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Results for “Digestive System Neoplasms”

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At least 757 records · Page 42Linked to original sources
PubMed1989

[Blood cholesterol in patients with cancer].

Cholesterolaemia values have been investigated in a simple of colon cancer patients and in two control samples consisting of age and sex corresponding subjects suffering respectively from peripheral arteriopathy and minor pathologies (hernias and varices). The study was extended subsequently to a sample of subjects suffering from thyroid neoplasia and two similarly constituted control samples. Cholesterolaemia was significantly lower in colon cancer patients than in the control samples whereas in subjects suffering from thyroid cancer, statistical significance was not attained even though a similar reduction was recorded. The reduction in cholesterol in cancer patients is, in the light of the most recent studies, an effect of cancer on cholesterolaemia, thus giving the lie to the theory that low blood cholesterol is a factor favouring the onset of cancer, and is a finding with by no means indifferent repercussions on the study of the behaviour and physiopathology of cancers.

Aged↗
PubMed1986

[Usefulness of the determination of CA 19-9 in the follow-up of patients with gastroenteric neoplasms in comparison to CEA].

28 cases of carcinoma of the digestive tract were studied in order to assess the value of assaying a new tumour marker (CA 19-9) on monitoring the postoperative course of neoplasia. CEA, a tumour antigen of more certain dependability was assayed at the same time. In the case series examined it was found useful to monitor both antigens since although CA 19-9 is less sensitive then CEA in cancers of the large intestine, it is more sensitive in carcinomas of the stomach and pancreas. These early data will have to be confirmed on larger samples but in general terms they do indicate the value of the combined monitoring of this new antigen and CEA in the follow-up of patients given surgery for carcinoma of the digestive tract.

Antigens, Neoplasm↗
PubMed1985

[Diagnostic value of a new serum marker of human digestive cancer: the carbohydrate antigen 19.9; comparison with the carcinoembryonic antigen].

In order to evaluate its diagnostic value for digestive cancers, the carbohydrate antigen 19.9 (CA 19.9) was quantitated by radioimmunoassay in the serum of 102 patients suffering from malignant or non-malignant diseases of the digestive or pulmonary tract and of 20 healthy subjects. The carcinoembryonic antigen (CEA) was quantitated by enzyme-immunoassay in the same sera. No correlation was found between the CA 19.9 and the CEA levels. The sensitivity of the CA 19.9 test for the detection of digestive cancers (0.51) was not significantly higher than neither that of the CEA assay (0.46), nor that of the combined tests (0.59). Numerous false positive results were encountered in the CA 19.9 assay in pulmonary diseases and in non-cancerous liver diseases, especially cirrhosis. Its specificity (0.84) did not prove to be superior to that of CEA (0.90). Thus, in our experience, the clinical interest of serum CA 19.9 determination for the diagnosis of digestive cancers seems doubtful.

Antigens, Neoplasm↗
PubMedDate not supplied

[Hartmann's procedure in colorectal tumors. Evolutions of the indications in a series of 46 patients].

The Authors report a retrospective study of 46 cases of Hartmann's operation in order to analyze the changing indications to this procedure in the management of colo-rectal cancer. The Hartmann's is operation has been performed in 46 out of 723 patients (6.4%) with colorectal cancer treated surgically from 1973 to 1997. Data concerning the indications have been analyzed in two consecutive periods, from 1973 to 1985 and from 1986 to 1997, respectively. In the first period, the procedure has been performed in patients with neoplastic perforation (40% of Hartmann's cases), and in an elective basis in patients with locally invasive tumor or intra-abdominal metastasis (20%). Indications for the procedure in the period 1986-1997 have been locally invasive tumor and/or distant metastasis (52.8% of Hartmann's procedures), neoplastic perforation (22.2%), high surgical anaesthesiologic risk (22.2%) or intestinal obstruction (2.8%). In the second period it has been noted a decrease of the number of patients that underwent Hartmann's procedure for bowel obstruction, and an increase in the number of cases in which the operation was performed for neoplastic perforation, for local and/or distant diffusion, or for high surgical risk.

Aged↗
PubMed2006

The influence of the surgeon's and the hospital's caseload on survival and local recurrence after colorectal cancer surgery.

BACKGROUND: Past studies have identified surgeon- and institution- related characteristics as prognostic factors in colorectal cancer surgery. The present work assesses the influence of the surgeon's and the hospital's caseload on long-term results of colorectal cancer surgery. METHODS: The data on 2706 patients from 2, randomized, colorectal cancer trials (Swiss Group for Clinical Cancer Research [SAKK] 40/81, SAKK 40/87) investigating adjuvant intraportal and systemic chemotherapy and 1 concurrent registration study (SAKK 40/88) were reviewed. A first analysis included 1809 eligible, nonmetastatic patients from all 3 studies. A subsequent subgroup analysis included 915 eligible patients from both randomized trials. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) were analyzed in multivariate models taking into account the possible effect of clustering. The main potential covariates were surgeon's annual caseload (>5 operations/year vs < or =5 operations/year), hospital's annual caseload (>26 operations/year vs < or =26 operations/year), tumor site, T stage, and nodal status. RESULTS: Primary analysis of all 3 studies combined found a high surgeon's caseload to be positively associated with OS (P = .025) and marginally with DFS (P = .058). Separate analysis for each trial, however, showed that a high surgeon's caseload was beneficial for outcome in both randomized trials but not in the registration study. A subgroup analysis of 915 patients with 376 rectal and 539 colonic primaries from both randomized trials, therefore, was performed. Neither age, gender, year of operation, adjuvant chemotherapy (intraportal vs systemic vs operation alone), hospital academic status (university vs non-university), training status of the surgeon (certified surgeon vs surgeon-in-training), nor inclusion in 1 of the 2 randomized trials (SAKK 40/81 vs SAKK 40/87) was a significant predictor of outcome. However, both high surgeon's and high hospital's annual caseloads were independent, beneficial prognostic factors for OS (P = .0003, P = .044) and DFS (P = .0008, P = .020), and marginally significant factors for LR (P = .057, P = .055). CONCLUSIONS: High surgeon's and hospital's annual caseloads are strong, independent prognostic factors for extending overall and disease-free survival and reducing the rate of local recurrence in 2 randomized colorectal cancer trials.

Chemotherapy, Adjuvant↗
PubMed1993

p53, retinoblastoma, and human papillomavirus in squamous cell carcinoma and adjacent normal mucosa of the upper aerodigestive tract.

OBJECTIVE: The primary objective of this study was to determine the incidence of p53 and retinoblastoma tumor suppressor gene mutations and human papillomavirus infection in squamous cell carcinoma and adjacent normal mucosa of the upper aerodigestive tract. The secondary objective was to associate these findings with clinical and histopathologic features. DESIGN: Point mutations of p53 were identified by single-strand conformation polymorphism analysis and confirmed by direct DNA sequence analysis. Polymerase chain reaction-based methods were used to identify loss of heterozygosity of the retinoblastoma tumor suppressor gene and the presence of human papillomavirus sequences. SETTING: University-based tertiary care center. PATIENTS OR OTHER PARTICIPANTS: Forty-five consecutive cases of upper aerodigestive tract squamous cell carcinoma. RESULTS: Eleven point mutations of p53 were identified in tumor samples (24%). No functional p53 mutations were detected in adjacent normal tissue from eight of these individuals nor was there evidence of p53 alteration in normal tissue adjacent to 12 of 30 additional tumors tested that demonstrated conformational alterations by single-strand conformation polymorphism analysis. The p53 mutations were significantly associated with local invasion. Loss of heterozygosity (which has a 20% chance of random occurrence in tumors) was detected at the retinoblastoma locus in 15% of the tumors tested. Five of the specimens (11%) were positive for human papillomavirus sequences (two of which also contained p53 mutations). CONCLUSIONS: These findings suggest that p53 but not retinoblastoma or human papillomavirus is an important prognostic factor and is involved as a late event in the pathogenesis of upper aerodigestive tract squamous cell carcinoma.

Base Sequence↗
PubMed1982

Sequential chemotherapy of advanced colorectal cancer with standard or high-dose methotrexate followed by 5-fluorouracil.

Thirty patients with advanced measurable colorectal cancer were randomized to receive either methotrexate (MTX) 200 mg/m2 or 40 mg/m2, followed in four hours by 5-fluorouracil (5-FU) 600 mg/m2. Patients receiving the higher dose MTX were given leucovorin rescue 24 hours later. Eight of 13 patients treated with 200 mg/m2 MTX + 5-FU developed severe hematologic toxicity, leading to two toxic deaths. In addition, 9/13 developed mild azotemia, and three patients had severe gastrointestinal toxicity. No patients with prior chemotherapy responded to either regimen. Among those without prior chemotherapy, there were two of six and three of eight partial responses, respectively, in the 200 mg/m2 and 40 mg/m2 MTX regimens. Sequential 200 mg/m2 MTX followed by 5-FU after four hours has unacceptable toxicity. Sequential treatment with standard dose MTX + 5-FU is tolerable and merits further study.

Aged↗
PubMed1998

Survival of patients with visceral metastatic melanoma from an occult primary lesion: a retrospective matched cohort study.

BACKGROUND: Malignant melanoma presents as metastatic disease without an apparent primary in about 4% of cases. These are referred to as occult primary melanoma (OPM). It is not known whether these represent de novo malignant transformation in non-cutaneous sites or the disappearance of an unrecognised primary, perhaps on an immunological basis. We hypothesised that OPM might have a superior prognosis compared to patients with similar disease extent from a known primary lesion (KPM). PATIENTS AND METHODS: We performed a retrospective cohort survival study of 146 patients with OPM and visceral metastases treated at the Sydney Melanoma Unit between 1983 and 1996. A control group of patients with KPM was matched for age, sex and site of visceral metastases. Survival was measured from the date of diagnosis of visceral metastases. RESULTS: Patients with OPM had a median survival of 233 days, significantly longer than the 176 days for those with KPM (P = 0.024; logrank test). Multivariate analysis allowing for simultaneous or prior involvement of lymph nodes, subcutaneous tissues or bone, and site of visceral involvement showed a significantly superior survival for OPM (hazard ratio (HR): 0.72; 95% confidence interval (CI): 0.55-0.93). A small part of the effect was explained by treatment, but models allowing for this still showed a significantly longer survival. CONCLUSIONS: Survival was longer in OPM patients. This may reflect an intrinsically superior host-tumour interaction.

Adolescent↗