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PubMed1986

The significance of synchronous carcinoma and polyps in the colon and rectum.

The relationship of colorectal carcinoma with polyps was studied retrospectively in 1202 patients. The incidence of synchronous carcinoma (SC) and metachronous carcinoma (MC), prognosis, and recurrence patterns were studied. Synchronous polyps (SP) were found in 36% of the patients. SC was found in 4.4% of the patients, and MC developed in 3.5% of patients. The incidence of SC and of MC increased with SP, and varied according to number, size, and histologic features of the polyps. The adjusted 5-year survival rate was improved in patients with SP compared with those without SP, both overall (79% versus 64%, respectively) and by Dukes' Stage B (87% versus 73%, respectively) and Dukes' Stage C (56% versus 39%, respectively). The pattern of relapse was the same for the SP and non-SP groups. Subtotal colectomy is recommended for colorectal carcinoma and SP in good-risk patients.

Adult↗
PubMed1989

Juvenile polyposis: a case with early presentation and death attributable to adenocarcinoma of the pancreas.

A male child who first presented in the second year of life demonstrated all the recognized clinicopathological manifestations of juvenile polyposis with associated birth defects. Subsequent death at age 19 years from adenocarcinoma of the pancreas further broadens the recognized spectrum of possible sequelae in this disorder and is in keeping with current hypotheses of inherent cancer potential throughout the polyposis syndromes.

Adenocarcinoma↗
PubMed1987

History of colorectal polypectomy and risk of subsequent colorectal cancer.

In a case control study, which formed part of a large, population-based investigation of the incidence, aetiology and survival of colorectal cancer, 24 of 715 cases and 4 of 727 age/sex group matched controls gave a past history of bowel polypectomy (X21 = 17, P less than 0.001, relative risk = 6.37, 95 per cent confidence interval = 2.2-18.6). There was no significant sex or site difference associated with a history of previous polypectomy. These findings are consistent with the view that colorectal polyps are markers of risk (sixfold in the present study) for the subsequent development of colorectal cancer. The data also support the emerging practice that those with adenomatous polyps need regular surveillance of their large bowel as a screening measure.

Adenocarcinoma↗
PubMed1993

Cronkhite-Canada syndrome associated with colon cancer: report of a case.

A 68-year-old man with the clinical features of Cronkhite-Canada syndrome developed cancer of the ascending colon. Although Cronkhite-Canada syndrome has always been considered a benign condition, it may be a premalignant disorder, as suggested by the clinical course of the patient whose case is described herein.

Adenocarcinoma, Mucinous↗
PubMed1986

Do synchronous adenomas influence prognosis after radical surgery for colorectal carcinoma? A prospective study.

From 1978 to 1983, radical surgery for colorectal cancer was performed in 319 consecutive patients who were included in a prospective evaluation of perioperative and repeated postoperative colonoscopy with polypectomy. Synchronous adenomas were found and removed in 87 patients. The probability of survival without recurrent cancer and of not dying from local and/or distant spread was significantly higher (p less than 0.02) in patients with synchronous adenomas than in those without. This unexpected finding could only to a minor degree be explained by a greater prevalence of well differentiated cancers and fewer poorly differentiated cancers in patients with synchronous adenomas. Detailed analysis revealed only one other major difference between the two groups, namely a higher risk of adenomas developing during follow-up of patients with synchronous adenomas (p less than 0.001). The present results may be relevant to future prospective clinical studies in which perioperative and regular postoperative colonoscopy is included.

Aged↗
PubMed1986

[Colorectal polyps and cancers by sub-site: epidemiologic findings in Geneva and Vaud].

The present study is a comparative analysis of the adenomatous polyps and colorectal cancers, registered during a determined period within the population of the cantons of Geneva and Vaud. The analysis is particularly based on the polyp/cancer ratio by sub-site. Histological type as well as age and sex of the patient are taken into consideration.

Adult↗
PubMed1988

A prospective, randomized trial of perioperative prophylactic cefamandole in elective colorectal surgery for malignancy.

The impact on wound infection of the addition of perioperative cefamandole to a mechanical bowel preparation with oral antibiotics was studied in a prospective randomized series of patients undergoing elective colectomy for biopsy-proven carcinoma or adenomatous polyps. Seventy patients were randomized, all underwent mechanical bowel preparation and received oral neomycin and erythromycin base. Thirty-four patients also received a preoperative and four postoperative doses of cefamandole, while 36 patients were randomized to receive no parenteral antibiotics. The two groups were well stratified for age, sex, and risk factors. The Dukes stage was similar and the surgical procedures were equally distributed in the two groups. There were no wound infections in the 34 patients receiving cefamandole and only one wound infection (2.8 percent) in the 36 control patients. Therefore, the addition of perioperative intravenous cefamandole to a good mechanical bowel preparation with oral antibiotics was of no benefit in reducing wound infections following resection of colorectal malignancies in this select group of patients.

Carcinoma, Squamous Cell↗
PubMed1989

Primary rectal lymphoma and malignant lymphomatous polyposis. Two cases illustrating current methods in diagnosis and management.

Two cases of colorectal lymphoma are presented. Preoperative histologic diagnosis is difficult and examination of the fresh specimen using immunocytochemical and gene rearrangement techniques are necessary to establish the precise nature of the lesion. Surgical excision is the mainstay of treatment for localized lymphoma of the colorectum and chemotherapy for malignant lymphomatous polyposis.

Aged↗
PubMed1987

Do size, histology, or cytology of colorectal adenomas and their removal influence serum CEA?

Based on the adenoma-carcinoma sequence the authors studied whether determination of serum carcinoembryonic antigen (CEA) provided any conclusions concerning malignant transformation of a colorectal adenoma. In 32 patients with single or multiple adenomas, serum CEA did not differ from 119 healthy individuals. In 43 percent, a decrease of CEA could be observed after polypectomy, while it increased in 22 percent or remained unchanged in 35 percent. No correlation was found between adenoma volume and serum CEA. There was a tendency toward a higher serum CEA level in patients with villous adenoma as compared with those with tubular structure. CEA concentrations were independent from the degree of cellular atypia, but polypectomy was followed by a decrease of serum CEA in villous adenoma or of moderate cellular atypia, reflecting a possible influence on production or shedding of CEA by these subtypes of adenoma. The results indicate, therefore, that serum CEA is not able to recognize the malignant potential of colorectal adenoma.

Adenoma↗
PubMed1987

The Melbourne Colorectal Cancer Study. Characterization of patients with a family history of colorectal cancer.

The characteristics of 702 colorectal cancer patients are described in relation to the presence of absence of a family history of colorectal cancer in near relatives. No statistically significant associations were found between those with a family history of colorectal cancer and age at detection, sex, country of birth, religion, number of cancers (single, synchronous, or metachronous), previously removed benign colorectal polyps, and adenomatous polyps found in the resection specimen. The family history rate of colorectal cancer for colon cancer cases was statistically significantly higher than for rectal cancer cases (chi 2(1) = 3.8, P = .05) and there was a gradient of decreasing risk from colon to rectum. The family history rate of colorectal cancer in parents of those who were less than 50 years old was twice that of those 50 or older (P = .07), consistent with the view that earlier age of onset is a characteristic of those with a family history of colorectal cancer. There was a statistically significantly higher family history rate of colorectal cancer in respondents who knew of the disease compared with those who did not (chi 2(1) = 5.5, P less than .05). It is unclear if this effect represents recall bias or self-selection bias. In contrast, the rates for a family history of heart disease and stroke were similar, irrespective of the respondent's knowledge of their colorectal cancer status. Thus in the Melbourne study, the family history rate of colorectal cancer was higher in colon cancer than in rectal cancer, there was a decreasing gradient of risk from colon to rectum, and a tendency for earlier age of onset of colorectal cancer in those with a history of this cancer in a parent.

Age Factors↗
PubMed2000

Cronkhite-Canada syndrome: report of two cases.

Two cases of Cronkhite-Canada syndrome are reported. In the first case, a 56-year-old woman had an adenoma of the colon, arising within the Cronkhite-Canada polyps, which was removed by endoscopic polypectomy. This suggests possible neoplastic transformation of polyps in this syndrome. She achieved remission with corticosteroids, but the polyposis recurred (only in the stomach) 7 months after the remission. In the recurrent polyposis, corticosteroid therapy resulted again in complete remission, which has lasted for 5 years. In the second case, a 69-year-old man developed typical manifestations of the syndrome while under emotional stress. He had a past history of chronic pityriasis lichenoides, and serum antinuclear antibody was positive. These findings suggested a possible role of autoimmune response in the pathogenesis of the syndrome. Corticosteroids were also effective in this patient.

Adenoma↗
PubMed2005

Histologic risk factors and clinical outcome in colorectal malignant polyp: a pooled-data analysis.

PURPOSE: The malignant polyp carries a significant risk of lymphohematic metastasis and mortality. Clinical usefulness of histologic risk factors is still controversial. The study was designed to compute the association between the main histologic risk factors and the occurrence of unfavorable outcomes in patients with malignant polyps. METHODS: A MEDLINE search regarding malignant polyps was performed. Three histologic risk factors (positive resection margin, poor differentiation of carcinoma, vascular invasion) and five (residual disease, recurrent disease, lymph node metastasis, hematogenous metastasis, mortality) unfavorable clinical outcomes were evaluated. Further analysis was performed by subgrouping polyps in high-risk and low-risk groups. RESULTS: Thirty-one studies enrolling 1,900 patients with malignant polyp were selected. Positivity of resection margin was significantly predictive of the presence of residual disease (odds ratio, 22; P < 0.0001), poorly differentiated carcinoma was associated with an increased mortality (odds ratio, 9.2; P < 0.05), and vascular invasion with a higher lymph node metastasis risk (odds ratio, 7; P < 0.05). Patients with high-risk polyps showed a significantly worse outcome than those with low-risk, especially for mortality (odds ratio, 11; P < 0.05). Surgical-related death was as low as 0.8 percent. CONCLUSIONS: All three histologic risk factors are significantly associated with the clinical outcome. Classification in low-risk and high-risk patients may be regarded as a meaningful staging procedure.

Carcinoma↗
PubMed2006

Effective screening for bowel cancer: a United kingdom perspective.

Bowel cancer is a major cause of morbidity and death and is a high cost to health care systems. Screening currently offers the best chance of improving outcomes from bowel cancer. When introducing screening, the problems encountered in other cancers need to be avoided to maximize benefits and minimize harms.

Adenomatous Polyps↗