Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P52742 (pT3)
 1,034 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Some 50 total mesorectal excision specimens were examined following rectal excision for cancer. Circumferential margin involvement was rare, but mesorectal tumour deposits were present in 17 of 44 patients with pT3 tumours, and 23 of 44 had mesorectal nodal involvement. No patient with a pT2 tumour had mesorectal involvement. Failure to excise the mesorectum completely has the potential to leave gross or microscopic residual disease that may in theory predispose to local failure. Total mesorectal excision is necessary to avoid incomplete pathological evaluation of the mesorectum and understaging of rectal cancer.
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PMID:Pathological evidence in support of total mesorectal excision in the management of rectal cancer. 886 20

In order to evaluate the usefulness of pre-operative intra-arterial selective polychemotherapy (PIASP), we carried out a retrospective study of 107 patients (65 males, 42 females) with locally advanced rectal cancer (LARC) (pT3-4 N0-1 M0), who were treated between 1988 and 1991. Fifty-two patients (MG) underwent PIASP (Adriablastin 60-90 mg, fluorouracil 3-4 g) with subsequent radical surgery. Fifty-five patients (R0) received surgery alone. Angiographic findings after PIASP showed approximately 50-70% reduction in the vascular network in the tumour and surrounding tissues. A post-operative morphological study confirmed the considerable tumour dystrophy, necrobiosis and necrosis. Comparative statistical analysis in two patient groups showed that overall 5-year survival was significantly better in MG (64.76 +/- 1.85%) than in R0 (38.23 +/- 1.74%; chi 2 = 9.1; P < 0.05). A similar situation was observed in all research subgroups: T3 N0 M0 (MG, 85.71 +/- 3.29% and R0, 65.63 +/- 2.85%; chi 2 = 2.61; P < 0.05); T3 N1 M0 (MG, 47.06 +/- 4.68% and R0, 0.0, chi 2 = 14.37; P < 0.05); T4 N0-1 M0 (MG, 8.57 +/- 4.29% and R0, 0.0, chi 2 = 2.09; P < 0.05). Significantly better 5-year survival rates were seen in MG than in R0 with the medial cellular differentiation in carcinoma (77.42 +/- 2.98% and 36.23 +/- 2.41%, chi 2 = 9.81; P < 0.05, respectively), the most frequent histological tumour structures. There is a trend for improved 5-year survival in low differentiation carcinoma (MG, 47.62 + 5.29% and R0, 35.29 +/- 4.37%, chi 2 = 0.28, P > 0.05). The MG group showed eight local relapses of disease (15.38%), while the R0 group showed 21 (38.1%), the MG group demonstrated 12 distant metastasis (23.07%) while R0 demonstrated 19 (34.54%), the median relapse-free survival was 101.6 weeks in MG and 74.45 weeks in R0. The use of the combined PIASP with subsequent surgery treatment of patients with LARC allows a better prognosis than does surgery alone.
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PMID:Neoadjuvant intra-arterial polychemotherapy of locally advanced rectal cancer. 923 97

Preservation of the pelvic plexus in surgery for rectal cancer could shorten the distance between the cancer and the lateral resection margin, whereby the curability of the operation may be reduced. To clarify the indications for preserving the pelvic plexus in such surgery, the relationship of the pelvic plexus to the rectum and rectal cancer was investigated anatomically in 12 autopsied specimens and 12 surgical specimens. The rectum and anus were dissected with all the pelvic organs from autopsied cadavers and transverse sections were prepared at 10-mm intervals after fixation. The location of the pelvic plexus was then measured on the tissue preparations, and compared to that of surgical specimens from rectal cancers with concurrent resection of the pelvic plexus. The pelvic plexus was located from 3.3 +/- 1.2 cm above to 2.3 +/- 1.9 cm below the peritoneal reflection in the autopsied specimens. The average distances between the muscularis propria and the pelvic plexus in the autopsied specimens and surgical specimens were 8.3 +/- 3.5 mm and 14.7 +/- 4.5 mm, respectively, showing a significant difference (P < 0.05). Pelvic plexuses were located about 10 mm from the outer margin of rectal muscularis propria. These findings indicate that concurrent resection of the pelvic plexus may be required to secure sufficient surgical clearance in pT3 rectal cancers, especially those invading deeply beyond the muscularis propria (a2).
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PMID:An assessment of the anatomical relationship between the pelvic plexus and the rectal wall to determine the indications for its preservation in surgery for rectal cancer. 941 51

Adjuvant combined radio-chemotherapy in rectal cancer is indicated in stage UICC II and III (pT3/4 and/or pN+) without distant metastases (exception: resectable metastases of the liver). Radiotherapy alone improves local control in the pelvis. A statistical significant improvement of survival is only achievable in combination with systemic chemotherapy. In Germany neo-adjuvant, conventional fractionated radio-chemotherapy over five weeks is applied in patients with surgically inoperable tumors to achieve a "down-staging" with improvement of resectability. Neo-adjuvant radiotherapy of operable rectal cancer in five fractions of high single doses within one week has revealed a statistical significant improvement of survival if compared to surgery alone in the Swedish rectal cancer trial, but is not standard in Germany yet. The influence of technical advances in surgery as total mesorectal excision (TME) on indications of adjuvant therapy is evaluated in prospective randomized studies at this time.
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PMID:[Results of radiotherapy in rectal carcinoma]. 1092 43

To obtain data on locoregional recurrence and survival rates in prognostically inhomogeneous pT3 rectal carcinomas we analyzed the data on 853 patients of the Erlangen Registry for Colo-Rectal Carcinomas (ERCRC) and 600 patients of the Study Group for Colo-Rectal Carcinoma (SGCRC), stage I-III, treated by radical surgery alone. The category pT3 was subdivided according to the histological measurement of the maximal tumor invasion beyond the outer border of the muscularis propria: pT3a (up to 5 mm) and pT3b (more than 5 mm). In the ERCRC locoregional recurrence rates were 10.4% (95% confidence interval 6.0-14.6) for pT3a and 26.3% (20.6-31.6) for pT3b (P<0.0001). The cancer-related 5-year survival rates were 85.4% (80.6-90.5) for pT3a and 54.1% (48.5-60.5) for pT3b (P<0.0001). Lymph node negative pT3a and pT2 patients showed very similar 5-year survival rates (91.2% vs. 93.6%, respectively) as well as lymph node positive pT3a and pT2 patients (77.8% vs. 82.8%, respectively). In the SGCRC patients similar but statistically marginal differences between pT3a and pT3b tumors were observed. An extended pT classification (pT1, pT2, pT3a, pT3b, pT4) thus allows an improved prediction of outcome in rectal carcinoma patients. The subdivision of pT3 enables the identification of stage II patients (pT3a pNO) who might not benefit from adjuvant treatment.
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PMID:The prognostic inhomogeneity in pT3 rectal carcinomas. 1168 28

In the last 40 years, radiotherapy as gained a major role in the curative treatment of rectal carcinoma. Based on a reported incidence of local failure after surgery between 15% and 50%, in patients with T3-4 rectal cancer, postoperative radiation has been proposed in this group of patients. However, postoperative radiotherapy results associated with a relatively high incidence of acute and late toxicity and the reported improvement in local control attained statistical significance only in the MRC randomized trial. A recent publication suggests that postoperative radiation should probably be reserved to the subgroup of pT3 patients with unfavourable features. Postoperative radiation therapy is considered also for patients with G1-2 carcinoma treated with local excision, who do not show lymphatic or venous invasion, and for those with pT2 stage or pT1 carcinoma with involved resection margins.
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PMID:[Postoperative radiotherapy of rectal carcinoma]. 1197 12

Initial treatments of locally advanced rectal cancers focus on local control, as local relapse of a rectal cancer is correlated with a high morbidity and mortality. We studied the effect of neoadjuvant radiochemotherapy on advanced rectal cancer patients in relation to downstaging, local relapse and survival. Post-treatment pathological staging, local relapse and survival were analysed in 66 patients from a single institution. 43 patients had irresectable cancer as determined by laparatomy (n=42) or rectal examination (n=1). These 43 patients received 45-56 Gy preoperatively with 5-fluorouracil (5-FU) and leucovorin (350/20 mg/m(2)x5 day (d)) in weeks 1 and 5 during the radiation therapy. 23 patients had primary resectable tumours with a T1-2 stage. Of the initially irresectable tumours 79% became macroscopically resectable, in 74% a R0 resection was performed. In 6 of 34 (18%) surgical specimens, no tumour was found (pT0), 7 patients had small tumour remnants (pT1-2). In these pT0-2 tumours, no local relapses occurred (observation period of median 4.5 years, range 18-87 months). In the 21 patients with pT3-4 tumours 3 local relapses were seen. In the 23 patients with primary resectable T1-2 tumours the relapse rate was 4%. Downstaging of an initially irresectable rectal tumour to pT2 or less results in a local relapse rate and overall survival that correspond with the rates in primary resectable cancer with the same T classification.
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PMID:A favourable pathological stage after neoadjuvant radiochemotherapy in patients with initially irresectable rectal cancer correlates with a favourable prognosis. 1250 51

The method of iliopelvic lymphodissection was used in 61 patients aged from 42 to 72 years having histologically verified rectum cancer. The results of treatment by this method have shown that in 83.6% of the patients the tumor spread corresponded to pT3-T4, the metastatic involvement of regional lymph nodes was found in 52.5% of the patients. The most justified reason for a radical surgery and lymphodissection was a combination of the endoscopic signs of a considerable extension of the tumor around the circumference of the rectum with the CT signs of enlargement of the regional lymph nodes or the ingrowth of the tumor in the pararectal fat. In cases with the lymphogenic metastasing the cumulative 5 year survival was 43.6 +/- 8.7%, in cases without it it was 55.3 +/- 11.8%. A thorough preoperative evaluation of the extension of the tumor process allows to optimize indications for iliopelvic lymphodissection.
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PMID:[Ilio-pelvic lymphatic dissection in the rectal cancer]. 1266 Dec 47

Postoperative adjuvant chemotherapy reportedly improves advanced colorectal cancer patients' survival, however, it is necessary to assess what regimens are useful. Doxifluridine (5'-DFUR) is an intermediate of capecitabine approved in Europe and USA to treat metastatic colorectal cancer. 5'-DFUR is metabolized to 5-fluorouracil (5-FU) by thymidine phosphorylase existing in tumor at high concentrations, suggesting high 5-FU levels in tumor tissues and lesser complications. Present study compared usefulness of 5'-DFUR to that of oral 5-FU. Patients were enrolled at 38 centers from April 1993 to September 1996. They had diagnosed colorectal cancer of TNM stages II and III, and underwent macroscopic curative resection. Patients were prestratified into colon or rectum cancer and allocated into either 5'-DFUR (5'-DFUR 460 mg/m(2)/day + PSK 3 g/day) or 5-FU (5-FU 115 mg/m(2)/day + PSK 3 g/day) group by dynamic randomization (stratification factors such as depth of tumor, degree of lymph node metastasis, and location of tumor). Drugs were orally administered daily from postoperative week 2 to 54, with 6 mg/m(2) mitomycin C at operation and following days. Subjects for analysis were 277 in 5'-DFUR and 281 in 5-FU groups. Median follow-up was 6.5 years. Although no differences in overall survival curves were detected, multivariate analysis showed that 5'-DFUR + PSK regimen was a significantly better prognostic factor in patients with Dukes B or C (risk ratio, 1.451; p=0.048); with tumor depth of pT3 or pT4 (risk ratio, 1.568; p=0.020). For patients with advanced colorectal cancer, 5'-DFUR + PSK therapy may possibly be more useful than 5-FU + PSK, but further study is required.
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PMID:A randomized controlled trial of postoperative adjuvant immunochemotherapy for colorectal cancer with oral medicines. 1279 90

The current status of laparoscopic surgery and its indications for colorectal cancer are described. According to multi-institutional registry by the Japanese Society of Endoscopic Surgeons, the number of laparoscopic surgeries for advanced colorectal cancer has been increasing during the last couple years. The short- and long-term results of laparoscopic surgery for pT1 or pT2 colon cancer are favourable, and laparoscopic surgery could be a standard procedure for such cases. However, the indications for pT3/T4 cancer remain controversial due to limited length of follow-up. A multi-centre randomised controlled trial (RCT) comparing open with laparoscopic surgery for advanced (T3/T4) cancer is to start in autumn this year. Laparoscopic surgery for such cases should be confined to trial cases. Laparoscopic surgery for rectal cancer is feasible; however, it is associated with higher anastomotic leak rates. Issues on education and medical costs need to be resolved.
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PMID:[Current status on laparoscopic surgery for colorectal cancer]. 1517 Sep 73


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