Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Colorectal Neoplasms ; pathology ; surgery ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; surgery ; Neoadjuvant Therapy ; Preoperative Care ; Survival Rate

Anal Canal ; surgery ; Humans ; Neoplasm Recurrence, Local ; prevention & control ; Rectal Neoplasms ; pathology ; surgery

Combined Modality Therapy ; Digestive System Surgical Procedures ; methods ; Humans ; Laparoscopy ; Microsurgery ; Rectal Neoplasms ; drug therapy ; radiotherapy ; surgery ; Rectum ; surgery

Age Distribution ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; mortality ; prevention & control ; Diet ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Male ; Precancerous Conditions ; therapy ; Risk Factors ; Rural Population ; Sex Distribution ; Urban Population

Colorectal Neoplasms ; surgery ; therapy ; Humans ; Treatment Outcome

OBJECTIVETo evaluate the feasibility and utility of an ex vivo sentinel lymph node (SLN) identification and ultrastaging for colorectal cancer (CRC).

METHODSCRC patients undergoing resection of a primary colorectal cancer were considered for inclusion. Following resection, SLN identification was performed. The SLN was dissected from the mesentery and submitted separately for pathologic analysis. All lymph nodes were stained with HE. Blue lymph nodes, when negative by routine HE staining, were further analyzed.

RESULTSA total of 62 tumors from 60 patients with colorectal cancer were studied. 95.2% (59/62) specimens was successfully identified. In these 59 specimens, a total of 1114 (18.9 per specimens) lymph nodes were examined; of these, 157 (14.9%) were designated as SLNs. The number of blue-stained lymph nodes removed ranged from 1 to 9, with a mean of 2.7 blue nodes identified. The sensitivity of a blue-stained lymph node identifying metastatic disease was 39.1%. The false-negative was 23.7%. In 4 specimens micrometastases were detected only by immunohistochemistry with cytokeratin.

CONCLUSIONSEx vivo sentinel lymph nodes mapping in colorectal cancer is feasible and can identify the SLNs with a very high success rate. Ex vivo SLN mapping improves pathologic staging of patients with CRC. The SLN evaluation should not replace attempts to harvest large number of nodes for standard processing. SLN mapping can help improving the number of nodes for pathological examination.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Rosaniline Dyes ; Sentinel Lymph Node Biopsy ; methods

OBJECTIVETo investigate the outcome of surgical treatment for gastrointestinal stromal tumor(GIST) and the associated factors.

METHODSA total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University. The clinical data were retrospectively reviewed and the pathological examination was reviewed. Follow-up was performed.

RESULTSThere were 176 males and 101 females. The age ranged from 20 to 81 years old (median,57). Location of the tumor included colorectum (n=28),small bowel(n=76), stomach(n=173). All the patients had en bloc resection, including local excision in 98 patients, organ resection in 64, and extended resection in 115. The 5-year survival rates were 83.5%, 71.9%, and 61.9% in the three different procedures, respectively, and the difference was not statistically significant(P>0.05). Cox model showed that the tumor size, recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients(P<0.05).

CONCLUSIONSSurgery remains the major approach for gastrointestinal GIST. Complete resection is the principal treatment. Extensive resection or extended lymph nodes dissection is not associated with improved survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

OBJECTIVETo compare the effect of 5-fluorouracil (5-FU) portal vein infusion (PVI) for 7 days after radical resection, with intraluminal chemotherapy during operation for eliminating liver metastasis and elevating long-term prognosis in colorectal cancer.

METHODS162 colorectal cancer patients with radical resection were divided into portal vein chemotherapy group (group A, 82 cases) and intraluminal chemotherapy group (group B, 80 cases) randomly. In group A, 5-fluorouracil were infused with 1g per day constantly for 7 days after operation through portal vein catheters, which placed into greater omental vein and fixed on the abdominal wall. In group B, intraluminal chemotherapy was given and 5-fluorouracil 0.5 g was injected into the greater omental vein during operation.

RESULTSThe short-term complications and long-term effect in the two groups were compared by statistical software SPSS 8.0. Group A had more operative complications, and no statistical differences was found in hospital time and survival rate of the two groups. The 5-year survival rate is 76.7% (group A: 74.3%, group B: 79.2%), and the liver metastasis rate is 19.8%. There is no significant difference between the two group-survival curves. Multiple variable analysis suggested that Dukes' stage was the prognosis factor (P < 0.05).

CONCLUSIONSThe present study demonstrated that the two chemotherapy methods play an important role in preventing liver metastasis and improving the survival rate, and the intraluminal chemotherapy would be easier and simpler. The result should be further improved by using combined chemotherapy.

Adult ; Aged ; Antimetabolites, Antineoplastic ; administration & dosage ; Chemotherapy, Adjuvant ; Chemotherapy, Cancer, Regional Perfusion ; methods ; Colorectal Neoplasms ; drug therapy ; mortality ; therapy ; Combined Modality Therapy ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Portal Vein ; Survival Rate ; Treatment Outcome

OBJECTIVETo analyze the long- term results of radical resection for rectal cancer and the factors influencing the operative results.

METHODSFrom January 1990 to December 1999, clinical data of 689 patients who underwent radical resection for rectal cancer were analyzed retrospectively.

RESULTSThe overall operative mortality was 0.7%, the follow- up rate was 96.7%, the median survival rate was 67.4 months. The 1-, 3-, 5- and 10-year survival rate after operation was 89.9%, 77.3%, 69.6% and 63.3% respectively. Univariate analysis showed that the survival rate was related with the first onset symptom, tumor location, infiltrated circumference of intestine, T staging, Dukes staging, histological type, extent of lymph node metastasis and operative approaches. Multivariate analysis showed that tumor location, histological type, invasive depth and Dukes staging were independent prognostic factors.

CONCLUSIONSThe long-term efficacy after radical resection for rectal cancer is correlated with tumor location, histological type, invasive depth and Dukes staging.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; mortality ; pathology ; surgery ; Rectum ; pathology ; Regression Analysis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors (GIST) after complete resection.

METHODSTumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry (IHC). The association of above factors expressions with recurrence, metastasis and prognosis was examined.

RESULTSLog-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection (all P<0.05), and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival (all P<0.05). Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53 (all P<0.05), and the overall survival was only associated with Ki-67 (P<0.05).

CONCLUSIONKi-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Female ; Gastrointestinal Neoplasms ; metabolism ; surgery ; Gastrointestinal Stromal Tumors ; metabolism ; surgery ; Humans ; Hyaluronan Receptors ; metabolism ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Tumor Suppressor Protein p53 ; metabolism