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

Colon cancer is a public health problem worldwide. Although potentially curable at early stages, a substantial number of patients will inevitably present with or eventually develop metastatic disease, which is often incurable. Despite the progress achieved with the introduction of new cytotoxic agents, recurrence rates for patients with resected stage II/III disease remain > 20%. Therefore, a great deal of effort and resources have been put into improving early diagnosis and prevention tools as well as the efficacy of adjuvant treatment. Oxaliplatin-based chemotherapy is now considered the standard of care in node-positive colon cancer, but there remains controversy with regard to the indication and type of adjuvant treatment in patients with nodenegative disease. Oral fluoropyrimidines play a growing role in the management of colorectal cancer and can be currently considered an alternative to 5-fluorouracil. Numerous reports have suggested that elderly patients benefit equally from chemotherapy, but the growing numbers of octogenarian and nonagenarian patients in our clinics, many of whom occasionally struggle through treatment, are a reminder of the challenges ahead. Finally, as we might have reached a plateau in terms of cytotoxic chemotherapy, numerous clinical trials are now focusing on the role of biologic agents in the adjuvant setting.
Clin Colorectal Cancer 2008 May
PMID:Colon cancer: update on adjuvant therapy. 1862 35

Accurate nodal staging is of crucial importance in patients with nonmetastatic colon cancer, because it affects patient prognosis and delivery of adjuvant chemotherapy. In this article, we review the role of 2 controversial aspects of lymph node staging in colon cancer: the number of lymph nodes evaluated and sentinel lymph node (SLN) biopsy. Although it is clear that the number of lymph nodes assessed correlates with patient survival, the underlying mechanisms are far more uncertain, and thus, more research is warranted to determine whether interventions to increase nodal assessment will lead to improved patient outcomes. Sentinel lymph node biopsy does not appear to have the same advantages in the treatment of patients with colon cancer as in the treatment of patients with breast cancer or melanoma. Also, it might not improve colon cancer staging above standard pathology, and should be restricted to use in research settings.
Clin Colorectal Cancer 2008 Jul
PMID:Lymph node evaluation in early-stage colon cancer. 1865 Jan 92

Liver transplant recipients are at an increased risk of developing de novo malignancies because of the prolonged immunosuppression necessary to avoid acute and chronic rejections. Skin cancers and lymphoproliferative diseases are the most common malignancies, but the overall incidence of colon cancer in this patient population does differ from that of the general population. Therefore, colorectal cancer (CRC) is a major health concern in liver transplant recipients. Furthermore, there are unique subsets of liver transplant recipients, such as those with primary sclerosing cholangitis and inflammatory bowel disease, who are at an increased risk for developing CRC after liver transplantation and might require special screening/surveillance strategies. The similar principles for management of colon cancer can be applied to transplant recipients if the adjustment to maintain the need for the long-term immunosuppression is made. Colectomy can be performed safely during the posttransplantation period. Prophylactic colectomy at the time of liver transplantation has been performed in some patients at high risk or with known premalignant conditions. Chemotherapy with 5- fluorouracil and oxaliplatin has been used in transplant recipients for the treatment of metastatic CRC; however, further research is required to examine the safety, tolerability, and efficacy of combination chemotherapy and biologic agents in this patient population. This review summarizes the incidence, risk factors, diagnosis, and management of de novo CRC in liver transplant recipients.
Clin Colorectal Cancer 2008 Jul
PMID:Incidence and management of colorectal cancer in liver transplant recipients. 1865 Jan 94

Metastatic disease is present in up to 20% of patients at the time of diagnosis of colorectal cancer. The most frequently involved sites are the liver and the lungs. A rare form of lung metastatic disease is endobronchial metastases, most commonly seen with breast cancer and colon cancer. Their clinical and imaging profile is similar to primary bronchogenic carcinoma. Tumor expectoration is an unusual manifestation of endobronchial metastases (as well as of the primary lung carcinoma). We report the case of a 75-year-old man with known liver and lung metastatic disease from colon cancer who experienced an episode of tissue expectoration. Pathology examination of the expectorated piece of tissue was consistent with colonic adenocarcinoma. Tumor expectoration is a rare event, with < 30 cases reported in the literature. Most of the cases reported include secondary lung malignancies, with renal cell carcinoma being the most common primary site. Endobronchial metastases from colon cancer are rare. Patients with colon cancer can benefit from sputum cytology because this type of metastases is shown to have exfoliative properties. To assess the need for endobronchial management with stent placement or bracytherapy, bronchoscopy should be considered in certain circumstances (the onset of respiratory symptoms, rapid response to chemotherapy, long history of metastatic disease with multiple systemic therapies given, undulating response in tumor, as well as after a reported episode of tissue expectoration).
Clin Colorectal Cancer 2008 Jul
PMID:Expectoration of a lung metastasis in a patient with colorectal carcinoma. 1865 Jan 98

Colorectal cancer (CRC) is one of the most common cancers in the Western world, with > 500,000 new cases diagnosed each year. One of the strongest risk factors for colon cancer is age. Physicians and their older patients commonly face the dilemma of whether to give/receive systemic chemotherapy for CRC. Evidence supports similar survival benefits with adjuvant and palliative chemotherapy in elderly patients compared with younger age groups. Data on treatment- related side effects did not reveal a different toxicity profile for elderly patients. The safety and efficacy of systemic chemotherapy in fit older patients were proven, and this group of patients could be enrolled in clinical trials. Conversely, frail older patients are more likely to suffer adverse outcomes when faced with stressors and might not benefit from chemotherapy. Despite a growing body of data, a great deal of work is still needed to establish optimal strategies to care for patients diagnosed with cancer later in life. There is a paucity of reports published in the literature because of the difficulty in routinely collecting such data. We report an overview of recent studies (clinical trials, pooled analysis, and population studies) to provide more information and to identify new and better treatment options.
Clin Colorectal Cancer 2008 Nov
PMID:Colorectal cancer treatment in elderly patients: an update on recent clinical studies. 1903 86

It has been nearly two decades since the first laparoscopic colectomy was reported. However, the wide application of the procedure in various colorectal diseases, particularly colorectal malignancy, has been slow. With the recent reports ofoncological outcomes from randomised controlled trials, the oncological safety of laparoscopic colectomy has been proven and the long-term outcome is at least not inferior to open resection. The application of laparoscopic resection should not be regarded as a contraindication against management of colon cancer, but instead it appears the preferred treatment when the short-term benefits are considered. Regarding rectal cancer, the CLASICC (Conventional versus Laparoscopic-Assisted Surgery in Colorectal Cancer) trial showed equal oncological outcome in patients who underwent laparoscopic and open resection for rectal cancer in a randomised trial. The application of laparoscopic resection for rectal cancer should be accepted, though cautions are still needed to scrutinise more data from high quality studies.
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PMID:Outcome of laparoscopic colorectal resection. 1911 Aug 24

The Veterans Health Administration (VHA) has recently launched several nationwide initiatives to improve the quality of its colorectal cancer (CRC) screening and care. The timeliness of follow-up diagnostic tests in patients who have positive noncolonoscopic CRC screening tests is one of the target areas of these initiatives. Multiple aspects of colon cancer care are being monitored, and the degree of adherence to accepted quality measures is being assessed. The purpose of this review is to describe the background leading to these initiatives and their expected impact on CRC screening and management in the VHA.
Clin Colorectal Cancer 2009 Jan
PMID:Improving colorectal cancer screening and care in the Veterans Affairs Healthcare system. 1920 93

Colorectal cancer (CRC) represents a major public health problem accounting for > 1 million cases of new cancers and about half a million deaths worldwide. The risk of recurrence remains high despite curative surgery in early disease stages. The incremental benefit in absolute recurrence-free survival from 5-fluorouracil (5-FU)-based regimens in young patients with high-risk colon cancer is not insignificant. We present a case of a 57-year-old otherwise healthy white man who was treated with adjuvant chemotherapy consisting of modified 5-FU/leucovorin/oxaliplatin (FOLFOX6) regimen for stage III colon cancer. He experienced significant cardiotoxicity related to infusional 5-FU. Because of his young age and high-risk cancer, the patient opted to continue with adjuvant bolus 5-FU-containing chemotherapy after a lengthy discussion. With close cardiac monitoring and treatment with calcium channel blocker to prevent coronary vasospasm, he was able to successfully complete adjuvant chemotherapy. Currently, there are no guidelines for predicting a patient's risk for 5-FU-induced cardiotoxicity. Similarly, there is no uniform management of this 5-FU-related induced cardiotoxicity. We believe that our case report, with a brief review of related literature, might help fill some of this vacuum.
Clin Colorectal Cancer 2009 Jan
PMID:Coronary vasospasm with myocardial stunning in a patient with colon cancer receiving adjuvant chemotherapy with FOLFOX regimen. 1920 98

The structures of glycosphingolipids from highly purified colorectal cancer cells and normal colorectal epithelial cells of 16 patients have been analyzed in fine detail (Misonou Y, Shida K, Korekane H, Seki Y, Noura S, Ohue M, Miyamoto Y. 2009. Comprehensive Clinico-Glycomic Study of 16 Colorectal Cancer Specimens: Elucidation of aberrant glycosylation and ts mechanistic causes in colorectal cancer cells. J Proteome Res. 8:2990-3005). Further structural analyses demonstrated that colon cancer cells from two patients accumulated unusual glycosphingolipids which were not observed in either colorectal cancer cells or normal colorectal epithelial cells from the other patients. Mass spectrometry analyses revealed that the unusual structures include sulfated oligosaccharides. The structures of the glycosphingolipids of the cancer cells from these two cases were analyzed by methods which include enzymatic release of carbohydrate moieties, fluorescent labeling with aminopyridine and identification using two-dimensional mapping, enzymatic digestion and mass spectrometry together with methanolysis, and the use of newly synthesized sulfo-fucosylated oligosaccharides as standards. The colon cancer cells from one of the patients demonstrate a variety of oligosaccharides as major components which are sulfated at the C6 position of subterminal GlcNAc and at C3 positions of terminal galactose with or without sialylation or fucosylation. These include 6-sulfo Le(x), 6'-sialyl 6-sulfo lactosamine, and 3'-sialyl 6-sulfo Le(x), in addition to sialylated or fucosylated derivatives of type-1 and type-2 hybrid oligosaccharides. The colon cancer cells from the other patient have two kinds of sulfated oligosaccharides, a 6-sulfo Le(x) structure and a 3'-sulfo Le(x) structure, as minor components. Taking into consideration the clinical features of the two patients, the biological significance of sulfated glycosphingolipids on cancer cells is discussed.
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PMID:Unusual accumulation of sulfated glycosphingolipids in colon cancer cells. 1954 71

High-risk stage II and stage III colon cancers are associated with significant recurrence rates after surgical resection. Adjuvant chemotherapy has demonstrated a significant disease-free and overall survival benefit for patients, even if not helpful for all. Currently, there are limited clinical and molecular markers that can predict response to chemotherapy and clinical outcome in advanced colon cancer. Herein, we review and discuss recent data about the most promising clinicopathologic and molecular factors described thus far and that are of interest in the management of patients with colon cancer.
Clin Colorectal Cancer 2010 Jan
PMID:Is tailored adjuvant treatment for colon cancer possible? 2010 Jun 84


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