UI - 11821837
AU - Anonymous
Nothing succeeds like failure.
SO - Nat Biotechnol 2002 Feb;20(2):101
UI - 11928022
AU - Pietrabissa A; Moretto C; Carobbi A; Boggi U; Ghilli M; Mosca F
Hand-assisted laparoscopic low anterior resection: initial experience
with a new procedure.
SO - Surg Endosc 2002 Mar;16(3):431-5
AD - Divisione di Chirurgia Generale e Trapianti, Dipartimento di Oncologia,
del Trapianti e delle Nuove Tecnologie in Medicina, Ospedale di
Cisanello, via Paradisa 2 - 56124 Pisa, Italy. email@example.com
BACKGROUND: Laparoscopic low anterior resection for rectal cancer has
never gained wide acceptance among general surgeons, mainly due to the
technical difficulties encountered during pelvic dissection. It has
therefore been stated that these patients should undergo open rather
than laparoscopic surgery. Hand-assisted laparoscopic surgery (HALS) is
a new technique that has the potential to overcome many of the existing
limitations of pure laparoscopy. In the treatment of rectal cancer, HALS
could reproduce an operative setting similar to that of the open
approach. METHODS: To assess the technical feasibility of hand-assisted
laparoscopic low anterior resection for rectal cancer and evaluate
potential benefits and drawbacks of this new procedure, a pilot study
was conducted at a university hospital on 16 consecutive patients during
a 12-month period. Only patients with extraperitoneal rectal cancer were
included in this series. Patients' clinical data, operative time,
conversion rate, complications, and early outcome measures were
prospectively examined. RESULTS: There were 9 men and 7 women. The
average +/- SD operation time was 238 +/- 38 min. Conversion to open
surgery was never required. Ten of 16 patients were off pain medication
on the third postoperative day. Eight were able to walk the day after
surgery. Three minor postoperative complications were recorded. Mean
postoperative stay for patients without complications was 5.6 +/- 1.4
days. CONCLUSION: From a technical standpoint, the reported
hand-assisted procedure makes pelvic dissection during laparoscopic low
anterior resection almost equivalent to the laparotomic operation. The
incision for hand access that is needed with this technique does not
seem to compromise the quick recovery of patients undergoing purely
UI - 11596595
AU - Muss HB
Older age--not a barrier to cancer treatment.
SO - N Engl J Med 2001 Oct 11;345(15):1127-8
UI - 11764655
AU - Vordermark D; Sailer M; Flentje M; Thiede A; Kolbl O
Impaired sphincter function and good quality of life in anal carcinoma
patients after radiotherapy: a paradox?
SO - Front Radiat Ther Oncol 2002;37():132-9
AD - Department of Radiation Oncology, University of Wurzburg, Germany.
UI - 11818197
AU - Hemminki A
From molecular changes to customised therapy.
SO - Eur J Cancer 2002 Feb;38(3):333-8
AD - Division of Human Gene Therapy and the Gene Therapy Center, University
of Alabama at Birmingham, WTI #602, 1824 6th Ave S., Birmingham, AL
35294-3300, USA. firstname.lastname@example.org
The revolution in molecular methods has allowed the development of
approaches whereby cancer-specific changes can be utilised for targeted
therapies. Gene therapy strategies include mutation compensation for
correction of cancer-associated defects, and molecular chemotherapy for
delivering toxic substances locally to tumour cells. Viruses which
replicate only in tumour cells represent a powerful novel approach
undergoing intensive development, with some exciting clinical results.
Cancer vaccines are promising, although the final clinical evidence is
still pending. Monoclonal antibodies, in conjunction with
chemotherapeutics, are becoming standard therapy. Recently, the first
small molecular inhibitors have made clinical breakthroughs.
Importantly, the large amount of information available on genes
differentially expressed in cancer cells, allows correlation of
prognosis and treatment responses to molecular changes. Thus, the future
of cancer treatment could be customised treatment based on the molecular
properties of the tumour, utilising combinations of novel and
UI - 11818199
AU - Borner MM; Schoffski P; de Wit R; Caponigro F; Comella G; Sulkes A;
Greim G; Peters GJ; van der Born K; Wanders J; de Boer RF; Martin C;
Patient preference and pharmacokinetics of oral modulated UFT versus
intravenous fluorouracil and leucovorin: a randomised crossover trial in
advanced colorectal cancer.
SO - Eur J Cancer 2002 Feb;38(3):349-58
AD - Early Clinical Studies Group of The European Organization for Research
and Treatment of Cancer, Belgium. email@example.com
The aim of this study was to determine the patient's preference for oral
UFT/leucovorin (LV) or intravenous (i.v.) 5-fluorouracil (5-FU)/LV
chemotherapy in metastatic colorectal cancer and to compare 5-FU
exposure with these two treatment options. A total of 37 previously
untreated patients with advanced colorectal cancer were randomised to
start treatment with either oral UFT 300 mg/m2/day plus oral LV 90
mg/day for 28 days every 5 weeks or i.v. 5-FU 425 mg/m2/day plus LV 20
mg/m2/day for 5 days every 4 weeks. For the second treatment cycle,
patients were crossed-over to the alternative treatment regimen. Prior
to the first and after the second therapy cycle, patients were required
to complete a therapy preference questionnaire (TPQ). The
pharmacokinetics of 5-FU were determined by taking blood samples on days
8, 15 or 22 and 28 for UFT and on days 1 and 5 for i.v. 5-FU. 36
patients were eligible. 84% of the patients preferred oral UFT over i.v.
5-FU. After having experienced both treatment modalities, patients
indicated taking the medication at home, less stomatitis and diarrhoea,
and pill over injection as the most important reasons for their
preference. The area under the plasma concentration curve (AUC) for 5-FU
after UFT administration was 113 microM x min on day 8, 114 on day 15
and 98 on day 28; the peak levels (Cmax) were 1.2, 1.3 and 1.0 microM,
respectively. The AUC for the 5-FU/LV courses was 3083 microM x min for
day 1 and 3809 for day 5 (P=0.002). The Cmax was 170.1 and 196.2 microM
(P=0.06) and the clearance 2.6 and 1.9 l/min, respectively (P=0.002).
Patients with metastatic colorectal cancer clearly preferred oral over
i.v. chemotherapy treatment. This choice was most importantly influenced
by convenience and toxicity considerations. Although i.v. bolus 5-FU
leads to higher peak 5-FU concentrations and AUC values compared with
oral UFT, this pharmacokinetic advantage of i.v. 5-FU seems to translate
mainly into higher toxicity as seen in large randomised studies
comparing oral UFT/LV with i.v. 5-FU/LV. Oral UFT/LV compares favourably
with i.v. 5-FU/LV in terms of toxicity and patient's preference and
leads to prolonged 5-FU exposure, which is comparable to continuous i.v.
UI - 11910475
AU - Matsumoto K; Murayama T; Nagasaki K; Osumi K; Tanaka K; Nakamaru M;
One-stage surgical management of concomitant abdominal aortic aneurysm
and gastric or colorectal cancer.
SO - World J Surg 2002 Apr;26(4):434-7
AD - Department of Surgery, Keio University School of Medicine, 35
Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. firstname.lastname@example.org
One-stage surgical management of concomitant abdominal aortic aneurysm
(AAA) and gastric or colorectal cancer should provide certain benefits.
We reviewed the records of 21 patients with both AAA and gastric or
colorectal cancer who underwent one-stage surgical management. Four had
distal gastrectomy, 2 had total gastrectomy, and 5 had abdominoperineal
rectal resection transperitoneally; 3 had total gastrectomy
transperitoneally and AAA repair extraperitoneally. Two underwent right
hemicolectomy and thromboexclusion of the AAA. Two had creation of a
temporary ileostomy and implantation of an interposition graft. Two
underwent left hemicolectomy, creation of a temporary transversostomy,
and implantation of an interposition graft. One had a Hartmann's
procedure and implantation of a bifurcated prosthetic interposition
graft for AAA. There were no operative deaths or serious postoperative
complications. One patient had colorectal ischemia that resolved with
conservative treatment. Eighteen of the 21 patients (85.7%) were alive
10 months to 14 years postoperatively. In conclusion, one-stage surgical
treatment of concomitant AAA and gastric or colorectal cancer is well
tolerated and can avoid the time, financial costs, and patient anxiety
involved in a second operation.
UI - 11910488
AU - Weil R; Ohana G; Halpern M; Estlein D; Avni A; Wolloch Y
Small nonpolypoid colorectal carcinoma.
SO - World J Surg 2002 Apr;26(4):503-8
AD - Department of Surgery B, Golda Campus, Rabin Medical Center, Kakal 7
Street, Petach-Tikva, Israel. email@example.com
The objective of this study was to characterize and assess the presence
and frequency of small nonpolypoid colorectal adenocarcinomas among
patients with colorectal cancer referred for surgery. The medical,
endoscopic, and surgical reports and the histopathologic slides of all
patients operated on for colorectal cancer were retrospectively
reviewed. Small nonpolypoid colorectal cancer (SNPCC) was defined as a
malignant, nonpolypoid lesion smaller than 15 mm. SNPCC was classified
according to the Japanese macroscopic classification of colorectal
carcinoma. The frequency of SNPCC among patients referred for operation
was 1.8%. Most of these patients were asymptomatic and were diagnosed by
the same endoscopist using a high-resolution video-endoscope without the
assistance of enhancement techniques. These lesions had a mean size of
10.8 mm, were mainly of the flat or flat elevated type, and were located
in the distal colon. Among patients with colorectal cancer referred for
surgery, 1.8% had SNPCC. These lesions can be detected using
high-resolution video-endoscopy equipment without the need for
enhancement techniques, as reported in Japanese series. Increased
awareness of the existence of such SNPCC lesions may help the average
endoscopist detect such lesions. As SNPCC represents colorectal cancer,
all the cases in our series were treated by typical oncologic surgical
UI - 11884047
AU - Nesbakken A; Nygaard K; Westerheim O; Mala T; Lunde OC
Local recurrence after mesorectal excision for rectal cancer.
SO - Eur J Surg Oncol 2002 Mar;28(2):126-34
AD - Department of Surgery, Aker Hospital, Oslo, Norway.
AIMS: Controversy still exists about the optimal surgical treatment of
rectal cancer. The main purpose of the present study was to compare
local recurrence (LR) rates after mesorectal excision (ME) and
conventional surgery (CS) technique. METHODS: All rectal cancer patients
from a defined catchment area were included. Outcome after ME in the
period 1993-1999 (n=161) was compared with the outcome after CS (n=217)
in the period 1983-1992. Partial ME (PME) was the routine in upper, and
total ME the routine in mid- and low rectal cancer. The follow-up
programmes were identical, and the median observation times very similar
(37 and 38 months) in the two periods. Five-year actuarial LR rate and
survival were estimated using the Kaplan-Meier method, and adjustment
for prognostic factors was performed with Cox regression analysis.
RESULTS: Total LR rate after R0 resection was 7.7% crude and 9% 5 year
actuarial in the ME period, as compared with 16.0% crude and 24%
actuarial in the CS period (P=0.02). Cox regression analyses confirmed
these differences with a hazard ratio of 0.40 for ME vs CS (P=0.02).
Isolated LR rate was 2% after ME and 8% after CS. Five-year actuarial
total LR rate after rectal resection with curative intent was 11% after
ME and 27% after CS (P<0.01). Actuarial total LR rate after PME was 6%,
and none of these patients developed isolated LR. CONCLUSION:
Standardization of surgical technique and application of ME resulted in
a significant reduction of LRs. LR rate was low after PME, indicating
that this procedure is adequate in upper rectal cancer. Copyright
Harcourt Publishers Limited.
UI - 11832841
AU - Pringle W; Swan E
Continuing care after discharge from hospital for stoma patients.
SO - Br J Nurs 2001 Oct 25-Nov 7;10(19):1275-88
AD - University Hospital, Birmingham NHS Trust.
The purpose of this study was to monitor the progress of patients given
a permanent colostomy for colorectal carcinoma and to evaluate the need
for nursing interventions or referral. A pretested semistructured
interview schedule was used. Interviews were conducted at 1 week, 1
month, 6 months and 1 year after discharge. Complete data sets were
obtained from 112 patients. In this study it was found that survival was
strongly related to Dukes' staging system. More than half of those
surviving to 1 year suffered fatigue, one in 10 had severe pain and one
in five had parastomal hernia. At each interview approximately one in
four people required intervention and one in 10 were referred. This
study demonstrates the need for home visits and sustained patient
contact. High priority should be given to a full benefit analysis of
screening programmes, including the considerable costs of aftercare.
UI - 11935216
AU - Boisdron-Celle M; Craipeau C; Brienza S; Delva R; Guerin-Meyer V;
Cvitkovic E; Gamelin E
Influence of oxaliplatin on 5-fluorouracil plasma clearance and clinical
SO - Cancer Chemother Pharmacol 2002 Mar;49(3):235-43
AD - Department of Medical Oncology and Clinical Pharmacology, Centre Paul
Papin, Centre Regional de Lutte Contre le Cancer, 49000 Angers cedex,
The influence of oxaliplatin (OXA) on 5-fluorouracil (5-FU) plasma
clearance was investigated. PATIENTS AND METHODS: A group of 29 patients
with advanced colorectal cancer refractory to prior weekly 8-h 5-FU
infusion plus bolus folinic acid (FA), received the same combination
plus OXA at 130 mg/m(2) every 3 weeks, OXA plus 5-FU plus FA on day 1,
and 5-FU plus FA on days 8 and 15. Steady-state 5-FU concentrations in
plasma were measured weekly and 5-FU clearance was calculated. Both
before and after the addition of OXA, the 5-FU dose was individually
adjusted according to the pharmacokinetic follow-up (target steady-state
plasma concentrations 2.5-3 mg/l). RESULTS AND DISCUSSION: A total of
122 OXA-containing infusions and 338 5-FU plus FA infusions were given
and the median number of infusions per patient was 4 (2-9) and 10
(5-28), respectively. 5-FU plasma clearance was significantly decreased
on days 8 and 15 when compared with the value on day 1 and with the
values before OXA introduction using a direct paired comparison (2.36
and 2.31 l/min, respectively, vs 3.12 and 3.05 l/min; P<10(-5)). Of 25
evaluable patients, 6 had an objective response after the introduction
of OXA (24% objective response rate, 95% confidence interval 9.4-45%).
CONCLUSION: OXA reduces 5-FU plasma clearance for 15 days. This may be a
factor in the synergy between the two drugs. It is not linked to
dihydropyrimidine dehydrogenase inhibition. Implications for drug
schedules in clinical practice are discussed.
UI - 11926558
AU - Kapsoritakis AN; Potamianos SP; Koukourakis MI; Tzardi M; Mouzas IA;
Roussomoustakaki M; Alexandrakis G; Kouroumalis EA
Diminutive polyps of large bowel should be an early target for
SO - Dig Liver Dis 2002 Feb;34(2):137-40
AD - Department of Gastroenterology, University Hospital of Crete, Greece.
BACKGROUND AND AIMS: Aim of the present study is to ascertain the
importance of diminutive colorectal polyps and define the need for
removal according to their characteristics and malignant potential.
PATIENTS AND METHODS: A total of 4,723 patients who underwent
colonoscopy were evaluated and 624 patients with 826 polyps were
recorded. There were 352 patients with 443 diminutive polyps, studied
according to their distribution. Of these, 371 were removed,
histologically examined and correlated to patient characteristics and
occurrence of synchronous neoplasms. RESULTS: Of the right colon polyps,
81/115 were diminutive, versus 362/711 of the left colon (p<0.0001).
Adenomas were more common in patients over 50 years of age, (p<0.0001).
In all colonic segments, diminutive adenomas prevailed over hyperplastic
polyps, whereas the proportion of diminutive adenomas predominated in
the right colon (p=0.0015). Adenomas were classified as tubular 39%,
tubulovillous 55.7% and villous 5.3%. The degree of dysplasia was mild
in 45.5%, moderate in 51% and severe in 3.5%. The prevalence of
synchronous neoplasms was 37.4%. They were more frequently found in
males over 50 years of age and in patients with diminutive adenomas
compared to those with diminutive hyperplastic polyps (p=0.0078).
CONCLUSIONS: The majority of right colon polyps are diminutive. The
proportion of diminutive adenomas is higher in patients over 50 years
and in the right vs left colon. Diminutive polyps should be removed
taking into account the high prevalence of adenomas with a villous
component and their significant degree of dysplasia.
UI - 11914629
AU - Leupin N; Curschmann J; Kranzbuhler H; Maurer CA; Laissue JA;
Acute radiation colitis in patients treated with short-term preoperative
radiotherapy for rectal cancer.
SO - Am J Surg Pathol 2002 Apr;26(4):498-504
AD - Institute of Pathology and the Department of Visceral Surgery,
Inselspital, University of Bern, Bern, Switzerland.
The histopathologic features of acute radiation-induced colitis in
humans have been described in occasional, >20-year-old studies, but they
have not been analyzed in detail. We characterize such findings in 34
patients with rectal cancer who underwent surgery a few days after
preoperative irradiation with 25 Gy given over 5-7 days, and we compare
the results to the histopathologic features detected in 18 patients
treated by a conventional preoperative irradiation protocol consisting
of 45 Gy during 5 weeks followed by surgery after a time interval of at
least 3 weeks. Short-term preoperative irradiation therapy generally
induced severe mucosal inflammation characterized by increased
cellularity of the lamina propria, prominent eosinophilic infiltrates,
crypt disarray, surface and crypt epithelial damage, nuclear
abnormalities, and presence of apoptotic bodies in the crypt epithelium.
These histopathologic features were absent or detected only occasionally
in the patient group treated according to the long-term preoperative
irradiation protocol. Despite acute severe inflammation, none of the
patients treated by short-term irradiation developed perioperative
complications. These observations indicate that acute radiation colitis
may remain clinically silent and resolve spontaneously within a few
weeks after irradiation. Given the widening acceptance of short-term
preoperative irradiation protocols for rectal cancer, pathologists
should be aware of the rather characteristic histologic findings of
acute radiation colitis and avoid unnecessary concern of clinicians. The
differential diagnosis includes infectious colitis, collagenous and
ischemic colitis, nonsteroidal anti-inflammatory drug-associated
colitis, and chronic idiopathic inflammatory bowel disease.
UI - 11965460
AU - Yong L; Deane M; Monson JR; Darzi A
Systematic review of laparoscopic surgery for colorectal malignancy.
SO - Surg Endosc 2001 Dec;15(12):1431-9
AD - Academic Department of Minimal Access and Colorectal Surgery, Imperial
College of Science Technology and Medicine, London W2 1NY, England.
BACKGROUND: We set out to evaluate the current literature on the use of
laparoscopic surgery for malignant colorectal disease and identify its
place in current practice. METHODS: We performed a systematic review of
1997. Inclusion criteria were used to select the most robust studies.
The quality of each study was assessed against predefined criteria and
weighted according to hierarchy of evidence and sample size. RESULTS:
The published literature was found to be low in the hierarchy of
evidence. Of the 157 studies located, only 42 papers were found to be of
sufficiently high quality to be included in the review. Only 13 of these
42 papers concentrated specifically on malignant colorectal disease. We
noted the following findings: The average age of patients was 63.2
years. The most frequently reported contraindication to laparoscopic
surgery was obesity. Conversion rate to open procedure varied between
1.5% and 48%. The most common postoperative complication was wound
infection. Thirty-day mortality varied between 0 and 5.1%. Disease stage
and pathology were poorly reported. Patient recovery benefits varied. It
was not possible to identify the effectiveness, safety, survival
outcome, or cost of laparoscopic surgery for colorectal malignancy in
comparison to open surgery. CONCLUSIONS: Six years after the first
report of laparoscopic surgery, studies low in the hierarchy of evidence
continue to be reported. This reflects a lack of control following the
introduction of this new technology. The majority of reports continue to
be feasibility studies. The variable nature and content of the
literature demonstrate the lack of standardization and the absence of an
agreed core minimum data set. The benefit of laparoscopic surgery for
malignant colorectal disease remains unclear. Until the mechanisms of
port site recurrences are elucidated and long-term data on survival
outcomes become available, laparoscopic surgery for malignant disease
should be carried out only in the context of a large, multicenter
randomized controlled trial.
UI - 11965461
AU - Cutini G; Gesuelli GC; Sartelli M; Brianzoni E; Musolino G; Nestori M;
Scibe R; Berbellini A
The role of lymphoscintigraphy in rectal laparoscopic surgery: can the
sentinel node concept be applied to rectal carcinoma?
SO - Surg Endosc 2001 Dec;15(12):1440-3
AD - Department of General Surgery, Macerata Hospital, Via S. Lucia 2, 62100
BACKGROUND: Lymphadenectomy for rectal cancer, whether by open surgery
or laparoscopy, is still a controversial subject. If we consider that
approximately 20% of patients have nodal obturator metastases, then we
must concede that extended lymphadenectomy is useless in the other 80%
of patients. We set out to determine whether lymphoscintigraphy could
show the lymphatic drainage from the cancer toward the obturator lymph
nodes and thus help us to select the patients who would benefit by their
removal. We also analyzed the possibility of applying the concept of the
sentinel node to the treatment of rectal cancer. METHODS: Among 42
people who underwent laparoscopy for rectal cancer 11 patients with TNM
stages T2-T3N0M0 were studied by CT & MRI, rectal ultrasonography, and
lymphoscintigraphy with a colloidal injection of human albumin labeled
with 99mTc at the base of the neoplasm. Afterward, the 11 patients
underwent a lymphadenectomy that extended to the obturator nodes.
RESULTS: In two patients, lymphoscintigraphy showed lymphatic drainage
toward the obturator nodes. In one case, there were metastases.
Lymphoscintigraphy did not show lymphatic drainage toward the obturator
nodes in any of the other patients, and there were no metastases among
them. It was not possible to identify a sentinel node. CONCLUSION:
Lymphoscintigraphy can be used to select patients with rectal cancer who
will be helped by a lymphadenectomy extended to the obturator nodes.
However, the concept of the sentinel node cannot be applied to rectal
UI - 11976405
AU - Ahn EH; Schroeder JJ
Sphingoid bases and ceramide induce apoptosis in HT-29 and HCT-116 human
colon cancer cells.
SO - Exp Biol Med (Maywood) 2002 May;227(5):345-53
AD - Department of Food Science and Human Nutrition, Michigan State
University, East Lansing, MI 48824-1224, USA.
Complex dietary sphingolipids such as sphingomyelin and
glycosphingolipids have been reported to inhibit development of colon
cancer. This protective role may be the result of turnover to bioactive
metabolites including sphingoid bases (sphingosine and sphinganine) and
ceramide, which inhibit proliferation and stimulate apoptosis. The
purpose of the present study was to investigate the effects of sphingoid
bases and ceramides on the growth, death, and cell cycle of HT-29 and
HCT-116 human colon cancer cells. The importance of the 4,5-trans double
bond present in both sphingosine and C(2)-ceramide (a short chain analog
of ceramide) was evaluated by comparing the effects of these lipids with
those of sphinganine and C(2)-dihydroceramide (a short chain analog of
dihydroceramide), which lack this structural feature. Sphingosine,
sphinganine, and C(2)-ceramide inhibited growth and caused death of
colon cancer cells in time- and concentration-dependent manners, whereas
C(2)-dihydroceramide had no effect. These findings suggest that the
4,5-trans double bond is necessary for the inhibitory effects of
C(2)-ceramide, but not for sphingoid bases. Evaluation of cellular
morphology via fluorescence microscopy and quantitation of fragmented
low-molecular weight DNA using the diphenylamine assay demonstrated that
sphingoid bases and C(2)-ceramide cause chromatin and nuclear
condensation as well as fragmentation of DNA, suggesting these lipids
kill colon cancer cells by inducing apoptosis. Flow cytometric analyses
confirmed that sphingoid bases and C(2)-ceramide increased the number of
cells in the A(0) peak indicative of apoptosis and demonstrated that
sphingoid bases arrest the cell cycle at G(2)/M phase and cause
accumulation in the S phase. These findings establish that sphingoid
bases and ceramide induce apoptosis in colon cancer cells and implicate
them as potential mediators of the protective role of more complex
dietary sphingolipids in colon carcinogenesis.
UI - 11111452
AU - Berg DT; Lilienfeld C
Therapeutic options for treating advanced colorectal cancer.
SO - Clin J Oncol Nurs 2000 Sep-Oct;4(5):209-16
AD - firstname.lastname@example.org
Despite recent decreases in overall incidence and mortality, colorectal
cancer is a major health concern affecting 1 of every 18 Americans.
Although potentially curable if detected early, 25% of patients present
with metastatic disease, whereas another 10%-60% develop metastases
resulting from the spread of microscopic disease not noted at the time
of initial surgery. Historical treatment options for advanced colorectal
cancer have been unsatisfactory, with survival rates of approximately
9%. This article reviews the newer treatment options that are available
to patients while providing nurses with information they need to
confidently care for patients receiving these treatments.
UI - 11899406
AU - Pack DA; Hefferman NM
Readers bring attention to value of surgical intervention in treating
SO - Clin J Oncol Nurs 2001 Jan-Feb;5(1):5-6
UI - 11961596
AU - Kanehira E; Yamashita Y; Omura K; Kinoshita T; Kawakami K; Watanabe G
Early clinical results of endorectal surgery using a newly designed
rectal tube with a side window.
SO - Surg Endosc 2002 Jan;16(1):14-7
AD - First Department of Surgery, Kanazawa University, Kanazawa City
920-8641, Japan. email@example.com
BACKGROUND: Transanal endoscopic microsurgery (TEM) using the original
Buess devices requires the use of a completely closed system for
positive pressure gas insufflation. To simplify the setup of the system
and expose the target lesion in the rectum without gas insufflation, we
have developed a new operating rectal tube with a side window. METHODS:
The new rectal tube is a transparent cylinder measuring 40 mm in
diameter with its forward end closed and a 40-mm opening on its side.
When a rectal tumor is captured within the opening, it can be clearly
visualized without positive gas insufflation. Under endoscopic control,
the lesion is then resected and the defect is closed by suturing. Using
this new system, we performed endorectal surgery on 10 patients with
rectal tumors. Our series included four benign adenomas, two carcinomas
in situ, two T2 cancers, and two carcinoid tumors. RESULTS: The
operation was performed successfully in all 10 cases. There were no
significant operative complications and the postoperative course was
excellent in all cases. Pathological analysis revealed that the surgical
margins of all specimens were completely free from tumor. CONCLUSIONS:
Our early clinical results suggest that the newly designed operating
rectal tube with a side window simplifies the endorectal surgical
procedure and facilitates the safe resection of rectal tumors < 40 mm in
UI - 11961595
AU - Scheidbach H; Schneider C; Konradt J; Barlehner E; Kohler L; Wittekind
Ch; Kockerling F
Laparoscopic abdominoperineal resection and anterior resection with
curative intent for carcinoma of the rectum.
SO - Surg Endosc 2002 Jan;16(1):7-13
AD - Department of Surgery and Center for Minimally Invasive Surgery, Hanover
Hospital, Roesebeckstrasse 15 (Siloah), D-30449 Hannover, Germany.
BACKGROUND: Within a 5-year period, 380 rectal carcinoma patients
undergoing laparoscopic abdominoperineal excision or laparoscopic
anterior resection were recruited to a multicenter study by 23
institutions in Germany and Austria. This study was initiated by the
Laparoscopic Colorectal Surgery Study Group. RESULTS: One hundred
forty-nine patients (39.2%) underwent abdominoperineal resection (APR),
and 231 patients (60.8%) were treated by anterior resection (AR). The
mean operating time was 208 min, and the conversion rate was 6.1%.
Intraoperative complications, mostly vascular or bowel injuries, were
observed in 22 patients (5.8%). Overall, a total of 257 postoperative
complications and problems occurred in 143 patients, resulting in a
morbidity rate of 37.6%. In the AR group, the anastomotic leakage rate
increased as the distance of the tumor from the anal verge decreased.
The perioperative mortality rate was low (6/1.6%). Most of the patients
received a high transsection of the inferior mesenteric artery with
radical lymph node dissection (342/90.0%); the mean number of recovered
lymph nodes was 13.0, with considerable variation among the individual
institutions. Intraoperative tumor cell spillage was reported in 12
patients (3.2%). Sufficient follow-up findings are available for 288
(77%) patients. To date, 19 patients have sustained a local recurrence
(6.6%), and 30 (10.4%) have developed distant metastases. Within the
(admittedly limited) mean follow-up of 24.8 months, the overall survival
rate is 86.6%, the disease-free survival (freedom from both local
recurrence and distant metastases) rate is 62.4% for APR, with the
corresponding rates for AR being 71.7 and 54.8%, respectively, as
established by the Kaplan-Meier function. These data show no alarmingly
high recurrence rates at this time. CONCLUSION: In principle,
laparoscopic anterior resection with curative intent generates
considerably more reservations than laparoscopic abdominoperineal
resection, which is technically much easier to perform.
UI - 10437612
AU - Rudroff C; Altendorf-Hoffmann A; Stangl R; Scheele J
Prospective randomised trial on adjuvant hepatic-artery infusion
chemotherapy after R0 resection of colorectal liver metastases.
SO - Langenbecks Arch Surg 1999 Jun;384(3):243-9
AD - Department of Surgery, Friedrich-Schiller-University, Jena, Germany.
BACKGROUND AND AIMS: The liver represents the predominant site of cancer
relapse after curative resection of hepatic metastases from colorectal
carcinoma. Adjuvant intra-arterial chemotherapy was therefore considered
a promising therapeutic approach in high-risk patients.
consecutive patients underwent R0 resection of colorectal liver
metastases. Thirty patients with mesenteric lymph-node metastases (Dukes
C) were randomised into two groups. In 14 group-A patients, a hepatic
artery port catheter was placed during liver resection. Four courses of
adjuvant chemotherapy were administered at 4-week intervals, consisting
of mitomycin C (8 mg/m2, day 1) and 5-fluorouracil (800 mg/m2, days
1-5). Sixteen group-B patients served as controls. The 12 patients with
no mesenteric lymph-node metastases (Dukes A/B) were included in the
follow-up program. RESULTS: After 5 years, 64% of Dukes A/B patients and
29% of Dukes C patients were alive (P<0.01). The probability of
remaining free of recurrent disease after 5 years and 10 years was 55%
and 18%, respectively (P<0.01). No significant difference in either
5-year survival (25% vs 31%) or long-term disease-free status (15% vs
23%) was detected between groups A and B. The initial tumour relapse was
shifted towards extrahepatic sites in group-A patients, but no
difference was obtained regarding the definite distribution of recurrent
disease. CONCLUSION: Routine application of adjuvant regional
chemotherapy after R0 liver resection is not warranted.
UI - 11127528
AU - Urbach DR; Hansen PD
Randomized controlled trial evaluating the effectiveness of hepatic
artery infusion (HAI) chemotherapy following curative resection of
hepatic colorectal metastases.
SO - Langenbecks Arch Surg 2000 Oct;385(6):436-9
UI - 11561563
AU - Matsushita M; Takakuwa H; Nishio A
Did surgical sutures really migrate into colonic polyps?
SO - Endoscopy 2001 Sep;33(9):818-9
UI - 11982094
AU - Thobaben M
Assessment and screening for colorectal cancer.
SO - Home Care Provid 1999 Jun;4(3):100-1
AD - Department of Nursing, Humboldt State University, Arcata, CA 95521, USA.
Despite the reduction of and improvement in the survival rates for colon
and rectum (colorectal) cancer, this form of cancer remains one of the
most prevalent malignancies in the United States. More than 90% of
colorectal cancer cases occur in people older than 50, the typical age
group of home care provider clients. Educating these clients about the
symptoms, screening methods, and treatments for colorectal cancer should
be a routine part of the care provided by home health providers.
UI - 11977647
AU - Liang H; Schlag PM
[Tumor downstaging through preoperative chemoradiotherapy in locally
advanced rectal cancer]
SO - Zhonghua Zhong Liu Za Zhi 2002 Jan;24(1):77-9
AD - Department of Gastroenteric Surgical Oncology, Tianjin Cancer Hospital,
Tianjin Medical University, Tianjin 300060, China.
OBJECTIVE: To evaluate the impact of preoperative chemoradiotherapy on
patients with locally advanced rectal cancer by clinical and
patients with locally advanced rectal cancer were treated. Pathology:
adenocarcinoma 27, mucinous adenocarcinoma 7 and ductal adenocarcinoma
6. The protocol was carried out in sequence of
chemo-->radio-->surgery-->chemotherapy. The treatment began with
preoperative chemotherapy with folinic acid 50 mg followed by 5-FU bolus
of 300 mg/m2 given for two cycles on d1-5 and d22-26 before irradiation.
Radiation therapy was delivered to a dose of 45 Gy, 1.8 Gy per fraction,
5 days a week. Surgery was done 4-6 weeks after this preoperative
treatments. Another 2 to 4 cycles of chemotherapy were added 2 to 4
weeks after operation. Twenty-one patients were treated by Dixon's
operation, 14 patients by Mile's operation and 1 by local tumorectomy
through the rectum. Radical operation was performed in 29 patients and
palliative resection was done in 7 patients. RESULTS: Grade III
hematological toxicity was observed in only 2(5.6%) patients. No patient
had grade III or IV acute toxicity in the gastrointestinal, skin or
urological systems. All patients underwent surgery. The perioperative
morbidity rate was 13.8% with no mortality or late toxicity. As a result
of this preoperative management, the tumor was reduced by an average of
28.0%, with a complete pathological response in 4(11.1%) patients. In 28
CR + PR (77.8%) patients, a downstaging in 19(52.8%) patients was
observed. Sixty percent of positive lymph nodes as assessed by
transrectal ultrasonography before therapy became pathologically
negative postoperatively, with the frequency of lymph node metastasis
decreased by 46.0%(83.0% to 37.0%). CONCLUSION: Preoperative
radiochemotherapy is proved as a safe method with a tolerable toxicity.
Complete pathological response, shrinkage of the primary tumor and
decrease in lymph node metastasis are observed after preoperative
radiochemotherapeutic regimen. An overall benefit of downstaging the
primary tumor and a greatly enhanced effect of surgery is enjoyed by the
UI - 11977649
AU - Lin Q; Li Z; Zhang L; Zhang S; Xu G; Guo L; An D
[Effects on micro-vessel density after pre-operative intra-arterial
infusion chemotherapy in colorectal cancer]
SO - Zhonghua Zhong Liu Za Zhi 2002 Jan;24(1):84-6
AD - Department of General Surgery, Beijing Tongren Hospital, Capital Medical
University, Beijing 100730, China.
OBJECTIVE: To evaluate the effects of pre-operative intra-arterial
infusion chemotherapy on colorectal cancer. METHODS: Twenty-eight
patients with colorectal cancer, treated by surgery from February to
patients in group A (pre-operative intra-arterial infusion chemotherapy)
and 16 in group B (control). Arterial contrast technique was used in
group A, then mitromycin 10 mg, 5-Fu 1,000 mg, epirubicin 60 mg were
given through Weidner's way. RESULTS: Micro-vessel density in the
center, surface of the tumor and adjacent tissue around the tumor were
40.46 +/- 7.06, 52.27 +/- 18.40, 49.92 +/- 8.15 in group A, and 46.09
+/- 12.21, 73.44 +/- 22.06, 51.94 +/- 12.64 in group B. Micro-vessel
density on the surface in group A was significantly lower than that of
group B (P < 0.05), with no significance between the center and the
adjacent tissue. CONCLUSION: Pre-operative intra-arterial infusion
chemotherapy is able to reduce micro-vessel density on the surface of
UI - 11987311
AU - Anonymous
Capecitabine and tegafur + uracil: new preparations. Metastatic
colorectal cancer: two oral fluorouracil precursors, few advantages.
SO - Prescrire Int 2002 Apr;11(58):44-7
(1) The standard chemotherapy for metastatic colorectal cancer is
intravenous fluorouracil combined with calcium folinate. This treatment
improves the median survival time by approximately 4-6 months compared
with optimal palliative care. (2) Two metabolic precursors of
fluorouracil are now available in the European Union for first-line oral
treatment of metastatic colorectal cancer, namely capecitabine and
tegafur + uracil. According to the licensing terms, only the
tegafur-uracil combination must be given with calcium folinate. (3) The
evaluation files on each of these two cytotoxic agents contain data from
two comparative unblinded trials versus intravenous fluorouracil +
calcium folinate (Mayo Clinic protocol). None of these trials showed a
difference in survival. (4) Both drugs caused severe diarrhoea in 12% of
patients. Severe palmoplantar erythrodysesthesia was more frequent on
capecitabine. Longer postmarketing follow-up is available for the
tegafur + uracil combination, which has been used in Japan for many
years. (5) Patients receiving capecitabine or tegafur + uracil + calcium
folinate have to take large numbers of tablets or capsules. (6) In
practice, the standard treatment for metastatic colorectal cancer
remains the fluorouracil + calcium folinate combination. The tegafur +
uracil + calcium folinate combination is only useful for patients who
prefer oral administration. Capecitabine has no documented advantage
over this latter combination.
UI - 11836596
AU - Mori T; Ohnishi M; Komiyama M; Tsutsui A; Yabushita H; Okada H
Prediction of cell kill kinetics of anticancer agents using the collagen
gel droplet embedded-culture drug sensitivity test.
SO - Oncol Rep 2002 Mar-Apr;9(2):301-5
AD - Department of Hospital Pharmacy, Aichi Medical University, School of
Medicine, Nagakute-cho, Aichi-gun, Aichi 480-1195, Japan.
A vital component of chemotherapy is selecting effective anticancer
agents for the patient and determining an appropriate dose and
administration regimen. Prediction of the drug sensitivity of each
patient and cell kill kinetics of the drug may improve the outcome of
treatment and avoid unnecessary dosing of the drug. For this reason, the
development and clinical application of anticancer drug sensitivity
tests and cell kill kinetics tests which successfully reflect clinical
outcomes are required. In the present study, we tried to establish a
cell kill kinetics test through the use of new anticancer agents:
paclitaxel, docetaxel, SN-38, vinorelbine, and gemcitabine. These agents
were studied at concentrations close to their clinical doses using a
collagen gel droplet embedded-culture drug sensitivity test (CD-DST). It
is thought that the mechanism, by which the anticancer agents used in
this study exert their effects is dependent on the cell cycle; however,
the cell kill kinetics of these agents at clinical concentrations has
not yet been clarified in vitro. We investigated the drug sensitivity
and cell kill kinetics of these new anticancer agents against a human
colon cancer strain. Results of this study suggest that the test method
established by us can predict drug sensitivity and cell kill kinetics of
the agents, and can be a useful tool in deciding appropriate treatment
regimen for individual patients.
UI - 11989900
AU - Beretta GD; Ferrari VD; Barni S; Pancera G; Labianca R
Medical treatment of colorectal cancer in elderly (>70 years): GISCAD
experience and future perspectives. Italian Group for the Study of
Digestive Tract Cancer.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S109-12
AD - UO Oncologia Medica Ospedali Riuniti, Bergamo.
UI - 11989901
AU - Aschele C; Sartor L; Lonardi S
Indications and feasibility of adjuvant chemotherapy in elderly patients
with colorectal cancer.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S113-4
AD - Division of Medical Oncology, Azienda Ospedaliera Universita di Padova.
UI - 11989931
AU - Labianca R; Beretta G; Mosconi S; Pessi MA
Is there an advantage for oral therapy in elderly? UFT.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S71-2
AD - Unita di Oncologia Medica, Ospedali Riuniti, Bergamo.
UI - 11989940
AU - Olmi P
Limits to the radiation therapy due to age.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S95-7
AD - Divisione di Radioterapia, Istituto Nazionale Tumori, Milano.
UI - 11995701
AU - Martoni A; Mini E; Pinto C; Gentile A; Mazzei T
[Oxaliplatin: combinations with thymidylate synthetase inhibitors: two