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At least 883 records · Page 49Linked to original sources
PubMed1992

Surgical treatment of colon and rectum adenocarcinoma in elderly patients.

The results are presented of disease-free interval and overall survival in 53 elderly patients with colon or rectum adenocarcinoma treated with curative surgery. The average age was 75.3 years (median = 75.0); 21 patients were male and 32 were female. Tumor location was as follows: rectum 18 (34%), sigmoid 17 (32.1%), right colon 14 (26.4%), and transverse colon 4 (7.5%) All patients were surgically treated following the classical patterns for tumor resection. After pathological examination, which included the histological grade differentiation, the disease stage was reevaluated following the pTNM system. Overall and disease-free survival at 5 years, for all patients, independent of histological grade differentiation and disease stage, were 75.3% and 55.5%, respectively. Overall survival at 5 years for patients with grades I and II histological differentiation was 74.1% and 85.0%, respectively. None of the grade III patients (2 cases) survived more than 1 year. The 5 years disease-free survival for patients with histological grade differentiation I and II was 56.8% and 60%, respectively. There was no statistically significant difference in overall survival for patients with stages SI, SII, and SIII, but the disease-free survival at 5 years by stages was found to be significant with rates of 100%, 67.6%, and 22.6%. Postoperative mortality was 4 (7.5%). The postoperative mortality and survival rates obtained in this group of patients encourage us not to consider age as a limiting factor for curative surgical treatment.

Adenocarcinoma↗
PubMed1990

A case-control study of alcoholic beverage consumption in relation to risk of cancer of the right colon and rectum in men.

To examine the relation between alcoholic beverage consumption and risk of cancer of the right colon and rectum, 644 male cases and 992 male community controls were interviewed by telephone. The risks of cancer at these sites associated with alcohol consumption five years in the past were similar; using subjects with right colon cancer for reference, the adjusted relative risk (RR) of rectal cancer associated with five or more drinks per day was 0.9 (95% confidence limits = 0.4, 1.7). Alcohol consumption 20 years in the past was associated with a greater risk of rectal cancer (RR for five or more drinks per day = 1.8 [1.0, 3.3]). Analyses based on a community controls provided weaker evidence, consistent with previous findings, that heavy consumption of alcohol five years in the past, and possibly of beer in particular, was associated with moderately increased risk of colorectal cancer (RR of cancer of the right colon associated with consumption of five or more alcoholic drinks per day was 1.8 [1.0, 3.2], and of cancer of the rectum was 1.5 [0.9, 2.5]).

Aged↗
PubMed1994

Endorectal ultrasound and leiomyosarcoma of the rectum.

Leiomyosarcomas of the rectum are uncommon neoplasms accounting for fewer than 1% of all malignancies of the colon and rectum. Approximately 215 cases have been described in the literature. Distinction from leiomyoma is often difficult, but regarding dignity is important. The case reported is that of a 68-year-old man in whom a 2.2-cm rectal mass covered by mucosa was diagnosed by rectoscopy and endorectal ultrasound. After treatment by wide local excision the histological specimen revealed a low-grade, highly differentiated leiomyosarcoma. Due to the lack of a large series of this disease, there is disagreement over the therapeutic strategy. At the moment a selective treatment approach seems to be the most frequently advocated. Large tumors and those extending beyond the rectal wall are treated by radical surgical resection. Leiomyosarcomas less than 2.5 cm in size and confined to the bowel wall can be treated by wide local excision. Endosonography can provide exact assessment of tumor size and expansion and is of great value in selecting the appropriate treatment.

Aged↗
PubMed1976

The correlation between liver scintigraphy and serum CEA levels in the detection of liver metastases from rectum carcinoma. A retrospective study.

Radiocolloid liver scintigraphy for the detection of liver metastases is widely used. Because of the known limitations of this technique we investigated the correlation between liver scintigraphy and serum CEA levels in patients with a confirmed diagnosis of primary rectum carcinoma. The serum CEA level is not suitable as a screening test for cancer, but it can be helpful as an extra parameter for the detection of liver metastases. The correlation between liver scintigraphy, the serum CEA level and the clinical findings has also been studied. A good correlation between liver scintigraphy and the serum CEA level was found. Serum CEA levels can be helpful in facilitating the evaluation of liver scintigraphy in patients with carcinoma of the rectum.

Carcinoembryonic Antigen↗
PubMed1975

Benign lymphoid polyps of the rectum.

Benign lymphoid polyps are a rare histologic entity and should not be confused with malignant disease of the colon and rectum. Although retention polyps are the single most common type of colonic polyp in children, the presence of multiple clustered polyps in the rectum should alert the radiologist to the possibility of benign lymphoid polyps. A representative case is described and a review of the pediatric experience with this entity is discussed.

Child↗
PubMed1977

[Risk of combined surgical procedures in operations of colon and rectum (author's transl)].

In a period of 4 years in the Clinic of Abdominal- and Transplantationsurgery of the Medical School Hannover 63 combined surgical procedures were performed in 56 patients with operations of colon and rectum. In comparison with a group of patients, who were treated with similar operations as a single procedure, the increase of risk was studied. Small combined procedures like appendectomia, herniotomia, exstirpation of cysts or removal of diverticula indicate no elevation of the operative risk. Cholecystectomy or prostatectomy, though increasing the entire trauma of operation, did not elevate the rate of complications significantly. In accordance with our results outlines regarding the performance and indication of operations in combination with colon- and rectum surgery are discribed.

Adult↗
PubMed1978

[Transsphincteric approach to the rectum in cases of low early cancer (author's transl)].

Based on 4 years of experience with the transsphincteric approach to the anorectum in 24 cases of low-situated cancers of the rectum, an attempt is made to demonstrate which tumors are treatable by this method and which are not. Exophytic or polyploid tumors with a diameter of not more than 3-4 cm, that are easily palpated and appear freely mobile, and have histologically a differentiated pattern may be approached by transsphincteric resection, under the condition that the tumor has not spread across the wall of the rectum or into adjacent lymph nodes. The method is not recommended in any other instances becauses of the high risk of recurrencies.

Anal Canal↗
PubMed1981

[Restorative surgery for cancer of the rectum (author's transl)].

Sphincter-saving operations in cancer of the rectum are possible in 60%-70%. The definitive decision for a sphincter-saving rectum resection or a local tumor excision is based upon the results of an exact histological examination. Strict clinical and histopathological selection of patients and observance of certain safeguards are necessary. when comparing the time periods 1969-1973 and 1974-1978, 5-year survival after curative surgical therapy has increased from 50.2 +/- 7.7% to 60.7 +/- 7.6% during the same period of time the proportion of restorative surgery has risen from 17%-64%.

Colostomy↗
PubMed1989

Computed tomography of the rectum with water as contrast agent.

The use of intrarectally administered plain tap water as a contrast medium for CT scan of the rectum and sigmoid combined with iv iodine contrast medium was prospectively studied in 28 patients. This method allowed correct demonstration of mural wall abnormalities in all patients and therefore represents a simple, inexpensive, and efficient modality for CT study of the rectum and sigmoid.

Contrast Media↗
PubMed1996

The "inadequate doughnut" technique for stapling in rigid rectums.

PURPOSE: A technique to achieve sound anastomosis of a stiff irradiated rectum is described. METHOD: After application of the pursestring, manipulation of the rectal stump creates an inadequate doughnut anteriorly after firing the circular stapler, which is conveniently repaired manually. RESULTS: A sound anastomosis is achieved. CONCLUSION: This technique is efficient and reliable for creating a sound anastomosis in the rigid rectum.

Anastomosis, Surgical↗
PubMed1992

Biopathologic characteristics of DNA content in crypt cells of transitional mucosa adjacent to carcinomas of the rectum and rectosigmoid.

The transitional mucosa (TM) adjacent to carcinomas of the large bowel shows histologic and mucin histochemical changes that may indicate premalignant change and may be of prognostic value after radical resection. In this study, 10 anterior resection specimens from patients with carcinomas of the rectum and rectosigmoid were used to compare the nuclear DNA content in TM with those in cancer tissue and with those in nontransitional mucosa (N-TM; i.e., uninvolved mucosa remote from tumors showing normal histologic and mucin histochemical features). The nuclear DNA content was assessed using DNA image cytometry on Feulgen-stained sections. As compared with N-TM, crypts in TM contained greater numbers of cells, were elongated, and were more likely to be branched with marked sialomucin secretion, accompanied by a marked reduction in the normal sulfomucin content. The mean nuclear DNA content in the upper, middle, and lower thirds of crypts was significantly higher in TM than in N-TM, and the nuclear DNA content in TM exhibited no correlation to that in tumors. The results suggest that TM adjacent to carcinomas of the rectum and rectosigmoid has higher proliferative activity, providing further evidence that TM may be an unstable premalignant change.

Adenocarcinoma↗
PubMed1994

Neuroendocrine cancers of the colon and rectum. Results of a ten-year experience.

PURPOSE: Our goal was to define the incidence of neuroendocrine carcinomas of the colon and rectum, the patterns of neuroendocrine expression, and the cellular subtype within neuroendocrine tumors. We attempted to determine whether differences in neuroendocrine expression or specific cell type influenced survival. METHODS: Over a ten-year period, 988 patients had resections for colorectal cancer. Using immunohistochemical staining methods specific for neuroendocrine markers, 39 (3.9 percent) neuroendocrine cancers were identified retrospectively. Tumors were also stained with monoclonal antibody A-80 which is specific for exocrine differentiation. In this way we were able to determine the extent of neuroendocrine differentiation such as pure neuroendocrine, predominant neuroendocrine, and equal neuroendocrine-exocrine expression. RESULTS: Average patient age was 65.5 (range, 28-89) years; there were 25 males and 14 females. Nineteen tumors were located in the right colon, 11 in the left, and 9 were in the rectum. Three histopathologic patterns were identified: pure neuroendocrine (n = 11), predominantly neuroendocrine (n = 17), and cancers with equal exocrine and neuroendocrine differentiation (n = 7). Three cellular subtypes were seen: small-cell (n = 15), intermediate-cell (n = 15), and well-differentiated neuroendocrine cancers (n = 5). There was one Dukes A cancer, 7 Dukes B, 16 Dukes C, and 15 patients had metastases to distant sites at the time of diagnosis. As a group, neuroendocrine tumors have a poor prognosis: six-month survival was 58 percent, three-year survival was 15 percent, and five-year survival was 6 percent. Survival statistically correlated with tumor stage (P = 0.01) but not with age, sex, tumor location, histopathologic pattern, or neuroendocrine subtypes. Median survival for pure neuroendocrine carcinomas was seven months and for predominantly neuroendocrine carcinomas was five months. Tumors with equal neuroendocrine and exocrine differentiation had a median survival of 22 months (P = 0.3). Small-cell neuroendocrine carcinomas had a median survival of five months, intermediate-cell had 11 months, and well-differentiated had a median survival of 22 months (P = 0.1). CONCLUSIONS: Neuroendocrine differentiation is found in at least 3.9 percent of colon and rectal cancers. Many of these tumors were initially diagnosed as "carcinoids," the diagnosis was changed to "neuroendocrine carcinoma" after immunohistochemical staining. Overall survival is poor especially for small-cell and pure neuroendocrine carcinomas.

Adult↗
PubMed1996

More effective endoscopic resection with a two-channel colonoscope for carcinoid tumors of the rectum.

PURPOSE: Complete resection of small carcinoid tumors of the rectum is difficult with conventional polypectomy, because these tumors are most often located in the submucosal layer of the rectal wall. To completely remove these tumors, we used a two-channel videocolonoscope with which both a grasping forceps and a polypectomy snare could be used simultaneously. We evaluated its clinical usefulness in comparison with one-channel colonoscopic polypectomy. METHODS: At Osaka Medical Center for Cancer and Cardiovascular Diseases, seven carcinoid tumors in seven patients were removed with a one-channel videocolonoscope from 1985 to 1992. In 1993 and 1994, ten tumors in nine patients were removed with a two-channel colonoscope. RESULTS: The rate of complete removal of carcinoid tumors with a two-channel videocolonoscope (9 of 10 tumors, 90 percent) was significantly higher (P < 0.05) than with a one-channel videocolonoscope (2 of 7 tumors, 29 percent). No complications occurred during or after endoscopic resection with a two-channel colonoscope. CONCLUSIONS: Endoscopic resection with a two-channel colonoscope is a useful and safe method for resection of small carcinoid tumors of the rectum.

Carcinoid Tumor↗
PubMed1990

Conservative management of tumors of the rectum by radiotherapy and local excision.

Twenty-five patients with invasive adenocarcinoma of the rectum were treated by preoperative external irradiation (35 Gy), local excision, and peroperative placement of a plastic tube loop in the tumor bed for perioperative brachytherapy (20 or 25 Gy). Patients treated were too frail for radical resection (14 patients) or had refused a permanent colostomy (11 patients). With a mean follow-up of 40.5 months, there have been 5 patients with local relapse, 3 of whom had salvage abdominoperineal resections: 2 have no evidence of disease and 1 has developed distant metastatic disease. The 20 patients with local control have normally functioning sphincters; 1 has developed distant metastatic disease. This combined approach was designed to expand the curative role of local resection in carcinoma of the rectum. The surgical techniques are thoroughly described and the potential role and indications of this approach are discussed.

Adenocarcinoma↗
PubMed1996

Laparoscopic-assisted transvaginal resection of the rectum.

Laparoscopic resection of the low rectum is technically difficult. This article describes a technique for laparoscopic-assisted, transvaginal low anterior resection of the rectum, which is technically easier and leads to an excellent cosmetic result.

Female↗
PubMed1997

Overview of colorectal cancer in Japan: report from the Registry of the Japanese Society for Cancer of the Colon and Rectum.

BACKGROUND AND PURPOSE: In Japan, the incidence of colorectal cancer has increased remarkably since World War II, and interest in this cancer has grown rapidly among Japanese clinicians and pathologists. As a result, the Japanese Society for Cancer of the Colon and Rectum started a multi-institutional registry of colorectal cancer in 1980. The purpose of this report is to present an overview of the actual state of surgical and pathologic aspects of colorectal cancer treated in the leading hospitals in Japan. MATERIALS AND METHODS: Registry files of clinical and pathologic findings for 38,369 patients treated between 1974 and 1986 with five-year follow-up information and 26,360 patients treated between 1991 and 1994 with no follow-up information were reviewed. RESULTS: Numbers of registered patients have increased annually, reflecting a trend toward an increasing incidence of this cancer in Japan. Colon cancer increased more than rectal cancer in both genders. Resection of the primary lesion was achieved in more than 97 percent of patients who underwent surgical operation recently. The curative resection rate has improved from 65.1 to 79.1 percent for colon cancer and from 71.4 to 80.4 percent for rectal cancer between the 1974 and 1979 and the 1991 and 1994 periods, and operative mortality of those has decreased from 1.8 and 2 percent to 0.5 and 0.5 percent, respectively. There was a trend toward a decrease in locally advanced cancer in terms of cancer invasion into the bowel wall. Stage IV colon cancer also decreased from 22.9 to 16.6 percent with time. The five-year survival rate of each pTNM stage has gradually been improving and was especially evident for patients with Stages I, II, and III of rectal cancer. Overall five-year survival rates for colorectal cancer patients currently exceeds 60 percent. CONCLUSION: The overall incidence of colorectal cancer and the ratio of colon cancer to rectal cancer patients in Japan are increasing. Results of surgical treatment are satisfactory with respect to curative resection rate, operative mortality, and the five-year survival rate. Registry data of the Japanese Society for Cancer of the Colon and Rectum are useful for reporting the actual state of diagnosis, treatment, and end results of colorectal cancer in Japan.

Adenocarcinoma↗
PubMedDate not supplied

Role of pre-operative irradiation for anal preservation in cancer of the low rectum.

Since 1979, 157 patients with T2, T3, or T4 cancer of the lower rectum have been treated by a short course of irradiation, 30 Gy within 12 days by cobalt 60 using 120 degrees arc rotation on a sacral field, followed by a 2-month rest before surgery. The operative specimens were tumor-free in 13% of patients, Dukes' A in 40% of patients, Dukes' B in 22% of patients, and Dukes' C in 25% of patients. Three (1.9%) patients died postoperatively. At 3 years (107 patients) and 5 years (74 patients) the rates of death of local failure were 7.5% and 9.5%, respectively. The 3-year and 5-year disease-free survival were 71% and 58%. Since 1983, the surgeons took advantage of the tumor regression to carry out sphincter-saving operation in 67 patients with T2, T3, and T4 tumors of the lower third of the rectum. The proportion of patients treated by restorative surgery instead of abdominoperineal resection has grown significantly during the past 4 years, from 22% to 71%. Diverting colostomy was performed in 10 patients. Anastomotic leakages were observed in 7 patients. Of 31 patients who underwent low anterior resection and were followed 3 to 7 years (mean 4.5 years), 5 patients died of distant metastasis and 3 patients are alive after segmental hepatectomy. One patient had local recurrence which was controlled by abdominoperineal resection. The rate of 3-year disease-free survival was 77%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗