Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Digestive System Neoplasms”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed1996

Cancer of the digestive system in Circumpolar Inuit.

Cancer of the oesophagus, stomach, small intestine, colon, rectum, liver, gallbladder, biliary tract and pancreas was studied in the Inuit populations of Alaska, Canada and Greenland. Indirect standardization to the populations in Canada, Connecticut (USA) and Denmark was used. High risk of oesophageal cancer was observed in both sexes with standardized incidence ratios (SIRs) of up to 7. An increased risk of colon and rectum cancer occurred among Alaskan Inuit compared with the Inuit populations in Canada and Greenland, which had lower rates. Liver and gallbladder cancer rates were high, with SIRs of 1.5 to 4.1, whereas there were no differences in pancreatic cancer in the populations compared. Dietary habits, alcohol and tobacco consumption are believed to play an important role in most of the observed cancer patterns, but for liver cancer hepatitis B virus infection is also believed to have a causal role.

Alaska↗
PubMed1999

Socioeconomic status, social mobility and cancer occurrence during working life: a case-control study among French electricity and gas workers.

OBJECTIVES: A case-control study within a cohort of the workers employed by Electricité de France and Gaz de France between 1988 and 1992 was carried out to investigate relationships between cancers and socioeconomic status, including the effects of social mobility, by studying three professional career points. METHODS: All the incident cases of breast cancer in women and all the incident cases of upper respiratory and digestive tract cancer (comprising cancers of the larynx, pharynx, buccal cavity and esophagus), lung cancer, hematopoietic system cancers and colon cancer in men were extracted from the Cancer Register of the Social Security Department. The controls were matched for age (men) and for age and length of employment in the company (women). Socioeconomic status was measured at three professional career points (beginning, midpoint (about 35), and time of diagnosis (about 48)) by two types of socio-professional variables: employee category (low, medium, high) and a variable based on the French socioeconomic status classification system. An estimation of social mobility was done between career beginning and midpoint. Cases and controls were compared for socioeconomic status at the three career points. They were also compared for social mobility. RESULTS: The differences between the social categories were larger at the start than later in the career for breast cancer in women. The category of operations staff was used as a reference, and this analysis shows a difference between the risks associated with supervisors (OR = 2.0) and managers and specialist professions (OR = 1.5). There were large differences according to the type of cancer in men. A socioeconomic gradient in the incidence of cancers of the upper respiratory and digestive tract was observed at every career stage. The gradient was largest at the moment of diagnosis. The odds ratio was 3.4 for supervisors, 7.8 for operations staff and 14.8 for production staff. There was a socioeconomic gradient in lung cancer at all points in the career and in the incidence of the hematopoietic system cancers at mid-career and at diagnosis. No association between socioeconomic status and colon cancer was found. Social mobility accentuated all these results. CONCLUSION: Socioeconomic status is involved in the development of cancers. Our study suggests that the transition from social to biological processes could act via specific lifestyle and/or work-related risk factors. When there is a social gradient in the incidence of a cancer, an individual's social change is at least as important as his/her original social status in the relationship between cancer and social class.

Adult↗
PubMed1996

Cancer mortality among north African migrants in France.

BACKGROUND: Data on cancer mortality in North African migrants to France (the largest foreign-born community in the country) are presented, providing useful insights both into cancer patterns in North Africa and their changes following migration. METHODS: The cancer mortality in migrants from North Africa (Algeria, Morocco, Tunisia and Egypt) resident in France relative to that of the local-born population, is estimated from mortality data for the period 1979-1985, and population data from the 1982 French census. Risks of death from different cancers were adjusted for important confounding factors such as social status and area of residence. RESULTS: The risks are quite similar for Algerian, Tunisian and Moroccan migrants. Compared to the local-born, those Maghrebian migrants of one or both sexes have higher risks of death from cancer of the nasopharynx, gallbladder and bladder (in Algerians only). Conversely, Maghrebian migrants have lower risks of death from cancer of the oral cavity, other pharynx, oesophagus, stomach, colon, rectum, lung, larynx, melanoma (in Algerians only), kidney and nervous system (except in Tunisians), breast, ovary, and cervix uteri (except in Moroccans). For Egyptian migrants, because of small numbers, few of the estimates are statistically significant. They are at lower risk of death from lung cancer and at higher risk for lymphoma and leukaemia. CONCLUSION: The findings provide confirmatory evidence of the unusual cancer patterns among North African populations, who have low risks for most cancer sites, and high risks for certain cancers, such as of the nasopharynx and bladder.

Adolescent↗
PubMed1999

Surface-rendering imaging of gastrointestinal lesions by three-dimensional endoscopic ultrasonography.

BACKGROUND AND STUDY AIMS: In three-dimensional endoscopic ultrasonography (3D-EUS), a surface-rendering method can provide both a surface image and a cross-sectional ultrasonographic image. We evaluated the usefulness of this imaging method for digestive tract lesions. PATIENTS AND METHODS: A total of 30 patients underwent 3D-EUS with surface-rendering using a 3D probe system which arranged individual radial scanning images into 128 points on a computer monitor to outline the surface of a lesion. A complete surface image of the lesion was displayed on the computer monitor using lines obtained from 40 radial scanning images. RESULTS: Surface-rendering images of lesions were similar to endoscopic images. The surface-rendering method permitted precise correlation of two-dimensional images depicting a slice of a lesion with the corresponding surface of the lesion. Unlike conventional endoscopy, this approach permitted observations of lesions at any desired angle. Complete images of lesions were achieved in 14 patients and were half-completed in another five, but could not be obtained in 11 patients: in six the distance between the lesion and the 3D probe was too short to avoid artifacts, while in five the lesion was larger than the longitudinal scanning length of 4 cm or greater than 90 in extent in radial scanning images. Artifacts caused by heartbeat led to irregular images in four patients, including three with esophageal cancer and one with gastric cancer. CONCLUSIONS: Despite some problems, surface-rendering imaging should prove useful for diagnosis, and the method will improve as software is perfected.

Colonic Neoplasms↗
PubMed2002

[116 multiple primary cancers in the digestive system].

OBJECTIVE: To study the clinical characteristics, diagnosis, strategy of treatment and prognosis of multiple primary cancers in the digestive system. METHODS: All malignant lesions in the digestive system encountered in the past 10 years were analysed by a computer software. RESULTS: 116 cases of multiple cancers were observed with an incidence of 1.74%. Male to female ratio was 2.7:1. There were 62 synchronous carcinomas and 54 metachronous ones. In decreasing sequence, they were: colon > stomach > rectum > liver. The 1-, 3-and 5-year survival rates of the synchronous ones were 42.3%, 23.1% and 11.5%. Those of metachronous ones were 95.2%, 85.7% and 76.2%. CONCLUSION: High frequency of multiple primary cancers is found in the colon, especially over the right side. Metachronous carcinomas usually give better prognosis than the synchronous ones. The longer the interval between the development of the two primary lesions, the better the prognosis. Multiple cancers of the colon have satisfactory prognosis. The key to improve the treatment is to be vigilant against lesions in the digestive tract so as to arrive at a timely diagnosis and treatment. The strategy of combining radical treatment with immuno-supportive therapy is advocated.

Colonic Neoplasms↗
PubMed1997

Induction of apoptosis in neuroendocrine tumors of the digestive system during treatment with somatostatin analogs.

The extent of apoptosis identified by in situ DNA nick end labelling (TUNEL) on tissue samples obtained from patients with neuroendocrine tumors was correlated with the clinical outcome in patients treated with high-dose somatostatin analog (lanreotide 12 mg/day), n = 8, or other biotherapy including interferon-alpha (IFN-alpha), n = 4, low-dose somatostatin analog (octreotide or lanreotide), n = 3, or a combination of both, n = 1. Biopsies were obtained before the start of treatment and/or after 6 months and 12 months. After 6 months of treatment, 5 patients receiving high-dose somatostatin analog showed a biochemical response (decrease in different neuroendocrine tumor markers) and 4 of these showed an increase in apoptotic index (AI: percentage of apoptotic cells) by 1.94 +/- 1.71%. At 12 months, AI was also increased in patients with a biochemical response (4.22 +/- 3.93%). However, none showed a decrease in tumor size on computerized tomography (CT) and none of the patients treated with low-dose somatostatin analog or IFN-alpha showed any significant increase in AI during treatment. In an experimental model, nude mice were xenografted with the neuroendocrine cell line (BON-1). From the 2nd day of tumor implantation, they received treatment with either placebo, high-dose octreotide, IFN-alpha, or a combination of both, for 28 days. In mice receiving treatment with high-dose octreotide (300 microg/kg, t.i.d) there was a threefold increase in apoptotic cells as compared to the placebo group (p = 0.0084), while the combination group had few cells with ultra-structural changes indicating apoptosis and the IFN-alpha treated group showed no significant changes. However, tumor growth inhibition was more pronounced in the combination group (p = 0.0011). This probably denotes that tumor growth inhibition could be achieved more efficiently by blocking the cell cycle than by inducing apoptosis. We concluded that treatment with high-dose somatostatin analogs may induce apoptosis in neuroendocrine tumors, while this is not found during treatment with low-dose somatostatin analogs or IFN-alpha. We also found that an increase in AI during high-dose somatostatin analog treatment was correlated with the biochemical response, but not with the tumor size as detected by CT in patients or with the tumor mass in the experimental model.

Aged↗
PubMed2004

Intraoperative radiofrequency ablation (RFA) for irresectable liver malignancies.

AIMS: To evaluate the outcome of patients who received radiofrequency ablation (RFA) at open laparotomy in patients with irresectable liver malignancies. METHODS: Twenty-six consecutive patients who underwent explorative laparotomy and were found to be irresectable or who had been assessed not suitable for either resection or percutaneous RFA received intraoperative RFA. An expandable electrode (RITA Medical systems) was used. Follow-up comprised CT-scans in 6-12 week intervals. RESULTS: Patients' age ranged from 35 to 72 years (median 61). A variety of pathologies were treated. In 26 patients, 88 hepatic lesions were treated: 32 with resection and 56 with RFA. The mean diameter was 4.0+/-2.6 cm with a maximum of 10 cm. In 22 patients with hepatic metastases (18 colorectal, one leiomyosarcoma, one endometrium carcinoma, one renal cell carcinoma, one malignant phaeochromocytoma) 74 lesions (median 3.4 per patient) were treated (25 by resection, 49 by RFA). Eleven patients received simultaneous resection and RFA: resection of anatomical segments in six and atypical resection in seven patients. Procedure related complication rate was 19.2%. The mean follow-up was 14.6+/-9.2 months (2-36 months). Three patients developed recurrence at the site of previous RFA indicating incomplete ablation. The overall local control rate after one year was 92 and 90.9% for patients with colorectal liver metastases, respectively. Seventeen patients (65.4%) suffered from tumour progress. In 14 patients (53.9%) tumour occurred at new hepatic localisations and in five patients extrahepatic tumour relapse was diagnosed. Twelve patients have died so far (median survival 18 months, range 4-27). Nineteen patients had either completed a follow-up of at least 12 months or died within this period, resulting in an one year survival rate of 79% (80% for liver metastases). CONCLUSION: Intraoperative RFA is a valuable tool in liver surgery which extends the surgical spectrum in cases of irresectable malignancies.

Adult↗
PubMed1997

Activity of temozolomide against human tumor colony-forming units.

8-Carbamoyl-3-methylimidazo(5,1-d)-1,2,3,5-tetrazin-4(3H)-one (temozolomide) is a new imidazole tetrazinone compound with promising preclinical and clinical activity in nitrosourea-sensitive and -resistant models and manageable toxicity in Phase I and II clinical trials. In this study, we investigated the antiproliferative activity of temozolomide against a large variety of human tumors taken directly from patients in an in vitro soft agar tumor cloning system. Temozolomide was studied using a continuous exposure at final concentrations from 0.1 to 10.0 microM against a total of 222 tumor specimens, of which 101 (45%) were evaluable. A decrease in tumor colony formation was considered significant if survival of colonies treated with temozolomide was </=50% of that in controls. In vitro responses were seen in 9 of 101 [9%; 95% confidence interval (CI), 3-14], 16 of 100 (16%; 95% CI, 8. 5-23), and 35 of 101 (35%; 95% CI, 26-45) tumor specimens at concentrations of 0.1, 1.0, and 10.0 microM, respectively (P < 0. 001). The level of O6-guanine-alkyl-transferase was evaluable in 19 specimens before treatment but did not correlate with a response to temozolomide. At a concentration of 10 microM, a good cytotoxic activity was seen in breast (42%; 95% CI, 15-72), ovarian (36%; 95% CI, 11-69), and non-small cell lung cancers (27%; 95% CI, 6-61). Interestingly, activity was also seen in renal cell carcinomas (50%; 95% CI, 19-81), colon cancers (42%; 95% CI, 15-72), melanomas (33%; 95% CI, 13-59), and some other tumors, including sarcomas and both prostatic and pancreatic carcinomas that are usually considered very resistant to several conventional chemotherapy agents. Moreover, we observed that a subset of tumors that were not sensitive to dacarbazine, carmustine, cisplatin, doxorubicin, 5-fluorouracil, etoposide, and vinblastine were sensitive to temozolomide. These data indicate both that temozolomide is an active drug in vitro against a large variety of human tumors, including some tumors usually resistant to conventional chemotherapy, and that further clinical evaluation is warranted.

Adrenal Gland Neoplasms↗
PubMed1989

An analysis of the reduced morbidity and mortality rates after pancreaticoduodenectomy.

We examined the course of 51 consecutive patients who underwent pancreaticoduodenectomies between 1979 and 1987. Fifteen patients (30%) had a traditional pancreaticoduodenectomy and 36 (70%) had a pylorus-preserving procedure. Operative blood loss, resumption of oral intake, and time to discharge from the hospital were not different for the two operations. One patient (2%) died of complications of the operation, and 14 patients (27%) had nonlethal intra-abdominal complications. Two patients required reoperation: 1 had a hemoperitoneum and 1 had a breakdown of a choledochoenterostomy. Of the patients undergoing pancreaticoduodenectomy for cancer, 26 (74%) of 35 survived 1 year, 9 (47%) of 19 survived 3 years, and 3 (33%) of 10 patients survived 5 or more years postoperatively. Our data showed that (1) on a service where a large number of these operations is performed, the mortality rate of patients who have undergone a pancreaticoduodenectomy is substantially lower than in the past and that (2) the main reasons for these improved results are greater experience of a few surgeons who perform the procedure regularly and the availability of computed tomographic scans and skilled interventional radiologists, which allows postoperative infection and pancreatic fistulas to be controlled. Although pancreaticoduodenectomy is only palliative in most patients with cancer, it provides the best palliation and the only chance of cure, and the procedure can be recommended when performed in tertiary care centers that possess these elements of success.

Adenocarcinoma↗
PubMed1986

Failure to improve survival by improved diagnostic techniques in patients with malignant jaundice.

In a consecutive series of 118 patients with malignant obstructive jaundice at North Tees General Hospital only 70 patients were adjudged fit to undergo surgery. Tumour resection was possible in only four patients. Palliative bypass was performed in 45 patients while 21 patients had no procedure other than an exploratory laparotomy. In contrast to the accuracy of investigation the results of surgery have been poor with considerable mortality (42.8 per cent) and lack of long-term survivors. The results emphasize the role of non-surgical methods for relieving jaundice of malignant aetiology, especially in frail elderly patients and those who have metastases at the time of presentation.

Adult↗
PubMed1993

Estimates of the worldwide incidence of eighteen major cancers in 1985.

The annual incidence rates (crude and age-standardized) and numbers of new cases of 18 different cancers have been estimated for the year 1985 in 24 areas of the world. The total number of new cancer cases (excluding non-melanoma skin cancer) was 7.6 million, 52% of which occur in developing countries. The most common cancer in the world today is lung cancer, accounting for 17.6% of cancers of men worldwide, and 22% of cancers in men in the developed countries. Stomach cancer is now second in frequency (it was slightly more common than lung cancer in 1980) and breast cancer--by far the most important cancer of women (19.1% of the total)--is third. There are very large differences in the relative importance of the different cancers by world area. The major cancers of developed countries (other than the 3 already named) are cancers of the colon-rectum and prostate, and, in developing countries, cancers of the cervix uteri, mouth and pharynx, liver and oesophagus. The implications of these patterns for cancer control, and specifically prevention, are discussed. Tobacco smoking and chewing are almost certainly the major preventable causes of cancer today.

Adolescent↗
PubMed2001

Comparative evaluation of surgical stress of laparoscopic and open surgeries for colorectal carcinoma.

PURPOSE: To objectively evaluate the benefits of laparoscopic procedures for colorectal carcinoma, a prospective study to measure the stress response to laparoscopic surgery (n = 15) compared with open surgery (n = 12) was undertaken. In addition, to compare the various parameters relevant to surgical stress, the major surgery group (transthoracic esophagectomy for esophageal carcinoma, n = 4; and left upper abdominal evisceration for gastric carcinoma, n = 3) was assigned. METHODS: Peripheral blood samples were obtained to measure serum interleukin-6, C-reactive protein, peripheral leukocytes, and lymphocyte counts. Additionally, the level of lymphocyte apoptosis was quantified using flow cytometry. RESULTS: The interleukin-6 and C-reactive protein levels were significantly greater in the open group than in the laparoscopy group one day (P < 0.05) and two days (P < 0.05) after surgery, respectively. In the laparoscopy group, lymphocyte counts were significantly higher than in the open group two days after surgery. The laparoscopy and open groups did not differ significantly in their lymphocyte apoptotic index. In the major surgery group, the apoptotic index was significantly higher than in either the laparoscopy group or the open group in the early postoperative period. CONCLUSION: Changes in the various parameters pertinent to surgical stress evaluated in this study suggest that laparoscopic surgery for colorectal carcinoma leads to less postoperative stress than conventional open surgery.

Aged↗
PubMed2004

Minilaparoscopy in the diagnosis of peritoneal tumor spread: prospective controlled comparison with computed tomography.

BACKGROUND: Early diagnosis of peritoneal spread in malignant disease prevents unnecessary laparotomies. Minimally invasive laparoscopy with the patient under conscious sedation is a new, easily feasible diagnostic technique. This study compares prospective and controlled diagnostic minilaparoscopy with computed tomography (CT) scan for the diagnosis of peritoneal metastases. METHODS: In this study, 56 patients with malignant disease were prospectively investigated with diagnostic minilaparoscopy and CT scan. RESULTS: The study criteria were fulfilled by 54 patients. Minilaparoscopy detected peritoneal carcinosis in 28 of 54 cases, whereas CT detected the disease in 14 of 54 cases. For 36 patients, the diagnosis could be verified by histologic examination of peritoneal biopsies or laparotomy. In this group, minilaparoscopy detected peritoneal carcinosis in 25 of 36 cases, whereas CT detected the disease in 12 of 36 cases. CONCLUSIONS: Minilaparoscopy was more sensitive than CT in detecting peritoneal carcinosis (100% vs 47.8%; p < 0.01). Considering its low grade of invasiveness and superior sensitivity, minilaparoscopy should be regarded as the procedure of choice for the early detection of peritoneal carcinosis.

Adult↗
PubMed2005

Therapeutic, prophylactic, and preresection applications of laparoscopic gastric and biliary bypass for patients with periampullary malignancy.

BACKGROUND: Laparoscopic bypass surgery for the palliation of gastric and biliary obstruction is associated with a rapid recovery. This study aimed to extend its application to other aspects in the management of patients with periampullary cancer. METHODS: Between 2001 and 2004, 21 patients (median age, 68 years) underwent laparoscopic gastric (n = 8), biliary (n = 5), and combined gastric and biliary (n = 8) bypass. In addition to its therapeutic role (n = 12), indications included a concomitant prophylactic gastric (n = 3) and biliary (n = 2) bypass as well as pre- 1 Whipple's relief of deep jaundice at the time of staging laparoscopy (n = 3). Construction of the biliary bypass to the gallbladder (n = 11) or bile duct (n = 2) was based on preoperative imaging. RESULTS: All procedures were completed laparoscopically. The median operating times for gastric, biliary, and combined bypass were 75, 60, and 130 min, respectively. The addition of a prophylactic bypass did not significantly prolong the operating time, as compared with a single therapeutic bypass. One patient died postoperatively of aspiration pneumonia. The postoperative hospital stay (median, 4 days) was not significantly influenced by the type of bypass. No recurrence of or new obstructive symptoms developed during the follow-up period after a therapeutic or prophylactic bypass. CONCLUSIONS: Applications of laparoscopic gastric and biliary bypass can safely be expanded to include a prophylactic role and preresection relief of obstructive jaundice. Prophylactic bypass surgery does not prolong operating time or hospital stay significantly and prevents future onset of obstructive symptoms.

Adult↗
PubMed2000

Early diagnosis of postoperative infection: assessment of whole blood chemiluminescence.

Whole blood chemiluminescence (CL), which allows for the evaluation of both the oxygen radical release by phagocytes and the serum opsonin activity using very small amounts of blood, is considered to be a useful means of assessing the host defense against infection. We measured the whole blood chemiluminescence in 59 patients before and after open surgery (surgery by a laparotomy) for gastrointestinal disease. Early postoperative infection was detected in 12 (20.3%) of the 59 patients. These 12 patients all had significantly higher white blood cell counts compared with the noninfected patients on the third and subsequent days after surgery (P < 0.01). The peak CL in the early postoperative infected group was also significantly higher than that in the noninfected group on the day of surgery (P < 0.0001), 1 day after surgery (P < 0.0001), and 3 days after surgery (P < 0.01). Whole blood CL may therefore be a useful modality for the early detection of postoperative infection in the future.

Adult↗
PubMed2000

Intra-abdominal metastases in musculoskeletal sarcomas.

This study examined the incidence, histological type, clinical symptoms, and prognosis in patients with intra-abdominal metastases of musculoskeletal sarcomas. The medical records of 505 patients with musculoskeletal sarcomas were reviewed for examples of intra-abdominal metastases. The incidence of intra-abdominal metastases (excluding lung) was: 4% in the liver (20 patients), 1.2% in gastrointestine (6 patients), 0.8% in pancreas (4 patients), and 0.8% on the peritoneal surface (4 patients). Patients with a previous hisory of lung metastases and those with high-grade liposarcoma tended to show metastasis in the intra-abdominal organs. Most patients with liver metastasis had no symptoms. Patients with gastrointestinal metastasis had abdominal pain, anemia, and melena. Patients with pancreatic metastasis had diabetes and jaundice. Six patients underwent surgical treatment, and two of them survived for more than 2 years. Metastases within the abdomen must be considered as a possible site for dissemination of musculoskeletal sarcomas, especially in patients with advanced disease and those with liposarcoma.

Adolescent↗