No abstract

Of 352 patients with colorectal carcinoma followed for a minimum of 5 years after surgery, 39 cases (11.1%; median age 60 years) had mucinous adenocarcinoma, and 4 (1.1%; median age 62 years) had signet-ring cell carcinoma. Mucinous carcinomas were most frequently located in the rectum (61.5%) and in the sigmoid colon (15.3%) and presented with stage C and D disease in 41 and 15% of the cases, respectively. Disease recurrence was more frequently observed in patients with mucinous (51.7%) or signet-ring lesions (100%) as compared with adenocarcinomas. Five-year survival was 45 (median 48 months), 28 (median 27), and 0% (median 15 months) in patients with adenocarcinomas, mucinous adenocarcinomas, and signet-ring cell carcinomas, respectively (p < 0.05). Mucinous carcinomas of the rectum had had a significantly worse prognosis (5-year survival 17%, median 33 months) as compared with adenocarcinomas of the same site (5-year survival 34%, median 25 months; p < 0.05).

The histories of 90 consecutive patients who underwent curative surgery for rectal cancer from January 1975 to December 1981 were reviewed. Twenty of 90 patients (22.2%) recurred locally. The site of the primary lesion and tumor differentiation are the most important factors influencing local recurrence. Median survival from recurrence was 3 months and no patient was alive after 15 months. No significant difference in survival was observed in patients surgically treated for recurrence compared to untreated patients.

In our study, adherence to a strict follow-up program unfortunately proved to be ineffective for improving long-term survival for patients who underwent reoperation with curative intent.

Objective: Sialyl Lewis^x (sLe^x) is one ligand for E selectin (CD62E), a glycoprotein that is expressed on activated endothelial cells. Adhesion mediated by endothelial E selectin and sLe^x expressed on human tumor cells could be relevant for the development of metastases. The aim of this study was to investigate whether or not a correlation exists between pre-operative levels of ganglioside serum sLe^x and disease-free interval and survival in colorectal cancer patients. Patients and Methods: Thirty Duke’s B and 52 Duke’s C patients undergoing resection for colorectal cancer were studied. The median follow-up time was 34.8 months. A pool of 57 sera from normal subjects was used as an Internal Normal Standard (INS). sLe^x analyses were performed by a thin layer chromatography (TLC) immunostaining technique. Results were expressed as the ratio (R) between bands of INS and bands from each neoplastic serum. Results: The median R value was 0.80 in normal subjects, 0.70 in Duke’s B patients and 1.0 in Duke’s C patients. No significant differences were detected between sLe^x concentrations in sera from normal and neoplastic subjects (p = 0.1). Using an arbitrary cutoff of R = 0.9, the mean disease-free interval in the whole series was 47.4 months for R <0.9 and 126.0 months for R ≧ 0.9 (p = 0.04). The survival time was 76.8 months for patients with R values <0.9 and 156.3 months for patients with R values ≧0.9 (p = 0.1). Conclusions: High serum levels of ganglioside sLe^x significantly correlate with a favorable prognosis and with a lower occurrence of metastases. It is conceivable that soluble sLe^x may compete with membrane-bound sLe^x in the course of interactions between activated endothelium and tumor cells that have reached the circulation.