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1. Petersen VC, Baxter KJ, Love SB, Shepherd NA: Identification of objective pathological prognostic determinants and models of prognosis in Dukes' B colon cancer. Gut; 2002 Jul;51(1):65-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Identification of objective pathological prognostic determinants and models of prognosis in Dukes' B colon cancer.
  • BACKGROUND AND AIMS: There is a need for objective easily determined pathological prognostic parameters in Dukes' B colon carcinoma to allow selection of such patients for further treatment as the role of adjuvant chemotherapy for these patients remains unclear.
  • This study was initiated to assess the influence of pathological factors on prognosis in an unselected prospective series of Dukes' B colonic cancer.
  • METHODS: The Gloucester Colorectal Cancer study, established in 1988, recruited more than 1000 cases.
  • Meticulous pathological assessment of the 268 Dukes' B colonic cancer resections in this series included evaluation of all pathological factors that could influence staging and prognosis.
  • CONCLUSIONS: The cumulative prognostic index allows apportionment of patients with Dukes' B colon cancer into defined prognostic groups, which in turn could allow more objective selection of patients for adjuvant therapy, especially as part of clinical trials.

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  • [CommentIn] Gut. 2002 Jul;51(1):6-7 [12077080.001]
  • (PMID = 12077094.001).
  • [ISSN] 0017-5749
  • [Journal-full-title] Gut
  • [ISO-abbreviation] Gut
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1773289
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2. Morris EJ, Maughan NJ, Forman D, Quirke P: Who to treat with adjuvant therapy in Dukes B/stage II colorectal cancer? The need for high quality pathology. Gut; 2007 Oct;56(10):1419-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Who to treat with adjuvant therapy in Dukes B/stage II colorectal cancer? The need for high quality pathology.
  • OBJECTIVE: To identify by routine pathology which Dukes B colorectal cancer patients may benefit from chemotherapy.
  • METHOD: Retrospective study of the five year survival of colorectal cancer patients for whom colorectal pathology minimum datasets had been collected between 1997 and 2000 in the Yorkshire region of the UK.
  • The study population consisted of 1625 Dukes B and 480 Dukes C patients who possessed one positive node treated between 1997 and 2000.
  • The predictive ability of the Petersen prognostic model was investigated and survival of Dukes B patients with potentially high risk pathological features was compared to that of Dukes C patients with one positive node.
  • The index offered a statistically significant survival difference of 24.3% and 30.3% between high and low risk colon (p<0.01) and rectal cancer patients (p<0.01).
  • Survival of Dukes B patients with any of the high risk pathological factors or low nodal yields was lower than that of Dukes C patients who possessed one positive node.
  • CONCLUSION: Petersen's index discriminated between high and low risk Dukes B colorectal tumours, but inadequate pathological reporting diminished its ability to identify all high risk patients.
  • The survival of patients with any high risk feature was lower than the threshold for adjuvant therapy of one lymph node positive Dukes C colorectal cancer.
  • Chemotherapy may benefit patients with such features.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Colorectal Neoplasms / drug therapy. Colorectal Neoplasms / pathology
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Invasiveness. Patient Selection. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 17494107.001).
  • [ISSN] 0017-5749
  • [Journal-full-title] Gut
  • [ISO-abbreviation] Gut
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ PMC2000279
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3. Platell C, Lim D, Tajudeen N, Tan JL, Wong K: Dose surgical sub-specialization influence survival in patients with colorectal cancer? World J Gastroenterol; 2003 May;9(5):961-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Dose surgical sub-specialization influence survival in patients with colorectal cancer?
  • AIM: To perform a review of patients with colorectal cancer to a community hospital and to compare the risk-adjusted survival between patients managed in general surgical units versus a colorectal unit.
  • METHODS: The study evaluated all patients with colorectal cancer referred to either general surgical units or a colorectal unit from 1/1996 to 6/2001.
  • These variables included age, ASA score, disease stage, emergency surgery, adjuvant chemotherapy and/or radiotherapy, disease location, and surgical unit.
  • Patients in the colorectal group were more likely to have rectal cancer and Stage I cancers, and less likely to have Stage II cancers.
  • Survival regression analysis identified age, ASA score, disease stage, adjuvant chemotherapy, and treatment in a colorectal unit (Hazards ratio: 0.67; 95 % CI: 0.53 to 0.84, P =0.0005), as significant independent predictors of survival.
  • CONCLUSION: The results suggest that there may be a survival advantage for patients with colon and rectal cancers being treated within a specialist colorectal surgical unit.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Colorectal Surgery. Female. General Surgery. Hospitals, Community. Hospitals, Teaching. Humans. Male. Middle Aged. Survival Rate. Treatment Outcome. Western Australia

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  • (PMID = 12717838.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] China
  • [Other-IDs] NLM/ PMC4611405
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4. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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5. Taal BG, Van Tinteren H, Zoetmulder FA, NACCP group: Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III. Br J Cancer; 2001 Nov 16;85(10):1437-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III.
  • Based on the first favourable results of adjuvant therapy of 5FU plus levamisole in Dukes C colonic cancer in 1990, we conducted a prospective trial.
  • 1029 patients were randomised to receive one year 5FU plus levamisole or no further treatment following curative surgery for stage II or III colon (n = 730) or rectal cancer (n = 299).
  • 45% were in stage II and 55% in stage III.
  • With a median follow-up of 4 years and 9 months a significant reduction in odds of death (25%, SD 9%, P = 0.007) was observed for those with adjuvant treatment (65% at 5 year) compared to the observation group (55%).
  • Improved relative survival was present in stage III (56% vs 44%), and in stage II patients (78% vs 70%).
  • In rectal cancer a non-significant difference in disease-free or overall survival was observed.
  • Distant metastases developed in 76%, while local recurrence alone occurred in 14%.
  • An early start of adjuvant treatment (< 4 weeks) did not affect results.
  • In conclusion, one year 5FU plus levamisole was of benefit in stage II and III colonic cancer; in rectal cancer a significant positive effect could not be demonstrated.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colonic Neoplasms / drug therapy. Colonic Neoplasms / mortality. Rectal Neoplasms / drug therapy. Rectal Neoplasms / mortality
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Aged. Chemotherapy, Adjuvant. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Levamisole / administration & dosage. Male. Middle Aged. Neoplasm Staging. Patient Compliance. Survival Analysis. Survival Rate. Treatment Outcome

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  • (PMID = 11720425.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] Scotland
  • [Chemical-registry-number] 2880D3468G / Levamisole; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC2363941
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6. 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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7. Glasgow SC, Yu J, Carvalho LP, Shannon WD, Fleshman JW, McLeod HL: Unfavourable expression of pharmacologic markers in mucinous colorectal cancer. Br J Cancer; 2005 Jan 31;92(2):259-64
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  • [Title] Unfavourable expression of pharmacologic markers in mucinous colorectal cancer.
  • Patients with mucinous colorectal cancer generally have worse prognoses than those with the nonmucinous variety.
  • The reason for this disparity is unclear, but may result from a differential response to adjuvant chemotherapy.
  • We examined known molecular markers for response to common chemotherapy in these two histological subtypes.
  • In all, 21 patients with mucinous and 30 with nonmucinous Dukes C colorectal cancer were reviewed for demographic data and outcome.
  • Quantitative expression levels of drug pathway genes were determined using TaqMan RT-PCR (5-fluorouracil (5-FU): TYMS, DPYD, ECGF1; oxaliplatin: GSTP1 (glutathione S-transferase pi), ERCC1 and 2; irinotecan: ABCB1, ABCG2, CYP3A4, UGT1A1, CES2, TOP1).
  • Mucinous colorectal cancer overexpresses markers of resistance to 5-FU and oxaliplatin.
  • The presence of mucin should be carefully evaluated in developmental trials of new agents for treating colorectal cancer.

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  • (PMID = 15655543.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA091842; United States / NIGMS NIH HHS / GM / U01 GM063340; United States / NIGMS NIH HHS / GM / U01 GM63340
  • [Publication-type] Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA Primers; 0 / Organoplatinum Compounds; 0 / RNA, Messenger; 04ZR38536J / oxaliplatin; 7673326042 / irinotecan; U3P01618RT / Fluorouracil; XT3Z54Z28A / Camptothecin
  • [Other-IDs] NLM/ PMC2361854
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8. Dahl O, Fluge Ø, Carlsen E, Wiig JN, Myrvold HE, Vonen B, Podhorny N, Bjerkeset O, Eide TJ, Halvorsen TB, Tveit KM, Norwegian Gastrointestinal Cancer Group: Final results of a randomised phase III study on adjuvant chemotherapy with 5 FU and levamisol in colon and rectum cancer stage II and III by the Norwegian Gastrointestinal Cancer Group. Acta Oncol; 2009;48(3):368-76
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  • [Title] Final results of a randomised phase III study on adjuvant chemotherapy with 5 FU and levamisol in colon and rectum cancer stage II and III by the Norwegian Gastrointestinal Cancer Group.
  • BACKGROUND: The recommendation of adjuvant chemotherapy for colon cancer with lymph node metastases, based on two studies from USA, was reluctantly accepted by Norwegian medical doctors.
  • It was therefore decided to assess the role of adjuvant therapy with 5fluorouracil (5-FU) combined with levamisole (Lev) in a confirmatory randomised study.
  • MATERIAL AND METHODS: Four hundred and twenty five patients with operable colon and rectum cancer, Stage II and III (Dukes' stage B and C), were from January 1993 to October 1996, included in a randomised multicentre trial in Norway.
  • Therapy started with a loading course of bolus i.v.
  • RESULTS: There was no significant survival difference between the two groups at 5 years: Disease-free survival (DFS) was 73% after chemotherapy, 68% (p=0.24) in the control group, and corresponding cancer specific survival (CSS) 75% and 71%, respectively (p=0.69).
  • There was no difference between the two groups when analysed for colon and rectum separately.
  • However, the subgroup of colon cancer with stage III exhibited a statistically significant difference both for DFS, 58% vs. 37% (p=0.012) and CSS, 65% vs. 47% (p=0.032) in favour of adjuvant chemotherapy.
  • Toxicity was generally mild and acceptable with no drug related fatalities.
  • CONCLUSIONS: Colon cancer patients with lymph node metastases benefit from adjuvant chemotherapy with 5-FU/Lev with acceptable toxicity.
  • Rectal cancer does not benefit from this regimen.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Agents / therapeutic use. Antirheumatic Agents / therapeutic use. Colonic Neoplasms / drug therapy. Fluorouracil / therapeutic use. Levamisole / therapeutic use. Rectal Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Drug Therapy, Combination. Female. Humans. Male. Middle Aged. Neoplasm Staging. Norway. Survival Rate. Young Adult

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  • (PMID = 19242829.001).
  • [ISSN] 1651-226X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antirheumatic Agents; 2880D3468G / Levamisole; U3P01618RT / Fluorouracil
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9. Bleeker WA, Hayes VM, Karrenbeld A, Hofstra RM, Verlind E, Hermans J, Poppema S, Buys CH, Plukker JT: Prognostic significance of K-ras and TP53 mutations in the role of adjuvant chemotherapy on survival in patients with Dukes C colon cancer. Dis Colon Rectum; 2001 Mar;44(3):358-63
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  • [Title] Prognostic significance of K-ras and TP53 mutations in the role of adjuvant chemotherapy on survival in patients with Dukes C colon cancer.
  • PURPOSE: Mutations in K-ras and TP53 genes are common in colorectal cancer.
  • They affect biologic behavior and might influence chemotherapy susceptibility in these tumors.
  • We investigated whether the survival of patients with Dukes C colon cancer treated with adjuvant chemotherapy is influenced by K-ras and TP53 mutations.
  • METHODS: Mutation screening of the hot spots of the K-ras gene and of the evolutionarily conserved regions of the TP53 gene was performed by denaturing gradient gel electrophoresis technique in formalin-fixed paraffin-embedded specimens of 55 consecutive patients with Dukes C colon cancer treated with adjuvant 5-fluorouracil-based chemotherapy.
  • RESULTS: Alterations in the mutation hot spots of K-ras were found at codon 12 (n = 11) and 13 (n = 4) in 15 of the 55 carcinomas (27 percent).
  • Cancer-specific survival did not differ significantly between patients with K-ras or TP53 or both mutated and nonmutated tumors, respectively (log-rank test: K-ras, P = 0.72 and TP53, P = 0.77; K-ras and TP53, P = 0.8).
  • CONCLUSIONS: Patients with K-ras or TP53 or both mutated Dukes C colon tumors have the same survival as nonmutated tumors when treated with adjuvant chemotherapy.
  • These data suggest that mutations in K-ras or TP53 alone are not prognostic indicators in patients with Dukes C colon cancer receiving adjuvant 5-Fluorouracil-based therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colonic Neoplasms / genetics. DNA Mutational Analysis. Fluorouracil / administration & dosage. Proto-Oncogene Proteins p21(ras) / genetics. Tumor Suppressor Protein p53 / genetics
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Codon. Combined Modality Therapy. Exons. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • (PMID = 11289281.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Codon; 0 / Tumor Suppressor Protein p53; EC 3.6.5.2 / HRAS protein, human; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras); U3P01618RT / Fluorouracil
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10. Bhatavdekar JM, Patel DD, Chikhlikar PR, Shah NG, Vora HH, Ghosh N, Trivedi TI: Molecular markers are predictors of recurrence and survival in patients with Dukes B and Dukes C colorectal adenocarcinoma. Dis Colon Rectum; 2001 Apr;44(4):523-33
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  • [Title] Molecular markers are predictors of recurrence and survival in patients with Dukes B and Dukes C colorectal adenocarcinoma.
  • PURPOSE: The goal was to investigate the prognostic value of various molecular markers like CEA, Cyclin D1, Bcl-2, c-Myc, p53, p21ras, Ki-67, CD44, Factor VIII-related antigen, cytokeratin-19, adenoma antigen, and prolactin in patients with Dukes B and Dukes C colorectal adenocarcinoma.
  • The patients with colorectal cancer were followed for a period of five years or their death within that period.
  • Besides Dukes stage, multivariate analysis indicated a significantly reduced relapse-free survival in patients expressing CD44 and cytokeratin-19 (P < 0.005).
  • Similarly, besides Dukes stage, multivariate analysis indicated a significantly poor overall survival in patients expressing CD44, cytokeratin-19 and prolactin (P < 0.01).
  • In patients with Dukes B disease, only cytokeratin-19 and CD44 expression attained statistical significance (P < 0.05), whereas in patients with Dukes C disease, CD44, p21ras- and c-Myc expression attained statistical significance (P < 0.018).
  • Also, a multivariate analysis in relation to treatment given was performed using CD44 and cytokeratin-19.
  • CONCLUSION: Besides Dukes stage, multivariate analysis of all the studied molecular markers showed that patients expressing CD44 and cytokeratin-19 had a significantly reduced relapse-free and poor overall survival.
  • Moreover, patients expressing both these markers (CD44 and cytokeratin-19) had the lowest significant relative risk for developing recurrence than patients with both markers negative when treated with surgery followed by adjuvant chemotherapy as compared with patients treated with surgery alone.
  • Thus, in patients with colorectal cancer, immunohistochemical localization of CD44 and cytokeratin-19 may be included as a part of routine pathologic evaluation along with conventional prognostic factors.


11. Koda K, Miyazaki M, Sarashina H, Suwa T, Saito N, Suzuki M, Ogawa K, Watanabe S, Kodaira S, Nakazato H: A randomized controlled trial of postoperative adjuvant immunochemotherapy for colorectal cancer with oral medicines. Int J Oncol; 2003 Jul;23(1):165-72
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  • [Title] A randomized controlled trial of postoperative adjuvant immunochemotherapy for colorectal cancer with oral medicines.
  • Postoperative adjuvant chemotherapy reportedly improves advanced colorectal cancer patients' survival, however, it is necessary to assess what regimens are useful.
  • Doxifluridine (5'-DFUR) is an intermediate of capecitabine approved in Europe and USA to treat metastatic colorectal cancer.
  • 5'-DFUR is metabolized to 5-fluorouracil (5-FU) by thymidine phosphorylase existing in tumor at high concentrations, suggesting high 5-FU levels in tumor tissues and lesser complications.
  • They had diagnosed colorectal cancer of TNM stages II and III, and underwent macroscopic curative resection.
  • Patients were prestratified into colon or rectum cancer and allocated into either 5'-DFUR (5'-DFUR 460 mg/m(2)/day + PSK 3 g/day) or 5-FU (5-FU 115 mg/m(2)/day + PSK 3 g/day) group by dynamic randomization (stratification factors such as depth of tumor, degree of lymph node metastasis, and location of tumor).
  • Drugs were orally administered daily from postoperative week 2 to 54, with 6 mg/m(2) mitomycin C at operation and following days.
  • Although no differences in overall survival curves were detected, multivariate analysis showed that 5'-DFUR + PSK regimen was a significantly better prognostic factor in patients with Dukes B or C (risk ratio, 1.451; p=0.048); with tumor depth of pT3 or pT4 (risk ratio, 1.568; p=0.020).
  • For patients with advanced colorectal cancer, 5'-DFUR + PSK therapy may possibly be more useful than 5-FU + PSK, but further study is required.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. Colorectal Neoplasms / drug therapy. Colorectal Neoplasms / surgery. Floxuridine / therapeutic use. Fluorouracil / therapeutic use
  • [MeSH-minor] Administration, Oral. Adult. Aged. Antimetabolites, Antineoplastic / therapeutic use. Female. Humans. Immunosuppressive Agents / therapeutic use. Lymphatic Metastasis. Male. Middle Aged. Prognosis. Recurrence. Time Factors. Treatment Outcome

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  • (PMID = 12792790.001).
  • [ISSN] 1019-6439
  • [Journal-full-title] International journal of oncology
  • [ISO-abbreviation] Int. J. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Antimetabolites, Antineoplastic; 0 / Immunosuppressive Agents; 039LU44I5M / Floxuridine; U3P01618RT / Fluorouracil; V1JK16Y2JP / doxifluridine
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12. Thebo JS, Senagore AJ, Reinhold DS, Stapleton SR: Molecular staging of colorectal cancer: K-ras mutation analysis of lymph nodes upstages Dukes B patients. Dis Colon Rectum; 2000 Feb;43(2):155-9; discussion 159-62
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  • [Title] Molecular staging of colorectal cancer: K-ras mutation analysis of lymph nodes upstages Dukes B patients.
  • PURPOSE: Multiple attempts have been made to improve the clinical/pathologic staging system of Dukes to focus adjuvant therapy decisions.
  • The purpose of this study was to determine whether K-ras mutational status of regional nodes in patients with Dukes B2 colorectal cancer could be used to stage their disease more accurately.
  • Patients with Dukes B2 tumors that have mutations in codon 12 or 13 of the K-ras gene were identified.
  • None of the four patients with mutation-free nodes developed recurrence compared with 37.5 percent (6/16) with K-ras positive lymph nodes.
  • CONCLUSIONS: The data suggest that patients with Dukes B2 colorectal cancers that have mutations in codon 12 or 13 of the K-ras gene are at high risk for the development of nodal metastases.
  • Mutational analysis of the lymph nodes identifies high-risk patients who should be considered for adjuvant chemotherapy.
  • Therefore, K-ras mutational analysis should be considered for molecular staging of colorectal cancer.

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  • (PMID = 10696887.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / DNA Primers; 0 / DNA, Neoplasm
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13. Galizia G, Ferraraccio F, Lieto E, Orditura M, Castellano P, Imperatore V, Romano C, Vollaro M, Agostini B, Pignatelli C, De Vita F: Prognostic value of p27, p53, and vascular endothelial growth factor in Dukes A and B colon cancer patients undergoing potentially curative surgery. Dis Colon Rectum; 2004 Nov;47(11):1904-14
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  • [Title] Prognostic value of p27, p53, and vascular endothelial growth factor in Dukes A and B colon cancer patients undergoing potentially curative surgery.
  • PURPOSE: Early-stage colon cancer patients (Dukes A or B; pT1-T3 pNO pMO) are excluded from adjuvant chemotherapy following potentially curative surgery because they are expected to have good long-term survival.
  • This indicates that the conventional staging procedures may be unable to precisely predict cancer prognosis.
  • METHODS: In 65 early-stage colon cancers, we investigated by immunohistochemistry the role of molecular markers such as p27, p53, and vascular endothelial growth factor in identifying high-risk patients who may benefit from adjuvant treatments.
  • RESULTS: No clinicopathologic factor, namely Dukes stage, t parameter, number of resected nodes, and vascular or lymphatic invasion, was found be an independent significant predictor of disease-specific and disease-free survival.
  • In contrast, each molecular marker predicted survival and recurrence rates much better than the conventional Dukes staging system.
  • Nearly all cancer-related deaths were observed among patients whose colon cancers expressed all three molecular alterations.
  • Regardless of Dukes stage, the recurrence rate was found to increase with the increase in the number of molecular alterations.
  • Early-stage colon cancers expressing p27 down-regulation and high p53 and vascular endothelial growth factor immunoreactivity showed a 100 percent actuarial four-year recurrence rate.
  • CONCLUSIONS: Assessment of molecular alterations may be useful to identify a higher-risk group of early-stage colon cancer patients who may benefit from adjuvant chemotherapy.

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  • (PMID = 15622584.001).
  • [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
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cell Cycle Proteins; 0 / Tumor Suppressor Protein p53; 0 / Tumor Suppressor Proteins; 0 / Vascular Endothelial Growth Factor A; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27
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14. Gervaz P, Bouzourene H, Cerottini JP, Chaubert P, Benhattar J, Secic M, Wexner S, Givel JC, Belin B: Dukes B colorectal cancer: distinct genetic categories and clinical outcome based on proximal or distal tumor location. Dis Colon Rectum; 2001 Mar;44(3):364-72; discussion 372-3
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  • [Title] Dukes B colorectal cancer: distinct genetic categories and clinical outcome based on proximal or distal tumor location.
  • PURPOSE: The aim of this study was to determine whether tumor location proximal or distal to the splenic flexure is associated with distinct molecular patterns and can predict clinical outcome in a homogeneous group of patients with Dukes B (T3-T4, N0, M0) colorectal cancer.
  • It has been hypothesized that proximal and distal colorectal cancer may arise through different pathogenetic mechanisms.
  • Although p53 and Ki-ras gene mutations occur frequently in distal tumors, another form of genomic instability associated with defective DNA mismatch repair has been predominantly identified in the proximal colon.
  • METHODS: A total of 126 patients with a lymph node-negative sporadic colon or rectum adenocarcinoma were prospectively assessed with the endpoint of death by cancer.
  • No patient received either radiotherapy or chemotherapy. p53 protein was studied by immunohistochemistry using DO-7 monoclonal antibody, and p53 and Ki-ras gene mutations were detected by single strand conformation polymorphism assay.
  • Nuclear p53 staining was found in 57 tumors (47 percent), and was more frequent in distal than in proximal tumors (55 vs. 21 percent; chi-squared test, P < 0.001).
  • Distal colon tumors and rectal tumors exhibited similar molecular patterns and showed no difference in clinical outcome.
  • In comparison with distal colorectal cancer, proximal tumors were found to be statistically significantly different on the following factors: mucinous content (P = 0.008), degree of histologic differentiation (P = 0.012), p53 protein expression, and gene mutation (P = 0.001 and 0.01 respectively).
  • Finally, patients with proximal tumors had a marginally better survival than those with distal colon or rectal cancers (log-rank test, P = 0.045).
  • CONCLUSION: In this series of Dukes B colorectal cancers, p53 protein expression was an independent factor for survival, which also correlated with tumor location.
  • Eighty-six percent of p53-positive tumors were located in the distal colon and rectum.
  • Distal colon and rectum tumors had similar molecular and clinical characteristics.
  • Location of the neoplasm in reference to the splenic flexure should be considered before group stratification in future trials of adjuvant chemotherapy in patients with Dukes B tumors.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Colon / pathology. Female. Humans. Male. Middle Aged. Neoplasm Staging. Polymorphism, Single-Stranded Conformational. Prospective Studies. Rectum / pathology. Survival Rate

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  • (PMID = 11289282.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Tumor Suppressor Protein p53; EC 3.6.5.2 / HRAS protein, human; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras)
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15. Borie F, El Nasser M, Herrero A, Gras-Aygon C, Daures JP, Tretarre B, CRISAP-LR: [Impact of the French consensus guidelines on the management of colonic and rectal cancer: a population-based study]. J Chir (Paris); 2008 May-Jun;145(3):247-51
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  • [Title] [Impact of the French consensus guidelines on the management of colonic and rectal cancer: a population-based study].
  • [Transliterated title] Impact des conférences de consensus sur la prise en charge du cancer du côlon et du rectum.
  • AIM: To compare the management of colorectal cancer (CRC) before and after the French consensus conferences of rectal cancer (RC) in 1994 and colonic cancer (CC) in 1998.
  • METHODS: From 344 CCR incident cases in 1992 and 545 in 2000, patient characteristics, tumor data, and diagnostic and treatment modalities were collected to compare the management of CRC.
  • No trends were observed in disease stage at diagnosis or rate of resection.
  • For CC with Dukes stage C and D, the use of chemotherapy increased significantly: for Dukes Stage C from 45% in 1992 to 55% in 2000; for Dukes Stage D from 37% in 1992 to 67% in 2000.

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  • (PMID = 18772733.001).
  • [ISSN] 0021-7697
  • [Journal-full-title] Journal de chirurgie
  • [ISO-abbreviation] J Chir (Paris)
  • [Language] fre
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] France
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16. Stelzner F, von Mallek D, Ruhlmann J, Biersack HJ: [PET-CT studies of metastasizing cancer of the colon and rectum. Variability of tumor aggressiveness as a micro-evolutionary process of cancer stem cells with predetermined prognosis]. Chirurg; 2009 Jul;80(7):645-51
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  • [Title] [PET-CT studies of metastasizing cancer of the colon and rectum. Variability of tumor aggressiveness as a micro-evolutionary process of cancer stem cells with predetermined prognosis].
  • [Transliterated title] PET-CT-Untersuchungen zur Stammzellkarzinogenese im Kolorektalbereich. Malignitätsvariabilität als mikroevolutionärer Prozess mit festgelegter Prognose.
  • Formation of cancer stem cells which are both rare and variably therapy-resistant marks the beginning of a new disease without precursors.
  • In vitro studies have shown that hybrid cancers which behave in a similar way to Dukes A, B or C cancers in vivo can be produce by horizontal gene transfer.
  • The primary tumor acts as the supplier of cancer stem cells for metastases which appear in different organs.
  • When chemotherapy is administered the distribution of metastases in different organs appears dependent of the response or non-response of cancer stem cells to this therapy.
  • Large numbers of colorectal carcinomas existed for the same time duration before death (15 years) independent of the malignancy grade.
  • [MeSH-major] Cell Transformation, Neoplastic / pathology. Colorectal Neoplasms / pathology. Image Processing, Computer-Assisted. Liver Neoplasms / pathology. Liver Neoplasms / secondary. Lung Neoplasms / pathology. Lung Neoplasms / secondary. Neoplasm Recurrence, Local / pathology. Neoplastic Stem Cells / pathology. Positron-Emission Tomography. Tomography, X-Ray Computed
  • [MeSH-minor] Aged. Biological Evolution. Cell Survival / drug effects. Cell Survival / genetics. Cell Survival / radiation effects. Chemotherapy, Adjuvant. Combined Modality Therapy. Disease Progression. Drug Resistance, Neoplasm / drug effects. Drug Resistance, Neoplasm / genetics. Drug Resistance, Neoplasm / radiation effects. Gene Transfer Techniques. Humans. Male. Middle Aged. Neoplasm Staging. Neoplastic Cells, Circulating / pathology. Organ Specificity. Probability Theory. Prognosis. Radiotherapy, Adjuvant

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  • (PMID = 19562240.001).
  • [ISSN] 1433-0385
  • [Journal-full-title] Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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17. 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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18. Sarid D, Wigler N, Gutkin Z, Merimsky O, Leider-Trejo L, Ron IG: Cutaneous and subcutaneous metastases of rectal cancer. Int J Clin Oncol; 2004 Jun;9(3):202-5
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  • [Title] Cutaneous and subcutaneous metastases of rectal cancer.
  • The occurrence of cutaneous metastatic disease from colorectal cancer is uncommon and typically signifies widespread disease with poor prognosis.
  • The woman was found to have an adenocarcinoma of the rectum, a Dukes' C lesion, extending over the entire rectal wall into the perirectal fat; five of eight regional lymph nodes showed metastases.
  • Adjuvant radiotherapy followed by chemotherapy was administered for about 1 year.
  • A subcutaneous lump on the left abdominal wall found 16 months postoperatively was metastatic of rectal origin.
  • A metastatic adenocarcinoma of rectal origin was found in a single left lower axillary node 26 months later.
  • Computerized tomography (CT) examination 5 years after the first presentation of the rectal tumor and almost 4 years after the diagnosis of abdominal skin metastases disclosed recurrent pelvic disease with severe left hydronephrosis.
  • Treatment by systemic chemotherapy was partially successful, but she died 8 months after this chemotherapy was initiated.
  • [MeSH-major] Adenocarcinoma / secondary. Rectal Neoplasms / pathology. Skin Neoplasms / secondary
  • [MeSH-minor] Abdominal Wall / pathology. Axilla. Female. Humans. Lymphatic Metastasis. Middle Aged. Subcutaneous Tissue / pathology

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  • (PMID = 15221607.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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19. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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20. Sahraoui S, Acharki A, Tawfiq N, Jouhadi H, Bouras N, Benider A, Kahlain A: [Colorectal cancer in patients younger than 40 years of age]. Cancer Radiother; 2000 Nov-Dec;4(6):428-32
MedlinePlus Health Information. consumer health - Colorectal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Colorectal cancer in patients younger than 40 years of age].
  • [Transliterated title] Cancers rectocoliques chez le sujet de moins de 40 ans.
  • A family history of colorectal cancer was noted in 5%.
  • The most frequent symptoms were bleeding and rectal pain.
  • The localisation of the tumour was the rectum in 70 cases.
  • According to the anatomopathological profile, Dukes stages C and D were the most frequent and mucosal adenocarcinoma was noted in 24 cases.
  • Seventy patients had surgery, associated with radiation therapy in 59 cases.
  • Adjuvant chemotherapy was given in 44 cases and palliative treatment in 17 cases.
  • Worse prognostic factors were mucosal adenocarcinoma, poor differentiated adenocarcinoma and Dukes C and D stages.
  • [MeSH-minor] Adult. Age of Onset. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Male. Neoplasm Staging. Palliative Care. Prognosis. Retrospective Studies

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  • (PMID = 11191849.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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21. Borie F, El Nasser M, Herrero A, Gras-Aygon C, Crisap-Lr, Daures JP, Tretarre B: [Not Available]. J Chir (Paris); 2008 May;145(3):247-51

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Transliterated title] Impact des conférences de consensus sur la prise en charge du cancer du côlon et du rectum: Étude de population.
  • Impact of the French consensus guidlines on the management of colonic and rectal cancer: A population-based study F. Borie, M.
  • Gras-Aygon, CRISAP-LR, J.-P. Daures, B.
  • Tretarre Aim: To compare the management of colorectal cancer (CRC) before and after the French consensus conferences of rectal cancer (RC) in 1994 and colonic cancer (CC) in 1998.
  • METHODS: From 344 CCR incident cases in 1992 and 545 in 2000, patient characteristics, tumor data, and diagnostic and treatment modalities were collected to compare the management of CRC.
  • No trends were observed in disease stage at diagnosis or rate of resection.
  • For CC with Dukes stage C and D, the use of chemotherapy increased significantly: for Dukes Stage C from 45% in 1992 to 55% in 2000; for Dukes Stage D from 37% in 1992 to 67% in 2000.

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  • [Copyright] Copyright © 2008 Elsevier Masson SAS. All rights reserved.
  • (PMID = 22805258.001).
  • [ISSN] 0021-7697
  • [Journal-full-title] Journal de chirurgie
  • [ISO-abbreviation] J Chir (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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22. Shirouzu K, Ogata Y, Araki Y: Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer. Dis Colon Rectum; 2004 Sep;47(9):1442-7
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  • [Title] Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer.
  • It is unclear whether autonomic nerve preservation is suitable curative procedure.
  • We clarify the significance of autonomic nerve preservation for an advanced lower rectal cancer.
  • In either Dukes A+B or Dukes C disease, the TME-P(+) group did not increase local recurrence or decrease ten-year disease-free survival compared with the TME-P(-) group of Period 1975 to 1984.
  • CONCLUSIONS: Autonomic nerve preservation is oncologically and functionally excellent and suitable for almost all patients with advanced lower rectal cancer.
  • Intensive chemotherapy is needed for patients whose autonomic nerves were killed in suspicion of nerve invasion.
  • [MeSH-major] Autonomic Nervous System / injuries. Lymph Node Excision. Neoplasm Recurrence, Local. Postoperative Complications / prevention & control. Rectal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Sexual Dysfunction, Physiological / etiology. Survival Analysis. Treatment Outcome. Urination Disorders / etiology

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  • (PMID = 15486739.001).
  • [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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23. 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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24. 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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25. Braat AE, Oosterhuis JW, de Vries JE, Tollenaar RA: Lymphatic staging in colorectal cancer: pathologic, molecular, and sentinel node techniques. Dis Colon Rectum; 2005 Feb;48(2):371-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Lymphatic staging in colorectal cancer: pathologic, molecular, and sentinel node techniques.
  • PURPOSE: Accurate staging in colorectal cancer is important to predict prognosis and identify patients who could benefit from adjuvant therapy.
  • Patients with lymphatic metastasis, Stage III/Dukes C, are generally treated with adjuvant chemotherapy.
  • Still, patients without lymphatic metastasis do have relapse as high as 27 percent in five years in Dukes B2.
  • If these (micro)metastasis can be identified, these patients might benefit from adjuvant therapy.
  • RESULTS: We found 30 articles about sentinel node in colorectal cancer describing original series.
  • The sentinel node technique has been recently described for use in colorectal cancer.
  • Whether to treat patients with adjuvant therapy if occult (micro)metastasis are found needs to be proven in future studies.

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  • (PMID = 15812587.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 119
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26. Kingston EF, Goulding H, Bateman AC: Vascular invasion is underrecognized in colorectal cancer using conventional hematoxylin and eosin staining. Dis Colon Rectum; 2007 Nov;50(11):1867-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Vascular invasion is underrecognized in colorectal cancer using conventional hematoxylin and eosin staining.
  • PURPOSE: This study was designed to test the hypothesis that highlighting vascular spaces with histochemical or immunohistochemical stains facilitates the identification of extramural and intramural vascular invasion in resected colorectal cancer specimens compared with routine hematoxylin and eosin staining.
  • METHODS: Archival tumor sections from 50 resected colorectal cancers, in which extramural vascular invasion was not seen within the original tissue sections, were stained with hematoxylin and eosin, elastic van gieson histochemistry, and immunohistochemistry for CD31 and CD34.
  • RESULTS: Vascular invasion was more commonly identified in Dukes C (pTanyN1/2) (vascular invasion seen in 24 of 25 cases by at least 1 method) than Dukes B tumors (pT3/4N0) (vascular invasion seen in 14 of 25 cases by at least 1 method).
  • Vascular invasion was identified in significantly more cases using elastic van gieson (24 cases; P = 0.0001), CD31 (18 cases; P = 0.0064), and CD34 (21 cases; P < 0.0001) than with hematoxylin and eosin alone (5 cases).
  • CONCLUSIONS: This study was novel in that it compared both histochemical and immunohistochemical methods for identifying vascular invasion in cases of colorectal cancer in which vascular invasion had not been identified during initial reporting.
  • Highlighting of endothelium significantly increases the observed incidence of vascular invasion in colorectal cancer compared with hematoxylin and eosin alone.
  • Elastic van gieson seemed sensitive for the presence of vascular invasion but with uncertain specificity.
  • The possibility that these immunohistochemical methods may identify a subset of patients with colorectal cancer who may benefit from chemotherapy warrants further study.

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  • [CommentIn] Dis Colon Rectum. 2008 Sep;51(9):1436-7; author reply 1438-9 [18594927.001]
  • (PMID = 17665249.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD31; 0 / Antigens, CD34; 0 / Coloring Agents; 0 / Fluorescent Dyes; TDQ283MPCW / Eosine Yellowish-(YS); YKM8PY2Z55 / Hematoxylin
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27. Biswal BM, Sain AH, Othman NH, Baba A: Adjuvant treatment in colorectal cancer. Experience from a referral center in eastern peninsular Malaysia. Trop Gastroenterol; 2002 Jul-Sep;23(3):134-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant treatment in colorectal cancer. Experience from a referral center in eastern peninsular Malaysia.
  • BACKGROUND: Colorectal cancer is one of the most common malignancies in the West, but in Asia the incidence is low.
  • However in Malaysia, colorectal cancer is increasing with a reported figure of 15% of all cancer cases.
  • The present retrospective analysis was performed to document the effect of such therapy among patients with colorectal cancer in Malaysia.
  • MATERIALS AND METHODS: This is a retrospective study on the use of adjuvant treatment in colorectal cancers.
  • Patients with histopathological evidence of risk factors were subjected to adjuvant radiotherapy and/or chemotherapy.
  • Cancers confined to rectum and rectosigmoid were subjected to pelvic radiotherapy to a tumor dose of 45 Gy in 20 fractions over 4-week period.
  • 5-flurouracil based chemotherapy was predominantly offered for colonic cancers.
  • RESULTS: One hundred thirty patients with colorectal cancers received adjuvant treatment with a median age of 58 years (range 22-76 years).
  • Modified Dukes' stage B2 (28%) and C (38%) constituted the majority, which were distributed in rectum (40%), rectosigmoid (19%), and in the remaining colon (41%).
  • Following treatment, the 2-year actuarial survival was 28% and 54% in colon and rectum cancer respectively.
  • CONCLUSIONS: This study showed that colorectal cancer is not infrequent among Malays in this region and rectal cancers had better survival than the colonic cancers.
  • [MeSH-major] Colorectal Neoplasms / drug therapy. Colorectal Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Chi-Square Distribution. Female. Fluorouracil / administration & dosage. Humans. Incidence. Malaysia / epidemiology. Male. Middle Aged. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 12693156.001).
  • [ISSN] 0250-636X
  • [Journal-full-title] Tropical gastroenterology : official journal of the Digestive Diseases Foundation
  • [ISO-abbreviation] Trop Gastroenterol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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28. Yau T, Watkins D, Cunningham D, Barbachano Y, Chau I, Chong G: Longitudinal assessment of quality of life in rectal cancer patients with or without stomas following primary resection. Dis Colon Rectum; 2009 Apr;52(4):669-77
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  • [Title] Longitudinal assessment of quality of life in rectal cancer patients with or without stomas following primary resection.
  • PURPOSE: The purpose of this study was to assess the longitudinal impact of stoma formation on the health-related quality of life of rectal cancer patients treated with adjuvant chemotherapy.
  • METHODS: Health-related quality of life data was prospectively collected in a randomized trial designed to compare 24 weeks of bolus 5-fluorouracil/leucovorin with 12 weeks of continuous 5-fluorouracil in patients with resected Dukes B and C colorectal cancer.
  • Health-related quality of life data was collected at baseline, during adjuvant treatment, and at one and three years after completion of chemotherapy.
  • RESULTS: Between 1993 and 2003, 186 rectal cancer patients were enrolled.
  • There was no significant difference in global health-related quality of life between patients with and patients without a stoma at any time point.
  • However, during adjuvant treatment, role (P = 0.04) and social (P = 0.005) functioning were significantly worse in stoma patients than in nonstoma patients.
  • Moreover, the impairment in social functioning persisted at one (P = 0.03) and three years (P = 0.04) after adjuvant chemotherapy.
  • CONCLUSION: Our results demonstrate important adverse effects of either temporary or permanent stoma formation on subsequent health-related quality of life in patients with rectal cancer.
  • [MeSH-major] Adenocarcinoma / surgery. Colostomy. Quality of Life. Rectal Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Postoperative Period

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  • (PMID = 19404073.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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29. Robinson B, Frizelle F, Dickson M, Frampton C: Colorectal cancer treated at Christchurch Hospital, New Zealand: a comparison of 1993 and 1998 cohorts. N Z Med J; 2005 Feb 25;118(1210):U1323
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  • [Title] Colorectal cancer treated at Christchurch Hospital, New Zealand: a comparison of 1993 and 1998 cohorts.
  • AIM: To compare clinicopathological variables, management, and outcome of two cohorts of unselected patients treated for colorectal cancer (CRC) at Christchurch Hospital, New Zealand in 1993-94 and 1998-99.
  • RESULTS: 356 patients in 1993-94 and 317 patients in 1998-99 had a confirmed diagnosis of adenocarcinoma of the colon or rectum.
  • At the minimum follow-up time of 42 months, 54% (40% of CRC) of the 356 patients in the first cohort, and 36% (26% of CRC) of the 317 patients in the second cohort had died.
  • The Kaplan-Meier survival curves showed significant improvement in 1998-99 overall, as well as for Dukes stages A plus B, stage C, and stage D disease.
  • Computed tomography (CT) scan-staging increased from 11.3% to 62.8%.
  • On multivariate analysis, cohort, stage, vascular/lymphatic invasion, and elective surgery were independent prognostic factors for disease-specific mortality.
  • Over the 5 years (1993-94 to 1998-99), surgery by consultant increased from 44% to 82%, adjuvant chemotherapy for Dukes stage C increased from 21% to 45%, and chemotherapy for metastatic disease increased from 2.4% to 23% of stage D and from 2.5% to 36.5% of those patients who developed metastases.
  • CONCLUSION: The improvement in outcome is attributed to more specialised surgery, more frequent CT scan staging, and greater use of chemotherapy.
  • [MeSH-minor] Analysis of Variance. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant / utilization. Cohort Effect. Elective Surgical Procedures. Humans. Multivariate Analysis. Neoplasm Staging. New Zealand / epidemiology. Retrospective Studies. Survival Analysis. Tomography, X-Ray Computed / utilization. Treatment Outcome

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  • [CommentIn] N Z Med J. 2005 Feb 25;118(1210):U1330 [15776102.001]
  • (PMID = 15776099.001).
  • [ISSN] 1175-8716
  • [Journal-full-title] The New Zealand medical journal
  • [ISO-abbreviation] N. Z. Med. J.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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30. Sutoh I, Kohno H, Nakashima Y, Hishikawa Y, Tabara H, Tachibana M, Kubota H, Nagasue N: Concurrent expressions of metallothionein, glutathione S-transferase-pi, and P-glycoprotein in colorectal cancers. Dis Colon Rectum; 2000 Feb;43(2):221-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: Because the status of the inherent drug-resistance of colorectal cancers remains obscure, human colorectal cancers with no neoadjuvant therapy were retrospectively investigated regarding the expression of three drug-resistant proteins: metallothionein, glutathione S-transferase-pi, and P-glycoprotein.
  • METHODS: Paraffin-embedded tissues of 130 colorectal cancers (Dukes A, 20; B, 49; C, 41; D, 20) obtained by surgical resections from 1982 to 1989 were used.
  • The data were compared with clinicopathologic features (Dukes A-D) and patients' prognosis (Dukes AC).
  • A total of 120 (86 percent) expressed at least one drug-resistant protein.
  • Rectal cancers positively expressed P-glycoprotein and three proteins more frequently.
  • The disease-free survival rates of patients with Dukes A through C cancer with positive staining for one, two, and three proteins were 100, 94, and 83 percent (at 1 year); 100, 72, and 51 percent (at 3 years); and 94, 66, and 38 percent (at 5 years), respectively (Kaplan-Meier with log-rank test; P = 0.016).
  • In the multivariate Cox analysis, age, Dukes stage, tumor size, and glutathione S-transferase-pi were independent prognostic factors.
  • CONCLUSIONS: The patients with concurrent expression of drug-resistant proteins in their cancers had worse prognoses.
  • Examining drug-resistant proteins in colorectal cancers may be useful in selecting adjuvant chemotherapy and in predicting prognosis more accurately.
  • [MeSH-minor] Aged. Biomarkers, Tumor / metabolism. Combined Modality Therapy. Disease-Free Survival. Female. Glutathione S-Transferase pi. Humans. Immunoenzyme Techniques. Male. Neoplasm Invasiveness. Retrospective Studies

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  • (PMID = 10696897.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Isoenzymes; 0 / P-Glycoprotein; 9038-94-2 / Metallothionein; EC 2.5.1.18 / GSTP1 protein, human; EC 2.5.1.18 / Glutathione S-Transferase pi; EC 2.5.1.18 / Glutathione Transferase
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31. Ramani VS, Gollins SW, Wong H: Weekly fluorouracil at 425 mg/m(2) plus low-dose folinic acid for 24 weeks as adjuvant treatment for colorectal cancer: assessment of toxicity and delivery. Clin Oncol (R Coll Radiol); 2006 Nov;18(9):649-57
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  • [Title] Weekly fluorouracil at 425 mg/m(2) plus low-dose folinic acid for 24 weeks as adjuvant treatment for colorectal cancer: assessment of toxicity and delivery.
  • AIMS: To assess the toxicity and dose delivery of weekly bolus 5-fluorouracil (5-FU) at 425 mg/m(2) plus low-dose folinic acid (FA) for 24 weeks as adjuvant treatment for colorectal cancer.
  • RESULTS: There were 53 men and 47 women (median age: 64 and 65 years, respectively); 77 patients with colon cancer and 23 with cancer of the rectum; 34 patients with Dukes' stage B and 66 with Dukes' stage C.
  • The median 'conventional' dose intensity (DI), calculated from the first cycle to the last, was 408 mg/m(2)/week (96%).
  • The median DI over 24 weeks was 387 mg/m(2)/week (91%).
  • A higher median 24-week DI was delivered to men (407 mg/m(2)/week, 96%) than women (361 mg/m(2)/ week, 85%; P = 0.009).
  • Women older than 65 years showed a significantly reduced median DI over 24 weeks (347 mg/ m(2)/week, 82%) compared with men aged 65 years or younger (407 mg/m(2)/week, 96%; P = 0.049) and men older than 65 years (425 mg/m(2)/week, 100%; P = 0.001), although the difference against women aged 65 years or younger (377 mg/ m(2)/week, 89%) was not statistically significant (P = 0.09).
  • CONCLUSION: This regimen has shown what might be considered high rates of grade 3 and 4 toxicity for an adjuvant treatment, although the delivered DI was acceptable.
  • Caution is urged in the treatment of elderly female patients who have statistically higher rates of grade 3 and 4 toxicity and lower DI.
  • [MeSH-major] Colorectal Neoplasms / drug therapy. Fluorouracil / administration & dosage. Leucovorin / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant / adverse effects. Dose-Response Relationship, Drug. Drug Administration Schedule. Drug Delivery Systems. Female. Humans. Male. Middle Aged. Patient Compliance. Withholding Treatment / statistics & numerical data

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  • (PMID = 17100149.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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