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J J DeCosse

Publications and source records attributed to J J DeCosse.

At least 55 records · Page 3Linked to original sources
PubMed1987

Sodium transport in a mouse model of colonic carcinogenesis.

Following 4 weeks of s.c. injections of 1,2-dimethylhydrazine, a carcinogen that produces colon cancer in CF1 mice, an increase in the unidirectional mucosal to serosal flux and net absorption of sodium was observed in the distal colon. This increase in sodium transport was amiloride sensitive. 1,2-Dimethylhydrazine treatment had no effect on sodium transport in the distal colon of DBA/2 mice, a strain which does not develop colonic malignant transformation. Although stimulation of sodium transport has been observed in cultured cell systems exposed to growth factors, similar changes in sodium transport have not previously been demonstrated in an intact epithelium at an early stage of carcinogenesis. The present study in mouse distal colon demonstrates that sodium transport is altered in 1,2-dimethylhydrazine-induced malignant transformation of the large bowel.

1,2-Dimethylhydrazine↗
PubMed1987

Effect of flurbiprofen and 16,16-dimethyl-prostaglandin E2 on gastrointestinal tumorigenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats. I. Squamous epithelium and mesenchymal tissue.

The effect of exogenous synthetic prostaglandins and the inhibition of endogenous prostaglandin synthesis on gastrointestinal tumorigenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine [(MNNG) CAS: 70-25-7] was studied in female Wistar rats (100 g). Animals were divided into 6 groups: Group I was treated with MNNG alone (No. = 43); group II was treated with MNNG after application of the cyclo-oxygenase inhibitor flurbiprofen (No. = 44); group III was treated with MNNG after oral administration of 16,16-dimethyl-prostaglandin E2 (16,16-dm-PGE2; No. = 43); group IV received flurbiprofen alone (No. = 15); group V was treated with 16,16-dm-PGE2 alone (No. = 11). Animals in group VI served as controls (No. = 15). All drugs were administered orally. Hyperkeratosis and hyperplasia of the forestomach developed by 10 days after the first treatment with the carcinogen. Later, benign papillomas and dysplastic lesions were noted. Progressive ingrowth of squamous epithelium from the forestomach ridge into the glandular stomach started as early as day 13 and was more frequent in animals treated with a combination of MNNG plus flurbiprofen (P less than .001). The first squamous cell carcinomas of the forestomach were detected on day 51. Their incidence was 38, 60, and 42% in groups I, II, and III, respectively. This difference was not statistically significant. The incidence of mesenchymal tumors (leiomyosarcoma) in the stomach and duodenum was higher following treatment with MNNG plus flurbiprofen as compared to the incidence following treatment with MNNG alone or in combination with 16,16-dm-PGE2 (P less than .005). No malignant tumors developed in the gastrointestinal tracts of animals treated with flurbiprofen or 16,16-dm-PGE2 alone or in controls. The higher incidence of gastric and duodenal leiomyosarcomas after treatment with flurbiprofen suggests that reduction of prostaglandin synthesis favored the development of MNNG-induced cancer in mesenchymal tissues of the upper gastrointestinal tract.

Animals↗
PubMed1986

Recurrent epidermoid cancer of the anus.

Of 83 patients with recurrent epidermoid cancer of the anus, 67 had tumors in the anal canal and 16 had tumors at the anal margin. Local pelvic or perineal recurrence after abdominoperineal resection of tumors in the canal had a poor prognosis. Median survival after combination chemotherapy and megavoltage irradiation was 14 months. With irradiation alone, median survival was 7 months, although nearly half of these patients had been treated with orthovoltage techniques. Untreated patients with visceral metastases had a median survival of 8 months, but no improvement in survival was seen after treatment with chemotherapy. In contrast, patients who had metastases in inguinal lymph nodes had a 55% 5-year survival rate after inguinal dissection. Patients with tumors at the anal margin did not have visceral metastases. This is an important difference between tumors arising in the canal and those arising at the anal margin. Local excision was satisfactory treatment for 90% of the patients who had local recurrence in the perianal skin; abdominoperineal resection was rarely required. Inguinal lymph node metastases from margin cancer are uncommon, but three of five such patients survived 5 years after groin dissection. A combination of 5-fluorouracil, mitomycin C, and radiation therapy was used for patients with pelvic recurrence after abdominoperineal resection of epidermoid cancer of the anal canal. In this study, there was no evaluation of the role of megavoltage irradiation alone at the recommended doses of 5500 to 6000 rad for these patients. Some patients with visceral metastases respond to combination chemotherapy, but median survival is not improved; evaluation of new chemotherapeutic regimens is required. Patients with canal tumors metastatic to inguinal nodes should be treated by groin dissection as their prognosis is relatively good. Local recurrence of tumors at the anal margin can be satisfactorily treated by further local excision; those patients with margin tumors metastatic to inguinal nodes require groin dissection.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Chemotherapy for soft tissue sarcoma.

Adriamycin is the only active single agent for patients with metastatic sarcoma; combination chemotherapy regimens that omit Adriamycin are ineffective in adults. Despite early success with CYVADIC, there have been recent doubts regarding its efficacy. No other chemotherapeutic combination has provided consistently better results than CYVADIC. As complete responses occur in less than 15 per cent of patients there is a need for further evaluation of new regimens. It is necessary to evaluate new regimens in prospective, randomized studies. Response criteria should be consistent and reproducible. Attenuation schedules and data relating to the total administered dosage should be provided. It would also be beneficial to analyze prognostic variables so that patients liable to an unfavorable outcome could be identified before commencement of treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Value of splenectomy in non-Hodgkin's lymphoma.

A retrospective review of patients with non-Hodgkin's lymphoma (NHL) who underwent palliative splenectomy for splenomegaly, hypersplenism, or autoimmune complications was done. From 1970 through 1981, 46 patients had palliative splenectomy for splenomegaly alone (n = 3) or various hematologic abnormalities with (n = 35) or without (n = 8) splenomegaly. Splenectomy was performed for life-threatening (n = 7), severe (n = 15), or mild (n = 24) symptoms/signs. The most common hematologic abnormalities were thrombocytopenia (platelet count less than 120,000/mm3; n = 38) and/or anemia (hemoglobin level less than 11.0 g/mm3; n = 29). Response to splenectomy was defined as greater than a threefold increase in preoperative platelet count and/or an increase in hemoglobin levels to greater than 11.0 g/mm3 in the first postoperative month. Four patients with thrombocytopenia did not respond, whereas 33 patients responded with greater than a sevenfold increase in platelet count. All four nonresponders died of complications of thrombocytopenia or progressive disease. Eighteen of 28 (64%) patients with anemia responded to splenectomy. Larger spleens (2000 g versus 1410 g; P less than 0.05) and lower platelet counts (42,000 versus 75,000; P less than 0.05) were found in all nonresponding patients. Responders and nonresponders could not be distinguished on the basis of age, sex, race, duration of disease or splenic involvement, primary site of disease, histopathologic findings, bone marrow or lymphangiogram results, or prior chemotherapy and radiotherapy. Patients with mild symptoms/signs were more likely to respond hematologically than patients with life-threatening or severe symptoms/signs (86% versus 54%; P = 0.06). For all patients, 2- and 5-year survival from the time of splenectomy was 44% and 26%, respectively. Median survival was 18 months (range, 1-144 months). Inability to reverse hematologic abnormalities was associated with poor survival. All nonresponding patients died within 36 months of surgery, whereas 5-year survival in responding patients was 40%. Nine of 30 patients (30%) who responded hematologically survived longer than 5 years, but this group of patients could not be distinguished from the remaining patients on the basis of age, sex, race, duration of disease or splenic involvement, primary site of disease, histopathologic features, bone marrow or lymphangiogram results, or prior chemotherapy and radiotherapy. Surgery was well-tolerated (mortality, 9%; morbidity, 21%). All surgical mortalities and 78% of complications occurred in patients operated on for life-threatening or severe symptoms/signs.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

Epidermoid cancer of the anal margin. Pathologic features, treatment, and clinical results.

Epidermoid cancer of the anal margin should be distinguished from that in the canal because of its different clinical and pathologic characteristics, the suitability of local excision for its treatment, and its better overall prognosis. In addition, margin cancer rarely metastasises to visceral sites. Forty-eight patients with epidermoid cancer of the anal margin were reviewed. Two refused treatment, 4 had palliative therapy for advanced, inoperable disease, 31 had local excision, and 11 were treated by abdominoperineal resection. Local excision provided satisfactory results with a corrected 5 year survival of 88 percent, although locoregional recurrence developed in 46 percent of these patients during follow-up. A second local excision or inguinal lymphadenectomy provided good results in the patients with recurrence. Abdominoperineal resection did not provide better overall survival figures.

Adult↗
PubMed1985

Predicting tumor response in patients with colorectal hepatic metastases.

Until now, there has been no reliable means of predicting tumor response to chemotherapy in patients with metastatic colorectal cancer. Using arterial nuclide flow scans as a determinant of tumor response, the degree of tumor perfusion was evaluated in a blinded prospective study. Seventy-three patients with colorectal hepatic metastases received continuous hepatic arterial (N = 52) or systemic intravenous (N = 21) chemotherapy using an implantable pump. All patients had pretreatment hepatic arteriography and arterial flow scans using 99mTc macroaggregated albumin (99mTc-MAA). An arteriogram was characterized as positive if it showed tumor hypervascularity; the 99mTc-MAA flow scan was considered positive if it showed increased tumor uptake relative to the liver. Of 47 patients with an evaluable 99mTc-MAA flow scan who were treated with arterial infusion, 31 had a positive scan; in this group 16 responded to chemotherapy. The 99mTc-MAA scan was negative in 16 patients, of whom one responded to chemotherapy (p less than 0.006). The 99mTc-MAA scan had the greatest predictive value in previously untreated patients (sensitivity = 91%; specificity = 77%). The arteriogram was positive in 25 of 46 evaluable patients, but this finding had little predictive value for tumor response (sensitivity = 56%; specificity = 46%). Of 21 patients receiving systemic intravenous infusion, the scan was positive in nine patients, of whom seven responded to chemotherapy. The 99mTc-MAA scan was negative in 12 patients, of whom one responded to chemotherapy (sensitivity = 88%; specificity = 85%). When 99mTc-MAA-positive and -negative groups were compared, there were no differences in mean patient age, per cent liver involvement, tumor size, or plasma liver function tests. Hepatic tumor perfusion as determined by MAA arterial flow scan is a reliable predictor of tumor response in patients with metastases from large bowel cancer. The test provides a valuable criterion for selecting individuals for treatment of metastases from large bowel cancer by infusion chemotherapy.

Adult↗
PubMed1985

Acute effects of dietary cholic acid and methylazoxymethanol acetate on colon epithelial cell proliferation; metabolism of bile salts and neutral sterols in conventional and germfree SD rats.

The acute effects of cholic acid ingestion on methylazoxymethanol acetate [(MAM) CAS: 592-62-1]-treated conventional and germfree rats were investigated. Male SD rats were divided into 4 treatment groups. The first group received control chow; the second group, control chow plus 0.5% cholic acid; the third group, control chow plus MAM; and the fourth group, control chow plus 0.5% cholic acid plus MAM. Fecal bile acids, cholesterol, cholesteral degradation products, and neutral sterols, as well as labeling indices and numbers of epithelial cells per crypt column, were measured after 6 weeks of treatment. The administration of MAM to germfree groups diminished both fecal bulk and the amount of fecal water. MAM did not affect the fecal bile acid composition. Analysis of the fecal bile acids in conventional rats fed cholic acid demonstrated that half of the bile acids were in a form of deoxycholic acid. In the germfree groups fed cholic acid, 90% of the bile acids appeared unaltered in the feces. Neither in the germfree nor in the conventional groups was an effect seen of MAM on the output of fecal neutral sterols. The addition of cholic acid to the food decreased the output of neutral sterols both in the conventional (P less than .001) and in the germfree (P less than .02) animals. The germfree animals showed a reduced amount of neutral steroid excretion (P less than .01) when compared to the findings for the conventional groups. MAM had no influence on the fecal cholesterol or coprostanol output. The consumption of 0.5% cholic acid decreased the total output of cholesterol (P less than .05). The excretion of coprostanol was significantly diminished in the conventional rats fed cholic acid (P less than .001). No difference in labeling indices was observed between conventional and germfree rats, whether treated with cholic acid, MAM, or cholic acid plus MAM. However, all germfree groups showed less epithelial cells per crypt column (P less than .001) than did conventional animals.

Animals↗
PubMed1985

Enteral nutrition support in head and neck cancer: tube vs. oral feeding during radiation therapy.

This comparison of tube feeding with oral nutrition was made in patients with advanced head and neck cancer during intensive outpatient radiation therapy. Twenty-six patients with Stage III and IV head and neck cancers were stratified by site (nasopharynx vs. all other tumors, including recurrent nasopharynx) and randomized to receive oral or tube feeding during radiation therapy. All patients were counseled to have an intake of 40 kcal/kg and 1 gm protein per kilogram body weight. Body weights and dietary recalls were obtained weekly, along with evaluation of toxicities to therapy. Serum albumins were obtained at baseline, week 4, end of radiation therapy, and 1 month after radiation therapy. Patients with nasopharyngeal carcinoma presented with significantly less body weight loss (means = -2.6%) than patients with all other carcinomas (means = -9.8%; p = .008). No differences in toxic responses were observed despite larger radiation field size in the tube-fed group (p = .02). Serum albumins in both groups dropped during radiation therapy, with no difference between groups. The tube-fed group maintained higher caloric and protein intakes (35 to 42 kcal/kg, 1.2 to 1.6 gm protein per kilogram) than the oral-fed group (15 to 34 kcal/kg, 0.3 to 1.3 gm protein per kilogram). No differences in body weights were observed between the tube-fed (means = 3.8%) and the oral-fed (means = 3.3%) patients with nasopharyngeal carcinoma. Patients with oropharyngeal and recurrent nasopharyngeal carcinoma had significantly less weight loss with tube feeding (means = 0.2%) than with oral feeding (means = -7.3%; p = .005); thus, tube feeding is recommended during radiation therapy in such patients.

Adult↗
PubMed1985

Treatment of epidermoid carcinoma of the anal canal.

Epidermoid carcinoma of the anal canal should be differentiated from that of the anal margin because of the different clinical presentations, pathologic characteristics, treatments and prognosis. The traditional treatment for carcinoma of the canal, abdominoperineal resection, produced a 55 per cent absolute five year survival rate but at the expense of permanent colostomy. Initial treatment with 5-fluorouracil and mitomycin C combined with external beam radiation therapy reduced the size of the tumor in 72 per cent of the patients and, with subsequent local excision or abdominoperineal resection, resulted in a 78 per cent survival rate in five years. The long term results from combined treatment are better than abdominoperineal resection alone with preservation of anal function in 45 per cent of the patients.

Adult↗
PubMed1984

Treatment alternatives. Localized rectal cancer.

Cancers that occur in the low or mid rectum, and are superficial and freely movable on the underlying bowel wall, should be considered for local treatment provided they are not anaplastic and are technically accessible to excision. Although a variety of methods have been shown to be effective, we propose that initial local surgical excision as a "total biopsy" is the most rational approach to the management of such lesions. Factors indicating a poor prognosis, including extension through the entire thickness of the bowel wall, incomplete surgical excision, poorly differentiated histologic grading, venous or lymphatic invasion, or colloid type of tumor, can be identified, and more aggressive surgical treatment can be urged. When these factors are absent, the total biopsy then constitutes definitive treatment for this highly selected population.

Adult↗
PubMed1984

Nutritional rehabilitation in patients with advanced head and neck cancer receiving radiation therapy.

Previous studies of nutritional support in cancer patients have applied parenteral techniques for relatively short periods. The purpose of this prospective, randomized trial was to evaluate the efficacy of long-term enteral alimentation in patients at high risk for malnutrition during oncologic treatment. Forty patients with inoperable squamous carcinoma of the nasopharynx and oropharynx were randomized to either optimal oral nutrition or to intensive nasogastric tube feedings during radiation therapy for an average of 8 weeks. Dietetic counselling and oral supplements were provided to both groups. Body weight, dietary intake, and toxicity to therapy were assessed weekly; and serum protein concentrations and anthropometric measurements were made at the time of entry, during the fourth week, at the conclusion of radiation therapy, and 1 month after radiation therapy. Tumor status was assessed at the conclusion of radiation therapy and during routine follow-up, which ranged from 9 to 39 months. The 35 evaluable patients (18 tube fed and 17 orally fed) were comparable with regard to age, disease site, and total radiation dosage, but the tube group had more stage IV patients and a greater median radiation field size. The tube fed group showed no difference in the partial tumor response rate compared with the complete tumor response rate (16 of 18 patients versus 14 of 17 patients), a slightly longer duration of response in those who had recurrence compared with those without recurrence (4.5 months versus 3.4 months) and a similar overall survival pattern to that of the orally fed group. Compared with the orally fed group, the tube fed group had a higher mean caloric intake (39 kcal/kg per day versus 30 kcal/kg per day, p less than 0.001), mean protein intake (1.4 versus 1.1 g/kg per day, p less than 0.01), and in the oropharynx cancer patients, less mean body weight loss (0.6 percent versus 6.1 percent, p less than 0.04) during treatment. The tube fed patients maintained mean mid-arm circumference and recovered mean serum albumin levels after radiation therapy in contrast with the orally fed group. Intensive outpatient tube-feeding nutritional support during radiation therapy in patients with advanced inoperable squamous cancer of the oropharynx significantly improved mean weight maintenance, mean caloric and protein intake, and mean serum albumin levels compared with patients who received optimal oral nutrition. Tumor response to radiation therapy, however, was unchanged.

Administration, Oral↗
PubMed1984

Selective distribution of selenium in colon parallels its antitumor activity.

Results of epidemiologic and experimental studies suggest that selenium can inhibit the development of tumors. In rats, the administration of selenium decreases the incidence of carcinogen-induced colon tumors; the inhibition is greater in the proximal colon that in the distal colon. We investigated the distribution of selenium in the different segments of rat colon and determined the uptake of selenium in the mucosa and in the muscle layers of each segment. The colon was perfused before removal of the segments to ensure complete removal of blood-borne selenium. We found that the concentration of selenium was greater in the proximal colon than in the distal colon and that within each segment the uptake was higher in mucosa than in muscle. In addition, we determined the level of selenium in blood, serum, and liver at different times after the administration of various doses of selenium. Though the mechanism by which selenium prevents tumor development is unknown, the data indicate a correlation between the uptake of selenium in different segments of colon and inhibition of tumorigenesis.

Animals↗
PubMed1984

Orchiectomy alone in the treatment of clinical stage I nonseminomatous germ cell tumor of the testis.

Forty-five patients with clinical stage I nonseminomatous germ cell tumor of the testis (NSGCTT) were entered in a prospective clinical trial to receive no treatment other than orchiectomy until clinical evidence of relapse. Of this group, 36 patients (80%) have been continuously free of disease for a median duration of 19.5 months after orchiectomy. Nine patients (20%) have relapsed, eight within seven months of orchiectomy. Seven of nine relapsing patients have been rendered free of disease with chemotherapy and/or surgery for a median duration of seven months (range, one to 33 months) after completion of treatment; the other two patients are presently under treatment although one has progressive disease. The relapse rate was higher in patients with embryonal carcinoma than in those with teratocarcinoma, 57% versus 17%. These preliminary results imply that the omission of routine lymphadenectomy or lymph-node irradiation in clinical stage I NSGCTT deserves further trial.

Adolescent↗