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PubMed1990

[Gastrointestinal side effects of cytostatic treatment of gynecologic neoplasms].

Gastrointestinal complaints are the most frequent side effects of antineoplastic chemotherapy behind the bonemarrow depressions. Nearly all cytostatic drugs, favourably used treating gynaecological malignant tumours, show a high complication rats on the part of the digestive organs. Primary an secondary damages can be so serious that the continuation of an effective tumour therapy becomes impossible. Whereas mucous excitement and motility disturbances are caused by local toxicity of cytostatic drugs, on the other hand central and psychogenic factors are of essential importance concerning nausea and vomiting. Therefore all these side effects could not be treated effective antiemetics alone. Only by an ingenious combination of medical treatment, psychological guidance and appropriate nutrition complaints can be relieved so far that the patients quality of life is interfered as less as possible and that a sufficient compliance may be reached.

Antineoplastic Agents↗
PubMed1999

Decreased and aberrant nuclear lamin expression in gastrointestinal tract neoplasms.

BACKGROUND: Altered expression of lamins A/C and B1, constituent proteins of the nuclear lamina, may occur during differentiation and has also been reported in primary lung cancer. AIMS: To examine the expression of these proteins in gastrointestinal neoplasms. PATIENTS: Archival human paraffin wax blocks and frozen tissue from patients undergoing surgical resection or endoscopic biopsy. METHODS: Immunohistochemistry and western blotting using polyclonal antisera against A type lamins and lamin B1. RESULTS: The expression of lamin A/C was reduced and was frequently undetectable by immunohistochemistry in all primary colon carcinomas and adenomas, and in 7/8 primary gastric cancers. Lamin B1 expression was reduced in all colon cancers, 16/18 colonic adenomas, and 6/8 gastric cancers. Aberrant, cytoplasmic labelling with both antibodies occurred in some colonic cancers and around one third of colonic adenomas. Cytoplasmic lamin A/C expression was detected in 3/8 gastric cancers. Lamin expression was reduced in gastric dysplasia, but not intestinal metaplasia, atrophy, or chronic gastritis. Lamin expression was low in carcinomas of oesophagus, prostate, breast, and uterus, but not pancreas. CONCLUSIONS: Reduced expression of nuclear lamins, sometimes together with aberrant, cytoplasmic immunoreactivity is common in gastrointestinal neoplasms. Altered lamin expression may be a biomarker of malignancy in the gastrointestinal tract.

Adenocarcinoma↗
PubMed2004

Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy: prognostic factors and survival.

AIM: To identify the prognostic factors with regard to survival for patients with brain metastasis from primary tumors of the gastrointestinal tract. METHODS: Nine hundred and sixteen patients with brain metastases, treated with whole brain radiation therapy (WBRT) between January 1985 and December 2000 at the Department of Radiation Oncology, University Hospital Freiburg, were analyzed retrospectively. RESULTS: Fifty-seven patients presented with a primary tumor of the gastrointestinal tract (esophagus: n = 0, stomach: n = 10, colorectal: n = 47). Twenty-six patients had a solitary brain metastasis, 31 patients presented with multiple brain metastases. Surgical resection was performed in 25 patients. WBRT was applied with daily fractions of 2 Gray (Gy) or 3 Gy to a total dose of 50 Gy or 30 Gy, respectively. The interval between diagnoses of the primary tumors and brain metastases was 22.6 mo vs 8.0 mo for patients with primary tumors of the colon/rectum vs other primary tumors, respectively (P<0.01, log-rank). Median overall survival for all patients with brain metastases (n = 916) was 3.4 mo and 3.2 mo for patients with gastrointestinal neoplasms. Patients with gastrointestinal primary tumors presented significantly more often with a solitary brain metastasis than patients with other primary tumors (P<0.05, log-rank). In patients with gastrointestinal neoplasms (n = 57), the median overall survival was 5.8 mo for patients with solitary brain metastasis vs 2.7 mo for patients with multiple brain metastases (P<0.01, log-rank). The median overall survival for patients with a Karnofsky performance status (KPS) >=70 was 5.5 mo vs 2.1 mo for patients with KPS <70 (P<0.01, log-rank). At multivariate analysis (Cox Model) the performance status and the number of brain metastases were identified as independent prognostic factors for overall survival. CONCLUSION: Brain metastases occur late in the course of gastrointestinal tumors. Pretherapeutic variables like KPS and the number of brain metastases have a profound influence on treatment outcome.

Adult↗
PubMed2001

Role of conventional radiology in the diagnosis and staging of gastrointestinal tract neoplasms.

Preoperative diagnosis and staging of primary gastrointestinal (GI) neoplasms are challenges for both clinicians and radiologists. Barium studies are very sensitive in disclosing primary malignancies, even at an early stage. Radiologic signs depend on the evolutional stage of the disease and its appearance on gross pathology. A neoplasm may be manifested on barium studies by a wide spectrum of findings, including mucosal abnormalities, mass presence, ulcerative lesions, submucosal infiltration, and lumen stenosis. Advanced disease can be accurately diagnosed, whereas early cancer should be differentiated from other neoplastic or inflammatory disorders by meticulous analysis of radiologic findings. The extent of GI involvement and multiplicity of the lesions can be assessed on barium studies. In the staging of GI neoplasms, barium studies are of little value. Skeletal survey by conventional radiographs and chest plain films can reveal distant metastases in a short time and with low cost, although they are not that sensitive to the detection of early or subtle lesions. The exact role of conventional radiology in the imaging workup of GI malignancies depends on local expertise and availability of other diagnostic techniques and modalities.

Barium↗
PubMed1995

Laparoscopic sonography in screening metastases from gastrointestinal cancer: comparative accuracy with traditional procedures.

The wide use of operative and diagnostic laparoscopy has led to a greater use of the laparoscopic ultrasound (LUS) as a complementary procedure. A preliminary study was performed to evaluate the efficacy of LUS using a linear array laparoscopic probe characterized by double frequency, mechanical flexibility, and availability of Doppler analysis. LUS was performed in 36 patients with gastrointestinal neoplasms and compared with preoperative sonography, computed tomography, and with laparoscopy alone. LUS identified liver metastases with a sensitivity of 100% versus 60% for preoperative diagnostic means and laparoscopy. Nodal metastases were identified with a sensitivity of 96.1% and a specificity of 66.6%. Therapeutic planning was modified as result of LUS in 8 of 35 cases (22.9%). In patients with abdominal malignancy, LUS improves staging (cancer spread, nodal metastases, liver metastases), modifying therapeutic decisions. LUS represents a complementary, indispensable diagnostic method during laparoscopic surgery.

Bile Duct Neoplasms↗
PubMed2005

[Dual tumours in the GI tract: synchronous and metachronous stromal (GIST) and epithelial/neuroendocrine neoplasms].

Gastrointestinal stromal tumours (GIST) constitute the most frequent group of mesenchymal tumours in the gastrointestinal tract (GI). During the last several decades major advances have been taken in the diagnostics, treatment, and understanding of its pathogenesis. However, much less is known about the either metachronous or synchronous concurrence of GIST and other tumours of different histogenesis. In the present study clinicopathological data of 43 patients with histologically proved gastrointestinal stromal tumour were studied mainly in regard of the occurrence of a secondary neoplasm. Among the 43, 7 cases were found with secondary tumour mainly of epithelial origin. In three cases (cases 3, 5, and 7) GIST concurred with colorectal adenocarcinoma, in one case (case 1) GIST occurred in a patient with a 3-years-history of chronic lymphocytic leukaemia (CLL), in other two (cases 2 and 4) the stromal tumour was combined with in situ adenocarcinoma of the stomach and carcinoid of the pancreas, respectively. In case 6, GIST concurred with a duodenal Brunner gland adenoma. In five cases the stromal tumour and the other neoplasm occurred synchronously, and in four of them, being the stromal tumour clinically silent, GISTs were intraoperative findings. This confirms the importance of surgical intraabdominal control before closure. In one hand the repeated concurrence of GIST and colorectal adenocarcinoma in our series, and on the other hand, that of GIST and adenocarcinoma of the stomach in the literature, may indicate an at least partly common factor, which may be involved in the pathogenesis of these neoplasms.

Adenocarcinoma↗
PubMedDate not supplied

Detecting a small bowel tumor via wireless capsule endoscopy: a clinical case study.

Tumors of the small intestine account for fewer than 5% of gastrointestinal neoplasms. Approximately 20% of small bowel neoplasms are gastrointestinal stromal cell tumors, a spectrum of mesenchymal tumors of the gastrointestinal tract that range from benign to highly malignant. Diagnosis of gastrointestinal stromal cell tumors is usually incidental, given their rarity and the limitations of traditional endoscopy and radiology studies in visualizing the small intestine. The advent of wireless capsule endoscopy has improved the definitive diagnosis of small bowel disorders. This article outlines the course of diagnosis and treatment for a patient who presented to our hospital with severe anemia and demonstrates the role of capsule endoscopy in identifying the causes of obscure gastrointestinal bleeding.

Abdominal Pain↗
PubMed1982

Computed tomography in the staging of gastrointestinal carcinoma.

In all areas of the gastrointestinal tract studied to date, CT can detect gastrointestinal neoplasia and accurately delineate both the local and distant extent of disease. Computed tomography can stage both primary and recurrent gastrointestinal neoplasms more accurately than any other method short of surgical exploration. In many cases, CT staging of a gastrointestinal neoplasm has lessened the need for exploratory surgery, reduced hospital stay, and permitted appropriate chemotherapy or radiation therapy to be instituted promptly and effectively. As more experience with CT in staging gastrointestinal neoplasms is accumulated, the value of CT will become more widely acknowledged.

Adenocarcinoma↗
PubMed1999

A study of pattern of gastrointestinal malignant neoplasms in the last decade (1987-1996) in Alexandria.

The present study was conducted to reveal the pattern of different gastrointestinal malignant neoplasms in Alexandria in the last decade (1987-1996). All registered cases of GIT cancers in Alexandria. Main University Hospital in the last decade were included in the study. The results revealed that the total number of cases was 2184, 58.6% were males and 41.4% were females. The mean age of registered cases was significantly older among males than females (t = 2.43). The highest percentage (47.2%) of cases were in the age group (40- < 60 years). Less than quarters (73.3%) of the total cases have had malignant neoplasms of digestive organs and 26.7% have had malignant neoplasms of lips, oral cavity and pharynx. Of the latter category cancer pharynx came first in both sexes (49.9%) with the youngest mean age (45.65 +/- 15.79 years), followed by cancer tongue (24.9%) with the oldest mean age (58.56 +/- 12.4). Among cases of malignant neoplasms of digestive organs, cancer colon came first in both sexes (26.9%) with the youngest mean age (44.11 +/- 14.08 years). Cancer gall bladder came last (1.2%) with the oldest mean age (55.80 +/- 10.20 years). Over the last decade trend of malignant neoplasms of colon, rectum, liver and pancreas were increasing while the reverse was observed for cancer oesophagus and stomach. So it is necessary to plan for GIT cancer control programme.

Adolescent↗
PubMed2004

Isolated hepatic perfusion for the treatment of patients with advanced liver metastases from pancreatic and gastrointestinal neuroendocrine neoplasms.

BACKGROUND: We report results of using isolated hepatic perfusion (IHP) in patients with advanced progressive liver metastases (LM) from pancreatic and gastrointestinal neuroendocrine neoplasms (NENs). METHODS: Thirteen patients with LM from NENs (mean percent hepatic replacement, 30; range, 10-60) were treated with a 1-hour hyperthermic IHP via a laparotomy with the use of 1.5 or 2.0 mg/kg melphalan and/or 1 mg tumor necrosis factor. An oxygenated extracorporeal circuit with inflow through the gastroduodenal artery and common hepatic artery, and outflow to a segment of the inferior vena cava was used. Portal flow and inferior vena cava flow were shunted to the axillary vein. Radiographic response, recurrence pattern, and survival were assessed. RESULTS: Mean operative time was 9 hours (8-11 hours), and a median hospital stay was 10 days (6-64 days). Fifty percent of evaluable patients had a radiographic partial response in the liver (mean duration, 15 months; range, 6-26 months; 2 ongoing). Four had a marginal response (25%-49% reduction in the neoplasm). The median, hepatic, progression-free survival was 7 months (range, 3-27 months). The median actuarial survival was 48 months including 1 treatment mortality (median follow-up, 23 months). CONCLUSIONS: For patients with advanced LM from NENs, IHP provides a reasonable response rate and duration with acceptable morbidity; continued clinical evaluation is important.

Adult↗
PubMed2003

Molecular dimensions of gastrointestinal tumors: some thoughts for digestion.

Topics discussed here include PTEN mutations and colonic polyps; WNT signaling, APC, beta-catenin, and gastrointestinal neoplasms; mismatch-repair genes (MLH1, MSH2, PMS1, MSH6) and hereditary nonpolyposis colorectal cancer; MYH mutations and autosomal recessive colorectal tumors; STK11 mutations and Peutz-Jeghers syndrome; TGFbeta and gastrointestinal cancer; BMPR1A mutations and juvenile polyposis; FGF/FGFR alterations in gastrointestinal neoplasms; PTCH mutations and gastrointestinal neoplasms; RUNX3 expression and gastric cancer; role of mucins in gastric carcinogenesis; KIT, PDGFRalpha, and gastrointestinal stromal tumors; intestinal neurofibromatosis; and gastrointestinal tumors in other disorders.

Colonic Polyps↗
PubMed2006

Gastrointestinal tumors in children and adolescents.

Tumors of the pediatric gastrointestinal tract are extremely rare. Their infrequent presentation at treatment centers has not allowed for the development of standardized treatment protocols and prospective review. The most prevalent gastrointestinal neoplasms and malignancies are described, including gastrointestinal lymphoma, colorectal carcinoma, carcinoid tumors, gastrointestinal stromal tumors, leiomyomas, juvenile polyps, inflammatory pseudotumors, gastric tumors, and Peutz-Jeghers polyposis syndrome. Current recommendations for the medical and surgical management of these tumors are reviewed and summarized for this vast group of gastrointestinal neoplasms in children.

Adolescent↗
PubMed1990

Neoplasms of the bovine gastrointestinal tract.

Neoplasms of the bovine gastrointestinal tract are rare, possibly because of the low age of the sample population (slaughtered cattle). Forestomach neoplasia (papilloma/squamous cell carcinoma) has a high incidence in cattle from northern England and Scotland because of the mutagenic effects of bracken fern consumption and its interaction with BPV-4. Lymphosarcoma in the abomasum occurs in 41 per cent of cattle with lymphosarcoma, the most common bovine neoplasm in the United States. Small intestinal adenocarcinoma is associated with the papilloma/squamous cell carcinoma complex in the forestomach in England and Scotland, but occurs sporadically in other geographic locations. These lesions may be amenable to surgery, but death from metastatic disease occurs within 1 year. Neoplasms of the large intestine are rarely reported, but usually are adenocarcinoma. Adenoma and fibroma of the rectum may produce clinical signs of tenesmus and rectal prolapse. In general, neoplasia in cattle carries a poor prognosis because of early metastasis of adenocarcinoma and the high fatality of lymphosarcoma. Forestomach fibroma may be treated surgically with success, and palliative surgery for focal small intestinal tumors may be rewarding in individual cases.

Animals↗
PubMed1988

CT findings in metastatic ovarian tumors from gastrointestinal tract neoplasms (Krukenberg tumors).

The computed tomographic (CT) findings are reviewed in 7 patients with metastatic ovarian tumors from gastrointestinal tract neoplasms (Krukenberg tumors). All patients presented mixed ovarian masses. In 6 cases the masses were mainly cystic, with internal septa and focal or uniform enlargement of the cyst wall. In the seventh patient the ovarian mass appeared on the CT as mainly solid. The size of the neoplasm varied between 5 and 46 cm. Ascites was only seen in 1 case and in another the existence of a primary tumor in the sigmoid colon was demonstrated. In our cases the CT signs of ovarian metastasis were indistinguishable from primary tumors of the ovary.

Adenocarcinoma↗
PubMed2006

Successful nonsurgical management of perforation complicating endoscopic submucosal dissection of gastrointestinal epithelial neoplasms.

BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is a novel technique used for the treatment of gastrointestinal neoplasia. One of its major limitations, however, is the complication of perforation. PATIENTS AND METHODS: We included in our study all the cases of perforation that occurred during ESD procedures for gastrointestinal epithelial neoplasia between February 2000 and February 2005. Clinical outcomes after perforation were investigated. RESULTS: Perforation was experienced at 27 lesions in 27 patients (four in the esophagus, fourteen in the stomach, seven in the colon, and two in the rectum). Fibrosis under the lesions was confirmed histologically in seven patients (26 %). Immediate closure using endoclips was performed in all patients except for three asymptomatic patients in whom a stomach perforation was first noticed when free air was noticed on a radiograph the morning after the ESD procedure. Air accumulation was detected radiographically in 21 patients (78 %). The mean duration of antibiotic treatment was 6.7 days and the patients were fasted for a mean period of 5.3 days. The mean maximum body temperature was 37.3 degrees C, the mean white blood cell count was 9733/mm3, and the mean C-reactive protein level was 5.0 mg/dl. All the patients were discharged well from the ward after a mean time of 12.1 days after ESD, and no recurrence caused by tumor spread from the perforation occurred in any patient after a median follow-up period of 36 months (range 9 - 52 months). CONCLUSION: Successful nonsurgical management after ESD complicated by perforation is a highly feasible option if intensive conservative treatments are used following immediate endoscopic closure of the perforation.

Aged↗
PubMed2006

Homeobox genes and their functions on development and neoplasm in gastrointestinal tract.

AIM: To describe the role of homeobox genes on development and tumorigenesis in gastrointestinal tract. METHODS AND RESULTS: We searched the MEDLINE database (until March, 2006) with the keywords of homeobox genes, gastrointestinal tract, development, tumorigenesis, carcinogenesis and therapeutic targets. We reviewed the literature on classification of homeobox genes, development of gastrointestinal tract, carcinogenesis of gastrointestinal tract as well as therapeutic targets. CONCLUSIONS: The functional effects of homeobox family in development and tumorigenesis of gastrointestinal tract are identified. The importance of homeobox genes and a possibility of therapeutic intervention in clinical medicine are discussed.

DNA, Neoplasm↗