Latest & greatest articles for colorectal cancer

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Top results for colorectal cancer

1301. The genetics of colorectal cancer. (Abstract)

The genetics of colorectal cancer. Colon cancer is a common disease that can be sporadic, familial, or inherited. Recent advances have contributed to the understanding of the molecular basis of these various patterns of colon cancer. Germline genetic mutations are the basis of inherited colon cancer syndromes; an accumulation of somatic mutations in a cell is the basis of sporadic colon cancer; and, in Ashkenazi Jewish persons, a mutation that was previously thought to be a polymorphism may (...) cause familial colon cancer. Mutations of three different classes of genes have been described in colon cancer etiology: oncogenes, suppressor genes, and mismatch repair genes. Knowledge of many of the specific mutations responsible for colon carcinogenesis allows an understanding of the phenotypic manifestations observed and forms the basis of genetic testing for inherited disease. Although genetic testing is possible and available, it is only an adjunct to the clinical management of persons

2002 Annals of Internal Medicine

1302. Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study. (Abstract)

Prediction of colorectal cancer by a patient consultation questionnaire and scoring system: a prospective study. Current NHS guidelines for referral of patients with colorectal symptoms classify many as high risk but fail to identify a significant number of cancers in the low-risk group. We describe a practical scoring method to predict colorectal cancers.From October, 1999, 2268 patients with distal colonic symptoms, referred by general practitioners, completed a patient consultation (...) and specificities of scoring systems were compared with McNemar's test.Of the 2268 patients, 95 had colorectal cancer. The average weighted numerical score was significantly higher for patients with cancer than for non-cancer patients (mean 76.5 [95% CI 72.2-80.9] vs 44.5 [43.6-45.4]; p<0.0001). At similar cancer detection rates, the malignancy risk score derived from the patient consultation questionnaire and the weighted numerical score graded lower proportions of referrals as urgent than did the current NHS

2002 Lancet

1303. Screening for colorectal cancer: recommendation and rationale. (Abstract)

Screening for colorectal cancer: recommendation and rationale. This statement summarizes the current U.S. Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer and the supporting scientific evidence and updates the 1995 recommendations contained in the Guide to Clinical Preventive Services, 2nd edition. At that time, the USPSTF recommended screening for colorectal cancer with annual fecal occult blood testing, periodic sigmoidoscopy, or the combination

2002 Annals of Internal Medicine

1304. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. (Abstract)

of fecal occult blood testing in reducing colorectal cancer incidence and mortality rates compared with no screening. Data from well-conducted case-control studies supported the effectiveness of sigmoidoscopy and possibly colonoscopy in reducing colon cancer incidence and mortality rates. A nonrandomized, controlled trial examining colorectal cancer mortality rates and randomized trials examining diagnostic yield supported the use of fecal occult blood testing plus sigmoidoscopy. The effectiveness (...) of barium enema is unclear. Data are insufficient to support a definitive determination of the most effective screening strategy.Colorectal cancer screening reduces death from colorectal cancer and can decrease the incidence of disease through removal of adenomatous polyps. Several available screening options seem to be effective, but the single best screening approach cannot be determined because data are insufficient.

2002 Annals of Internal Medicine

1305. Analysis of minichromosome maintenance proteins as a novel method for detection of colorectal cancer in stool. (Abstract)

Analysis of minichromosome maintenance proteins as a novel method for detection of colorectal cancer in stool. Colorectal cancer is a common disease, and more reliable screening methods are needed for early detection. We aim to develop a non-invasive, stool-based assay that can identify colorectal cancer by detection of minichromosome maintenance protein 2 (MCM2) expression in colonocytes retrieved from the faecal surface. We devised a cell line model to investigate methods and conditions (...) for optimum colonocyte retrieval. In our clinical evaluation study, MCM2-positive cells were retrieved from 37 of 40 patients with symptomatic colorectal cancer, but from none of 25 healthy control individuals. These results suggest that immunocytochemical analysis of retrieved colonocytes might enable accurate detection of colorectal cancer in stool.

2002 Lancet

1306. Expression of 25-hydroxyvitamin D-1-alpha-hydroxylase mRNA in individuals with colorectal cancer. (Abstract)

metabolite, might be up regulated in human colon carcinomas. We used real-time reverse transcription PCR assays to measure absolute 1 alpha OHase mRNA concentrations in the colonic mucosa of 44 individuals without cancer, and in paired healthy colon and cancerous colon samples taken from 27 individuals with the disease, to ascertain whether or not such up regulation takes place. Our results suggest that concentrations of 1 alpha OHase mRNA in tumour samples and in healthy colon samples from individuals (...) Expression of 25-hydroxyvitamin D-1-alpha-hydroxylase mRNA in individuals with colorectal cancer. Vitamin D prevents proliferation, promotes differentiation, and induces apoptosis of colon cells, and reduced intake or insufficiency of the vitamin in the body are associated with increased risk of colorectal cancer. Results of previous studies have suggested that mRNA that codes for 25-hydroxyvitamin D-1-alpha-hydroxylase (1 alpha OHase), which converts 25-hydroxyvitamin D to its active

2002 Lancet

1307. Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. (Abstract)

Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Randomized clinical trials have demonstrated the efficacy of adjuvant 5-fluorouracil (5-FU)-based chemotherapy after surgical resection of node-positive colon cancer. Although this treatment became the standard in 1990 following a National Institutes of Health Consensus Conference, among those at least 65 years of age it is less likely to be offered to older or nonwhite (...) patients.To determine the association between 5-fu-based chemotherapy and survival in older patients.Retrospective cohort study.Combined database of the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and Medicare.4768 patients 65 years of age or older who received a diagnosis of node-positive colon cancer from 1992 to 1996, were covered by Medicare Parts A and B, and resided in the population covered by the SEER program.Propensity scores to control for known

2002 Annals of Internal Medicine

1308. Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of Intergroup 0089. (Abstract)

Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of Intergroup 0089. The incidence of second primary colorectal cancer in patients with a history of colon cancer, compared with patients with a history of adenomatous polyps, is unknown. It is unclear whether guidelines for colonoscopy screening in patients with polyps are appropriate for patients with previous colon cancer.To determine the incidence of second primary colorectal cancer after treatment (...) for localized colon cancer and to compare this incidence with that of first primary colorectal cancer in both the general population and high-risk patients.Historical cohort study.An international, multi-institutional trial of adjuvant 5-fluorouracil-based chemotherapy for localized colon cancer.3278 patients with resected stage II and stage III colon cancer.Occurrence of endoscopic or radiologic colon surveillance and incidence of second primary colorectal cancer.Forty-two cases of second primary invasive

2002 Annals of Internal Medicine

1309. Detection of proximal colorectal cancers through analysis of faecal DNA. (Abstract)

Detection of proximal colorectal cancers through analysis of faecal DNA. Detection of mutations in faecal DNA represents a promising, non-invasive approach for detecting colorectal cancers in average-risk populations. One of the first practical applications of this technology involves the examination of microsatellite markers in sporadic cancers with mismatch-repair deficiencies. Since such cancers nearly always occur in the proximal colon, this test might be useful as an adjunct (...) to sigmoidoscopy, which detects only distal colorectal lesions. We report here the first in-depth analysis of faecal DNA from patients with proximal cancers to determine the feasibility, sensitivity, and specificity of this approach. Using a sensitive method for microsatellite mutation detection, we found that 18 of 46 cancers had microsatellite alterations and that identical mutations could be identified in the faecal DNA of 17 of these 18 cases.

2002 Lancet

1310. Detection of APC mutations in fecal DNA from patients with colorectal tumors. (Abstract)

methods.We purified DNA from routinely collected stool samples and screened for APC mutations with the use of a novel approach called digital protein truncation. Many different mutations could potentially be identified in a sensitive and specific manner with this technique.Stool samples from 28 patients with nonmetastatic colorectal cancers, 18 patients with adenomas that were at least 1 cm in diameter, and 28 control patients without neoplastic disease were studied. APC mutations were identified in 26 (...) Detection of APC mutations in fecal DNA from patients with colorectal tumors. Noninvasive methods for detecting colorectal tumors have the potential to reduce morbidity and mortality from this disease. The mutations in the adenomatous polyposis coli (APC) gene that initiate colorectal tumors theoretically provide an optimal marker for detecting colorectal tumors. The purpose of our study was to determine the feasibility of detecting APC mutations in fecal DNA with the use of newly developed

2002 NEJM

1311. Counting alleles to predict recurrence of early-stage colorectal cancers. (Abstract)

Counting alleles to predict recurrence of early-stage colorectal cancers. Chromosome imbalances occur in many cancers and represent important biological properties of tumours. However, measurements of such imbalances are difficult. We used a new, quantitative approach to investigate the prognostic value of chromosome imbalances in early-stage colorectal cancers.We studied 180 patients with no evidence of lymph-node or distant metastases at the time of surgery. DNA from paraffin-embedded tumours (...) was tested for imbalances of chromosome 8p and 18q by digital SNP (single-nucleotide polymorphism)-a technique in which each allele in a sample is directly counted. Surviving patients had median follow-up of 68 months, and disease recurrence was used as the clinical endpoint.Tumours were divided into three groups: "L" tumours (n=93) had allelic imbalances of chromosomes 8p and 18q, "L/R" tumours (n=60) had allelic imbalances of either chromosome 8p or 18q but not both, and "R" tumours (n=27) retained

2002 Lancet

1312. Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon

- spondstotheToftheclassi?cation.Intheesophagus, the stomach, and the large bowel, the endoscopist classi?es the morphology of ‘‘super?cial’’ neoplastic lesions (intraepithelial neoplasia and carcinoma) in the variants of type 0. The pathologist classi?es the histology of the tumor in the groups of the Vienna classi?cationofneoplasia. When an operative specimen is available, the depth of invasion is classi?ed by the pathologist accordingtotheTofthep-TNMclassi?cation(‘‘p’’is postoperative). In the esophagus (...) of nodal metastases is small, and EMR can be considered safe. 127 ThecutofflimitisshowninDiagram11b.In this situation, the quantitative scale should be used insteadofdescribingthelayersassm1andsm2. S12 GASTROINTESTINAL ENDOSCOPY VOLUME 58, NO. 6 (SUPPL), 2003 Paris Workshop Participants The Paris endoscopic classi?cation of super?cial neoplastic lesionsInvasion of the submucosa in columnar neoplasia of the stomach and the large bowel For adenocarcinomas in Barrett’s esophagus and the stomach

2002 World Endoscopy Organization

1313. Curative surgery for obstruction from primary left colorectal carcinoma: primary or staged resection? (Abstract)

, Embase. Hand searching of the most important journals in the fields of oncology and surgery from the year 2000 until the time of writing.Randomised Clinical Trials (RCT) and Controlled Clinical Trials (CCT), in which a group of patients who undergo primary resection for intestinal obstruction from left primary colorectal carcinoma is compared with a group of patients who undergo staged resection for the same condition. Since only one study of this type was available, we considered all other studies (...) Curative surgery for obstruction from primary left colorectal carcinoma: primary or staged resection? In 8 to 29% of patients with colorectal carcinoma, obstruction is the main symptom at diagnosis, and 85% of patients undergoing emergency colorectal surgery have obstruction from colorectal carcinoma. The prognosis of patients who undergo emergency surgery for obstruction is often poor. So far, two types of surgical approach have been used for this condition: primary resection (primary

2002 Cochrane

1314. Follow-up strategies for patients treated for non-metastatic colorectal cancer. (Abstract)

Follow-up strategies for patients treated for non-metastatic colorectal cancer. It is common clinical practise to follow patients with colorectal cancer (CRC) for several years following their definitive surgery and/or adjuvant therapy. Despite this widespread practice there is considerable controversy about how often patients should be seen, what tests should be performed and whether these varying strategies have any significant impact on patient outcomes.To review the available evidence (...) concerning the benefits of intensive follow-up of colorectal cancer patients with respect to survival. Secondary endpoints include time to diagnosis of recurrence, quality of life and the harms and costs of surveillance and investigations.Relevant trials were identified by electronic searches of MEDLINE, EMBASE, CINAHL, CANCERLIT, Cochrane Controlled Trials Register, Science Citation Index, conference proceedings, trial registers, reference lists and contact with experts in the field.Only randomised

2002 Cochrane

1315. DNA markers predicting benefit from adjuvant fluorouracil in patients with colon cancer: a molecular study. (Abstract)

fluorouracil, and assessed each marker's prognostic and predictive value.Formalin-fixed paraffin-embedded paired normal and tumour samples were obtained from 393 patients with colon cancer from the UK AXIS trial of postoperative portal vein infusion fluorouracil versus control. We measured loss of heterozygosity (LOH) and microsatellite instability at four loci: P53 (17p13), D18S61 (18q22.3), D18S851 (18q21.1), and DP1 (5q21). The prognostic value of each marker was assessed with the log-rank test (...) DNA markers predicting benefit from adjuvant fluorouracil in patients with colon cancer: a molecular study. Present clinical algorithms assign adjuvant chemotherapy according to prognosis, but clinical decision-making would be greatly improved if reliable predictive markers were available to identify which subsets of patients benefit most from treatment. We examined molecular markers in preserved tissue from patients with Dukes' B or C colon cancer randomised to receive, or not, adjuvant

2002 Lancet Controlled trial quality: uncertain

1316. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. (Abstract)

Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Although early reports on laparoscopy-assisted colectomy (LAC) in patients with colon cancer suggested that it reduces perioperative morbidity, its influence on long-term results is unknown. Our study aimed to compare efficacy of LAC and open colectomy (OC) for treatment of non-metastatic colon cancer in terms of tumour recurrence and survival.From November, 1993, to July, 1998 (...) , all patients with adenocarcinoma of the colon were assessed for entry in this randomised trial. Adjuvant therapy and postoperative follow-up were the same in both groups. The main endpoint was cancer-related survival. Data were analysed according to the intention-to-treat principle.219 patients took part in the study (111 LAC group, 108 OC group). Patients in the LAC group recovered faster than those in the OC group, with shorter peristalsis-detection (p=0.001) and oral-intake times (p=0.001

2002 Lancet Controlled trial quality: uncertain

1317. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. Full Text available with Trip Pro

gastrointestinal stromal tumor. We assessed antitumor response and the safety and tolerability of the drug. Pharmacokinetics were assessed in a subgroup of patients.A total of 147 patients were randomly assigned to receive 400 mg or 600 mg of imatinib daily. Overall, 79 patients (53.7 percent) had a partial response, 41 patients (27.9 percent) had stable disease, and for technical reasons, response could not be evaluated in 7 patients (4.8 percent). No patient had a complete response to the treatment (...) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. Constitutive activation of KIT receptor tyrosine kinase is critical in the pathogenesis of gastrointestinal stromal tumors. Imatinib mesylate, a selective tyrosine kinase inhibitor, has been shown in preclinical models and preliminary clinical studies to have activity against such tumors.We conducted an open-label, randomized, multicenter trial to evaluate the activity of imatinib in patients with advanced

2002 NEJM Controlled trial quality: uncertain

1318. Edrecolomab alone or in combination with fluorouracil and folinic acid in the adjuvant treatment of stage III colon cancer: a randomised study. (Abstract)

Edrecolomab alone or in combination with fluorouracil and folinic acid in the adjuvant treatment of stage III colon cancer: a randomised study. Edrecolomab is a murine monoclonal antibody to the cell-surface glycoprotein 17-1A, which is expressed on epithelial tissues and on various carcinomas. Preliminary data suggested that it might be of use in the adjuvant treatment of patients with resected stage III colon cancer. We did a randomised trial in 27 countries to determine the effect of adding (...) [0.53-0.73], p<0.0001). Hypersensitivity reactions occurred in 452 (25%) patients receiving edrecolomab, causing treatment discontinuation in 71 (4%). The addition of edrecolomab to chemotherapy did not increase neutropenia, diarrhoea, or mucositis.The addition of edrecolomab to fluorouracil and folinic acid in the adjuvant treatment of resected stage III colon cancer does not improve overall or disease-free survival, and edrecolomab monotherapy is associated with significantly shorter overall

2002 Lancet Controlled trial quality: predicted high

1319. Imatinib for gastro-intestinal stromal tumours - horizon scanning review

Imatinib for gastro-intestinal stromal tumours - horizon scanning review Imatinib for gastro-intestinal stromal tumours - horizon scanning review Imatinib for gastro-intestinal stromal tumours - horizon scanning review NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NHSC. Imatinib for gastro-intestinal stromal tumours - horizon (...) scanning review. Birmingham: National Horizon Scanning Centre (NHSC). New and Emerging Technology Briefing. 2002 Authors' objectives To summarise the current research evidence on imatinib for gastro-intestinal stromal tumours. Authors' conclusions - Clinical impact: Although the patient group is relatively small, there are no effective alternative therapies if surgery is not curative. The median survival of unresectable or metastatic GIST is about 12 months. - Service impact: There will be little

2002 Health Technology Assessment (HTA) Database.

1320. Cetuximab for head and neck and colorectal cancer - horizon scanning review

Cetuximab for head and neck and colorectal cancer - horizon scanning review Cetuximab for head and neck and colorectal cancer - horizon scanning review Cetuximab for head and neck and colorectal cancer - horizon scanning review NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NHSC. Cetuximab for head and neck and colorectal cancer (...) - horizon scanning review. Birmingham: National Horizon Scanning Centre (NHSC). New and Emerging Technology Briefing. 2002 Authors' objectives To summarise the available evidence on cetuximab for head and neck and colorectal cancer. Authors' conclusions - Clinical impact: Although the number of patients with advanced head and neck cancer is relatively small, their prognosis is poor and their treatment options are limited and most have severe adverse effects on quality of life. The number of people

2002 Health Technology Assessment (HTA) Database.