Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of colorectal cancer in Ashkenazi Jews is two to three times higher than in non-Ashkenazis. For a community colorectal screening program 1339 asymptomatic Ashkenazis over 40 yr old were asked to participate. Of these 1012 (75%) took Hemoccult II kits [fecal occult blood tests (FOBT)], and 614 (46%) personally returned them. Screenees were interviewed regarding family and personal medical history. Fourteen persons (2.3%) had positive tests, in whom colonoscopy revealed two with cancer (Dukes' B,C) and two with a greater than 2 cm polyp. The remaining 600 persons were invited for flexible sigmoidoscopy (FS) but only 287 (48%) appeared. The mean depth of insertion of the instrument was 50.3 cm (range 30-120), but was poorer for women. FS identified lesions in 28 (9.7%) persons: three had Dukes' A carcinomas and 25 had less than 2 cm adenomatous polyps. Significantly more women than men accepted FOBT, but among those completing FOBT, there was no difference by sex for use of FS. Middle-aged persons (50-69 yr) found screening more acceptable than young or older persons. Among screenees who agreed to undergo FS, a significantly larger fraction had a first relative with colon cancer, or a personal history of colon or female genital neoplasia, compared to those not agreeing to FS. There were no differences in screenees with relatives with noncolon cancer. Eighty-eight couples completed FOBT and were invited for FS. The decision whether or not to participate was made for both members in 81 (92%) couples. In conclusion, effective screening programs have to take into consideration compliance patterns of the target population.
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PMID:A community-based program of colorectal screening in an asymptomatic population: evaluation of screening tests and compliance. 374 23

Previous analyses of findings from the Gastrointestinal Tumor Study Group (GITSG) study GI 6175, a four-arm randomized trial of patients with adjuvant colon cancer, have revealed no efficacy for chemotherapy or immunotherapy, but Dukes' Stage was found to have prognostic significance in both survival and disease-free survival. In this study, the exophytic tumor as primary type, maximal tumor dimension, and degree of differentiation were examined for prognostic importance. In a model simultaneously including treatment effects, significance levels for prognosis in total survival were: Dukes' stage (P less than 0.0001), exophytic tumors (P = 0.05), maximal dimension (P = 0.005), and well versus poor differentiated tumors (P = 0.06). This observation about tumor length, adjusted for stage and morphology, provides evidence that size is prognostic in colonic tumors. In addition, an interaction between tumor morphology and immunotherapy, adjusted for Dukes' stage, was noted. In 100 patients with exophytic tumors, significant survival and disease-free survival benefit (P less than 0.02) from immunotherapy occurred. Tumor morphology is found to be an important prognostic variable and should be carefully considered in the construction of future trials in this disease site.
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PMID:Importance of tumor pathology and morphology in patients with surgically resected colon cancer. Findings from the Gastrointestinal Tumor Study Group. 374 58

A detailed retrospective analysis was undertaken of the effect of perioperative blood transfusion on long-term survival of 113 patients with Dukes' Stages A, B and C1 cancer of the colon and 383 patients with invasive cancer of the breast who were treated in our institution between 1973 and 1978 and followed for 5 to 10 years. In the patients with colon cancer, a significant adverse effect of transfusion on long-term survival was seen. In this group there was a cumulative 5-year overall survival of 48% for the transfused and 74% for the nontransfused patients (P = 0.007, log-rank test). Perioperative blood transfusion was associated with a relative risk of 3.42 for all deaths (P = 0.005) and 4.25 for death due to cancer (P = 0.03), after adjustment for other important variables such as age, sex, stage, location of tumor, surgical procedure, and preoperative hemoglobin level. In contrast, in our study group of patients with breast cancers, who all underwent a modified radical mastectomy, no effect of blood transfusion on long-term survival was seen. Multivariate analysis adjusting for size of tumor, number of positive regional lymph nodes, menopausal status, estrogen receptor status and the addition or absence of chemotherapy, did not show any increased risk in all deaths or death due to cancer associated with blood transfusion. Although no definite explanation is available, our data show that there seems to be a difference in the relationship between perioperative blood transfusion and survival for colon and breast cancer patients.
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PMID:Perioperative blood transfusion and cancer prognosis. Different effects of blood transfusion on prognosis of colon and breast cancer patients. 380 42

Two hundred twenty-two patients with colon cancer, diagnosed in the past 5 years, were grouped by age into the sixth, seventh, and eighth decades. Examination showed an increased incidence of right-sided colon cancer by decade and a simultaneous fall in the incidence of rectosigmoid lesions. A trend toward a more favorable Dukes' pattern was evident with each rise in decade. We suggest that the shift in site of colon and rectal cancer toward the right is directly related to age and is a feature of the "aging gut."
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PMID:Rightward shift of colon cancer. A feature of the aging gut. 380 59

Of 705 patients who were treated at the Vanderbilt University and Metropolitan Nashville General Hospitals from 1973 to 1984 for carcinoma of the colon, 45 (6.3%) were 35 years of age or younger at the time of diagnosis. There were 25 men and 20 women; the average age was 29.3 years. Twenty-six patients (57.7%) presented with pain, 19 reported a change in bowel habits, and 18 had gastrointestinal bleeding which led to diagnostic investigation. At the time of diagnosis, only two patients had lesions which could be classified as Dukes' A, eight were Dukes' B, 28 were Dukes' C, and the remaining seven had Dukes' D lesions with distant metastasis. Nineteen patients had poorly differentiated tumors; survival in this group averaged 1 year. In the 19 patients who had well or moderately well-differentiated tumors, survival averaged 4.3 years. Fifteen patients had unresectable tumors at the time of initial treatment, and survival in this group has averaged 1.5 years. Thirty patients had tumors which were considered to be resectable by the operating surgeon, and nine of these 30 patients are alive without evidence of recurrence for an average of 5.6 years. The prognosis of carcinoma of the colon in the young has been poor, with the major factors being the unfavorable histologic features of these tumors and the advanced disease at the time of presentation in these patients. Those few patients who present early in the course of their disease respond well to radical resection.
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PMID:Carcinoma of the colon in patients 35 years of age and younger. 382 5

In this randomized trial adjuvant cytotoxic portal vein perfusion in patients undergoing surgery for colorectal cancer without liver metastases was assessed to determine whether the incidence of metachronous liver metastases could be reduced and survival thereby improved. There were 127 control patients and 117 patients who received adjuvant perfusion. A further 13 patients were excluded following randomization because of cirrhosis in 1, liver metastases at laparotomy in 3 and technical problems with cannulation in 9. Dukes' staging and degree of differentiation were similar in the two groups. There were fewer liver metastases in the perfusion patients and overall survival was improved. However, the benefit appears to be greatest in patients with Dukes' B colon cancer.
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PMID:A randomized controlled trial of adjuvant portal vein cytotoxic perfusion in colorectal cancer. 388 35

Cancer of the gastrointestinal tract represents a major international health problem. At the present time surgical resection for limited stages of disease represents the only treatment which can consistently provide long-term disease-free survival. Unfortunately, the majority of patients present with either microscopic metastatic disease in distant sites or advanced tumour growth which exceeds the limits of surgical resection. Relatively little progress has been made in the development of effective forms of non-surgical therapy. Gastric cancer, however, has been demonstrated to have greater sensitivity to forms of chemotherapy and radiation therapy than was previously appreciated. During the past decade, more effective forms of palliative therapy have been developed for patients with advanced disease, and approximately 15% of the cases with locally unresectable gastric cancer can now achieve long-term disease-free survival with combined forms of treatment. Unfortunately, similar progress has not been made in the management of pancreatic cancer or advanced colon cancer. The recent experience of the Gastrointestinal Tumor Study Group with the use of combined radiotherapy and chemotherapy for rectal cancer has demonstrated that improved disease-free survival can be achieved for patients with Dukes B and C disease. Overall, the current limited efficacy and considerable toxicity of conventional therapies strongly support the development of new approaches to the management of gastrointestinal cancer; this includes the exploitation of the recent progress that has been made in our understanding of cell proliferation and cell cycle control, and the importance of oncogenes and growth factors for regulation of these processes. Ultimately, our understanding of the molecular genetics of gastrointestinal cancer might allow for development of more effective means for both prevention and treatment at the molecular level.
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PMID:Therapy of gastrointestinal cancer. 391 66

The relationship of adenoma to carcinoma of the colon and rectum in individuals of families with nonpolyposis hereditary carcinoma of the colon and rectum syndrome is uncertain. In five families with hereditary carcinoma of the colon and rectum, the medical records of 39 patients who had 50 instances of carcinoma of the colon and rectum develop were studied. Six instances of disease were found in adenomas: Dukes' A in two; Dukes' B in three, and Dukes' C in one. The malignant polyp was the only neoplastic lesion in the colon in five of these instances. In only 12 of the patients (31 per cent) were adenomas (seven patients) or secondary disease (five patients) ever found. These data suggest that while uncommon adenomas are precursor lesions for malignant neoplasms in patients with carcinoma of the colon and hereditary carcinoma of the colon and rectum syndrome.
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PMID:Adenomas are precursor lesions for malignant growth in nonpolyposis hereditary carcinoma of the colon and rectum. 394 Apr 11

A series of recent studies has shown an association between low serum cholesterol level and cancer, particularly of the large bowel. To explore this issue, serum cholesterol measurements were collected from 244 patients with adenomatous polyps of the colon, 182 patients with Dukes' A or B colon cancer, and 688 hospital controls who were diagnosed between 1979 and 1981 at a New York City hospital. The mean serum cholesterol levels were lower for patients with cancer (207.2 mg/dL) than for controls (219.5 mg/dL), with patients with Dukes' B cancer accounting for most of the difference. Patients with adenomatous polyps (219.8 mg/dL) were similar to controls. After adjustments for nutritional status using the serum albumin level, there were no statistically significant differences among any of the groups. We conclude that the low serum cholesterol level previously associated with malignancies, and colon cancer in particular, is a consequence rather than a cause of the cancer.
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PMID:Serum cholesterol levels in adenomatous polyps and cancer of the colon. A case-control study. 394 15

Hepatic resection is the treatment of choice for a solitary metastatic deposit from a primary carcinoma of the large intestine in the absence of extrahepatic disease. This study was done to evaluate hepatic resection in the treatment of multiple hepatic metastases from carcinoma of the colon and rectum. Sixty-two patients underwent hepatic resection with an over-all operative mortality of 10 per cent, but a recent (1968-1981) mortality of 2 per cent. Three, five and ten year survival rates were 50, 34 and 21 per cent, respectively. No significant differences in survival patterns were noted comparing site (colon versus rectum), time interval from diagnosis of the primary to diagnosis of metastases (synchronous versus metachronous), sex (male versus female), size of the metastatic lesion (less than 5 centimeters versus greater than or equal to 5 centimeters) or number of metastatic lesions (single versus multiple). The pathologic stage of the primary carcinoma of the large intestine significantly (p less than 0.05) influenced survival patterns after hepatic resection with Dukes' B primary tumor having a median survival time of 123 months versus 27 months for patients with Dukes' C primary tumor. Sixty-seven per cent of those with a recurrence did so within the liver. Adjuvant chemotherapy had no demonstrable effect on survival patterns. Further improvement in survival statistics will require more sensitive staging procedures and effective adjuvant therapy, particularly for patients with Dukes' C primary carcinoma of the large intestine.
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PMID:Hepatic resection for metastases of the colon and rectum. 394 88


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