Expression of the cell adhesion molecule CEACAM6 in CRC is an independent prognostic factor allowing subdivision of patients into low- and high-risk groups. Whether CEACAM6 or CEA and CEACAM1 might be useful as predictive markers of chemotherapy benefit remains unclear.
A randomized double-blind trial has shown that, in 160 women with breast cancer undergoing lumpectomy or mastectomy with axillary clearance, perioperative and postoperative administration of tranexamic acid 1 g three times daily resulted in a significant reduction in the mean postoperative drainage volume compared with patients given placebo (283 versus 432 ml, P < 0.001). The frequency of postoperative seroma formation was also decreased by tranexamic acid administration (27 versus 37 per cent, P = 0.2). Haematoma formation was infrequent in both groups and was not altered by administration of tranexamic acid. No infectious complications occurred. Age over 60 years was a significant risk factor for overall wound complications but tumour size and regional lymph node metastases were not. Tranexamic acid may be used to reduce the frequency of postoperative wound complications following surgery for breast cancer.
From 1966 through 1970 we performed resections in 216 patients with carcinoma of the large bowel. The relative five year survival for all patients was 65.5%. The relative five year survival for all potentially curable patients was 80.4%. Patients with positive lymph nodes and full-thickness penetration of their tumors had a five year survival of 70.5% and a 10 year survival of 60.5%. In performing this study we have tested the principles of wide anatomical resection and radical lymphadenectomy. For their specific influences on survival we have also examined stage, site, age, sex, race, margins, local recurrence, hypogastric lymph node dissection, serosal penetration and various aspects of nodal status. The information derived from these parameters has confirmed our hypothesis that survival is directly related to radical anatomical resection and lymphadenectomy. For rectal cancer, extensive resection also reduces the incidence of local recurrence. We are persuaded that the principles of operation for large-bowel cancer are valid and that they merit universal adoption.
Patients with colon cancer substantially reframe their perception in estimating QL both under radical resection and under adjuvant chemotherapy or observation. This effect is an integral part of patients' adaptation to disease and treatment. An understanding of this phenomenon is of particular relevance for patient care. Its role in evaluating QL endpoints in clinical trials needs further investigation.
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