Current management of colorectal hepatic metastasis
ABSTRACT In the USA, cancers of the colon and rectum are the third most common site of new cancer cases and cancer deaths. With improved screening and adjuvant therapy, the survival of patients has increased substantially over the last decade. However, patients with metastatic disease often have limited survival. Hepatic metastasis is one of the most frequent sites of metastatic disease. In fact, 35-55% of patients with colorectal cancer will develop hepatic metastasis at some time during the course of their disease. Patients who are able to undergo complete resection of their hepatic metastases have the best chance of long-term survival. The goal of hepatic resection is to achieve complete resection of all metastases with microscopically negative surgical margins while preserving sufficient hepatic parenchyma. Survival following hepatic resection of colorectal metastasis now approaches 35-50%. However, approximately 65% of patients will have a recurrence at 5 years. Increasingly chemotherapeutic agents are being offered in the preoperative setting prior to operation. At the time of operation, patients with extensive hepatic disease can sometimes be offered ablative therapies combined with resection or staged approaches. Modern management of hepatic colorectal metastases necessitates a multidisciplinary approach to effectively treat these patients and increase the number of patients who will benefit from resection.
- SourceAvailable from: Khanittha Taneyhill
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- "Colorectal cancer (CRC) is one of the most common cancers and is the second leading cause of cancer-related deaths worldwide (Ferlay et al., 2011; Markowitz & Bertagnolli, 2009). Metastasis is considered to be the critical cause of CRC patient mortality (Carpizo & D'Angelica, 2009; Mayo & Pawlik, 2009). In metastasis, cancer cells spread to distant organs through blood or lymphatic vessels, circulate through the intravascular stream, and then proliferate at another site (Folkman, 1971). "
ABSTRACT: Angiogenesis is a critical event in cancer metastasis, via delivery of needed oxygen and nutrients to tumor cells. Anti-angiogenesis is one strategy for controlling cancer progression. We herein report anti-angiogenesis activity of dried longan seeds using colon adenocarcinoma cells (SW480 cells) and human umbilical vein endothelial cells (HUVECs). Sephadex LH-20 column chromatography was used for separate three dried longan seed fractions. We firstly evaluated vascular endothelial cell growth factor (VEGF) secretion, expression and colony formation of SW480 cells, using enzyme-linked immunosorbent assay (ELISA), Western blot analysis and soft agar assays. Meanwhile cell proliferation, gelatinase activity and tube formation of HUVECs were determined via proliferation assay, gelatin zymography and in vitro tube formation assay, respectively. The results suggest that dried longan seed fractions could be potential angiogenic inhibitors not only interruption of VEGF secretion and expression in SW480 cells but also abrogation of cell proliferation, the activity of gelatinase and tube formation of HUVECs.Journal of Functional Foods 07/2013; 5(3). DOI:10.1016/j.jff.2013.03.004 · 4.48 Impact Factor
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ABSTRACT: Objective Angiogenesis is a crucial step for tumor growth and progression. Changes of liver angiogenesis (without metastatic invasion) in response to primary tumors are not known. The aim of the study was to investigate the liver angiogenesis in non-metastatic colorectal cancer (CRC). Methods Human colorectal adenocarcinoma tumors were grown subcutaneously in nude mice. All animals showed tumor growth locally without macroscopic or microscopic evidence of liver metastases. Livers were investigated for their microvessel density (MVD) at different stages of tumor growth (as small, medium, and large-sized tumors). Normal non-tumor-bearing mice served as controls. To assess MVD, two endothelial cell markers (anti-CD34 and -CD31 antibodies), image analysis, and immunofluorescent technique were utilized. Enumeration of positive stained endothelial cells revealed the MVD. Results Non-metastatic livers showed increased levels of MVD vs. control. Moreover, levels of MVD were higher in small and medium-sized tumor groups versus large sized tumor groups. Conclusion The present data indicate that angiogenesis in the liver is induced in early-stages of CRC. However, this effect is suppressed with advanced tumor growth. These results provide an additional rationale for including antiangiogenic therapy in the treatment of early stages of CRC.The Chinese-German Journal of Clinical Oncology 10/2011; 10(10). DOI:10.1007/s10330-011-0858-8
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ABSTRACT: Objective The aim of this study was to explore the three-dimensional conformal radiotherapy combined with FOLFOX scheme chemotherapy in the treatment of postoperative recurrence of rectal cancer. Methods Sixty-eight cases of recurrent rectal cancer were divided randomly into two groups: 34 cases of conformal radiotherapy plus FOLFOX chemotherapy group (experiment group) and 34 cases of conformal radiotherapy (control group). After 6 MvX line with three-dimensional conformal radiotherapy technologies for recurrent lesions and pelvic cavity around subclinical lymphatic drainage radiotherapy after radiotherapy to DT 40 Gy to reposit was made use of between both groups, experiment group was made the new treatment plan to continue to irradiate to 50 Gy, and then Shrinkage GTV was pushed quantity in the field 66 Gy. Researchers took chemotherapy in the first week and the fourth week after radiotherapy, with 5-fluorouracil 500 mg/m2, calcium leucovorin 200 mg, d1-5 with intravenous drip, Oxaliplatin 130 mg/m2 and d1 with intravenous drip 2 h, 21 days was one cycle. Kaplan-Meier method was used for survival analysis. Results The survival rates for 1, 2 and 3 years for experiment group and control group were 88.2%, 64.7%, 47.1% and 66.7%, 38.2%, 29.4% (P = 0.03), the 2-year rate of distant metastases was 32.4% and 58.8% (P = 0.032) respectively. The median survival time was 33 and 20 months respectively. There were some side effects between the groups, but there was no statistical difference. Conclusion Three-dimensional conformal radiotherapy plus FOLFOX chemotherapy can be considered as a safe and effective approach to treat rectal cancer patients of postoperative recurrence, and can improve the survival rates of patients and reduce distant metastasis rate obviously and make the acute adverse reaction rate insignificantly.The Chinese-German Journal of Clinical Oncology 08/2012; 11(8). DOI:10.1007/s10330-011-0883-7