| 61. |
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| 62. |
- Grevfors, Niklas, et al.
(författare)
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Can acute abdominal CT prioritise patients with suspected diverticulitis for a subsequent clean colonic examination?
- 2012
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 14:7, s. 893-896
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to investigate whether patients with diverticulitis can be prioritised with higher urgency for a subsequent full colonic examination based upon the emergency abdominal computerised tomography (CT) at the time of presentation.Method: All patients with a diagnosis of diverticulitis hospitalized during 2006 having CT on admission and a subsequent 'clean colon' examination were reviewed. The CT was reviewed by two independent and blinded senior radiologists (A and B) for signs inconsistent with diverticulitis and suggestive of malignancy. The patients were classified on CT into group 1 (normal findings, non-tumour pathology or benign polyps < 1 cm) and group 2 (benign polyps ≥ 1 cm and cancer).Results: 93 patients were reviewed with 83 in group 1and 10 in group 2. Radiologist A suggested high priority colonic examination in 18% and 50% of groups 1 and 2, and Radiologist B in 63% and 90%. There was a statically significant inter-observer difference and also lower accuracy of Radiologist B than Radiologist A in predicting a subsequent 'clean colon' examination.Conclusion: Using an emergency acute CT scan at the time of diagnosis of diverticulitis to predict a clean colon examination for neoplasia is not reliable since there is considerable degree of inter-observer difference between rediologista.
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| 63. |
- Gunnlaugsson, Adalsteinn, et al.
(författare)
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Multicentre phase II trial of capecitabine and oxaliplatin in combination with radiotherapy for unresectable colorectal cancer : The CORGI-L study
- 2009
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 45:5, s. 807-813
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: This study assessed radiotherapy combined with capecitabine and oxaliplatin in patients with primary, inextirpable colorectal adenocarcinoma. PATIENTS AND METHODS: Forty-nine patients entered the trial. Two cycles of XELOX (capecitabine 1000mg/m(2) bid d1-14+oxaliplatin 130mg/m(2) d1, q3w) were followed by radiotherapy (50.4Gy), combined with capecitabine 825mg/m(2) bid every radiotherapy day and oxaliplatin 60mg/m(2) once weekly. The primary end-point was objective response. RESULTS: Forty-seven patients were evaluable. Twenty-nine (62% [95% CI: 46-75%]) achieved complete or partial response. Thirty-eight (81%) went through surgery of whom 37 (97%) had an R0 resection and five (13%) had a pathological complete response. Seventy-eight percent were alive and estimated local progression rate was 11% at 2 years. The most common grade 3+ toxicity during chemoradiotherapy was diarrhoea (24%). CONCLUSIONS: XELOX-RT was feasible and showed promising efficacy when treating patients with primary inextirpable colorectal cancer, establishing high local control rate.
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| 64. |
- Gurmu, Ambatchew, et al.
(författare)
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The inter-observer reliability is very low at clinical examination of parastomal hernia
- 2011
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Ingår i: International Journal of Colorectal Disease. - Heidelberg : Springer Science and Business Media LLC. - 0179-1958 .- 1432-1262. ; 26:1, s. 89-95
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Parastomal hernia in patients with a permanent colostomy is common. The aim of this study was to evaluate the reliability of the diagnosis based on clinical examination and to compare this examination with the result of a specially designed questionnaire and computerised tomography (CT) scan. METHODS: Forty-one patients operated upon with an abdominoperineal resection due to rectal cancer at three hospitals between 1996 and 2002 were included. At minimum of 4 years after the operation, they underwent clinical examination by two or three independent surgeons, answered a colostomy questionnaire and were offered a CT scan of the abdominal wall. RESULT: At Hospital I, 17 patients were examined by three surgeons, with inter-observer kappa values between 0.35 and 0.64. At Hospital II, 13 patients were examined by three surgeons, the kappa values ranged between 0.29 and 0.43. At Hospital III, 11 patients were examined by two surgeons, with kappa value of 0.73. The kappa value between CT scan and the colostomy questionnaire was 0.45. CONCLUSION: The inter-observer reliability was low, indicating that parastomal hernia is difficult to diagnose by patient history and clinical examination. Some herniae may not be detected by CT scan, and the correlation to patient-reported complaints is low. A more sensitive radiological method to detect parastomal hernia is needed.
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| 65. |
- Guzhova, Irina, et al.
(författare)
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Interferon-gamma cooperates with retinoic acid and phorbol ester to induce differentiation and growth inhibition of human neuroblastoma cells
- 2001
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 94:1, s. 97-108
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Tidskriftsartikel (refereegranskat)abstract
- The prognosis of patients with advanced stages of neuroblastoma with N-myc amplification remains poor despite escalated therapy, a situation that has called for alternative therapeutic approaches. Neuroblastoma cells, which represent immature peripheral neuronal cells, treated with certain physiologic and nonphysiologic agents such as retinoic acid (RA), phorbol esters and interferons (IFN) in vitro undergo cellular differentiation and stop to divide, a process that mimics normal neuronal development. Such "differentiation therapy" using RA after autologous bone marrow transplantation has recently given encouraging results in neuroblastoma patients with advanced disease. Considering approaches for improved differentiation therapy, we investigated possible synergistic effects of combining agents known to influence neuroblastoma growth and differentiation in vitro. Our results show that combined treatment with IFN-gamma and RA or the phorbol ester 12-O-tetradecanoyl-phorbol acetate (TPA) had synergistic or enhancing effects on morphologic differentiation and neurite outgrowth in 5 of 5 neuroblastoma cell lines, 3 of which expressed very high levels of N-myc mRNA due to N-myc amplification. The combinations RA+IFN-gamma or TPA+IFN-gamma also enhanced induced growth inhibition in all 5 cell lines, in several cases resulting in complete growth arrest under conditions where cells stimulated with either agent alone continued to grow. The phenotypic effects of the combined RA+IFN-gamma or TPA+IFN-gamma treatments were in most, but not all, investigated cases accompanied by moderate reductions in N-myc expression, suggesting that the cooperative signals may counteract N-Myc activity at several levels. The cooperativity between IFN-gamma and other differentiation signals may be relevant for approaches to improve the therapy for high-risk neuroblastoma with N-myc-amplification.
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| 66. |
- Hakama, Matti, et al.
(författare)
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Screening for colorectal cancer.
- 2005
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Ingår i: Acta Oncol. - 0284-186X. ; 44:5, s. 425-39
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Tidskriftsartikel (refereegranskat)
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| 67. |
- Hall, Håkan, et al.
(författare)
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In vitro autoradiography of carcinoembryonic antigen in tissue from patients with colorectal cancer using multifunctional antibody TF2 and 67/68Ga-labeled haptens by pretargeting
- 2012
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Ingår i: American Journal of Nuclear Medicine and Molecular Imaging. - 2160-8407. ; 2:2, s. 141-150
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Tidskriftsartikel (refereegranskat)abstract
- The carcinoembryonic antigen (CEA) was visualized in vitro in tissue from patients with colorectal cancer with trivalent bispecific antibody TF2 and two hapten molecules, [(67/68)Ga]Ga-IMP461 and [(67/68)Ga]Ga-IMP485 by means of pretargeting. Colorectal cancer tissue samples obtained from surgery at Uppsala University Hospital, were frozen fresh and cryosectioned. The two hapten molecules comprising 1,4,7-triazacyclononanetriacetic acid chelate moiety (NOTA) were labeled with (67)Ga or (68)Ga. The autoradiography was conducted by incubating the tissue samples with the bispecific antibody TF2, followed by washing and incubation with one of the radiolabeled hapten molecules. After washing, drying and exposure to phosphor imager plates, the autoradiograms were analyzed and compared to standard histochemistry (hematoxylin-eosin). Pronounced binding was found in the tissue from colorectal cancer using the bispecific antibody TF2 and either of the haptens [(67/68)Ga]Ga-IMP461 and [(67/68)Ga]Ga-IMP485. Distinct binding was also detected in the epithelium of most samples of neighboring tissue, taken at a minimum of 10 cm from the site of the tumor. It is concluded that pretargeting CEA with the bispecific antibody TF2 followed by the addition of (67/68)Ga-labeled hapten is extremely sensitive for visualizing this marker for colorectal cancer. This methodology is therefore a very specific complement to other histochemical techniques in the diagnosis of biopsies or in samples taken from surgery. Use of the pretargeting technique in vivo may also be an advance in diagnosing patients with colorectal cancer, either using (67)Ga and SPECT or (68)Ga and PET.
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| 68. |
- Hansson, Johan, et al.
(författare)
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Postoperative adverse events and long-term survival after cytoreductive surgery and intraperitoneal chemotherapy
- 2009
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 35:2, s. 202-208
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Peritoneal carcinomatosis (PC) is fatal without special combined cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC). This study was designed to identify factors that may increase the risk of postoperative morbidity and mortality from combined CRS and IPC interventions for PC. Survival based on primary tumour type and extent of surgery is reported. METHODS: Between May 1991 and November 2004, 123 patients were treated with CRS and IPC for PC. Based on the National Cancer Institute Common Toxicity Criteria for grade 3 and 4, data on 30 days postoperative morbidity and 90 days mortality were analysed. RESULTS: Grade 3-4 adverse events were observed in 51 patients (41%) and were associated with stoma formation, duration of surgery, peroperative blood loss and peritoneal cancer index (PCI). Excision, or electrocautery evaporation, of tumour from small bowel surface was correlated to bowel morbidity. Five patients had treatment-related mortality (4%) within 90 days. Survival was associated with macroscopic radical surgery, prior surgical score, PCI and primary tumour type. CONCLUSIONS: CRS and IPC for PC are associated with high morbidity and mortality. However, in light of the potential benefit indicated by long-term survival, the adverse event from this treatment is considered acceptable.
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| 69. |
- Heald, Richard, et al.
(författare)
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Optimering af kirurgi ved rectumcancer : [Optimising surgery for rectal cancer]
- 2011
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Ingår i: Ugeskrift for læger. - 1603-6824. ; 173:14, s. 1044-1047
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Tidskriftsartikel (refereegranskat)abstract
- The crucial aspect of open as well as laparoscopic rectal cancer surgery is to find the correct dissection plane to avoid damage of the nerves and to create a perfect specimen. By doing so, a "specimen oriented" resection will be achieved and the risk of a positive circumferential resection margin minimized. Currently, and for the foreseeable future, open surgery remains optimal for complex cases and in cases where a low difficult restorative resection is needed. Optimal surgery remains a crucial part in the curative treatment of this technically challenging cancer.
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| 70. |
- Hesselager, Caroline, et al.
(författare)
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Short-term outcome after neoadjuvant high-dose-rate endorectal brachytherapy or short-course external beam radiotherapy in resectable rectal cancer
- 2013
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 15:6, s. 662-666
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Tidskriftsartikel (refereegranskat)abstract
- AIM:Total mesorectal excision with preoperative radiotherapy reduces local recurrence in rectal cancer, but radiotherapy increases the risk of complications. The study compared the immediate postoperative outcome after external beam radiotherapy with high dose endorectal brachytherapy (HDREBT).METHOD:Patients (n=318) treated with preoperative HDREBT, (26 Gy over 4 days) followed by surgery after 4-8 weeks were matched with 318 patients from the Swedish Rectal Cancer Register treated with 5 Gy daily over 5 days and surgery in the subsequent week (SCRT) and 318 having surgery alone. All 954 patients were followed for 30 days after surgery. Complications were divided into surgical, cardiovascular and infectious.RESULTS:The SCRT group had fewer cardiovascular complications (3.1%) than HDREBT (9.4%, p=0.002) and RT- (7.2%, p=0.03). Perioperative bleeding was less in HDREBT patients (379.3 ml) than SCRT (947.2 ml; p<0.0001) and RT- (918.9 ml), and the re-intervention rate was lower in HDREBT (4.1%) than SCRT patients (14.2%; p=0.005) and RT- (12.3%; p<0.005). The HDREBT group had fewer R2 resections than the SCRT and RT- groups, but a higher proportion of R0-resections than the RT- group (p=0.03).CONCLUSION:No major differences in postoperative complications were found. HDREBT patients had a higher rate of cardiovascular complications but less perioperative bleeding and fewer re-interventions. A longer interval between radiotherapy and surgery may be beneficial for tumour regression and this could be reflected in the number of radical resections.
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