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Objective To analyze clinical manifestations, histology, immunohistochemistry (IHC), surgical treatment and prognosis of colorectal stromal tumours. Methods The clinical and pathological data of 30 cases of colorectal stromal tumors were analyzed retrospectively. According to Fletcher proposed approach for defining risk group in GIST, these cases were grouped into VLR, LR, IR and HR.Cox multiple regression multiple factor analysis method was used to evaluate impact factors for prognosis.Results Radical resection was achieved in all 30 cases. Tumors located in the colon in 4 ( 13% ) cases, in the rectum in 20 (67%) cases, and within the anal canal in 6 (20%) cases. C-kit expression was positive in 86. 7% cases as determined by IHC. Postoperatively, 29 cases were followed-up from 4 to 130 mos. The Fletcher proposed approach for defining risk group in GIST was closely related to the survival rates ( B =4. 226,P =0. 02). The 3- and 5-year survival rate was 73% and 53% respectively. Conclusions Surgical resection and molecular target treatment is the treatment of choice for colorectal stromal tumors. The Fletcher's classification of malignancy risk group for colorectal stromal tumors is statistically related to the modus operandi and patients' survival rate.
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Objective To estimate the operative risk and outcomes of colorectal cancer patients 80 years of age and older. Methods Colorectal cancer resection was performed in 99 patients 80 years of age and older between Dec. 1987 and June 2005. The informations about clinical data, co-morbidity,complications, operative mortality and survival were retrospectively analyzed. The patients were followed-up for 45.12 months (range 1-136) months. Results Of 99 patients, co-morbidity was found in 43 patients (43.4% ) and complication in 10 patients (10.1%). No patient died of operation.Eighty patients completed the follow-up study. The overall 3-year survival rate and disease-free survival rate were 64.3% and 61.1%, respectively. Whereas the overall 5-year survival rate and disease-free survival rate were 52.8% and 52.1%, respectively. In univariate analysis, curative or palliative operation, tumor differentiation, cancer embolism in the vasculature, tumor staging and complications were proved to be significant prognostic factors. Multivariate survival analysis,however, showed that only the curative or palliative operation was independent factor for survival.Conclusions The high risk of co-morbidity for patients 80 years of age and older is not the obstacle to cancer resection.These patients will have satisfactory outcomes via optimal treatment and operation.
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Objective To evaluate the colonoscopy surveillance in colorectal cancer patients after surgical removal of the tumor.Methods From June 1986 to June 2007,2762 asymptomatic patients who had underwent operation for colorectal cancer were put into colonoscopy surveillance.They had the first examination 3-6 months after the operation,and were re-examined once a year thereafter for 3 years.The follow-up findings were compared with those from the 218 symptomatic patients who had colorectal cancer surgery from September 1981 to May 1986.Results In 2762 asymptomatic patients,48 cases of multiple primary cancer were detected,in which 39 cases(1.4%) were found at one examination and 9 cases(0.3%)at different examination.The TNM staging of these lesions included stage Ⅰ in 6,stage Ⅱ in 31 and stage Ⅲ in 11.During the surveillance,583 cases(21.1%) of adenoma were detected and endoscopically resected,in which 17(3.2%) were invasive early cancer and 58(9.9%) were high grade dysplasia.In 218 patients with symptoms,29 cases(13.3%) of adenoma and 27 cases( 12.4%) of cancer were detected,including 4 cases of stage Ⅰ cancer,6 of stage Ⅱ and 16 of stage Ⅲ.Conclusion Colonoscopy surveillance in colorectal cancer patients after surgery is important in finding precancerous lesion and early stage cancer,and is recommended in all patients.
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Objective To study the clinicopathological characteristics of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese population with different criteria and guidelines. Methods Twenty four families fulfilling Amsterdam Criteria (AC), 15 additional families fulfilling Japanese Criteria (JC) and the remaining 19 patients fitting Bethesda Guidelines (BG) were analyzed. Results In the 24 AC families there were 116 malignant tumor patients including 90 colorectal cancer (CRC) subjects and in the 15 JC families there were 54 malignant tumor patients including 33 CRC cases. The two groups displayed similar clinical features. Mean age of first CRC at diagnosis was 46.1 and 51.4 years old, respectively. The proximal colonic cancers accounted for 55.4% versus 44.8%. Synchronous and metachronous multiple CRCs occurred in 25.6% and 18.2% of patients respectively. Totally there were 55 extracolonic tumors in the two groups. Gastric and endometrial carcinomas were two most common extracolonic tumor types in our series. The tumors of the 34 probands showed more frequent exophytic growth pattern, higher occurance of poorly differentiated carcinoma, A / B Dukes stage and more Crohn's like lymphoid reaction ( P
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Objective To study the clinical characteristics of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese patients. Methods A series of 101 patients with colorectal cancers (CRC) and HNPCC associated tumors from 22 families fulfilling Amsterdam criteria were analyzed. Results Eighty-four patients were found to have CRC. Mean age at diagnosis of first CRC was 45.7 years. 58.3% and 23.8% of the first CRC were located proximal to the spleen flexure and in rectum respectively. 23.8% of patients had synchronous and metachronous CRC. Twenty patients had extracolonic tumors, among which gastric cancer was the most common tumor type in our series. Conclusions The frequency of HNPCC was 2.6% in this series of patients. It is characterized by early onset with a propensity to involve the proximal colon, and high frequency of multiplicity. Gastric cancer seems more frequent in Chinese patients, which is different from American and European reports. So it is necessary to set up criteria for diagnosis of HNPCC in Chinese.
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Objective To study the clinical characteristics of hereditary nonpolyposis colorectal cancer (HNPCC). WT5”HZMethods Ten kindreds of HNPCC in South Zhejiang area were analyzed. ResultsWT5”BZ Among the 10 families, 27 persons had colorectal cancer with age ranging from 19 to 71(average 45 3 years),74 percent of cases being diagnosed before the age of 50. The total of the colorectal cancer foci in 27 cases were 37, 40 percent of focis located proximal to splenic flexure, 30 percent of cases had multiple primary colorectal cancer, among which 14 8 percent of cases had synchronous multiple primary colorectal cancer, 18 5 percent of cases had metachronous multiple primary colorectal cancer. Thirteen cases died during follow-up of 1～23 years, 14 cases were still alive during follow-up of 1～28 years. KG2Conclusion HNPCC has definite charactistics that are of much help to early diagnosis.
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PURPOSE In order to correct the wrong point of view which considered the colorectal adenoma with malignant change as early stage of carcinoma or as carcinoma with low grade malignancy and to avoid performing simple operation unreasonably. METHODS 148 cases of colorectal adenoma with malignant change which were treated in our department in 1995-1997 were submitted to a retrospective study. RESULTS We find only 27 cases (18. 8%) whose malignant changes were localized in the layers of mucosa.mucosalmuscle and submucosa,72 cases (50. 0 % , whose malignant changes had penetrated to the layer of serosa, and 43 cases (30. 7 % ) had lymph nodes metastases,18 cases (12. 5%) had blood metastases or implantations. We also find 51 cases (35. 5%) that couldn't get a definite diagnoses of malignant changes although 1-3 times of biopsies had been made before operation. and of them in fact 39 cases (74. 3%)had malignant changes that had penetrated to the layers muscle and serosa ,10 cases (19.6%) had metastases of lymph nodes and 7 cases (13. 7%) and blood metastases or implantations. CONCLUSION The adenoma with malignant change can not be considered as the early stage of carcinoma. We can not say the adenoma whose diagnosis was made by 1 - 3 times of biopsies is a real adenoma and certainly has no malignant change. We can not say the tumor whose original diagnosis was adenoma still belongs to the early stage of carcinoma either. So we suggest to treat the adenoma with malignant change correctly,aviod performing simple operation unreasonably.
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Purpose:To study the clinical and pathologica l features of rectal carcinoid and factors influencing the prognosis.Metho ds:Data of 43 rectal carcinoid patients were analyzed retrospectively.4 2 patients were followed up postoperatively. Primary tumors were classified by s ize and muscularis invasion respectively.Results:The 5-year su rvival rate was 100% for the patients with tumor 2cm. the 5-year survival rate was 100% for the patients without muscularis invasion, and 50% for those with muscularis invasion.Conclusions:Tumor size and muscularis invasion are important pr ognostic factors for rectal carcinold.
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Purpose: The purpose of this study was to assess the method of compartment resection and evaluate its application to patients with extremity soft tissue sarcomas. Methods: From 1997 to 2002, 10 cases of thigh sarcoma underwent this operation (7 cases of posterior compartment and 3 anterior compartment) while 2 cases with upper limb disease received similar resection. Results: All the limbs of this group with such tumors were preserved. We followed up the 12 patients in the range of 10 to 60 months, 10(82%) were alive without tumor recurrence or metastases. One patient local with recurrent tumor is receiving radiotherapy now and another died from distance metastases. Conclusions: This improvement in the rate of limb -preserving resection in our series has been the result of compartment resection.