Local Recurrence Of Colorectal Cancer Research Articles

Clinical assessment of positron emission tomography for the diagnosis of local recurrence in colorectal cancer.

The clinical value of positron emission tomography (PET) for the diagnosis of local pelvic recurrence of colorectal cancer was evaluated. Computed tomography (CT) and magnetic resonance imaging (MRI) of the pelvis were performed at regular intervals in 23 patients who had undergone resection for colorectal cancer. The 23 patients had a total of 25 lesions. PET images of the 25 lesions and of six primary lesions in patients with rectal cancer were obtained. A differential absorption ratio (DAR) was calculated in order to examine the accumulation of [18F]2-fluoro-2-deoxy-D-glucose (18FDG) on PET images. Histological diagnoses of the pelvic masses were obtained by CT-guided needle biopsy. On CT or MRI, a pelvic mass with a spicular shape (n = 1) was non-recurrent, whereas a nodular or lumpy shape indicated a locally recurrent lesion (n = 10). Masses with a nodulospicular shape (n = 12) did not correlate with the histological features. On PET, 15 of 16 histologically proven local recurrences were imaged positively. By setting a DAR of 2.8 as a cut-off value, local recurrences could be diagnosed with 100 per cent accuracy. PET is a clinically useful tool for the detection of local recurrence of colorectal cancer, particularly for distinguishing between recurrence and granulation tissues in the pelvic cavity.

Implantation on the suture material and efficacy of povidone-iodine solution.

Suture implantation of viable exfoliated tumour cells may be responsible for local recurrence of colorectal cancer. Using a colon cancer cell line, we obtained a suture implantation without intraperitoneal metastasis in about 80% of the control animals, when sacrificed on the 2nd postoperative week. The cytotoxic efficacy of povidone-iodine (PVP-I) was tested in vivo by a rat model with viable intracaecal tumour cells, and in vitro by trypan blue exclusion and the MTT assay. In vivo PVP-I at 5% significantly reduced the incidence of tumour growth, while the product at 2.5% had a significant effect in only the monofilament polypropylene group. In an in vitro toxicity study, PVP-I higher than 0.16% was effective at killing almost all tumour cells. PVP-I had effective cytotoxicity in vivo and in vitro, being less cytotoxic in vivo than in vitro.

Developments in colorectal cancer surgery.

The developments in colorectal cancer since the 19th century are reviewed. Local recurrence of colorectal cancer after curative surgery is a major problem and may occur because of inadequate removal of the primary tumour and lymph node metastases, or intra-operative spill of tumour cells. Colorectal surgeons differ with regard to postoperative mortality. The best surgical technique has not yet been determined; there have been only two prospective randomised trials on surgical technique. However, it is predicted that laparoscopic surgery will have an important place in colorectal surgery.

Pathologic, anatomic, and biologic factors correlated with local recurrence of colorectal cancer

Summary The anatomic patterns of failure after surgical resection of colorectal cancer have been well described and have provided useful clinical information for selecting patients who are at high risk for local-regional failure. Based on these studies, adjuvant pelvic irradiation for rectal cancer patients with disease stages T3,4 and N0,1 has improved local control and survival. Similar studies with adjuvant irradiation for colon cancer patients are still needed and may be underway soon. However, the utility of local irradiation for colon cancer patients may be harder to prove because the incidence of local-regional failure is, in important as pathologic stage in determining the risk of local-regional relapse. Recent adjuvant trials have begun to record margin distance prospectively, have begun to record margin distance prospectively, and data may soon be available regarding this point. Finally, biologic tumor markers, including kinetic and genetic parameters, should be investigated further. Our preliminary data indicate that tumor cell kinetic information can be useful in delineating those patients with advanced rectal cancers who are at increased risk for local failure after pelvic irradiation and surgery. This method may identify those in whom either increased radiation dose levels or accelerated radiation fractionation may be indicated. Furthermore, patterns-of-failure studies incorporating these newer marker studies may possibly add to, or replace, the staging systems currently used to select patients for adjuvant therapy.

Detection of locally recurrent colorectal cancer with radiolabeled monoclonal antibody H-15.

H‐15 (HT‐29‐15) is an IgG1 mouse monoclonal antibody (mAb) to a cell surface antigen (molecular mass, 200,000 daltons) present on virtually all colorectal cancers and also in normal pancreatic ducts and bile ducts, but not in other normal tissues. The biological distribution and imaging characteristics of iodine‐131 (l31I)‐labeled mAb H‐15 were studied in 5 primary colorectal cancer patients and 9 patients with local recurrence of colorectal cancer. H‐15 mAb labeled with 0.5‐10 mCi of 131I was administered 7 to 8 days before surgery at 4 dose levels, ranging from 0.2 to 6 nig. Selective mAb H‐15 localization to tumor tissues was demonstrated in 6 of 12 patients with antigen‐positive tumors: in two patients, recurrent tumors were negative to H‐15 mAb, although the primary tumors were positive. In six patients with positive radioimaging, tumor:normal tissue ratios ranged from 2.05 to 5.35 and tumor:serum ratios from 1,18 to 2.73. The clarity of images seems to correlate well with the latter ratios. Technetium‐99 (99mTc)‐albumin blood pool studies in selected cases showed that local recurrence of colorectal cancers was hypovascular, emphasizing the selective localization of mAb H‐15 despite poor blood flow distribution in the tumors. The results altogether demonstrated that radioimmnnodetection with 131I mAb H‐15 is valuable for differentiating recurrent colorectal cancer from granuloma formation after surgery.

<SUP>131</SUP> I標識A7による大腸癌局所再発巣のradioimmunoimaging

<SUP>131</SUP> I標識A7による大腸癌局所再発巣のradioimmunoimaging

Comparison of anti-fetal colonic microvillus and anti-CEA antibodies in peroperative radioimmunolocalisation of colorectal cancer

Local recurrence of colorectal cancer may result from failure to assess accurately the extent of tumour at operation. It has been suggested that peroperative radioimmunolocalisation may improve this assessment. The degree to which this is possible has been studied using a hand-held gamma detecting probe and comparing two 125I-labelled monoclonal antibodies to colorectal tumours. The antibodies were to fetal colonic microvillus membrane (FM1D10) and to carcinoembryonic antigen (A5B7). Sixty-nine per cent (9/13) of the FM1D10 and 98% (43/44) of A5B7 labelled tumours took up significant amounts of antibody with a tumour to normal colon ratio of more than 1.5:1. The uptake was significantly better for A5B7 with a median tumour to normal colon ratio of 3.3 (1.1-13.8) compared to 1.85 (0.75-7.7) for FM1D10 (P less than 0.001). The tumour: colon ratio of both antibodies was independent of the serum CEA, Dukes' stage or the degree of histological differentiation. There was a linear correlation for tumour to normal colon ratios between the gamma detecting probe and the same tissue examined in a conventional well counter (correlation coefficient r = 0.78, P less than 0.001). Colorectal tumours demonstrate a rapid and reliable uptake of anti-CEA monoclonal antibody A5B7. This antibody can be detected with a peroperative gamma detecting probe and has the potential to improve the surgeon's appreciation of the extent of tumour and therefore may influence the surgery performed. Detailed clinical studies are now being carried out.

Local recurrence of colorectal cancer. A District General Hospital's experience

International Journal of Clinical PracticeVolume 42, Issue 6 p. 225-227 Clinical Study Local recurrence of colorectal cancer. A District General Hospital's experience N A Habib FRCS, N A Habib FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorP M Dawson FRCS, Corresponding Author P M Dawson FRCS n/[email protected] Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireAddress correspondence to Mr P M Dawson, FRCS, West Middlesex University Hospital, Isleworth, Middlesex.Search for more papers by this authorM A Peck MB ChB, M A Peck MB ChB Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorJ W Blaxland FRCS, J W Blaxland FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorR J Luck FRCS, R J Luck FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this author N A Habib FRCS, N A Habib FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorP M Dawson FRCS, Corresponding Author P M Dawson FRCS n/[email protected] Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireAddress correspondence to Mr P M Dawson, FRCS, West Middlesex University Hospital, Isleworth, Middlesex.Search for more papers by this authorM A Peck MB ChB, M A Peck MB ChB Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorJ W Blaxland FRCS, J W Blaxland FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this authorR J Luck FRCS, R J Luck FRCS Departments of Surgery, King Edward VII Hospital, Windsor and Heatherwood Hospital, Ascot, BerkshireSearch for more papers by this author First published: 01 June 1988 https://doi.org/10.1111/j.1742-1241.1988.tb08564.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume42, Issue6June 1988Pages 225-227 RelatedInformation

A CLINICAL STUDY OF LOCAL RECURRENCE OF COLORECTAL CANCER

Clinical study was performed on cases of local recurrence of colo-rectal cancer. The subjects of the present study included 35 cases of colon cancer and 36 cases of rectal cancer who underwent curative operation. Recurrence was observed in five out of 35 cases of colon cancer and in 11 out of 36 cases of rectal cancer. Of these cases, there were two cases of local recurrence of colon cancer including lymph node recurrence and five cases of local recurrence of rectal cancer. Through positive resection of the site of local recurrence including the lymph node in these cases of local recurrence of colo-rectal cancer, an average survival time of five years was attained, including a case showing a long survival period of 10 years following initial surgery. Because there is no other effective means of therapy for local recurrent cases of colo-rectal cancer, it is considered that early detection by careful follow-up employing various tests such as CT scanning, echography and CEA determination in the out-patient clinic followed by positive operative therapy for recurrent cases is the only available effective therapy.

The sialomucin content of colonic resection margins.

In a prospective trial, the resection margins of 130 patients who underwent apparently curative resection for colorectal cancers were examined. Sialomucin was markedly increased in 17.0 percent of proximal resection margins and 17.3 percent in distal resection margins. Clinical follow-up has demonstrated four patients who have developed local recurrence of their disease. Three of these patients had increased sialomucin staining in the resection margins at the time of initial surgery. High iron diamine-alcian blue staining of resection margin may identify those patients at risk of developing local recurrence of colorectal cancer or metachronous tumor following apparently curative resection.