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Ap resection rectal carcinoma

Alexander Ferko, Ondřej Malý, Július Örhalmi, Josef Dolejš
BACKGROUND: The quality of a total mesorectal excision (TME) is one of the most important prognostic factors for local recurrence of rectal carcinoma. The aim of this study was to clarify the manner in which lesser pelvis dimensions affect the quality of TME via the transabdominal approach, while simultaneously defining the criteria for selecting patients most likely to have Grade 3 TME outcomes for a transanal approach using the TaTME technique. METHODS: An analysis from the registry was conducted using 93 of total 198 patients with rectal cancer of the mid- and lower third of the rectum who underwent: (1) a low anterior resection, (2) an ultra-low resection with coloanal anastomosis, or (3) an intersphincteric rectal resection, all with total mesorectal excision...
March 2016: Surgical Endoscopy
D Umlaufová, P Skapa, J Hoch, J Prausová
BACKGROUND: Extranodal mesorectal deposits (ENDs) occur frequently in advanced rectal tumors. It is supposed they are related to a higher incidence of local recurrence and a poor prognosis. AIM: To discover both occurrence and impact of ENDs in patients with advanced rectal cancer after neoadjuvant therapy and surgery. PATIENTS, METHOD: 325 patients meeting following criteria were enrolled: rectal adenocarcinoma, neoadjuvant therapy, anterior or AP rectal resection, complete check up information...
June 2009: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Hai-yang Feng, De-chuan Li, Rong-can Lou, Yuan Zhu, Lu-ying Liu
OBJECTIVE: To explore the effect of combined preoperative chemotherapy with radiotherapy on locally advanced lower rectal carcinoma. METHODS: Thirty- five patients with locally advanced lower rectal carcinoma were received a new regimen of combined preoperative chemotherapy with radiotherapy. Routine fr action of radiation was given with total dose of 46 Gy,2 Gy per fraction,five ti mes a week. Patients received oxaliplatin 130 mg/m(2) (infusion) on day 1, plus leu novorin 200 mg/m(2) and 5- FU 500 mg/m(2)(intravenous bolus) from day 1 to day 3 eve ry 3 weeks for total two cycles before irradiation...
March 2005: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
V Kalezic, M Bjelovic, M Petrovic, P Pesko, V Cuk, S Knezevic-Usaj, J Marinkovic, N Radovanovic
BACKGROUND/AIMS: The aim of this study was to establish whether, and to what extent, pre- and intraoperatively detected characteristics (demographic, anamnestic and laboratory data) and tumor characteristics can be used in the assessment of regional lymph node involvement in patients with colorectal carcinoma. The assessment also included the number of lymph nodes involved in patients with positive lymph nodes. Considering that the number of obtained lymph nodes widely varies in resected specimens, assessment parameters also included the percentage of the involved lymph nodes within the total population of lymph nodes...
March 1998: Hepato-gastroenterology
C Nies, R Leppek, H Sitter, H J Klotter, J Riera, K J Klose, W B Schwerk, M Rothmund
OBJECTIVE: To evaluate preoperative and operative methods of detecting liver metastases in patients undergoing primary resection for colorectal carcinoma. DESIGN: Prospective, open study. SETTING: Teaching hospital, Germany. SUBJECTS: 51 Patients with confirmed primary colorectal carcinoma. INTERVENTIONS: Computed tomography during arterial portography (CT-AP), percutaneous ultrasonography (US), operative palpation and examination of the liver, operative US, and computed tomography (CT) follow-up 6-12 months postoperatively...
October 1996: European Journal of Surgery, Acta Chirurgica
C S Wong, H Stern, B J Cummings
PURPOSE: To assess the patterns of failure and outcome following conservative surgery and post-operative radiation therapy for rectal cancer. METHODS AND MATERIALS: Twenty-five patients underwent post-operative radiation therapy (50 Gy in 20 fractions over 4 weeks) following local excision or electrocoagulation for carcinoma of the rectum. None of the patients had palpable residual disease following surgery. Selection factors for post-operative radiation therapy were refusal of a permanent colostomy, excessive operative risk of an abdominal perineal resection and concern regarding local control with conservative surgery alone...
March 15, 1993: International Journal of Radiation Oncology, Biology, Physics
A Cerrotta, G Gardani, L Lozza, R Kenda, S Tana, F Valvo, R Zucali
A series of 191 patients submitted to adjuvant radiotherapy after surgery for rectal and rectosigmoid carcinoma from January, 1975, to December, 1990, has been analyzed to evaluate the incidence of high grade small bowel late toxicity (grades III/IV according to RTOG/EORTC scoring system). Surgical approach was abdominoperineal Miles resection in 92 patients, while a sphincter preserving bowel resection was performed in 99. The total radiation dose to the pelvis ranged from 40 to 60 Gy in 4 to 8 weeks, with conventional fractionation...
May 1995: La Radiologia Medica
I Gough
Serum immunoglobulins (IgG, IgA and IgM) were measured in 75 patients with colorectal carcinoma. The levels of all three immunoglobulins were significantly higher in patients with recurrent colorectal carcinoma compared to those with resectable Duke's B or C colorectal carcinoma, particularly for IgM which was elevated above the normal range in 23 of 55 patients (41.8%). In recurrent disease there was no difference in serum immunoglobulin levels for multiple compared to single metastatic sites, or for patients with heaptic metastases compared to those with non-hepatic metastases...
October 1981: Australian and New Zealand Journal of Surgery
P I Tartter, G Slater, A E Papatestas, A H Aufses
Two hundred and eighty-three patients were observed for a minimum of 38 months after undergoing resection of Dukes' B2, C1 or C2 classification for carcinoma of the colon and rectum. Cumulative recurrence rates were higher in patients with elevated preoperative serum alkaline phosphatase levels. Site specific recurrence rates revealed a lower incidence of metastases to the liver in patients with elevated preoperative alkaline phosphatase levels. Elevated serum alkaline phosphatase values in patients with carcinoma of the colon may reflect hepatic metastases, but when metastases to the liver are not detected at laparotomy, patients with elevated levels of alkaline phosphatase are at no greater risk of having metastases to the liver develop than patients with normal levels...
June 1984: Surgery, Gynecology & Obstetrics
A Y Bedikian, T T Chen, M A Malahy, Y Z Patt, G P Bodey
In this study of 232 patients with histologically confirmed large bowel carcinoma, patient- and tumor-related characteristics were examined and their effect on prognosis was determined. Serum alkaline phosphatase and albumin concentrations, symptom duration prior to diagnosis of the primary tumor, and the status of the primary tumor showed the strongest relationship to survival after diagnosis of surgically noncurable disease. Patients who had normal serum alkaline phosphatase and albumin concentrations, patients whose symptoms lasted over 12 months before diagnosis, and patients whose primary tumor had been resected before diagnosis of noncurable disease had a good prognosis...
March 1984: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
C J Lahr, S J Soong, G Cloud, J W Smith, M M Urist, C M Balch
A multifactorial analysis was used to identify the dominant prognostic variables predicting survival rates of 175 patients with hepatic metastases from colorectal carcinoma. Seven of 22 parameters examined simultaneously were found to independently influence the median survival rate in these patients: (1) elevated alkaline phosphatase (p = 0.0004), (2) elevated serum bilirubin level (p = 0.0005), (3) location of hepatic metastases (unilateral or bilateral, p = 0.0022), (4) number of metastatic nodes involved (0, 1-5, greater than 5; p = 0...
November 1983: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
J Papillon
Radiation treatment is playing an increasing role in the management of patients with ano-rectal carcinoma. This role may be categorized as a) adjuvant therapy of rectal cancer, b) definitive irradiation of rectal cancer, and c) radiotherapy of carcinoma of the anal canal. Preoperative irradiation according to a well-planned protocol is able not only to decrease the incidence of local failures but also to convert some tumors, initially suitable for AP resection, into a conservative procedure. Applied to selected cases, intracavitary irradiation can control limited rectal cancer with a rate higher than other conservative methods (series of 231 cases followed more than five years)...
September 1984: Journal of the Canadian Association of Radiologists
J Boey, T K Choi, J Wong, G B Ong
The records of 126 patients with adenocarcinoma of the colon and rectum who presented with liver involvement were reviewed. Prognosis was determined by the amount of metastases to the liver, which was usually extensive of ascites or a raised alkaline phosphatase level was present. The longest survival period was achieved with resection of the primary tumor along with hepatic lesions confined to a single lobe, especially those due to direct tumor infiltration. If liver deposits were found bilaterally, palliative resection of the primary lesion relieved intestinal symptoms...
December 1981: Surgery, Gynecology & Obstetrics
S N Booth, G C Jamieson, J P King, J Leonard, G D Oates, P W Dykes
Carcinoembryonic antigen (C.E.A.) estimation has been used in the preoperative assessment of colorectal carcinoma patients and has been shown to give a useful guide to the presence of metastatic disease and ultimately to a poor prognosis if the serum concentration is 100 ng/ml or more. C.E.A. has been shown to be a more reliable index of tumour spread than either clinical examination or serum alkaline phosphatase estimation. Raised C.E.A. levels of less than 100 ng/ml do not, however, necessarily imply a poor prognosis...
October 26, 1974: British Medical Journal (1857-1980)
A C Kinn, U Ohman
Bladder function and sexual potency were studied before and after surgery for rectal carcinoma. Urinary voiding after postoperative removal of indwelling catheter was impaired in seven of 22 men, leading to prostatic surgery in four. Two years later, eight of 16 men reported disturbed voiding, but no significant changes were found in bladder capacity, residual volume, flow rate, or detrusor pressure. Sexual potency was reduced in five of ten men, in one with retrograde ejaculation; and three did not achieve erection...
January 1986: Diseases of the Colon and Rectum
P G Alley, R K McNee
In a population-based study of 402 cases of colorectal cancer in Auckland, 72 patients (18%) demonstrated liver metastases either at presentation or at initial surgery. The findings of pre-operative weight loss, hepatomegaly and elevated alkaline phosphatase were significantly associated with heptic metastases. Individually these factors were insensitive indicators of the presence of liver metastases. Two or more of these risk factors were demonstrated by 54% of the patients with liver secondaries compared to 19% in the series without liver metastases...
August 28, 1985: New Zealand Medical Journal
B Shank, W Enker, J Santana, K Morrissey, J Daly, S Quan, W Knapper
Forty-nine patients with primary adenocarcinoma of the rectum, clinically localized to the pelvis were treated with pre-op radiotherapy (RT) 1500 cGy/5 fx with AP/PA fields, followed by immediate curative resection. Patients staged as Astler-Coller B2, C1, or C2 were considered for post-op RT, 4140 cGy/23 fxs with a 4-field technique. There were 47 evaluable patients in this non-randomized study. Two groups of patients were analyzed, namely pre-op RT only (24 patients) and combined pre- and post-op ("sandwich") RT (23 patients)...
January 1987: International Journal of Radiation Oncology, Biology, Physics
J Klompje, N J Petrelli, L Herrera, A Mittelman
A retrospective review was undertaken to determine the influence of preoperative alkaline phosphatase levels on the prognosis of patients who had undergone resection of liver metastasis from colorectal adenocarcinoma at Roswell Park Memorial Institute. From March 1967 to March 1985, 26 patients underwent laparotomy who were thought to have solitary liver metastasis. Twenty of these patients were divided into two groups: group A consisted of seven patients who survived at least 24 months without any evidence of disease and were free of disease at the time of this report...
August 1987: European Journal of Surgical Oncology
J M Jessup, C M McBride, F C Ames, L Guarda, D M Ota, M M Romsdahl, R G Martin
The ability of active specific immunotherapy to enhance immune responses to autologous tumor-associated antigens (TAA) and to prolong the disease-free interval was evaluated in patients with Dukes B2 and C colorectal carcinoma who had undergone potentially curative resections. Patients were sensitized in the early postoperative period with irradiated autologous adenocarcinoma cells mixed with bacillus Calmette-Guérin (BCG) to yield either a low-dose vaccine (3 X 10(6) tumor cells) or a high-dose vaccine (1 X 10(7) tumor cells)...
1986: Cancer Immunology, Immunotherapy: CII
H J Wanebo, M Llaneras, T Martin, D Kaiser
In 1978, a prospective program was initiated to evaluate postoperative monitoring of patients after resection of carcinoma of the colon and rectum. The program included clinical examination, interval endoscopy, measurement of carcinoembryonic antigen (CEA), selected liver function tests (alkaline phosphatase and gamma glutamyl transferase) and roentgenologic testing: roentgenograms of the chest, barium enema, intravenous pyelogram (IVP) and computerized axial tomographic (CAT) scan. Of the initial 226 patients enrolled, 179 had at least one abnormal elevation of the CEA level, and in 70 (39 per cent), recurrence developed...
December 1989: Surgery, Gynecology & Obstetrics
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