Clinical analysis of colorectal cancer with invasion to the adjacent organs

The clinicopathologic features of 39 cases of colorectal cancer with invasion to the adjacent organs (si,ai) were studied. Twenty seven were cases with combined resection of involved organs. Twenty two and 17 cases were located in colon and rectum, respectively. The D region was mostly involved, followed by, the C and T region. Five cases had invasion to the gastrointestinal tract, 2 cases had invasion to the liver, gall bladder or pancreas. Twenty one cases had urogenital organ invasion and 11 cases had invasion to sacrum and other organs. The survival rate of cases with combined resection of the involved organs was significantly high compared with non-resection. Also, the survival rate of curative resection was significantly high compared with non-curative resection. Aggressive resection of involved organs seems to be important for good prognosis

Clinicopathological studies in patients with colorectal cancers without lymphnode metastasis

The clinicopathologic findines and the prognosis of 154 patients without regional lymph nodes metastasis or distant metastasis (n(-)group) were compared with those in 134 patients with regional lymph nodes metastasis and without distant netastasis (n(+)group). The mean age of the n(-) group was significantly younger than that of the n(+) group (p<0.05) and there was no significant sexual preponderance. The proportion of the cases without lymphatic vessel invasion in the n(-) group was significantly higher than in the n(+) group (p<0.01). The proportion of the cases without venous invasion was significantly higher in the n(-) group than in the n(-) group (p<0.05). There was no difference in cumulative surval rate of patients in then(-) group than in the n(+) group (p<0.05). There was no difference in cumulative survial rate of patients in the n(-) group in respect to the background factors such as sex, tumor site, and venous invasion. However, the survial rate of patients whose cancer invasion was limited within the mucosa (m), submucosa (sm) and musclar propria (pm) was significantly better than that of patients who had subserosal or subadventitial penetration (ss(al)), serosal or adeventitial penetration (s(a2)) and cancer invasion adjacent organs (si(ai))(p<0.05). The survial rate of patients with lymphatic vessel invasion was significantly higher than that of patients without lymphatic vessel invasion (p<0.05). That the poor prognostic factors in n(-) colorectal cancer patients are cancer penetration to/beyond ss(al), or positive lymphatic vessal invasion

Operative morbidity of elderly patients with gastrointestinal disease

The operative morbidity and its relating factors were studied on 95 patients, 80 years old or older, operated for gastrointestinal (GI) diseases under general anesthesia at the department in a recent 11-year period. Among a total of 98 cases of GI diseases including 32 of gastric cancer, 17 of colorectal cancer, 16 of cholelithiasis and 33 of others, 108 procedures were performed for 38 gastric, 27 colorectal, 31 hepato-biliary-pancreatic and 12 other surgical conditions. Fifty-four operative complications occurred in 39 cases(41%), which were 13 respiratory, 11 delirium, 9 cardiovascular and 21 other complications. The respiratory morbidity rate was significantly high in males and significantly low in the cases receiving halanced epidural anesthesia. Postoperative delirium occurred more frequently in patients having an intraoperative blood loss of over 200 ml, and the cardiovascular morbidity rate was significantly high for an operative time of over 3 hours. The operative morbidity and 30-day operative mortality rate were significantly higher for emergency operations than for non-emergency operations. These findings suggest that, in the surgery for elderly patients and especially in an emergent situation, special care must be paid to decrease the quantity of bleeding and shorten the duration of operation by employing a proper procedure and anesthesia

Recurrent breast cancer

To study the relationship between recurrence factors, recurrence sites, prognoses and disease free intervals (DFI), 63 patients with recurrent breast cancer after radical surgery were divided into 3 groups by disease free intervals of less than 2 years (A group, 25 cases), 2 to 5 years (B group, 23 cases) and more than 5 years (C group, 15 cases). The average age at surgery was higher, and the diameter of the tumor decreased as the DFI increased. The rate of lymph node metastasis was higher in group A. The proportion of cases in stage b was small in group C. Common sites of recurrence were soft tissue in group A and and bone in group C. The survival rate was significantly higher in group C compared to those in groups A and B (p<0.05). It is necessary to follow patients treated for breast cancer for a long period postoperatively, and if the recurrence develop, multidisciplinary therapy to prolong survival should consider these prognostic factors