A prospective clinicopathologic study of venous invasion in colorectal cancer

Article Abstract:

In colorectal cancer (cancer of the colon or rectum) the relationship between venous invasion and metastasis (cancer spread) to organs remains controversial. A long-term prospective study was carried out with 645 patients who underwent surgery for colorectal cancer. The average age of the 385 men was 61.7 years; the average age of the 260 women was 61.4 years. There were 253 patients with colon cancer, 376 with rectal cancer, and 16 with anal cancer. Liver metastasis occurred in 27 percent of the patients with moderate venous invasion; 33 percent of patients with marked venous invasion; and 20 percent of patients with prominent extramural (beyond the wall) invasion. The incidence of cancer metastasis to the lung did not differ among the groups. The six-year survival rate for patients with Dukes' stage B cancer (cancer penetration into the mucosa of the colon) was 94 percent for patients without venous invasion; 88 percent for those with slight invasion; and 74 percent with moderate invasion. There was a significant difference in survival between patients with tumors without venous invasion and those with tumors that had moderate to marked invasion. For patients with Dukes' stage C, regional lymph node metastasis from colorectal cancer, survival was 77 percent for slight invasion; 56 percent for moderate, and 44 percent for marked venous invasion. Survival for patients with venous intramural invasion only was 85 percent; for those with predominant intramural invasion, but some extramural invasion, it was 73 percent; and for those with predominantly extramural invasion, it was 45 percent. It is concluded that the degree and location of venous invasion influences liver metastasis, local recurrence, survival rate, and may also have prognostic significance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Metastasis, Cancer invasiveness, Cancer metastasis

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Cancer occurrence in a cohort of patients surgically treated for peptic ulcer

Article Abstract:

Peptic ulcer is a condition in which the lining of the stomach or intestine is eroded by the destructive action of hydrochloric acid produced by the stomach. Before the discovery of potent drugs that inhibit gastric acid secretion, standard medical treatment for severe cases of peptic ulcer was surgical removal of the afflicted portion of the stomach or intestine. The incidence of cancer in patients who have undergone surgical treatment for peptic ulcer has been the subject of several epidemiological studies. The results of these studies have suggested there is an increased cancer rate among these individuals, but no studies have used a large enough sample population to draw firm conclusions. To further investigate cancer occurrence in a larger group of patients, 4,107 Danish patients who were surgically treated for peptic ulcer between 1955 and 1960 were followed. Overall, 930 cases of cancer were identified. When the risk of developing cancer for this group changed over time compared with the general population. In the first five years following surgery, the patients were 1.43 times as likely (relative risk 1.43) to develop cancer as the general population. Over the next 10 years, the risk of cancer was only about half as great for the surgery patients (relative risk 0.55). However, after 10 years, the risk rose slowly until it was more than two times as great 25 years following surgery. Lung cancer also occurred more frequently in the surgery patients (relative risk 1.66); this risk did not change over time after peptic ulcer surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Denmark, Complications and side effects, Lung cancer, Stomach cancer, Peptic ulcer

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Colorectal cancer in a small rural hospital

Article Abstract:

Most published studies and papers are produced by university or university-affiliated medical centers. The remaining 7 percent of published articles are based on data from community hospitals. Colorectal cancer is the third most common cancer in the United States. Over a 20-year period, there were 168 cases of colorectal cancer treated at a small (50 bed) hospital in Iowa. All of the affected patients were treated by one general surgeon. The majority of the patients were 70 years or older; this age is older than that reported in most studies and may reflect the population of Iowa. When these patients were diagnosed with colorectal cancer the stage of the disease was relatively advanced; 71 percent of the cancers had metastasized, or spread to lymph nodes or other organs of the body; 19 percent of the tumors had obstructed the bowel; and 8 percent had perforated the bowel. The incidence of localized disease in this study (29 percent) differed from most published studies which report a 40 to 55 percent rate of localized disease. Among the patients in this study, the five-year survival was 50 percent. Mortality was similar to that of other studies and was directly related to the stage of the disease. Community education and vigorous screening programs could increase the number of patients diagnosed while still in the early stage of colorectal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Iowa, Medicine, Rural, Rural medicine

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