Current management of colorectal hepatic metastasis
Department of Surgery, Division of Surgical Oncology, The Johns Hopkins 600 North Wolfe Street, Halsted 614, Baltimore, MD 21287, USA. Expert review of gastroenterology & hepatology
(Impact Factor: 2.42).
05/2009; 3(2):131-44. DOI: 10.1586/egh.09.8
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.
Available from: Khanittha Taneyhill
- "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). "
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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.
Available from: PubMed Central
- "Survival following hepatic resection of colorectal metastasis now approaches 35%-50%. However, the recurrence rate in 5 years is as high as approximately 65% 3. To date, the precise mechanisms leading to liver metastasis in colon cancer remains unknown, and biomarkers for liver metastasis are still lacking. "
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ABSTRACT: To investigate the expression of glioma-associated oncogene homolog 1(Gli-1) in colon cancer and its association with clinicopathological parameters and postoperative liver metastasis.
Expression of Gli-1 was detected by immunohistochemistry in paraffin-embedded specimens of 96 cases of colon cancer. Relationship between Gli-1 expression and clinicopathological parameters, postoperative liver metastasis were analyzed.
Gli-1 protein expression was significantly increased in colon cancer tissues compared to normal colon tissues (P=0.037). Gli-1 expression in colon tissues was increased in patients with lymph node metastases (P=0.022) and higher T stages (P=0.030). Postoperative live metastasis-free survival period was significantly longer in low Gli-1 expression group than that of high Gli-1 expression group (48.22±10.03 months vs 20.46±6.32 months, P=0.001). Multivariate analysis showed that Gli-1 expression level is an independent prognostic factor for postoperative live metastasis-free survival.
Colon cancer is associated with an upregulation of Gli-1 protein expression in colon tissues. In patients with colon cancer, Gli-1 expression level is closely related to lymph node metastases, T stages and postoperative live metastasis-free survival periods, indicative of a possible role of Gli-1 expression in colon cancer progression.
Available from: dx.plos.org
- "When developing an effective anti-tumor therapeutic agent, it is important to develop agents which inhibit tumor recurrence . The metastatic ability of cancer cells to migrate from their origin to other target tissues is one of the major reasons that make it difficult to develop an efficient anti-cancer agent , . In our heterotopic cancer animal model, we observed that subcutaneous inoculation of CT-26 colon cancer cells caused spontaneous metastasis of the cells into the lung tissue (Fig. 6A). "
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ABSTRACT: The development of efficient anti-cancer therapy has been a topic of intense interest for several decades. Combined administration of certain molecules and immune cells has been shown to be an effective form of anti-cancer therapy. Here, we examined the effects of administering an immune stimulating peptide (WKYMVm), 5-fluoro-uracil (5-FU), and mature dendritic cells (mDCs) against heterotopic cancer animal model. Administration of the triple combination strongly reduced tumor volume in CT-26-inoculated heterotopic cancer animal model. The induced anti-tumor activity was well correlated with FAS expression, caspase-3 activation, and cancer cell apoptosis. The triple combination treatment caused recruitment of CD8 T lymphocytes and natural killer (NK) cells into the tumor. The production of two cytokines, IFN-γ and IL-12, were strongly stimulated by administration of the triple combination. Depletion of CD8 T lymphocytes or NK cells by administration of anti-CD8 or anti-asialoGM1 antibody inhibited the anti-tumor activity and cytokine production of the triple combination. The triple combination strongly inhibited metastasis of colon cancer cells in a heterotopic cancer animal model as well as in a metastatic cancer animal model, and enhanced the survival rate of the mice model. Adoptive transfer of CD8 T lymphocytes and NK cells further increased the survival rate. Taken together, we suggest that the use of triple combination therapy of WKYMVm, 5-FU, and mDCs may have implications in solid tumor and metastasis treatment.
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