Outcome in colorectal carcinoma: seven-year study of a population.

Clarke, D.; Jones, Peter F.; Needham, C. D.

doi:10.1136/bmj.280.6212.431

Cited by 51 publications

(10 citation statements)

References 6 publications

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“…2 The two studies, both over 24 months, took place in 1968-9 and during 1980-2, and both recorded outcome over seven years. The details of the first study have been published2; here the second study is reported and the two are compared.…”

Section: Introductionmentioning

confidence: 99%

Outcome in colorectal adenocarcinoma: two seven-year studies of a population.

Gordon

Dawson

Bennett

et al. 1993

BMJ

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Objective-To record every patient with proved colorectal adenocarcinoma presenting from a defined population over two years in 1968-9 and during 1980-2, and to compare treatment and outcome over seven years. Design-Retrospective in 1968-9 and prospective in 1980-2. Setting-Aberdeen general hospitals.Subjects-Every patient presenting to the four general surgical units with histological proof of colorectal adenocarcinoma.Main findings-On average, one new patient presented each week per 100000 population. The proportion of patients aged 65 and over rose from 67% to 71%. An operation was performed on 385 patients in 1968-9 and on 399 during 1980-2. At laparotomy the proportion of patients who seemed to be curable and had a radical operation rose slightly, from 56% to 61%, and operative mortality fell from 9% to 5%. In all there were 421 survivors of curative surgery, and seven years later three quarters were either alive (51%) or had died without recurrence (25%). In both studies some 40% of patients were considered incurable when they presented, but the number who had a palliative resection rose from 59% to 85%.Conclusions-The contribution of radical surgery to the treatment of colorectal adenocarcinoma is substantial, with three quarters ofpatients so treated showing no evidence ofrecurrence after seven years. Operative mortality in an elderly population is now low, and improvement in late outcome is more likely to come from developments in adjuvant therapy than in operative technique. A continuing problem is that 40% of patients are not curable when they present, although palliative resection can now be offered to over 80%. IntroductionCarcinoma of the large bowel is the neoplasm most often treated by general surgeons. Its management is now receiving much attention, with reports opening with the statement that over 20000 people die each year in Britain from this cause and that five year survival is less than 30%.' These figures very properly attract attention, but two surveys of the population of northeastem Scotland suggest that, for several reasons, they need careful interpretation.More than half of the patients who now present are 70 or more years of age, so causes of death natural to an elderly population will account for considerable late mortality. Secondly, results are seriously affected by the fact that 40% of patients are beyond hope of cure when they present, and virtually all die within three years. Finally, although radical surgery is often successful in patients who seem to be curable at the time of operation, follow up reveals that occult local or distant spread was already present in one

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Section: Introductionmentioning

confidence: 99%

Outcome in colorectal adenocarcinoma: two seven-year studies of a population.

Gordon

Dawson

Bennett

et al. 1993

BMJ

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“…Conse-quently, efforts have concentrated on the de velopment of a more effective application of chemotherapy and radiotherapy. These mo dalities, however, have made only a small im pression on the natural history of the disease [4][5][6]. Despite improved radiotherapy, sur vival rates have not changed significantly in the last three decades [6].…”

Section: Introductionmentioning

confidence: 99%

Oxygen-Derived Free-Radical Scavengers Prolong Survival in Colonic Cancer

Salim

1992

Chemotherapy

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The influence of scavengers of oxygen-derived free radicals on survival in colonic cancer was studied. Following curative surgery for carcinoma of the sigmoid colon at Dukes’ stage C, 198 patients making an uneventful recovery from surgery were randomized to the control group or to receive allopurinol (50 mg orally 4 times a day) or dimethyl sulphoxide (DMSO, 500 mg orally 4 times a day). In 144 fully evaluable patients who were studied for 5 years, allopurinol and DMSO incurred a significant (p < 0.01) survival advantage over the whole period of study. The similarity in efficacy between allopurinol and DMSO and the fact that the only action they share is scavenging oxyradicals, suggest that these radicals are implicated in the detrimental effects of malignancy and that removing them provides a survival advantage in patients bearing colonic carcinoma.

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“…Overall, 70% of large-bowel cancer pa tients die within 5 years of diagnosis, which in the majority of cases is made when the disease is too advanced to cure [6][7][8][9], Distant spread of colorectal cancer, particularly to the liver, remains a major problem. Median survival in untreated patients is between 4 and 18 months and less than 10% survive 3 years or more [10,11].…”

Section: Discussionmentioning

confidence: 99%

Scavengers of Oxygen-Derived Free Radicals Prolong Survival in Advanced Colonic Cancer

Salim

1993

Tumor Biol

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The influence of oxygen-derived free radicals on survival in advanced colonic cancer was assessed in a prospective randomized controlled double-blind trial using the radical scavengers dimethyl sulphoxide (DMSO) and allopurinol. Following palliative sigmoid colectomy for carcinoma at Dukes’ stage D, 306 patients were randomized to the control group or to electrocoagulation of liver secondaries alone or with allopurinol (50 mg by mouth 4 times a day) or DMSO (500 mg by mouth 4 times a day). In 193 fully evaluable patients who were studied for 5 years, allopurinol and DMSO incurred a significant (p < 0.05) survival advantage over the whole period of study. The similarity in efficacy between allopurinol and DMSO and the fact that the only action they share is scavenging oxyradicals, suggest that these radicals mediate the detrimental effects of malignancy and that removing them incurs a survival advantage for patients with advanced colonic cancer.

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Outcome in colorectal carcinoma: seven-year study of a population.

Cited by 51 publications

References 6 publications

Outcome in colorectal adenocarcinoma: two seven-year studies of a population.

Outcome in colorectal adenocarcinoma: two seven-year studies of a population.

Oxygen-Derived Free-Radical Scavengers Prolong Survival in Colonic Cancer

Scavengers of Oxygen-Derived Free Radicals Prolong Survival in Advanced Colonic Cancer

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