Cancer of the colon, rectum and anal canal

Bacon, Harry E.

doi:10.1016/0002-9610(57)90581-0

Cited by 28 publications

(12 citation statements)

References 14 publications

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“…Recurrence, especially local recurrence, is responsible for the great majority of deaths in the first two years after surgery [1,7,19]. It is well recognized that the incidence of local recurrence is a direct consequence of the proportion of undifferentiated cells and of the tumoral invasion of the bowel wall [1,7,12,19]. Less undifferentiated and less invasive tumors tend to have better prognosis [19,22,23,29].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, as mentioned above [1,7,12,19,[22][23][24][25][26][27]35], the incidence of local recurrence depends also on the tumoral infiltration of the rectum wall.…”

Section: Adjuvant Therapy On Cancer Of the Lower Rectum Evaluation Omentioning

confidence: 99%

“…Was this fact responsible for better survival results observed in irradiated patients with pT3? It is very clearly demonstrated [1,7,12,19] that recurrence and survival is directly proportional to the number of lymph nodes invaded: as the incidence of lymphatic invasion decreased, there were better rates of recurrence and survival.…”

Section: Adjuvant Therapy On Cancer Of the Lower Rectum Evaluation Omentioning

confidence: 99%

“…Pre-operative radiotherapy as complementary to surgery, although recognized as effective on controlling the interval-free of rectal cancer, has not been utilized as frequently as expected [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Adjuvant Therapy on Cancer of the Lower Rectum. Evaluation of the Effects of Preoperative Radiotherapy on the Prognosis of Patients with Cancer of the Lower Rectum

Neto¹,

Reis²,

Kagohara³

et al. 2012

JCT

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Aims:The prognosis on treatment of the cancer of the rectum has not changed in the last fifty years. Survival rates of 50% to 55% seems immutable in several published series. The main cause for those results is the high incidence of recurrence, either local or widespread. Local recurrence is directly related to the number of undifferentiated cells and to the grade of wall invasion. Widespread recurrence depends specifically on the lymphatic and vascular spreading. So any kind of treatment that would diminish the number of undifferentiated cells and the size or the tumor wall penetration would certainly decrease the local recurrence rate, lengthening the interval free from cancer and, perhaps, modifying the long term survival rate. Between 1978 and 2009, a total of 538 patients with adenocarcinoma of the lower rectum (from the pectinate line to 10 cm above) were treated by preoperative radiotherapy. Methodology: The same protocol was used in all the patients -400 cGy, 200 cGy/day, during 4 consecutive weeks (anterior and posterior pelvic fields) by means of a Linear Megavoltage Accelerator (25 MeV). Surgery was performed 2 months after completion of the radiotherapy. Results: Statistical analysis of the whole group showed that preoperative radiotherapy does decrease frequency of undifferentiated cells. Moreover, the incidence of local recurrence diminished after irradiation by 3.4%. Preoperative radiotherapy reduces tumor volume (ERUS) and wall invasion, as well as the mortality rate due to local recurrence (2.4%) and alters long-term survival rate (80.1%). Conclusion: Preoperative radiotherapy is really effective in reducing the number of undifferentiated cells and in diminishing the tumor volume and the carcinomatous infiltration of the rectal wall.

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Section: Discussionmentioning

confidence: 99%

“…Nonetheless, as mentioned above [1,7,12,19,[22][23][24][25][26][27]35], the incidence of local recurrence depends also on the tumoral infiltration of the rectum wall.…”

Section: Adjuvant Therapy On Cancer Of the Lower Rectum Evaluation Omentioning

confidence: 99%

Section: Adjuvant Therapy On Cancer Of the Lower Rectum Evaluation Omentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Adjuvant Therapy on Cancer of the Lower Rectum. Evaluation of the Effects of Preoperative Radiotherapy on the Prognosis of Patients with Cancer of the Lower Rectum

Neto¹,

Reis²,

Kagohara³

et al. 2012

JCT

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“…Bacon [3] compared his extended removal of the lym phatic channels in the pelvis with his simple excision without lymphadenectomy, emphasizing the increase of the 5-year survival rate by 7% and the minimal increase of the morbidity but longer operating time and additional blood transfusions. However, his comparison was carried out between the adenectomy reported in 1962 and the nonadenectomy done in 1949.…”

mentioning

confidence: 99%

The Pros and Cons of Lymphadenectomy in Association with Rectal Excision for Carcinoma of the Rectum

Shindo¹,

Yasutomi²,

Takahashi³

et al. 1985

Dig Surg

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A clinical study was carried out in 717 resected cases of rectal carcinoma. Abdomino-perineal excisions were performed in 75% of the cases and low anterior resection in 25%. Regional lymph nodes were divided into 3 groups (N1, N2 and N3), and operative grades were classified as R1, R2 and R3 according to complete dissection of the corresponding lymph node groups. The 5-year survival rate was 48.8% in the Rl grade, 58.7% in R2 and 67.7% in R3. Even within each stage of cancer advance, the 5-year survival rate was better, as lymphadenectomy was more extensive. Local recurrence within 5 years after rectal surgery occurred in 28% of the cases in the R1 grade, in 19% of R2 and in 10.7% of R3 patients. The rate of urinary disturbance was 6.1, 24.5 and 27.5%, respectively. The rate of sexual dysfunction was 38.2, 68.1 and 76.7%, respectively. Statistically there was no significance in each of the factors mentioned above between abdomino-perineal excision and low anterior resection, but there was a significant difference between the R1 and R3 grade. Extensive lymphadenectomy is indicated for advanced cancer of the rectum, but a more careful maneuver is mandatory in order to protect the pelvic nerves.

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