ABSTRACT
PURPOSE: This study was designed to evaluate results, especially mortality and morbidity, of surgical resection with curative intent for patients with a local recurrence of rectal cancer, in combination with radiotherapy. METHODS: Consecutive medical records of 163 patients with local recurrence of rectal carcinoma after previous "curative" therapy for primary rectal cancer were reviewed. Although 35 patients had an exploratory laparotomy, only 27 had local recurrence amendable to resection (6 irresectable locoregional recurrences and 2 distant metastases found at laparotomy). Twenty-one patients received radiotherapy. There was no perioperative mortality. Median follow-up time was 42 (range, 22-92) months. RESULTS: Local recurrence occurred in 16 (59 percent) patients. Ten patients are alive, of whom nine have good local control. Estimated five-year survival (Kaplan-Meier) is 20 percent. Survival was significantly better in patients without a second recurrence, but radicality of the resection was not influential. Good local control could be obtained in 12 (44 percent) patients, and 1 patient is living with symptoms. CONCLUSIONS: In selected patients with local recurrence of rectal carcinoma, reoperation with irradiation may result in good palliation and possibly cure.
Subject(s)
Neoplasm Recurrence, Local/surgery , Rectal Neoplasms/surgery , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multivariate Analysis , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/radiotherapy , Radiotherapy, Adjuvant , Rectal Neoplasms/mortality , Rectal Neoplasms/radiotherapy , Retrospective Studies , Risk Factors , Survival AnalysisABSTRACT
The expression of the replication gene O of bacteriophage lambda was put under the control of the lac promoter-operator region integrated into the pBR322 cloning vehicle. The new plasmid pKK104 was introduced into minicells and the O gene induced by isopropyl-beta-thiogalactoside (IPTG). The O protein could be identified as a major component in extracts from these cells, in association with the cell membrane fractions. The molecular weight of the O protein in SDS gels is about 33 000, and it is metabolically unstable but apparently stable upon isolation as a membrane-associated fraction.