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1. Hisashige A, Yoshida S, Kodaira S: Cost-effectiveness of adjuvant chemotherapy with uracil-tegafur for curatively resected stage III rectal cancer. Br J Cancer; 2008 Oct 21;99(8):1232-8
Genetic Alliance. consumer health - Rectal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cost-effectiveness of adjuvant chemotherapy with uracil-tegafur for curatively resected stage III rectal cancer.
  • Recently, the National Surgical Adjuvant Study of Colorectal Cancer in Japan, a randomised controlled trial of oral uracil-tegafur (UFT) adjuvant therapy for stage III rectal cancer, showed remarkable survival gains, compared with surgery alone.
  • To evaluate value for money of adjuvant UFT therapy, cost-effective analysis was carried out.
  • Cost-effectiveness analysis of adjuvant UFT therapy was carried out from a payer's perspective, compared with surgery alone.
  • For 5.6-year observation, 10-year follow-up and over lifetime, adjuvant UFT therapy gained 0.50, 0.96 and 2.28 QALYs, and reduced costs by $2457, $1771 and $1843 per person compared with surgery alone, respectively (3% discount rate for both effect and costs).
  • Economic evaluation of adjuvant UFT therapy showed that this therapy is cost saving and can be considered as a cost-effective treatment universally accepted for wide use in Japan.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / economics. Rectal Neoplasms / drug therapy. Rectal Neoplasms / economics
  • [MeSH-minor] Chemotherapy, Adjuvant / economics. Cost-Benefit Analysis. Digestive System Surgical Procedures. Female. Humans. Japan. Kaplan-Meier Estimate. Male. Middle Aged. Quality-Adjusted Life Years. Tegafur / administration & dosage. Tegafur / economics. Uracil / administration & dosage. Uracil / economics

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  • (PMID = 18797469.001).
  • [ISSN] 1532-1827
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil
  • [Other-IDs] NLM/ PMC2570527
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2. Bachet JB, Rougier P, de Gramont A, André T: [Rectal cancer and adjuvant chemotherapy: which conclusions?]. Bull Cancer; 2010 Jan;97(1):107-22
Genetic Alliance. consumer health - Rectal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Rectal cancer and adjuvant chemotherapy: which conclusions?].
  • [Transliterated title] Cancer du rectum et chimiothérapie adjuvante: quelles conclusions?
  • Adenocarcinoma of the rectum represents about a third of cases of colorectal cancer, with an annual incidence of 12,000 cases in France.
  • On the contrary of colon cancer, the benefice of adjuvant chemotherapy in rectal cancer has not been definitively proved, more because this question was assessed in few recent studies than because negative results.
  • Preoperative radiochemotherapy is now the reference treatment for mid and lower rectal cancers, and allow to increase the local control without improvement of progression free survival and overall survival.
  • The data of the "historical studies" of adjuvant treatment in rectal cancer published before 1990, of the meta-analysis of adjuvant trials in rectal cancer and of the QUASAR study suggest that adjuvant chemotherapy with fluoropyrimidines (intravenous or oral), in absence of pre-operative treatment, decrease the risk of metastatic relapse after curative surgery for a rectal cancer of stage II or III.
  • This benefice seems similar to the one observed in colon cancer.
  • In the EORTC radiotherapy group trial 22921, an adjuvant chemotherapy with 5-fluorouracil and low dose of leucovorin was not associated with a significantly improvement of overall survival but, despite the fact that only 42.9% of patients received all planed cycles, the progression free survival was increased (not significantly) in groups receiving adjuvant chemotherapy.
  • The French recommendations are to discuss the indication of adjuvant chemotherapy by fluoropyrimidines in cases of stage III rectal cancer on histopathologic reports and no chemotherapy in case of stade II.
  • Despite the fact that none study have assessed a combination of fluoropyrimidines and oxaliplatin in adjuvant setting in rectal cancer, like in colon cancer, the Folfox4, modified Folfox6 or Xelox regimens are valid options in stage III (experts opinion).
  • In cases of pathologic complete remission or in absence of involved nodes, the benefice of adjuvant chemotherapy is not assessed.
  • In all cases, the decision of adjuvant chemotherapy has to be taken during a multidisciplinary meeting.
  • The interest of a combination of fluoropyrimidine and oxaliplatin is assessed in currently adjuvant trials (PETTAC-6 and CAO/ARO/AIO-04), and future trials will assess the interest of neoadjuvant chemotherapy.
  • [MeSH-major] Adenocarcinoma / drug therapy. Rectal Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Humans

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  • (PMID = 19965305.001).
  • [ISSN] 1769-6917
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 58
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3. Ong S, Watters JM, Grunfeld E, O'Rourke K: Predictors of referral for adjuvant therapy for colorectal cancer. Can J Surg; 2005 Jun;48(3):225-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Predictors of referral for adjuvant therapy for colorectal cancer.
  • OBJECTIVE: We carried out a retrospective cohort study at the Ottawa Hospital-Civic Campus to determine the proportions of patients referred for and provided adjuvant therapy for colorectal cancer (CRC) among those eligible according to published clinical practice guidelines.
  • METHOD: Patients with stage III colon or stage II or stage III rectal cancer who had had potentially curative surgical resection for CRC and were seen at the Ottawa Hospital during 1999 and 2000 were eligible.
  • We noted the number of medical or radiation oncology consultations, or both, and the subsequent receipt of adjuvant chemotherapy or radiotherapy, or both.
  • Of the 158 patients, 113 (72%) received adjuvant therapy, 90 (87%) eligible patients aged less than 75 years and 23 (43%) older patients.
  • Gender and cancer site (colon or rectum) were not significant predictors of referral for, or receipt of, adjuvant therapy in general.
  • CONCLUSIONS: The observed rates of referral for and receipt of adjuvant therapy for CRC are greater than generally published and appear reasonably concordant with current clinical practice guidelines, but optimal rates are undefined.
  • However, our knowledge of the factors important to the process of clinical decision-making about adjuvant therapy for CRC is incomplete, and there may be patients, especially older ones, for whom adjuvant therapy would be appropriate but who are not being referred or treated.
  • [MeSH-major] Colonic Neoplasms / drug therapy. Colonic Neoplasms / radiotherapy. Practice Patterns, Physicians'. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy. Referral and Consultation
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Comorbidity. Female. Humans. Logistic Models. Male. Middle Aged. Radiotherapy, Adjuvant. Retrospective Studies

  • Genetic Alliance. consumer health - Colorectal Cancer.
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  • (PMID = 16013627.001).
  • [ISSN] 0008-428X
  • [Journal-full-title] Canadian journal of surgery. Journal canadien de chirurgie
  • [ISO-abbreviation] Can J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Canada
  • [Other-IDs] NLM/ PMC3211554
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4. Hotta T, Takifuji K, Yokoyama S, Matsuda K, Higashiguchi T, Tominaga T, Oku Y, Nasu T, Yamaue H: Rectal cancer surgery in the elderly: analysis of consecutive 158 patients with stage III rectal cancer. Langenbecks Arch Surg; 2007 Sep;392(5):549-58
Genetic Alliance. consumer health - Rectal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Rectal cancer surgery in the elderly: analysis of consecutive 158 patients with stage III rectal cancer.
  • BACKGROUND: It is difficult to establish a clear-cut indication for rectal surgery in elderly patients because of greater risk.
  • MATERIALS AND METHODS: We clarified the potential predictors of the cancer-related and disease-free survivals after surgery, the factors associated with the elderly, preoperative comorbid conditions, and postoperative complications in 158 patients with stage III rectal cancer who underwent surgery, including 33 elderly patients (>or=75 years) and 125 younger patients (<75 years).
  • RESULTS: An old age and macroscopic types 3 and 4 were independent poor prognostic factors of cancer-related survival, whereas the disease-free survival of the younger patients was not longer than for the elderly patients.
  • Histopathological type except well differentiated and without chemotherapy were significant tumor characteristics associated with the elderly patients.
  • CONCLUSION: Strength of the adjuvant and intensive therapies after recurrence may contribute to gain long-term survival in the elderly rectal cancer patients.
  • [MeSH-major] Rectal Neoplasms / surgery
  • [MeSH-minor] Age Factors. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Combined Modality Therapy. Comorbidity. Disease-Free Survival. Female. Follow-Up Studies. Health Status Indicators. Humans. Male. Multivariate Analysis. Neoplasm Invasiveness. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Pelvic Exenteration. Postoperative Complications / etiology. Postoperative Complications / mortality. Postoperative Complications / surgery. Prognosis. Radiotherapy, Adjuvant. Rectum / pathology. Rectum / surgery

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  • (PMID = 17593386.001).
  • [ISSN] 1435-2451
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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5. Osuagwu CC, Okafor OC, Ezeome ER, Uche CE, Ememonu C, Kesieme E: Familial adenomatous polyposis with synchronous invasive colonic carcinomas and metastatic jejunal adenocarcinoma in a Nigerian male. Rare Tumors; 2010;2(4):e66

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • An intriguing feature of this case is an ulcerated jejunal carcinoma which was metastatic rather than synchronous carcinoma.
  • This patient presented with partial large bowel obstruction and the pathological analysis revealed 4 invasive adenocarcinomas, 3 in the colon and 1 in the jejunum (Dukes stage D).
  • Palliative pancolectomy and jejunal tumour resection with chemotherapy was offered to him.
  • The challenges of managing a hereditary cancer syndrome in a resource poor country are highlighted.

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  • (PMID = 21234258.001).
  • [ISSN] 2036-3613
  • [Journal-full-title] Rare tumors
  • [ISO-abbreviation] Rare Tumors
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Other-IDs] NLM/ PMC3019601
  • [Keywords] NOTNLM ; adenocarcinoma. / colon / familial adenomatous polyposis / jejunum
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6. Ishibashi K, Hokama N, Ishiguro T, Kuwabara K, Okada N, Ohsawa T, Miyazaki T, Yokoyama M, Ishida H: [Administration of polysaccharide K (PSK) for stage III rectal cancer in clinical practice]. Gan To Kagaku Ryoho; 2009 Nov;36(12):1975-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Administration of polysaccharide K (PSK) for stage III rectal cancer in clinical practice].
  • This retrospective study was performed to examine the frequency of PSK administration in patients with Stage III rectal cancer in clinical practice, and the effect of PSK on patient outcome.
  • The subjects were 71 patients with Stage III rectal cancer who received postoperative adjuvant chemotherapy comprising fluoropyrimidines between April 1997 and March 2006.
  • Among the patients who were given PSK, the frequency of concomitant use of UFT alone was higher in Stage III a patients, while the rate of concomitant use of fluoropyrimidines and Leucovorin was higher in Stage III b patients (p<0.01).
  • Multivariate analyses revealed that the only predictive factor affecting recurrence, disease-free survival, and overall survival was Stage III b.
  • Although the rate of concomitant use of PSK in adjuvant chemotherapy for patients with Stage III rectal cancer was high, we did not evaluate the effect of PSK because there was a marked bias in relation to the subclassification of Stage III disease and the use of Leucovorin in these subjects.
  • Prospective randomized trials with stratification of Stage III disease will be needed in the future to validate the efficacy of PSK.
  • [MeSH-major] Adenocarcinoma / therapy. Proteoglycans / therapeutic use. Rectal Neoplasms / therapy
  • [MeSH-minor] Aged. Antineoplastic Agents / administration & dosage. Chemotherapy, Adjuvant. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Retrospective Studies

  • Genetic Alliance. consumer health - Rectal Cancer.
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  • (PMID = 20037296.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Proteoglycans; 66455-27-4 / krestin
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7. Ahn JB, Chung HC, Yoo NC, Roh JK, Kim NK, Suh CO, Kim GE, Seong JS, Shim WH, Chung HC: Efficacy of postoperative concurrent chemoradiation for resectable rectal cancer: a single institute experience. Cancer Res Treat; 2004 Aug;36(4):228-34
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy of postoperative concurrent chemoradiation for resectable rectal cancer: a single institute experience.
  • PURPOSE: For patients with Dukes' stage B and C rectal cancer, surgery followed by adjuvant chemoradiotherapy is considered to be the standard treatment.
  • However, the drugs used in combination with 5-fluorouracil (5-FU), the method of administration, duration of adjuvant therapy and the frequencies of administration presently remain controversial topics.
  • We investigated (1) the efficacy and safety of adjuvant radiotherapy and 5-FU/leucovorin (LV) chemotherapy for patients who had undergone curative resection and (2) the effect of dose related factors of 5-FU on survival.
  • MATERIALS AND METHODS: 130 rectal cancer patients with Dukes' B or C stage disease who were treated with curative resection were evaluated.
  • The adjuvant therapy consisted of two cycles of 5-FU/LV chemotherapy followed by pelvic radiotherapy with chemotherapy, and then 4 approximately 10 more cycles of the same chemotherapy regimen were delivered based on the disease stage.
  • The chemotherapy related morbidity was minimal, and there was no mortality for these patients.
  • The cumulative dose of 5-FU/BSA had a significant effect on the 5-year overall survival for Dukes' C rectal cancer patients (p=0.03).
  • CONCLUSION: An adjuvant therapy of radiotherapy and 5-FU/LV chemotherapy is effective and tolerable for Dukes' B and C rectal cancer patients.

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  • (PMID = 20368839.001).
  • [ISSN] 2005-9256
  • [Journal-full-title] Cancer research and treatment : official journal of Korean Cancer Association
  • [ISO-abbreviation] Cancer Res Treat
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2843890
  • [Keywords] NOTNLM ; 5-fluorouracil / Adjuvant chemotherapy / Dose intensity / Rectal cancer
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8. Akasu T, Moriya Y, Ohashi Y, Yoshida S, Shirao K, Kodaira S, National Surgical Adjuvant Study of Colorectal Cancer: Adjuvant chemotherapy with uracil-tegafur for pathological stage III rectal cancer after mesorectal excision with selective lateral pelvic lymphadenectomy: a multicenter randomized controlled trial. Jpn J Clin Oncol; 2006 Apr;36(4):237-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant chemotherapy with uracil-tegafur for pathological stage III rectal cancer after mesorectal excision with selective lateral pelvic lymphadenectomy: a multicenter randomized controlled trial.
  • BACKGROUND: Although adjuvant radiotherapy was proved to be effective for local control of rectal cancer even after standardized mesorectal excision, the role of adjuvant chemotherapy after such standardized surgery remains to be clarified.
  • We aimed to assess the efficacy of a combination of uracil and tegafur for pathological stage III rectal cancer treated by standardized mesorectal excision with selective lateral pelvic lymphadenectomy.
  • METHODS: We randomly assigned patients with completely resected stage III rectal cancer, who underwent standardized mesorectal excision with selective lateral pelvic lymphadenectomy, to receive either oral uracil-tegafur (400 mg/m2 tegafur per day) for one year or no treatment.
  • Standardization and quality control of the surgery and pathological techniques were ensured by use of the guidelines of the Japanese Society for Cancer of the Colon and Rectum.
  • The 3-year relapse-free survival and overall survival rates were 78 and 91% in the chemotherapy group and 60 and 81% in the surgery-alone group, respectively.
  • Grade 3 events occurred in 17% of the chemotherapy patients, but no grade 4 or more events occurred.
  • CONCLUSION: Adjuvant chemotherapy with uracil-tegafur improves survival of patients with stage III rectal cancer after standardized mesorectal excision with selective lateral pelvic lymphadenectomy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymph Node Excision. Rectal Neoplasms / drug therapy. Rectal Neoplasms / pathology. Rectum / surgery
  • [MeSH-minor] Adult. Aged. Alanine Transaminase / blood. Bilirubin / blood. Chemotherapy, Adjuvant. Drug Administration Schedule. Female. Humans. Leukopenia / chemically induced. Male. Middle Aged. Neoplasm Staging. Pelvis. Survival Rate. Tegafur / administration & dosage. Uracil / administration & dosage

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  • [CommentIn] Jpn J Clin Oncol. 2006 Apr;36(4):191-2 [16684858.001]
  • (PMID = 16675478.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil; EC 2.6.1.2 / Alanine Transaminase; RFM9X3LJ49 / Bilirubin
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9. Greene FL, Stewart AK, Norton HJ: New tumor-node-metastasis staging strategy for node-positive (stage III) rectal cancer: an analysis. J Clin Oncol; 2004 May 15;22(10):1778-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] New tumor-node-metastasis staging strategy for node-positive (stage III) rectal cancer: an analysis.
  • PURPOSE: The tumor-node-metastasis system for staging rectal cancer is based on invasion, number of involved nodes, and metastasis.
  • Nodal positivity defines stage III regardless of depth of invasion or number of positive nodes.
  • METHODS: We analyzed data entered into the National Cancer Data Base for 5,987 stage III patients with rectal cancer between 1991 and 1993.
  • Survival following surgery and adjuvant therapy was assessed.
  • RESULTS: Five-year observed survival rates for stage III subcategories were 55.1% in IIIA; 35.3% in IIIB; and 24.5% in IIIC.
  • Stratifying for treatment outcome, stage IIIA patients having surgery alone (n = 278) had poorer observed 5-year survival (39%) than patients treated with surgery and adjuvant chemotherapy or radiation therapy (chemo/XRT; n = 765; 60%).
  • CONCLUSION: The traditional stage III designation of rectal cancer fails to account for invasion (T1-4) and number of involved nodes (N1, N2).
  • The stratification of stage III patients into three subsets should be used in future analyses of rectal cancer.
  • The effect of postoperative adjuvant therapy was beneficial in all subsets.
  • [MeSH-major] Neoplasm Staging / methods. Rectal Neoplasms / mortality

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  • [CommentIn] J Clin Oncol. 2004 May 15;22(10):1773-5 [15067029.001]
  • (PMID = 14769855.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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10. Law WL, Poon JT, Fan JK, Lo SH: Comparison of outcome of open and laparoscopic resection for stage II and stage III rectal cancer. Ann Surg Oncol; 2009 Jun;16(6):1488-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of outcome of open and laparoscopic resection for stage II and stage III rectal cancer.
  • BACKGROUND: Laparoscopic resection for advanced rectal cancer has not been widely accepted, and there are only few studies with survival data.
  • This study aimed to compare the survival of patients who underwent laparoscopic and open resection for stage II and III rectal cancer.
  • MATERIALS AND METHODS: Consecutive patients (open resection: n = 310; laparoscopic resection: n = 111) who underwent curative resection for stage II and III rectal cancer from June 2000 to December 2006 were included.
  • RESULTS: The age, gender, medical morbidity, types of operation, and American Society of Anesthesiologists (ASA) status were similar between the two groups.
  • Other independent poor prognostic factors included lymph node metastasis, poor differentiation, perineural invasion, presence of postoperative complications, and no chemotherapy.
  • CONCLUSIONS: Laparoscopic resection for locally advanced rectal cancer is associated with more favorable overall survival when compared with open resection.
  • [MeSH-major] Colectomy / methods. Rectal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Laparoscopy. Male. Middle Aged. Survival Analysis. Treatment Outcome

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  • [CommentIn] Ann Surg Oncol. 2009 Jun;16(6):1451-3 [19357928.001]
  • (PMID = 19290491.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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11. McGory ML, Zingmond DS, Sekeris E, Bastani R, Ko CY: A patient's race/ethnicity does not explain the underuse of appropriate adjuvant therapy in colorectal cancer. Dis Colon Rectum; 2006 Mar;49(3):319-29
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A patient's race/ethnicity does not explain the underuse of appropriate adjuvant therapy in colorectal cancer.
  • INTRODUCTION: To improve colorectal cancer outcomes, appropriate adjuvant therapy (chemotherapy, radiation therapy) should be given.
  • Numerous studies have demonstrated underuse of adjuvant therapy in colorectal cancer.
  • The current study examines variables associated with underuse of adjuvant therapy.
  • METHODS: Three population-based databases were linked: California Cancer Registry, California Patient Discharge Database, 2000 Census.
  • All colorectal cancer patients diagnosed from 1994 to 2001 were studied.
  • Patient characteristics (age, gender, race/ethnicity, comorbidities, payer, diagnosis year, socioeconomic status) were used in five multivariate regression analyses to predict receipt of chemotherapy for Stage III colon cancer, and receipt of chemotherapy and radiation therapy for Stages II, III rectal cancer.
  • RESULTS: The overall cohort was 18,649 Stage III colon cancer and Stages II, III rectal cancer patients.
  • Receipt of chemotherapy was 48 percent for Stage III colon cancer, 48 percent for Stage II rectal cancer, and 66 percent for Stage III rectal cancer.
  • Receipt of radiation therapy was 52 percent for Stage II rectal cancer and 66 percent for Stage III rectal cancer.
  • In all five models, low socioeconomic status predicted underuse of chemotherapy or radiation therapy (P < 0.016).
  • CONCLUSIONS: Most literature identifies race/ethnicity as the reason for disparate receipt of adjuvant therapy in colorectal cancer.
  • Explicit measures to improve care to the poor with colorectal cancer are needed.
  • [MeSH-major] Colorectal Neoplasms / therapy. Neoadjuvant Therapy / utilization

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  • (PMID = 16475031.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 5U01CA086322-06
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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12. Wolmark N, Wieand HS, Hyams DM, Colangelo L, Dimitrov NV, Romond EH, Wexler M, Prager D, Cruz AB Jr, Gordon PH, Petrelli NJ, Deutsch M, Mamounas E, Wickerham DL, Fisher ER, Rockette H, Fisher B: Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst; 2000 Mar 1;92(5):388-96
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  • [Title] Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02.
  • BACKGROUND: The conviction that postoperative radiotherapy and chemotherapy represent an acceptable standard of care for patients with Dukes' B (stage II) and Dukes' C (stage III) carcinoma of the rectum evolved in the absence of data from clinical trials designed to determine whether the addition of radiotherapy results in improved disease-free survival and overall survival.
  • PATIENTS AND METHODS: Eligible patients (n = 694) with Dukes' B or C carcinoma of the rectum were enrolled in National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol R-02 from September 1987 through December 1992 and were followed.
  • They were randomly assigned to receive either postoperative adjuvant chemotherapy alone (n = 348) or chemotherapy with postoperative radiotherapy (n = 346).
  • All female patients (n = 287) received 5-FU plus LV chemotherapy; male patients received either MOF (n = 207) or 5-FU plus LV (n = 200).
  • RESULTS: The average time on study for surviving patients is 93 months as of September 30, 1998.
  • Postoperative radiotherapy resulted in no beneficial effect on disease-free survival (P =.90) or overall survival (P =.89), regardless of which chemotherapy was utilized, although it reduced the cumulative incidence of locoregional relapse from 13% to 8% at 5-year follow-up (P =.02).
  • CONCLUSIONS: The addition of postoperative radiation therapy to chemotherapy in Dukes' B and C rectal cancer did not alter the subsequent incidence of distant disease, although there was a reduction in locoregional relapse when compared with chemotherapy alone.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Fluorouracil / therapeutic use. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Disease-Free Survival. Drug Administration Schedule. Female. Humans. Leucovorin / therapeutic use. Male. Middle Aged. Neoplasm Staging. Semustine / administration & dosage. Sex Factors. Survival Analysis. Time Factors. Vincristine / administration & dosage

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  • [CommentIn] J Natl Cancer Inst. 2000 Mar 1;92(5):361-2 [10699060.001]
  • (PMID = 10699069.001).
  • [ISSN] 0027-8874
  • [Journal-full-title] Journal of the National Cancer Institute
  • [ISO-abbreviation] J. Natl. Cancer Inst.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA12027; United States / NCI NIH HHS / CA / CA37377
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 13909-09-6 / Semustine; 5J49Q6B70F / Vincristine; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; MOF protocol
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13. Neugut AI, Fleischauer AT, Sundararajan V, Mitra N, Heitjan DF, Jacobson JS, Grann VR: Use of adjuvant chemotherapy and radiation therapy for rectal cancer among the elderly: a population-based study. J Clin Oncol; 2002 Jun 1;20(11):2643-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Use of adjuvant chemotherapy and radiation therapy for rectal cancer among the elderly: a population-based study.
  • PURPOSE: Combined adjuvant fluorouracil (5-FU)-based chemotherapy with radiation is now the standard of care for locally advanced rectal cancer in the United States.
  • We investigated the use of these treatments for stages II and III rectal cancer among the elderly and the effectiveness of these treatments on a population-based scale.
  • PATIENTS AND METHODS: The linked Surveillance, Epidemiology, and End-Results-Medicare database was used to identify 1,807 Medicare beneficiaries > or = 65 years of age with stage II or III rectal cancer who underwent surgical resection between 1992 and 1996.
  • We used multivariate analysis to identify factors associated with combined 5-FU and radiation therapy, and propensity score methodology to determine survival benefit for those treated.
  • RESULTS: We found that 37% of patients received both adjuvant 5-FU and radiation therapy, 11% 5-FU alone, and 14% radiation alone.
  • Decreasing age, increasing lymph node positivity, comorbid conditions, and nonblack race were associated with increased probability of treatment with 5-FU and radiation.
  • Combined chemotherapy/radiation therapy was associated with improved survival for stage III (relative risk, 0.71; 95% confidence interval, 0.56 to 0.90), but not for stage II rectal cancer (relative risk, 0.89; 95% confidence interval, 0.70 to 1.14).
  • CONCLUSION: The association of combined treatment with improved survival in node-positive disease was similar to that observed in other studies.
  • In the absence of data from well-designed randomized controlled trials, our observational data support efforts on the part of clinicians to make appropriate referrals and provide combined treatment for elderly patients with stage III rectal cancer.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Fluorouracil / therapeutic use. Rectal Neoplasms / therapy
  • [MeSH-minor] Age Factors. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Comorbidity. Female. Humans. Male. Multivariate Analysis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate

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  • [CommentIn] Am J Gastroenterol. 2003 Jun;98(6):1438 [12846252.001]
  • (PMID = 12039925.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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14. Jameson MB, Head M, Deva S: Colorectal cancer survival following adjuvant chemotherapy with weekly i.v. fluorouracil 425 mg/m&lt;sup&gt;2&lt;/sup&gt; and folinic acid 50mg. J Clin Oncol; 2009 May 20;27(15_suppl):e15089

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Colorectal cancer survival following adjuvant chemotherapy with weekly i.v. fluorouracil 425 mg/m<sup>2</sup> and folinic acid 50mg.
  • : e15089 Background: Adjuvant chemotherapy for colorectal cancer (CRC) using fluorouracil (5FU) and folinic acid (FA) has been proven effective and the QUASAR trial showed that a weekly administration schedule was as effective as, and less toxic than, the same daily doses delivered over 5 days every 4 weeks (the "Mayo regimen").
  • Data was gathered on patient characteristics, duration of adjuvant chemotherapy and survival.
  • RESULTS: 417 patients (pts) were seen: 181 females, 236 males; median age 67 yrs (24-89); 291 with colon cancer, 126 with rectal cancer; 1 stage 1; 100 stage 2, 316 stage 3.
  • 210 pts with colon cancer received adjuvant weekly 5FU/FA (32 stage 2, 178 stage 3) as did 58 pts with rectal cancer (50 of whom also received concurrent chemoradiation).
  • 75% of pts with colon cancer received all 30 planned doses and 59% of rectal cancer pts received all 20 planned doses.
  • 3 year survival for all pts treated with this regimen was 83.0% and for the subgroups with colon and rectal cancer it was 82.4% and 84.5% respectively.
  • For stage 2 and 3 colon cancer pts treated with this regimen 3 year survival was 87.9% and 76.0% respectively; for stage III rectal cancer pts it was 84.1%.

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  • (PMID = 27964554.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Glimelius B, Dahl O, Cedermark B, Jakobsen A, Bentzen SM, Starkhammar H, Grönberg H, Hultborn R, Albertsson M, Påhlman L, Tveit KM, Nordic Gastrointestinal Tumour Adjuvant Therapy Group: Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group. Acta Oncol; 2005;44(8):904-12
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  • [Title] Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group.
  • Due to uncertainties regarding clinically meaningful gains from adjuvant chemotherapy after colorectal cancer surgery, several Nordic Groups in the early 1990s initiated randomised trials to prove or reject such gains.
  • Between October 1991 and December 1997, 2 224 patients under 76 years of age with colorectal cancer stages II and III were randomised to surgery alone (n = 1 121) or adjuvant chemotherapy (n = 1 103) which varied between trials (5FU/levamisole for 12 months, n = 444; 5FU/leucovorin for 4-5 months according to either a modified Mayo Clinic schedule (n = 262) or the Nordic schedule (n = 397).
  • A total of 812 patients had colon cancer stage II, 708 colon cancer stage III, 323 rectal cancer stage II and 368 rectal cancer stage III.
  • No statistically significant difference in overall survival, stratified for country or region, could be found in any group of patients according to stage or site.
  • In colon cancer stage III, an absolute difference of 7% (p = 0.15), favouring chemotherapy, was seen.
  • The present analyses corroborate a small but clinically meaningful survival gain from adjuvant chemotherapy in colon cancer stage III, but not in the other presentations.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colorectal Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Levamisole / administration & dosage. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • [ErratumIn] Acta Oncol. 2006;45(1):110
  • (PMID = 16332600.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] Norway
  • [Chemical-registry-number] 2880D3468G / Levamisole; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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16. Lygidakis NJ, Patil A, Giannoulis K, Fukuda T, Kumar R: Laparoscopic hyperthermic intraperitoneal chemotherapy as adjuvant modality following radical surgery for advanced rectal cancer a new look to an old problem. Hepatogastroenterology; 2010 Jan-Feb;57(97):73-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laparoscopic hyperthermic intraperitoneal chemotherapy as adjuvant modality following radical surgery for advanced rectal cancer a new look to an old problem.
  • BACKGROUND/AIMS: The benefits of adjuvant chemotherapy for colorectal cancer has been well accepted over the last decade.
  • Published data so far has been focused in the direction of giving the right chemotherapy dose, schedule, and combinations, in order to increase the efficacy and decrease the toxicity.
  • METHODOLOGY: Eighty-seven patients with histological proved stage III rectal carcinoma were subjected to a combined adjuvant modality using laparoscopic heperthermic endoperitoneal chemotherapy (HIPEC) and systemic chemotherapy twenty days following the initial surgery.
  • Among forty patients who completed the two year follow-up, two patients developed local recurrence.
  • CONCLUSIONS: Cytoreduction followed by HIPEC improves survival in patients with rectal carcinoma and lymphnode positive and neurovascular involvement.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carcinoma / therapy. Hyperthermia, Induced. Laparoscopy. Peritoneal Cavity. Rectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Follow-Up Studies. Humans. Instillation, Drug. Male. Middle Aged. Survival Rate. Treatment Outcome

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  • (PMID = 20422875.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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17. Fujita S, Nakanisi Y, Taniguchi H, Yamamoto S, Akasu T, Moriya Y, Shimoda T: Cancer invasion to Auerbach's plexus is an important prognostic factor in patients with pT3-pT4 colorectal cancer. Dis Colon Rectum; 2007 Nov;50(11):1860-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cancer invasion to Auerbach's plexus is an important prognostic factor in patients with pT3-pT4 colorectal cancer.
  • PURPOSE: By defining perineural invasion of colorectal cancer as invasion to Auerbach's plexus, we examined the usefulness of this pathologic finding as a prognostic factor.
  • METHODS: A total of 509 consecutive patients who underwent curative surgery for pT3 or pT4 colorectal cancer between May 1997 and December 2001 were reviewed.
  • The disease-free survival of the perineural invasion-positive group was significantly poorer than that of the perineural invasion-negative group for Stages II and III colon cancer, irrespective of the use of adjuvant chemotherapy.
  • This improved disease-free survival also was seen in patients with Stage II rectal cancer not treated with adjuvant chemotherapy.
  • There was a nonsignificant difference in disease-free survival for Stage II rectal cancer and Stage III rectal cancer treated with chemotherapy, that of the perineural invasion-positive group being poorer.
  • Multivariate analysis showed that lymph node status, perineural invasion, depth of invasion, and cancer site were significant prognostic factors.
  • CONCLUSIONS: Perineural invasion defined as cancer invasion to Auerbach's plexus is an important prognostic factor for colorectal cancer.
  • [MeSH-major] Colonic Neoplasms / mortality. Colonic Neoplasms / pathology. Myenteric Plexus / pathology. Rectal Neoplasms / mortality. Rectal Neoplasms / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Multivariate Analysis. Neoplasm Invasiveness. Neoplasm Staging. Peripheral Nerves / pathology. Prognosis. Survival Analysis

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  • (PMID = 17899273.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Park IJ, Kim HC, Yu CS, Kim TW, Jang SJ, Kim JC: Effect of adjuvant radiotherapy on local recurrence in stage II rectal cancer. Ann Surg Oncol; 2008 Feb;15(2):519-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Effect of adjuvant radiotherapy on local recurrence in stage II rectal cancer.
  • BACKGROUND: Prospective trials have demonstrated that chemotherapy combined with radiotherapy decreases local recurrence rates in stage II and stage III rectal cancer.
  • Some patients with stage II lesions, however, have relatively low risks of local recurrence.
  • We evaluated the effect of radiotherapy on local recurrence in patients with stage IIA rectal cancer.
  • METHODS: From the colorectal cancer database, we identified 390 stage IIA rectal cancer patients who underwent curative resection followed by adjuvant therapy from 1995 to 2002; a total of 72 patients who received preoperative chemoradiotherapy and who did not receive adjuvant therapy were excluded.
  • RESULTS: Of the 390 patients, 110 had primary tumors in the upper rectum, 136 in the midrectum, and 144 in the lower rectum.
  • Adjuvant chemotherapy was provided to 180 patients (46.2%), and chemotherapy plus radiotherapy was provided to 210 patients (53.8%).
  • Radiotherapy was significantly more common in younger patients (P = .01) and those with lower rectal cancer (P < .001).
  • In patients with mid and lower rectal cancer, the local recurrence rate was not affected by radiotherapy.
  • CONCLUSIONS: Radiotherapy did not seem to provide additional benefit in decreasing local recurrence rate of stage IIA rectal cancers.
  • [MeSH-major] Adenocarcinoma / radiotherapy. Adenocarcinoma / surgery. Neoplasm Recurrence, Local / radiotherapy. Rectal Neoplasms / radiotherapy. Rectal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Lymph Nodes / pathology. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Radiotherapy, Adjuvant

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  • (PMID = 17960464.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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19. Roos M, Wong JH, Roy-Chowdhury S, Lum SS, Morgan JW, Kazanjian AK: The impact of multidisciplinary therapy in node-positive rectal cancer. Am Surg; 2010 Oct;76(10):1163-6
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  • [Title] The impact of multidisciplinary therapy in node-positive rectal cancer.
  • Multidisciplinary therapy (MDT) of node-positive rectal cancer is considered optimal.
  • We performed a retrospective cohort study of node positive rectal cancer patients diagnosed between January 1, 1994 and December 31, 2003 in Region 5 of the California Cancer Registry to determine the impact of MDT on disease specific survival (DSS).
  • During the study period, 398 patients with stage III rectal cancer were identified.
  • Patients receiving XRT were far more likely to receive systemic chemotherapy (83% vs. 27%, P < 0.0001).
  • Multidisciplinary therapy of node-positive rectal cancer is associated with improved DSS.
  • However, substantial numbers of node positive rectal cancer patients are not receiving MDT.
  • Greater efforts are needed to implement consistent multidisciplinary algorithms into rectal cancer management.
  • [MeSH-major] Rectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Combined Modality Therapy. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Treatment Outcome

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  • (PMID = 21105635.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / PC / N02-PC-15105; United States / NCCDPHP CDC HHS / DP / U58DP000807-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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20. Klautke G, Fietkau R: Intensified neoadjuvant radiochemotherapy for locally advanced rectal cancer: a review. Int J Colorectal Dis; 2007 May;22(5):457-65
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  • [Title] Intensified neoadjuvant radiochemotherapy for locally advanced rectal cancer: a review.
  • BACKGROUND: The rate of local recurrence of locally advanced rectal cancer (stage III and IV according to the criteria of Union Internationale Contre Le Cancer) is still high, and also the rate of distant metastases.
  • AIM: The objective of this review of literature was to evaluate the necessity, the results, and comparability of the different regimes and to evaluate a potential impact on later adjuvant chemotherapy.
  • [MeSH-major] Neoadjuvant Therapy. Rectal Neoplasms / therapy
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal / therapeutic use. Antibodies, Monoclonal, Humanized. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bevacizumab. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Cetuximab. Fluorouracil / administration & dosage. Humans. Neoplasm Recurrence, Local / prevention & control. Organoplatinum Compounds / administration & dosage. Prodrugs / administration & dosage

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  • (PMID = 17072624.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Organoplatinum Compounds; 0 / Prodrugs; 04ZR38536J / oxaliplatin; 0H43101T0J / irinotecan; 2S9ZZM9Q9V / Bevacizumab; PQX0D8J21J / Cetuximab; U3P01618RT / Fluorouracil; XT3Z54Z28A / Camptothecin
  • [Number-of-references] 52
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21. Cronin DP, Harlan LC, Potosky AL, Clegg LX, Stevens JL, Mooney MM: Patterns of care for adjuvant therapy in a random population-based sample of patients diagnosed with colorectal cancer. Am J Gastroenterol; 2006 Oct;101(10):2308-18
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  • [Title] Patterns of care for adjuvant therapy in a random population-based sample of patients diagnosed with colorectal cancer.
  • OBJECTIVES: Over the past decade, clinical trials have proved the efficacy of treatments for colorectal cancer (CRC).
  • This study tracks dissemination of these treatments for patients diagnosed with stage II and III disease and compares risk of death for those who received guideline therapy to those who did not.
  • METHODS: We conducted a stratified randomly sampled, population-based study of CRC treatment trends in the United States.
  • Multivariate models were used to explore patient characteristics associated with receipt of treatments.
  • RESULTS: In 2000, guideline therapy receipt decreased among stage III rectal cancer patients, but increased for stage III colon and stage II rectal cancer patients.
  • As age increased, likelihood of receiving guideline treatment decreased (p < 0.0001).
  • Overall, race/ethnicity was significantly associated with guideline therapy (p = 0.04).
  • Rectal patients were less likely to have received guideline treatment.
  • Consistent with randomized clinical trial findings, all-cause mortality was lower in patients who received guideline therapy, regardless of Charlson comorbidity score.
  • CONCLUSIONS: Mortality was decreased in patients receiving guideline therapy.
  • Although, rates of guideline-concordant therapy are low in community clinical practice, they are apparently increasing.
  • Newer treatment (oxaliplatin, capecitabine) started to disseminate in 2000.
  • Age disparities remain despite no evidence of greater chemotherapy-induced toxicity in the elderly.
  • More equitable receipt of cancer treatment to all segments of the community will help to reduce mortality.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Colorectal Neoplasms / drug therapy. Guideline Adherence / statistics & numerical data. Practice Guidelines as Topic. Practice Patterns, Physicians' / statistics & numerical data. SEER Program

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  • (PMID = 17032196.001).
  • [ISSN] 0002-9270
  • [Journal-full-title] The American journal of gastroenterology
  • [ISO-abbreviation] Am. J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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22. Kalady MF, de Campos-Lobato LF, Stocchi L, Geisler DP, Dietz D, Lavery IC, Fazio VW: Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer. Ann Surg; 2009 Oct;250(4):582-9
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  • [Title] Predictive factors of pathologic complete response after neoadjuvant chemoradiation for rectal cancer.
  • OBJECTIVE: This study evaluates factors associated with a pathologic complete response (pCR) after neoadjuvant chemoradiation for rectal cancer.
  • SUMMARY BACKGROUND DATA: Approximately 20% of rectal cancer patients undergoing neoadjuvant chemoradiation achieve pCR, which has been associated with decreased local recurrence and improved recurrence-free survival.
  • METHODS: A total of 306 consecutive patients with stage II or stage III rectal cancer who underwent neoadjuvant chemoradiation then surgery between 1997 and 2007 were identified from a single-institution.
  • Sixty-four patients with concurrent inflammatory bowel disease, hereditary colorectal cancer, other malignancy, urgent surgery, incomplete chemoradiation, or insufficient data were excluded.
  • All patients received neoadjuvant 5-FU-based chemotherapy and external beam radiation.
  • The 2 groups were statistically similar in terms of age, gender, body mass index, tumor differentiation, radiation dose, and pretreatment stage.
  • On multivariate analysis, an interval ≥ 8 weeks between treatment completion and surgical resection was significantly associated with a higher rate of pCR, which correlated with decreased local recurrence and improved overall survival.
  • CONCLUSION: Despite traditional beliefs that certain patient and tumor factors influence pCR, an extended interval between completion of neoadjuvant therapy and surgery was the single most important determinant in achieving a pCR.
  • [MeSH-major] Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antimetabolites, Antineoplastic / therapeutic use. Chi-Square Distribution. Female. Fluorouracil / therapeutic use. Humans. Logistic Models. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging. Predictive Value of Tests. Statistics, Nonparametric. Survival Rate. Treatment Outcome


23. Cree M, Tonita J, Turner D, Nugent Z, Alvi R, Barss R, King C, Winget M: Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Saskatchewan, and Manitoba in 2004. Clin Colorectal Cancer; 2009 Jul;8(3):141-5
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  • [Title] Comparison of treatment received versus long-standing guidelines for stage III colon and stage II/III rectal cancer patients diagnosed in Alberta, Saskatchewan, and Manitoba in 2004.
  • PURPOSE: Guideline-recommended treatment for stage II/III colorectal cancer includes postsurgical chemotherapy and/or radiation as standard of care.
  • PATIENTS AND METHODS: All surgically treated patients diagnosed in 2004 with stage III colon or stage II/III rectal cancer and residing in Alberta, Saskatchewan, or Manitoba were identified from provincial cancer registries.
  • Sex, age at diagnosis, and area of residence were also obtained from the cancer registry.
  • The primary outcome of interest was receipt of standard care: surgery followed by chemotherapy or radiation therapy (adjuvant therapy).
  • chi2 tests and binary regression with log link assessed the relationship of patient demographic characteristics (age, sex, residence, cancer disease stage) with receipt of standard care.
  • RESULTS: About half of the patients received adjuvant therapy.
  • Patients with stage III rectal cancer were more likely to receive adjuvant treatment than stage II patients in Alberta and Saskatchewan.
  • There was a large decrease in the percentage of patients who received adjuvant treatment with increasing age in all the provinces (P < .001), ranging from about 80% of those aged < 65 years to about 20% of those aged >or= 75 years for colon cancer patients and from about 70% to 30%, respectively, for rectal cancer patients.
  • The decrease of adjuvant treatment with increasing age was most marked in Alberta.
  • CONCLUSION: The percentage of patients receiving guideline-recommended treatment is low.
  • [MeSH-major] Colonic Neoplasms / therapy. Guideline Adherence. Practice Patterns, Physicians' / statistics & numerical data. Rectal Neoplasms / therapy
  • [MeSH-minor] Aged. Alberta. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Manitoba. Neoplasm Staging. Practice Guidelines as Topic. Radiotherapy, Adjuvant. Saskatchewan

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  • (PMID = 19632928.001).
  • [ISSN] 1938-0674
  • [Journal-full-title] Clinical colorectal cancer
  • [ISO-abbreviation] Clin Colorectal Cancer
  • [Language] eng
  • [Grant] Canada / Canadian Institutes of Health Research / /
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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24. Gallego-Plazas J, Menárguez-Pina F, Maestre-Peiró A, González-Orozco V, Andreu F, Escudero-Barea MJ, Morcillo MA: Feasibility of adequate resectable rectal cancer treatment in a third-level hospital. Clin Transl Oncol; 2009 Mar;11(3):172-7
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  • [Title] Feasibility of adequate resectable rectal cancer treatment in a third-level hospital.
  • PURPOSE: The aim of this study was to determine the feasibility, concerning compliance to protocol and recommended clinical practice guidelines, as well as efficacy results of multidisciplinary treatment (surgery, radiotherapy and chemotherapy) of resectable rectal cancer in a third-level hospital devoid of radiotherapy and clinical oncology units.
  • PATIENTS AND METHODS: A retrospective, single-institution analysis was completed for 45 consecutive patients diagnosed with resectable rectal cancer who entered an officially proposed multidisciplinary treatment protocol from October 1998 to September 2003.
  • Adequacy of patient inclusion, according to clinical stage, was reviewed.
  • Neoadjuvant radiotherapy schedule, surgery procedures and adjuvant chemotherapy indication were assessed.
  • All treatment time intervals were analysed.
  • Finally, efficacy results are discussed and contextualised by comparison with results of clinical trials which support this treatment strategy.
  • RESULTS: According to an independent board review, 3 patients (6.7%) with stage I rectal cancer, 31 patients (68.9%) with stage II and 11 patients (24.4%) with stage III rectal cancer were included.
  • Median time from diagnosis to start of radiotherapy was 26.36 days (24.26- 28.57; CI 95%).
  • Median time from start of radiotherapy to surgery was 15.67 days (14.47-16.87; CI 95%).
  • Median time from completion of radiotherapy to surgery was 10.67 days (9.53-11.81; CI 95%).
  • Twenty-nine patients (64.4%) of the 45 that were initially included started adjuvant chemotherapy.
  • A statistically significant relationship between pathologic stage (grouped I-II vs. III) and the use of adjuvant chemotherapy was found (p=0.033; chi-square test).
  • Radiotherapy- and chemotherapy-induced toxicity did not differ from that previously reported.
  • With a median follow-up of 65.46 months, a total of 10 recurrences have been diagnosed, all of them in stage III patients.
  • CONCLUSION: Multidisciplinary treatment of resectable rectal cancer in a third-level hospital is feasible.
  • Although efficacy results are comparable to those previously reported in the literature, further improvements in clinical staging as well as in adjuvant chemotherapy indication are desirable.
  • [MeSH-major] Rectal Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Longitudinal Studies. Neoplasm Staging. Survival Rate

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  • (PMID = 19293055.001).
  • [ISSN] 1699-048X
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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25. Kakisaka T, Aiki F, Matsuhisa T, Hattori A, Kazui K: [A case of metachronous multiple lung metastases and intraabdominal lymph node metastases of rectal cancer responding to S-1]. Gan To Kagaku Ryoho; 2010 Apr;37(4):723-5
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  • [Title] [A case of metachronous multiple lung metastases and intraabdominal lymph node metastases of rectal cancer responding to S-1].
  • A 70-year-old man was referred to our hospital with bowel obstruction because of rectal cancer.
  • High anterior resection of rectum and lymph node dissection was performed.
  • The rectal cancer was in stage III, and the patient selected no adjuvant chemotherapy.
  • S-1, 100 mg/body, was administered for 4 weeks followed by 2 drug-free weeks.
  • The effect of S-1 treatment was PR, and no severe side effect was observed throughout the treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lung Neoplasms / drug therapy. Oxonic Acid / therapeutic use. Rectal Neoplasms / drug therapy. Tegafur / therapeutic use
  • [MeSH-minor] Aged. Drug Combinations. Humans. Lymphatic Metastasis. Male. Tomography, X-Ray Computed

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  • (PMID = 20414035.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid
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26. Martí-Ragué J, Parés D, Biondo S, Navarro M, Figueras J, de Oca J, Pareja L, Cambray M, del Río C, Osorio A, Novell V, Jaurrieta E: [Survival and recurrence in the multidisciplinary approach of colorectal cancer]. Med Clin (Barc); 2004 Sep 11;123(8):291-6
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  • [Title] [Survival and recurrence in the multidisciplinary approach of colorectal cancer].
  • [Transliterated title] Supervivencia y recidiva en el tratamiento multidisciplinario del carcinoma colorrectal.
  • BACKGROUND AND OBJECTIVE: Colorectal cancer is one of the most frequent causes of death in the general population.
  • Our aim was to analyze our experience in the multidisciplinary approach of colorectal carcinoma during a three year period.
  • PATIENTS AND METHOD: Between January 1996 and December 1998, we studied prospectively 807 patients with colorectal cancer.
  • The epidemiology, treatment and outcome(recurrence and survival) were analyzed.
  • RESULTS: There were 598 colon (65.5%) and 279 rectal (34.5%) tumors in all the series.
  • Surgical treatment was elective in 84% and urgent in 16%, and was considered radical in 598 cases (74.1%).
  • Chemotherapy or radiotherapy was administered in 49.6% and 18.3% patients, respectively.
  • The overall 3-year survival was as follows: stage I 97.5%, stage II 90.6%, stage III 75.2%, and stage IV 12.6%.
  • The 3-year free-disease survival was as follows: in colon cancer 97.8% for stage I, 87.3% for stage II, and 71.4% for stage III; and in rectal cancer 96.8% for stage I, 85.1% for stage II, and 75.4% for stage III.
  • During the follow-up 124 patients (20.7%) developed recurrence: local (2.8%), systemic (15.9%) or both (2%).
  • [MeSH-major] Colorectal Neoplasms / mortality. Colorectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Prospective Studies. Survival Analysis

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  • (PMID = 15373975.001).
  • [ISSN] 0025-7753
  • [Journal-full-title] Medicina clínica
  • [ISO-abbreviation] Med Clin (Barc)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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27. Wang WS, Lin JK, Chiou TJ, Liu JH, Fan FS, Yen CC, Lin TC, Jiang JK, Yang SH, Wang HS, Chen PM: Preoperative carcinoembryonic antigen level as an independent prognostic factor in colorectal cancer: Taiwan experience. Jpn J Clin Oncol; 2000 Jan;30(1):12-6
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  • [Title] Preoperative carcinoembryonic antigen level as an independent prognostic factor in colorectal cancer: Taiwan experience.
  • BACKGROUND: Preoperative carcinoembryonic antigen (CEA) level is considered as a factor predictive of survival in colorectal cancer patients.
  • This study was carried out in an effort to evaluate the prognostic significance of preoperative CEA levels of patients with colorectal cancer in Taiwan.
  • 5-Fluorouracil-based adjuvant chemotherapy was administered if the patients had Dukes' C disease.
  • Reference to the Dukes' classification was according to the classical criteria described in 1932 for carcinoma of the rectum and adapted for use in colonic tumors.
  • By multivariate Cox analysis, lymph node metastases (p = 0.003), penetration of the bowel wall (p = 0.0001) and preoperative CEA levels (p = 0.0001) were found to be independent prognostic factors in colorectal cancer patients.
  • CONCLUSIONS: The data from our study indicate that in addition to lymph node metastases and penetration of the bowel wall, the preoperative CEA levels are also an independent prognostic factor in non-metastatic colorectal cancer patients after curative surgery.
  • This could serve as an appropriate modification to the initial Dukes' scheme in colorectal cancer.
  • [MeSH-major] Adenocarcinoma / blood. Carcinoembryonic Antigen / blood. Colonic Neoplasms / blood. Rectal Neoplasms / blood
  • [MeSH-minor] Age Factors. Analysis of Variance. Antimetabolites, Antineoplastic / therapeutic use. Chemotherapy, Adjuvant. Colon / pathology. Female. Fluorouracil / therapeutic use. Forecasting. Humans. Lymphatic Metastasis / pathology. Male. Middle Aged. Multivariate Analysis. Neoplasm Invasiveness. Prognosis. Proportional Hazards Models. Rectum / pathology. Retrospective Studies. Sex Factors. Survival Rate. Taiwan

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  • [CommentIn] Jpn J Clin Oncol. 2000 Nov;30(11):522-3 [11155925.001]
  • (PMID = 10770562.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Carcinoembryonic Antigen; U3P01618RT / Fluorouracil
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28. Spano JP, Bouillet T, Morere JF, Breau JL: [The interest of radiotherapy in cancer of the rectum]. Presse Med; 2003 Feb 22;32(7):315-22
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  • [Title] [The interest of radiotherapy in cancer of the rectum].
  • [Transliterated title] Intérêt de la radiothérapie dans le cancer du rectum.
  • CONTEXT: Surgery remains the standard treatment of rectal cancer.
  • This depends on the initial TNM stage and the surgical technique.
  • In order to optimally improve local control and survival of the patients, radiotherapy has become an unavoidable adjuvant treatment in specific situations.
  • ISOLATED RADIOTHERAPY: For locally advanced cancers (T3 or T4), pre-surgical radiotherapy followed by curative surgery is the standard treatment because of the improvement in global survival and good local control that has recently been confirmed.
  • With radiotherapy it is also possible to schedule conservative sphincter surgery in the case of low rectal lesions and permit surgery of initially inoperable lesions.
  • THE CONCOMITANT ASSOCIATION OF RADIOTHERAPY AND CHEMOTHERAPY DURING THE PRE-SURGICAL PERIOD: In rare cases in which the tumour stage was underestimated in the pre-surgical controls, post-surgical concomitant radio-chemotherapy is required.
  • In cases in which surgery was performed first line, in the presence of histological factors of poor prognosis, post-surgical radio-chemotherapy is warranted.
  • In the United States, the reference chemotherapy used in this association is 5 FU in continuous intravenous infusion.
  • In the rare cases of contraindication for surgery, exclusive concomitant radio-chemotherapy is an appropriate solution, even if no treatment has been validated in this indication.
  • MEDICAL TREATMENT: Exclusive radio-chemotherapy has only demonstrated interest in the palliative treatment of inoperable loco-regional relapses that have already undergone radiation or in metastatic stages as in colon cancers.
  • Currently post-surgical chemotherapy is recommended in stage III cancer of the rectum as in colon cancers at the same stage.
  • [MeSH-major] Neoadjuvant Therapy. Rectal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Neoplasm Staging. Palliative Care. Radiotherapy, Adjuvant. Survival Rate

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  • (PMID = 12610448.001).
  • [ISSN] 0755-4982
  • [Journal-full-title] Presse medicale (Paris, France : 1983)
  • [ISO-abbreviation] Presse Med
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] U3P01618RT / Fluorouracil
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29. Grothey A, Kellermann L, Schmoll HJ: [Deficits in management of patients with colorectal carcinoma in Germany. Results of multicenter documentation of therapy algorithms]. Med Klin (Munich); 2002 May 15;97(5):270-7
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  • [Title] [Deficits in management of patients with colorectal carcinoma in Germany. Results of multicenter documentation of therapy algorithms].
  • [Transliterated title] Defizite in der Behandlung von Patienten mit kolorektalem Karzinom in Deutschland. Ergebnisse einer multizentrischen Dokumentation von Therapiealgorithmen.
  • BACKGROUND: Adjuvant chemotherapy for patients with UICC III (Dukes C) colorectal cancer (consensus statements NIH 1990, German Cancer Society 1994) and palliative chemotherapy for metastatic disease have long been recognized to provide a survival benefit in colorectal cancer.
  • PATIENTS AND METHODS: Therefore, we asked 74 institutions treating colorectal cancer patients in Germany to document the treatment algorithms of all patients with colorectal cancer seen in the third quarter of 1998.
  • Clinical careers of 1,001 patients (m/f 465/536; median age 62.9 years [28-93]; colon 596, rectum 405; UICC I 117, II 206, III 407, IV 218) were documented.
  • RESULTS: Only 63.4% of patients with UICC III colorectal cancer received adjuvant therapy with a significant difference between hospitals with (67.1%) and without (42.6%) oncological departments (p < 0.01).
  • Higher age appeared to be the most important factor for withholding treatment since 196 of 286 (68.5%) patients < 70 years, but only 57 of 121 (47.1%) > 70 years underwent adjuvant therapy.
  • 78.4% of patients with UICC IV colorectal cancer (91.8% university hospitals, 76.8% hospital with, 50% without oncological departments, 66.7% rehabilitation clinics, 82.4% private practices) received palliative chemotherapy (first line: 5-FU/FA bolus 57%, 5-FU/FA infusion 20%, 5-FU mono 15%).
  • CONCLUSION: Considering an annual incidence of colorectal cancer in Germany of 52,000 with 30% UICC III, discounting patients > 80 years or ECOG status > 2, and estimating a survival benefit of 10% after adjuvant chemotherapy, approximately 530 lifes are lost annually in Germany due to insufficient treatment of UICC III colorectal cancer based on our survey.
  • In addition, substantial financial demand is generated by the subsequent palliative treatment of potentially curable patients.
  • --In conclusion, survey-based analysis of treatment algorithms can provide valuable insights into clinical practice in oncology and can disclose deficits in patient care as demonstrated here in colorectal cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colorectal Neoplasms / drug therapy. Critical Pathways. Quality Assurance, Health Care
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Chemotherapy, Adjuvant. Female. Fluorouracil / administration & dosage. Germany. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Neoplasm Staging. Palliative Care

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  • (PMID = 12078387.001).
  • [ISSN] 0723-5003
  • [Journal-full-title] Medizinische Klinik (Munich, Germany : 1983)
  • [ISO-abbreviation] Med. Klin. (Munich)
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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30. van Gent MD, Oosterkamp HM, Kagie MJ: [Manifest carcinoma of the glandula vestibularis major (Bartholin's gland), detected one year after an inguinal lymph-node metastasis]. Ned Tijdschr Geneeskd; 2007 Jul 28;151(30):1686-9
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  • [Title] [Manifest carcinoma of the glandula vestibularis major (Bartholin's gland), detected one year after an inguinal lymph-node metastasis].
  • [Transliterated title] Manifest carcinoom van de glandula vestibularis major (Bartholini), gedetecteerd één jaar na een lieskliermetastase.
  • A 68-year-old woman had had a TNM stage-III rectal carcinoma at the age of 54 for which she had undergone a low anterior resection followed by postoperative radiotherapy and adjuvant chemotherapy with fluorouracil and levamisol.
  • More than 10 years later she presented with a swelling in the right groin, which turned out to be a metastasis; this was a poorly differentiated carcinoma with some of the characteristics of a transitional epithelial carcinoma, for which no primary tumour was found.
  • One year later, a swelling was detected on the labium majus, caused by a poorly differentiated transitional epithelial carcinoma of the glandula vestibularis major (Bartholin's gland).
  • [MeSH-major] Bartholin's Glands / pathology. Carcinoma, Transitional Cell / diagnosis. Carcinoma, Transitional Cell / secondary. Vulvar Neoplasms / diagnosis

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  • (PMID = 17725258.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Netherlands
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31. Seegenschmiedt MH, Olschewski T: [Radiotherapy in rectal carcinoma. Indications, side effects and after-care]. MMW Fortschr Med; 2000 Aug 10;142(31-32):33-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Radiotherapy in rectal carcinoma. Indications, side effects and after-care].
  • [Transliterated title] Strahlentherapie beim Rektum-Ca. Indikationen, Nebenwirkungen und Nachsorge.
  • In patients at a high risk of developing a local recurrence or distant metastases, external beam radiotherapy used in combination with chemotherapy with 5-FU is indispensable.
  • Adjuvant treatment is indicated for stage II and stage III rectal carcinoma, following tearing or cutting of the tumor, and/or following an R1 or R2 tumor resection.
  • The fractionated radiation dose is 1.8-2 Gy/day, applied 5 times a week, for a total dose of 50 Gy at the dose reference point in the pelvis.
  • [MeSH-minor] Aftercare. Combined Modality Therapy. Dose Fractionation. Humans. Neoplasm Staging. Radiotherapy, Adjuvant

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  • (PMID = 10992765.001).
  • [ISSN] 1438-3276
  • [Journal-full-title] MMW Fortschritte der Medizin
  • [ISO-abbreviation] MMW Fortschr Med
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] GERMANY
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32. Eckert R, Zeidan Z: [Treatment, follow up and prevention of colorectal carcinoma: strategies and controversies in the year 2005]. Praxis (Bern 1994); 2005 Feb 2;94(5):151-9
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  • [Title] [Treatment, follow up and prevention of colorectal carcinoma: strategies and controversies in the year 2005].
  • [Transliterated title] Therapie, Nachsorge und Prävention des kolorektalen Karzinoms: Strategien und Kontroversen im Jahr 2005.
  • Colorectal carcinomas are common, so efficient strategies in their prevention and treatment will significantly lower mortality.
  • Adjuvant therapy reduces recurrence rates and is recommended in stage II and III rectal carcinoma and stage III colon carcinoma.
  • The optimal strategies for adjuvant therapy are currently being redefined.
  • The availability of new drugs has extended the therapeutic options in metastatic disease, improving response rates and overall survival in the palliative situation.
  • Sequential therapies with different drug combinations seem to be the most effective strategy.
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Colonic Neoplasms / pathology. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Laparoscopy. Life Style. Liver Neoplasms / secondary. Liver Neoplasms / surgery. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Male. Mass Screening. Neoadjuvant Therapy. Neoplasm Staging. Palliative Care. Postoperative Care. Primary Prevention. Quality of Life. Rectal Neoplasms / pathology. Time Factors

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  • (PMID = 15745381.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 26
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33. Vastyan AM, Walker J, Pintér AB, Gerrard M, Kajtar P: Colorectal carcinoma in children and adolescents--a report of seven cases. Eur J Pediatr Surg; 2001 Oct;11(5):338-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Colorectal carcinoma in children and adolescents--a report of seven cases.
  • Carcinoma of the colon and rectum is uncommon in this age group and has a poor prognosis.
  • Five patients had Dukes' stage C and two had Dukes' stage D tumour.
  • Post-operative chemotherapy was given to six patients and two had post-operative radiotherapy.

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  • [CommentIn] Eur J Pediatr Surg. 2003 Aug;13(4):287 [13680503.001]
  • (PMID = 11719875.001).
  • [ISSN] 0939-7248
  • [Journal-full-title] European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
  • [ISO-abbreviation] Eur J Pediatr Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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34. Cruz-Correa M, Hylind LM, Romans KE, Booker SV, Giardiello FM: Long-term treatment with sulindac in familial adenomatous polyposis: a prospective cohort study. Gastroenterology; 2002 Mar;122(3):641-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term treatment with sulindac in familial adenomatous polyposis: a prospective cohort study.
  • Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients, although long-term use of this therapy has not been studied.
  • We evaluated the long-term effectiveness and toxicity of sulindac in attempting to maintain retained rectal segments free of adenomas.
  • Number, size, and histologic grade of polyps, side effects, and medication compliance were assessed every 4 months.
  • At 35 months of follow-up, 1 patient developed stage III cancer in the rectal stump.
  • The most common side effect was rectal mucosal erosions in 6 patients.
  • CONCLUSIONS: Long-term use of sulindac seems to be effective in reducing polyp number and preventing recurrence of higher-grade adenomas in the retained rectal segment of most FAP patients.
  • [MeSH-major] Adenomatous Polyposis Coli / drug therapy. Anti-Inflammatory Agents, Non-Steroidal / administration & dosage. Sulindac / administration & dosage
  • [MeSH-minor] Adult. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Prospective Studies. Rectum / pathology

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  • (PMID = 11874996.001).
  • [ISSN] 0016-5085
  • [Journal-full-title] Gastroenterology
  • [ISO-abbreviation] Gastroenterology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Inflammatory Agents, Non-Steroidal; 184SNS8VUH / Sulindac
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35. Tokatli F, Koçak Z, Ozyilmaz F, Uygun K, Caloglu M, Uzal C: Small cell carcinoma of the rectum; report of a case. J BUON; 2002 Jan-Mar;7(1):75-7
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  • [Title] Small cell carcinoma of the rectum; report of a case.
  • Primary small cell undifferentiated carcinoma of the colon and rectum is a relatively rare tumour with an overall incidence of less than 1% among all colorectal cancers.
  • Despite the mean survival being around 6 months, long-term survival may be achieved in patients with localized disease treated with curative resection and adjuvant therapy.
  • We report on a patient with Dukes' C small cell carcinoma (SCC) of the rectum who underwent surgery followed by pelvic irradiation and chemotherapy and achieved long-term survival.

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  • (PMID = 17577266.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
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36. Bagatzounis A, Willner J, Oppitz U, Flentje M: The postoperative adjuvant radiation therapy and radiochemotherapy for UICC stage II and III rectal cancer. A retrospective analysis. Strahlenther Onkol; 2000 Mar;176(3):112-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The postoperative adjuvant radiation therapy and radiochemotherapy for UICC stage II and III rectal cancer. A retrospective analysis.
  • AIM: This analysis was undertaken to review the outcome and toxicity of postoperative adjuvant therapy for Stage II and III rectal cancer.
  • PATIENTS AND METHODS: We reviewed 112 patients treated with radiotherapy (44 patients) and radiochemotherapy (68 patients) after potentially curative (R0) surgery for rectal cancer (UICC Stages II and III), between 1983 and 1994 at the University Clinic of Würzburg.
  • Median radiation dose was 56 Gy (range: 45 to 66 Gy).
  • Chemotherapy consisted of 4 to 6 courses of 5-fluorouracil (5-FU) (420 mg/m2/d) and leucovorin (200 mg/m2/d).
  • RESULTS: The overall survival was 84% for patients with UICC Stage II and 45% for patients with UICC Stage III disease (p = 0.0045).
  • UICC Stage III disease was associated with high failure rates (40% pelvic recurrences and 53% distant metastases).
  • There was a statistically significant difference in terms of the incidence of distant metastases between the 2 treatment modalities for patients with Stage III disease (49% 5-year probability for developing distant metastases after radiochemotherapy vs 66% after radiotherapy, p = 0.047).
  • In a multivariate analysis, the addition of chemotherapy, lymph node stage and grading were independent prognostic factors for survival.
  • CONCLUSIONS: Prognosis of patients with UICC Stage III rectal cancer remains poor after "standard" surgery followed by postoperative adjuvant treatment (pelvic radiotherapy and bolus intravenous injection of 5-FU and leucovorin).
  • Major efforts should be made in order to improve prognosis for these patients, including optimization of surgical treatment and systemic treatment.
  • More effective multimodality treatment strategies should be investigated in prospective randomized trials.
  • [MeSH-major] Postoperative Care / methods. Rectal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant / statistics & numerical data. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant / statistics & numerical data. Retrospective Studies. Treatment Outcome

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  • (PMID = 10742831.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] GERMANY
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37. Sikma MA, Coenen JL, Kloosterziel C, Hasselt BA, Ruers TJ: A breakthrough in cryosurgery. Surg Endosc; 2002 May;16(5):870
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  • Liver cryosurgery is one of the treatment options for unresectable liver metastases.
  • Indications for the use of this treatment instead of classic surgery are bilobar disease, location of the tumor at an irresectable anatomic site, and comorbid conditions of the patient.
  • We describe a patient in whom a hepatobronchial fistula developed after cryosurgery.
  • The patient had cryosurgery because of an unresectable liver metastasis in a Dukes' C rectal carcinoma.
  • [MeSH-minor] Antimetabolites, Antineoplastic / therapeutic use. Bronchial Fistula / etiology. Carcinoma / drug therapy. Carcinoma / radiotherapy. Carcinoma / secondary. Carcinoma / surgery. Fistula / etiology. Fluorouracil / therapeutic use. Humans. Leucovorin / therapeutic use. Liver Diseases / etiology. Liver Neoplasms / secondary. Liver Neoplasms / surgery. Liver Neoplasms / ultrasonography. Male. Middle Aged. Postoperative Complications / etiology. Rectal Neoplasms / drug therapy. Rectal Neoplasms / radiotherapy. Rectal Neoplasms / surgery

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  • (PMID = 11997844.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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38. Wang WS, Chen PM, Chiou TJ, Liu JH, Fan FS, Lin TC, Jiang JK, Yang SH, Yen CC, Wang HS, Lin JK: Factors predictive of survival in patients with node-positive colorectal cancer in Taiwan. Hepatogastroenterology; 2000 Nov-Dec;47(36):1590-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Factors predictive of survival in patients with node-positive colorectal cancer in Taiwan.
  • BACKGROUND/AIMS: Preoperative CEA levels, depth of tumor penetration, and the number of positive lymph nodes were reported as independent factors prognostic of survival in colorectal cancer patients.
  • This study was carried out in an effort to evaluate the prognostic significance of these three factors in patients with Dukes' C colorectal cancer in Taiwan.
  • METHODOLOGY: Between 1992 and 1994, a total of 112 patients with node-positive colorectal cancer were evaluated retrospectively at the Veteran General Hospital-Taipei.
  • All patients underwent potentially curative surgery and received 5-fluorouracil based adjuvant chemotherapy.
  • Reference to the Dukes' classification was according to the classical criteria described in 1932 for carcinoma of the rectum and adapted for use in colonic tumors.
  • Using multivariate Cox analysis the number of positive lymph nodes, penetration of the bowel wall, and preoperative CEA levels were still found as independent prognostic factors in node-positive colorectal cancer patients.
  • CONCLUSIONS: Data obtained from our study indicates that preoperative CEA levels, depth of tumor penetration, and the number of positive lymph nodes were independent prognostic factors in Dukes' C colorectal cancer patients.
  • They could serve as appropriate modifications of the initial Dukes scheme in node-positive diseases.

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  • (PMID = 11149009.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Carcinoembryonic Antigen
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