 35% for primary resection and diversion procedures and 7% for stage resection. The crude 5-year survival was 32% for primary resection, 42% for stage resection (not statistically significant), and 0 for diversion procedures. The poor prognosis for the obstructed patients in our study was mainly related to 1) high in-hospital mortality, 2) the lower rate of curative resection, 3) unequal distribution of the tumor site, and 4) to a small extent, the difference in Dukes' stage.
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PMID:Completely obstructive colorectal cancer. 275 39

Melphalan (MEL), an alkylating agent, has been modified to a derivative, N-acetylmelphalan (N-AcMEL), which can be conjugated to anticolon cancer monoclonal antibodies (MoAbs 30.6, I-1, and JGT) and used for immunochemotherapy. The final immunoconjugates possess potent cytotoxicity and specificity in preclinical studies. In a phase I clinical study, N-AcMEL-MoAb conjugates were administered via the hepatic artery to 10 patients, nine of whom had disseminated colorectal cancer (including the liver) and one of whom had Dukes' C colon cancer that had been resected. The selection of MoAb was based on the immunoperoxidase staining of the primary colon cancer tissue. Thus far doses of 1000 mg/m2 MoAb conjugated to 20 mg/m2 of N-AcMEL have been administered with no significant side effects, whereas MEL unconjugated to monoclonal antibodies would have caused myelosuppression in a proportion of patients at the same dosage. Serum antimouse antibody responses were noted in all of the patients; febrile reactions were noted with higher doses but were easily controlled with antipyretics, antihistamines and, if necessary, steroids. Serum sickness developed in one patient who was given a second course of treatment in the presence of human antimouse antibody, but the episode was self-limiting. Eight of the 10 patients had evaluable disease. Subjective improvement was noted in almost all of the patients examined, and 33%, or 3 of 9, of the treatments (nine courses of treatment in eight patients with evaluable disease; one of the patients had two courses of treatment) led to antitumor responses (minor response) by objective assessment with computed tomography of the liver. It is important to note that treatment with N-AcMEL-MoAb conjugates was safe at a dose of 20 mg/m2 of N-AcMEL, whereas the efficacy of such a form of treatment remains to be determined.
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PMID:Phase I clinical trial of drug-monoclonal antibody conjugates in patients with advanced colorectal carcinoma: a preliminary report. 278 31

The follow-up of colon cancer patients by monitoring serum carcinoembryonic antigen has advantages (better survival after early detection of recurrence by CEA rise) as well as disadvantages (false-positive rise of CEA, and early detection of incurable recurrences in asymptomatic patients). The effects of CEA follow-up on quality-adjusted life expectancy (QUALE) of patients with curatively resected colon carcinoma have been simulated by a Markov analysis using literature data. The value of CEA seems insignificant and varies, depending on the literature data used, from a mean increase of QUALE by 6 days (+0.4%) to a mean decrease by 2 days (-0.07%). This value depends on patient-related variables; the negative effects of CEA especially predominate in older patients with favourable Dukes' stages of primary tumour.
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PMID:[Carcinoembryonal antigen and the follow up of patients after resection of colon carcinoma with curative intent: a Markov process in decision analysis]. 281 76

In vitro tetraploidy (IVT) in cultures of skin fibroblasts was compared with tumor DNA ploidy, as determined by flow cytometry on paraffin-embedded material, in 99 patients with colorectal neoplasm. In 63 patients with non-heritable carcinoma we found a significant correlation between the number of aneuploid stemlines in the tumor and IVT in the fibroblast culture. Furthermore, tumor aneuploidy was significantly correlated to the size of the tetraploid subpopulation in the fibroblasts. There was no correlation between aneuploidy and Dukes's stage or the degree of differentiation. In 36 patients with adenoma no correlation between tumor aneuploidy and fibroblast IVT was demonstrated, whereas the number of tumor stemlines was significantly correlated to histopathologic stage and grade of dysplasia. IVT in cultured skin fibroblasts, which has been reported to reflect a genetic predisposition to colorectal cancer in heritable colon cancer syndromes, thus seems to be relevant also for the understanding of tumor formation and progression in the 'non-heritable' type of colorectal cancer.
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PMID:Association between tumor DNA aneuploidy and in vitro tetraploidy of skin fibroblasts in patients with colorectal neoplasms. 281 41

To determine the clinicopathologic significance of colloid carcinoma in carcinoma of the colon and rectosigmoid/rectum, a retrospective review of 462 patients who underwent potentially curative surgery at the New England Deaconess Hospital was performed. Seventy-seven patients (17%) were identified who had tumors with some component of colloid present. Colloid carcinoma occurred in 49 (11%). The remaining 28 (6%) had adenocarcinoma with colloid features. Compared to patients with pure adenocarcinoma, the 5-year actuarial survival of patients with colloid carcinoma was lower in the colon, rectosigmoid/rectum, and colorectum. Patterns of failure, expressed as the actuarial incidence of failure at 5 years, were examined by histologic condition and stage. Patients with Dukes' Stage B colloid carcinoma had a higher incidence of total failure, and patients with Dukes' Stage C colloid carcinoma had a higher incidence of local, abdominal, and total failure. None of the differences reached statistical significance. The presence of colloid carcinoma may have a real but small impact on the patterns of failure and survival in colorectal cancer.
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PMID:Colloid carcinoma of the colon and rectum. 282 24


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