Carcinoma of the colon and rectum:The natural history reviewed in 1704 patients

Abstract

For 1704 patients with large bowel cancer compiled by the Armed Forces Central Medical Registry, selected prognostic factors were related to five-year or longer survival. The majority of late deaths (those occurring after five years) resulted from cancer in the descending colon, sigmoid colon or rectum rather than from cancer in the right or transverse colon. For example, among all patients with cancer of the rectum, 15.4% of those with Dukes' B tumors and 10.9% of those with Dukes' C tumors died of rectal cancer between five and ten years after diagnosis. When late survival rates were compared, patients with right and transverse colon cancer (8 deaths/93 at risk) fared significantly better than those with left colon and rectal cancer (33 deaths/171 at risk; P = 0.01). Among patients with left-sided colon and rectal carcinoma, a further significant difference in late survival was found when stage of disease was considered: patients with Dukes' A cancers (3 deaths/47 at risk after five years) fared better than those with Dukes' C cancers (21 deaths/74 at risk) (P = 0.002). For Dukes' B and C stages of disease, patients with left colon and rectal cancer fared worse than those with right and transverse colon lesions after 60 months. Of all patients who died of large bowel cancer after five years, 69% had a recurrence of cancer by 60 months, and most late recurrences were located in the descending and sigmoid colon and in the rectum. These results show differences in survival after five years with respect to both site of cancer in the colon and stage of initial disease. Our findings indicate that many left-sided large bowel cancers have a slowly progressive natural history.

Prognostic and Diagnostic Significance of Tumor Budding Associated with β-Catenin Expression in Submucosal Invasive Colorectal Carcinoma

“…However, reviews of the literature showed that lymph node metastasis occurred in approximately 10% of the patients with submucosal invasive colorectal carcinoma (Tanaka et al 1995;Suzuki et al 2003). Lymph node metastasis is one of the most important prognostic factors in colorectal carcinoma (Eisenberg et al 1982;Gennari et al 2000). Patients with lymph node metastasis should undergo additional radical surgery even after ER.…”

Isolated splenic metastasis of colon cancer: a case report and literature review

“…The spleen is not a typical site of colorectal adenocarcinoma metastasis and, if any is observed, it is rarely a single and isolated metastasis, with evidence of widespread disease 4,6,[8][9][10][11][12][14][15][16][17][18] . Then, the spleen is rarely affected by isolated metastases, with around 20% of these patients with secondary liver lesions at the diagnosis 4,5,12 .…”

“…Other common metastatic sites include: lung, bone and brain 4,5 . The spleen is the main mass of lymphoid tissue in the body, but it is not a typical site of neoplastic metastasis in patients diagnosed with colon cancer 4,[6][7][8][9][10][11][12][13][14] . In theory, all cancers can involve the spleen 15 , but most cases observed usually involve other organs, with infrequent isolated splenic metastasis 4,6,[8][9][10][11][12][14][15][16][17][18] .…”

“…Neoplasms that frequently involve the spleen are tumors usually with a high metastatic potential, e.g., breast, lung, ovarian and uterine cancers [8][9][10] . Although there is no conclusive explanation for the low occurrence of splenic metastasis, the literature reports several hypotheses based on anatomical, pathological and immunological characteristics 4,[6][7][8][9][10][11][12]18,19 . These patients are usually asymptomatic, and the diagnosis is performed by imaging exams for CRC staging 5,8,10 , or in the follow-up period of patients that submitted to surgical treatments 7,9,11,13,14 .…”

Inhibition of hepatocyte growth factor-induced motility and in vitro invasion of human colon cancer cells by gamma-linolenic acid

“…Local invasion and systemic metastasis are commonly seen in these patients, with the liver being frequently involved (Donaldson and Welch, 1974;Eisenberg et al, 1982;August et al, 1984;AllenMersh, 1989). Anti-metastatic strategies and agents could therefore be of major importance in the treatment of such cancer patients.…”