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

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

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

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

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

Objective： This study was designed to explore the relationship between clinicobiological acting and expression of p21 protein and estrogen receptor(ER) in colorectal cancer. Methods： The intensity of expression of p21 protein and ER for 206 patients with colorectal cancers were determined by labeled-streptokinase avidin-biotin(LSAB) assay. Results： The expression of p21 protein is negatively correlated with that of ER in colorectal cancer(r=-0.6613, P<0.01). The intensity of expression of p21 protein and ER in colorectal cancers were not related with the patients age, sexuality, tumor position, pathological type, histological type, Dukes stage etc.(r< 0.4,P>0.05). Both the expressions were related to the prognosis of colorectal cancer(P<0.01). Higher the intensity of expression of p21 protein worse the patients prognosis, and higher the intensity of expression of ER better the patient s prognosis. Conclusions： The abnormal expression of p21 protein is related to the dysbolism of estrogen in colorectal cancer. The detection of p21 protein and ER are helpful for diagnosis and prognostic evaluation for colorectal cancer.

Objective：The aim of this study was to investigate the distribution of carcinoembryonic antigen (CEA) in colorectal cancerous tissue and to evaluate its clinicobiological significance, especially its prognostic value. Methods: Distribution of tissue CEA in 189 patients with colorectal cancer were detected with immunohistochemical method, and its relationship with many clinicopathological parameters was analyzed with SPSS software. Results: CEA distributed in both tumor tissue and normal mucosa but there was a significant difference between them. Staining positive rate of CEA in tumor tissue was 96.3％ , with 52.4％ strong and 36.5％ moderate. While in normal mucosa it was 17.4％ , with 16.2％ weak and 1.2％ moderate. There was a close relationship between tissue CEA and many clinicopathological parameters, such as differentiation, invasion depth, metastasis to regional lymph node, preoperative serum CEA level, postoperative tumor recurrence, metastasis, and postoperative survive. Conclusions: CEA overexpression in colorectal cancer tissue. Tissue CEA is a good prognostic indicator for colorectal cancer reflecting its clinicobiological features. Combining tissue CEA with serum CEA level should be better for predicting prognosis,and patient with both elevated preoperative serum CEA level and strong expression of CEA in tumor tissue indicates the worst prognosis.

OBJECTIVETo investigate the compliance and associated factors of postoperative chemotherapy for elderly patients with colorectal cancer.

METHODSA total of 386 elderly patients (>70 years old) with stage II(-IIII( colorectal cancer underwent surgery between January 2000 and January 2010. The clinicopathological data were retrospectively reviewed. There were 226 patients received postoperative chemotherapy and 160(41.4%) refused. Logistic regression model was used to analyze factors associated with patients compliance to chemotherapy. Patients were followed up by phone call regarding the reason for refusal.

RESULTSMultivariate analysis showed that gender, body mass index (BMI), body surface area (BSA), age, and complication were independent risk factors associated with chemotherapy compliance(All P<0.05). Follow-up phone questionnaire showed that 63.8%(51/80) of patients with stage II( cancer did not received chemotherapy because of the doctor's uncertainty of chemotherapy benefit. For stage III( patients, fear of chemotherapy (31.2%, 15/48), feeling uncomfortable (18.8%, 9/48), and financial issues(18.8%, 9/48) were the main factors. The desperate feeling was the predominant reason for stage IIII( patients(56.2%, 18/32).

CONCLUSIONSGender, BSA, age, and postoperative complication are the main factors associated with compliance to postoperative chemotherapy. Doctors' recommendation should be emphasized for stage II( patients. For stage III( patients, treatment recommendation should be enthusiastic.

Aged ; Chemoradiotherapy, Adjuvant ; Colorectal Neoplasms ; drug therapy ; surgery ; Humans ; Retrospective Studies ; Risk Factors