Detection of occult nodal metastases in patients with colorectal carcinoma

Article Abstract:

The presence of metastatic tumor spread to the lymph nodes has important prognostic significance in cases of colorectal cancer. The five-year survival of patients without lymph node involvement is 70 to 80 percent, while the survival of patients with cancer cells in local lymph nodes is about 30 percent. Since colorectal cancer cells express carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA), some researchers have suggested using antibodies for these tumor markers to examine the lymph nodes microscopically. This may reduce the probability of understaging a cancer by overlooking cancer cells in a node. To examine this possibility, 249 lymph nodes from 47 patients were examined using conventional histological techniques (microscopic examination of tissue structure) and immunohistochemical stains (tissue study by use of immunological techniques) for the tumor antigens. Conventional microscopy revealed tumor deposits in 49 of the 249 nodes. When the nodes were examined using the stains for the tumor antigens, all 49 cancer-positive nodes stained positively for CEA, and 45 (92 percent) stained positively for EMA. Of the 200 nodes which did not contain cancer when viewed by conventional examination, only one stained positive for CEA; this specimen was from a patient diagnosed to be at Duke's B stage (tumor progression classification) by conventional microscopy. None of the 200 nodes stained positively for the EMA. It appears that the conventional histologic technique used to identify tumor cells in lymph nodes is not improved upon by the more sophisticated technique. The staging of only one patient may have been affected, and this does not provide a significant benefit over the conventional method. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Colorectal cancer, Cancer metastasis, CEA (Oncology), Carcinoembryonic antigen, Diagnostic immunohistochemistry

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Hepatic arterial embolization with microencapsulated mitomycin C for unresectable hepatocellular carcinoma in cirrhosis

Article Abstract:

Mitomycin C, an antibiotic with anticancer activity, can be administered in microcapsule form into a blood vessel. Hepatoma is a tumor of the liver that is usually treated surgically. When this is not possible other methods must be explored; mitomycin C has been a novel treatment for hepatoma. The effectiveness of embolization or obstruction of the hepatic artery (the major blood vessel supplying the liver) with mitomycin C microcapsules in treating hepatoma was assessed in 24 men and 6 women with various stages of hepatoma. In all cases the tumor was inoperable or could not be removed because of cirrhosis, a chronic liver disease. Most patients received a dose of 0.5 milligrams mitomycin C per kilogram of body weight; the treatment was repeated at five to six week intervals. The 30 patients received a total of 70 courses of mitomycin C. Minor complications occurred in 63 percent of the patients, but resolved spontaneously or after drug treatment. Mitomycin C did not cause toxic effects on the liver or kidney, and no deaths occurred. A positive response to treatment, which was measured by the levels of alpha-fetoprotein and the volume of the tumor, was evident in 43 percent of the patients. The duration of survival was seven months, and survival rates at one year ranged from 0 to 78 percent, depending on the stage of the hepatoma. Thus, mitomycin C microcapsule embolization improved the quality of life and increased the survival of patients with hepatoma which could not be surgically removed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Dosage and administration, Liver cancer

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Mitomycin C adjuvant chemotherapy after Wertheim's hysterectomy for stage 1B cervical cancer

Article Abstract:

A radical hysterectomy (Wertheim's hysterectomy) is often used to manage cancer of the cervix in the early stages of the disease. Some patients can not undergo this type of surgery because they are at high risk for developing recurrence of the cancer; surgery increases the risk of spreading cancer in patients who have a large primary tumor or in whom cancer has spread to the pelvic lymph nodes. In these patients the five year survival rate was less than 50 percent when cancer has spread to between one and four pelvic lymph nodes, and drops below 20 percent when more than four pelvic lymph nodes are positive for cancer. Effective alternative therapy is required for these high risk cancer patients. A study of 16 patients with cancer of the cervix was conducted in which the effectiveness of mitomycin C (an antibiotic with anti-tumor action) was evaluated. Fourteen of the 16 patients are alive and without evidence of disease after a follow-up period of 29 months. A majority of patients experienced nausea and vomiting for one to two days after the drug was administered, and all the patients required blood and platelet transfusions. The disease-free survival rate for patients being treated with Mitomycin C was 87.5 percent, a rate similar to that for cervical cancer patients without lymph nodes involvement. These preliminary results show the effectiveness of mitomycin C for patients who are not suitable candidates for radical hysterectomy as treatment for cancer of the cervix.

Methods, Cervical cancer, Hysterectomy

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