Gastrointestinal Cancer

COLUMBUS, Ohio--Rectal cancer is treated with a wide variety of operations and adjuvant therapy. This variety makes extensive preoperative evaluation mandatory, said Karamjit Khanduja, MD, chief of the Division of Colon and Rectal Surgery, Mt. Carmel Health, Columbus, Oho.

FORT LAUDERDALE, Fla--The National Comprehensive Cancer Network (NCCN) colon cancer screening guidelines committee came to "a remarkable degree of consensus on the recommendations," Stephen Gruber, MD, PhD, MPH, said at the group’s third annual conference. The NCCN is a coalition of 16 leading US cancer centers.

PARIS--Hepatic intraarterial (HIA) chemotherapy coupled with aggressive resection may improve the outlook for patients with liver metastases from colorectal cancer, Nancy Kemeny, MD, of Memorial Sloan-Kettering Cancer Center, said at the Eighth International Congress on Anti-Cancer Treatment (ICACT).

ORLANDO--A new high dose rate/intraoperative radiation therapy (HDR-IORT) delivery system utilizing the Harrison, Anderson, Mick (HAM) applicator is proving effective in treating primary unresectable and locally advanced, recurrent rectal cancer.

Scientists at the American Health Foundation’s Nutritional Carcinogenesis Division, under the direction of Dr. Bandaru S. Reddy, division chief and associate director of the Foundation’s Naylor Dana Institute, Valhalla, New York, and Dr. Karen Seibert of Searle Research & Development, St. Louis, Missouri, described an exceptionally strong inhibitor of colon cancer development in an animal model assay in the February 1, 1998, issue of Cancer Research.

PHILADELPHIA-Thomas Jefferson University’s new Familial Colorectal Cancer Registry is collecting information and blood and tissue samples from families with a higher-than-normal risk of colon cancer, to aid researchers looking for genetic markers of the disease and to provide genetic counseling and genetic testing, if appropriate, to participants.

A genetic mutation in the adenomatous polyposis (APC) gene found in 7% of Ashkenazi Jewish families in the United States does not necessarily lead to colon cancer, according to a study in the December 15, 1997, issue of Cancer Research.

Researchers from the University of Wurzburg in Germany have determined that a simple antibody test may be as effective in detecting Helicobacter pylori infection as the more invasive procedures that are currently used. They reported their findings

Over the past 7 years, 58 saline-filled tissues expanders (TEs) have been temporarily placed in 57 patients. The

The enormous influence of the surgeon on outlook in cancer was stressed by Professor Cornelis van de Velde of the Department of Surgery, Leiden University Medical Center, the Netherlands, during the 1997 European Cancer Conference.

CHICAGO-Recent clinical evidence clearly indicates that primary care physicians should offer colon cancer screening to all patients over age 50. “If you are not having this discussion, if you are not making this offer, you will be viewed as providing incomplete care,” said Steven H. Woolf, MD, MPH, professor of family practice, Medical College of Virginia, Richmond.

HAMBURG-The challenge in the treatment of pancreatic cancer “is to take systemic therapy one step further, whether it’s with new drugs or with novel approaches based on new biologic information,” Margaret Tempero, MD, of the University of Nebraska Medical Center, Omaha, said at the Ninth European Cancer Conference (ECCO 9), sponsored by the Federation of European Cancer Societies.

HAMBURG-A 10-center phase III trial from the Netherlands has revealed that adjuvant vaccine therapy not only reduces the risk of recurrence but also prolongs relapse-free survival in patients with Duke’s B2, B3, or C colon cancer, Dr. J.B. Vermorken reported at the Ninth European Cancer Conference (ECCO 9).

Therapeutic options for patients with advanced colorectal cancer who have failed treatment with fluorouracil (5-FU) are limited. Responses have been reported in this setting with a protracted venous infusion of 5-FU. Daily oral therapy with tegafur and uracil (UFT) plus leucovorin (LV) has the potential to mimic the pharmacology of continuous infusion 5-FU. Therefore, we undertook a phase II study of a 28-day schedule of a combination chemotherapy regimen containing oral UFT/leucovorin in patients with measurable metastatic colorectal cancer who had failed treatment with bolus 5-FU. In addition, we sought to determine whether coadministration of UFT and leucovorin alters the bioavailability of these agents. In a pretreatment phase, each patient underwent sequential pharmacokinetic sampling following a single dose of UFT alone, leucovorin alone, and the combination of UFT plus leucovorin. The preliminary results of this trial suggest that tegafur pharmacokinetics are not affected by coadministration of leucovorin and that folate pharmacokinetics are not affected by UFT. [ONCOLOGY 11(Suppl 10):22-25, 1997]

To evaluate the significance of postoperative adjuvant chemotherapy using mitomycin C (MMC) and UFT (tegafur and uracil) in combination, the Japanese Foundation for Multidisciplinary Treatment of Cancer conducted a prospective randomized controlled trial with 834 patients who had undergone curative resection for rectal cancer (T3 or T4 tumors and/or N1, N2, or N3 disease). The patients were randomly allocated to a treatment group (MMC/UFT, 416 patients) and a control group (surgery only, 418 patients). For patients in the treatment group, 20 mg of MMC was sprinkled on the operating field upon completion of surgery. MMC was intravenously injected at 6 mg/m2 on day 7, and then each month after surgery for 6 months. UFT was administered orally at 400 mg/day for 1 year. Although no difference was observed in the 5-year survival rate between the two groups, the 5-year disease-free survival rate in the MMC/UFT group was 69.1%, which was significantly higher than in the control group (59.3%, P = .005). The 5-year cumulative local recurrence rate was significantly lower in the MMC/UFT group (11.6%) than in the control group (19.0%) (P = .0071). We conclude that the adjuvant use of long-term oral UFT and intermittent intravenous MMC improves the disease-free survival rate of patients with curatively resected rectal cancer. [ONCOLOGY 11(Suppl 10):40-43, 1997]

Adjuvant chemotherapy has been shown to alter the natural history of patients with resected colon cancer. Two regimens (fluorouracil [5-FU] plus levamisole (Ergamisol) and 5-FU plus leucovorin) have been found most

Standard adjuvant therapy for transmural (T3) and/or node-positive rectal cancer is pelvic radiation therapy plus fluorouracil (5-FU)-based chemotherapy. Randomized trials are in progress to help determine the ideal

In a laboratory study using an experimental peritoneum model of gastrointestinal cancer, the UFTP [tegafur and uracil (UFT) plus cisplatin] regimen was shown to provide a survival benefit compared with the UFTM (UFT plus

The oral fluoropyrimidines have proved to be active in colorectal cancer in Japan and, recently, in the United States and Europe. Continuous oral administration simulates protracted fluorouracil (5-FU) continuous

A staple of summer, the common housefly may be a reservoir for Helicobacter pylori, the bacterium responsible for some

WASHINGTON-“A positive family history is the most common risk factor for large bowel malignancy other than age,” Randall W. Burt, MD, of the University of Utah Health Sciences Center, said at a symposium on colorectal cancer at Digestive Disease Week, sponsored by the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy.

PHILADELPHIA-Biologic tumor markers, in combination with the Duke’s anatomic staging system, may point the way toward the individualization of colo-rectal cancer treatment, says Daniel G. Haller, MD, of the University of Pennsylvania Medical Center.

Although candidate genes for hereditary pancreatic cancer have been identified (Figure 1), namely p16 and BRCA2, pancreatic cancer patients having an inherited predisposition will not be easy to recognize on clinical grounds.

WASHINGTON--The colorectal cancer rate continues to rise in African-American men while dropping for whites of both sexes and for black women, reported David S. Alberts, MD, associate dean for research, Arizona Cancer Center of the University of Arizona College of Medicine, Tucson.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative extent of disease evaluation, and role of the surgeon in

This special series on cancer and genetics is compiled and edited by Henry T. Lynch, MD, director of the Hereditary Cancer Institute, professor of medicine, and chairman of the Department of Preventive Medicine and Public Health, Creighton University School of Medicine, and director of the Creighton Cancer Center, Omaha, Nebraska. Part I of this three-part series on pancreatic cancer appeared in June 1997. Part II (below) reviews the gene mutations thought to contribute to the development of hereditary pancreatic cancer, and Part III will explores the clinical recognition of a hereditary predisposition to pancreatic cancer.

The Society of Surgical Oncology surgical practice guidelines focus on the signs and symptoms of primary cancer, timely evaluation of the symptomatic patient, appropriate preoperative extent of disease evaluation, and role of the surgeon in

CHICAGO--After many years of frustration, there may finally be a reason for guarded optimism about the development of effective therapy for patients with advanced stage pancreatic cancer, Mace Rothenberg, MD, said at the 9th annual meeting of the Network for Oncology Communication and Research, based in Atlanta.

Hereditary nonpolyposis colorectal cancer (HNPCC) is a dominantly inherited syndrome that is estimated to be responsible for between 0.5% to 5% of all colorectal cancers.[1] The syndrome is caused by germline mutations in any of at least four mismatch repair genes.

FORT LAUDERDALE, Fla--Clinicians now have at their disposal more accurate staging technologies for pancreatic cancer than were available in the past.