sodium-ethylxanthate and Rectal-Neoplasms

Studies of gender differences in colorectal cancer have shown temporal shifts in incidence and site distribution which can be attributed, in part, to environmental and behavioural factors. In high-risk populations, rectal cancer and left-sided colon cancer have been more frequent in older men, whereas right-sided colon cancer has been more commonly found in older women. Among known associations with reduced colorectal cancer risk, women appear to ingest more dietary fibre, seem to benefit more from physical activity and body mass, and consume less alcohol. Although these differences may contribute to the risk differential, hormonal events during reproductive years also appear to affect women's risk at older age. The interactions of sex hormone metabolism and nutrition, including dietary fibre, in colorectal carcinogenesis provide a rewarding field for investigation.

Topics: Colonic Neoplasms; Female; Humans; Male; Rectal Neoplasms; Sex; Sex Characteristics; Sex Factors

We have examined the results of abdominoperineal resection (APR) for primary cancer of the rectum performed in accordance with the principles of total mesorectal excision (TME) and autonomic nerve preservation (ANP). TME is defined as sharp pelvic dissection under direct vision between the parietal and visceral planes of the pelvic fascia. TME results in the resection of all mesorectal disease with intact, negative lateral or circumferential margins of resection. Statistical analysis was done of survival, local recurrence, and both sexual and urinary functions in a prospective database of consecutive patients. Operative mortality was 2% (3/148) due to cardiac disease. Overall survival was 60%, significantly worse than consecutive patients from the same database who were able to undergo sphincter preservation (81%) (p = 0.0003). Poorer survival was statistically related to the presence of positive lymph nodes (p = 0.0009). Overall, local recurrence rates were 5% (8/148) in patients without distant metastases, and 15% to 21% in patients with positive nodes. Positive lymph nodes, N2 disease, lymphatic vascular invasion, and perineural invasion were independent significant risk factors for local recurrence. Sexual function was preserved in approximately 57% of patients undergoing APR versus 85% of patients undergoing sphincter preservation. No significant urinary morbidity was encountered. Low rectal cancer requiring APR seems to be a disease with more locally advanced disease and adverse pathologic features than are seen with mid-rectal cancers treatable by low anterior resection. APR when performed in accordance with the principles of TME and ANP ensures the greatest likelihood of resecting all regional disease while preserving both sexual and urinary functions. Preoperative combined modality treatment may be warranted in all T3 or greater low rectal cancers.

Topics: Adult; Aged; Aged, 80 and over; Autonomic Nervous System; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Rectal Neoplasms; Rectum; Retrospective Studies; Risk Factors; Sex; Surgical Procedures, Operative; Survival Rate; Treatment Outcome; Urination

Topics: Adult; Aged; Black or African American; Colonic Neoplasms; Ethnology; Female; Humans; Injections, Intraperitoneal; Injections, Intravenous; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Postoperative Complications; Rectal Neoplasms; Sex; Thiotepa; White People

Oncologic resection of rectal cancer has been reported to be associated with a significant (10%-60%) rate of sexual and urinary dysfunction. We hypothesize that curative total mesorectal excision (TME) with autonomic nerve preservation (ANP) can be done with high rates of preservation of such function.. We studied prospectively preoperative and postoperative urinary and sexual function in patients who had sphincter-preserving operations for rectal carcinoma without preoperative irradiation. Standardized questionnaires were used preoperatively and postoperatively, including the International Prostatic Symptom Score and a score of quality of urinary function satisfaction. Urodynamic evaluation was performed preoperatively and 3 months after the operation. The sexual results were evaluated after 1 year.. Twenty patients, 13 men and 7 women, had TME, with ANP technique. Fourteen patients had coloanal anastomosis, 4 had a stapled colorectal anastomosis, and 2 had an ileoanal anastomosis. In all patients, hypogastric and sacral splanchnic nerves were identified and preserved. There was no mortality. Tumors are graded by Astler-Coller classification: A1 in 3 cases, A2 in 3, B1 in 7, B2 in 2, C2 in 1, and D in 1. There was no difference in preoperative and postoperative urinary function, International Prostatic Symptom Score, or urodynamic results, nor in the results of the quality of urinary function questionnaire. Four of the 7 women (69%) were sexually active before undergoing the surgical procedure. Sexual activity and ability to achieve orgasm was unchanged in these women. No dyspareunia was reported. Nine of the 13 men (69%) were sexually potent in the preoperative period. Sexual activity and potency were unchanged in these men. Retrograde ejaculation was reported in 1 man who previously had had normal antegrade ejaculation. After 3 months, 4 patients reported a reduced rigidity of erection, returning to normal by 1 year.. The authors conclude that TME and ANP for cancer limited to the mesorectum do not impair urinary and sexual function.

Topics: Adult; Aged; Autonomic Nervous System; Female; Humans; Male; Middle Aged; Penile Erection; Postoperative Period; Prospective Studies; Rectal Neoplasms; Rectum; Sex; Surveys and Questionnaires; Urination

Correlation coefficients for age-standardized incidence rates between cancers of the stomach, colon, rectum and lung over place (worldwide) and time (in Connecticut) vary from positive to negative values, indicating that these cancers are not caused by common environmental agents. Correlation coefficients for age-incidence patterns (the variation in age-specific rates with age) between these cancers, on the other hand, are all highly positive for both sexes. We conclude that the carcinogenic determinants that vary with age are common to the cancers studied and to both sexes, and distinct from the carcinogenic determinants that vary with place and time. For the cancers studied, incidence rates are negligible until age 30, at which time they increase dramatically and continue to increase at least until age 75. The rate of increase, however, diminishes continuously with advancing age after 30. We suggest that the role of aging in cancer incidence is determined by two components, one responsible for the dramatic rate increase beginning near age 30 and one responsible for the gradual diminution in that rate increase. The former may correspond to the activation of quiescent cells with damaged DNA or to the deactivation of DNA surveillance or repair or to impaired apoptosis, while the latter may correspond to the loss of cell division potential.

Topics: Adult; Aged; Aging; Colonic Neoplasms; Environment; Female; Humans; Incidence; Lung Neoplasms; Male; Middle Aged; Rectal Neoplasms; Registries; Sex; Sex Factors; Stomach Neoplasms; Time Factors

Rectal cancer surgery causes often postoperative morbidities such as defecation disturbance, dysuria and male sexual impotence. Compatibility of cancer eradication and function preservation are the problem should be resolved in the rectal cancer surgery. Defecation function were preserved in the patients with middle and upper rectal cancer by anterior resection transsacral resection, invagination or pull-through operation. Since 1984, usage of suture instruments made it practicable to increase sphincter preserving operation up to more than 65% of rectal cancer. Postoperative 5-years survivals were 81% of anterior resection, 71% of invagination operation and 57% of pull-through. Autonomic nerves preserving operation (ANP), aimed to prevent the urinary and sexual disfunction were studied both sides of the cancer spreads and extend of nerve plexuses. And ANP were adopted to the 185 cancers, limited to the submucosa or the proper muscle coat, by Study Group of Welfare Ministry. Their postoperative disfunction decreased to 15% of urination and 21% of male potency, while 33% and 81% respectively following conventional operation. Local excision for early cancer, which are defined as mucosal or submucosal cancer are discussed.

Topics: Autonomic Nervous System; Colostomy; Humans; Lymphatic Metastasis; Male; Quality of Life; Rectal Neoplasms; Rectum; Sex; Urination

Excision of the recto-sigmoid and rectum for cancer or inflammatory disease frequently damages the autonomic nerve supply. The anatomy and function of the autonomic nervous system in the pelvis is reviewed. Thirty-two patients who underwent excision of the rectum have been studied: 28 operations were for carcinoma, 4 for ulcerative colitis. A detailed history of sexual function was obtained preoperatively together with a neurological examination of the genitalia and perineum. Biopsies were taken from the surgical specimens and examined for the presence of nerve tissue. A further sexual history was taken 3 months postoperatively. Ten sexual active men (ages 46-74) who had anterior resections or abdominoperineal excisions for carcinoma tended to show impaired sexual activity if there was excessive nerve tissue in the specimen. Two out of 3 sexually active women (ages 53-68) who had cancer operations had satisfactory sexual function postoperatively. Four patients (ages-66) all had satisfactory sexual function after panproctocolectomy for ulcerative colitis. The advantages of avoiding damages to the pelvic autonomic nerves at operation are discussed.

Topics: Adult; Aged; Colitis, Ulcerative; Female; Humans; Male; Middle Aged; Pelvis; Postoperative Complications; Postoperative Period; Prospective Studies; Rectal Neoplasms; Rectum; Sex; Sexual Dysfunction, Physiological

The technique of pullthrough resection with delayed anastomosis for carcinoma of the rectum as performed at the Cleveland Clinic is described. A series of 84 cases of rectal cancer treated in this way is reported. The average tumour diameter was 4.5 cm, the average margin of resection was 4.1 cm and the average distance of the tumour from the anus was 7.6 cm. The incidence of necrosis of the pullthrough was 1.2 per cent. The overall 5-year survival was 63 per cent with 100 per cent, 57 per cent and 53 per cent for Dukes' A, B and C tumours respectively. The quality of bowel function following surgery is described in detail. It is felt that this procedure has an important place in sphincter conservation in carcinoma of the middle third of the rectum.

Topics: Adult; Aged; Colon; Female; Humans; Male; Methods; Middle Aged; Neoplasm Staging; Postoperative Complications; Rectal Neoplasms; Sex

Topics: Adult; Aged; Colonic Neoplasms; Esophageal Neoplasms; Ethnology; Female; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Rectal Neoplasms; Sex; Stomach Neoplasms

Topics: Adult; Aged; Blood Group Antigens; Colonic Neoplasms; Denmark; Esophageal Neoplasms; Female; Finland; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Norway; Rectal Neoplasms; Sex; Smoking; Stomach Neoplasms; Sweden

Topics: Adult; Aged; Colonic Neoplasms; Esophageal Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Iceland; Male; Middle Aged; Rectal Neoplasms; Sex; Stomach Neoplasms

Topics: Adolescent; Adult; Aged; Child; Colonic Neoplasms; Egypt; Esophageal Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Intestinal Neoplasms; Intestine, Small; Male; Middle Aged; Mouth Neoplasms; Rectal Neoplasms; Sex; Stomach Neoplasms

Topics: Adolescent; Adult; Aged; Bolivia; Brazil; California; Chile; Colombia; Colonic Neoplasms; England; Esophageal Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Intestinal Neoplasms; Male; Middle Aged; Rectal Neoplasms; Sampling Studies; Sex; Stomach Neoplasms; Venezuela

Topics: Adult; Aged; Aging; Cathartics; Colonic Neoplasms; Constipation; Defecation; Enema; Environment; Female; Hospitalization; Humans; Longevity; Male; Middle Aged; Occupations; Rectal Neoplasms; Religion; Retrospective Studies; Sex; Smoking; Statistics as Topic

Topics: Adenocarcinoma, Mucinous; Adult; Aged; Black or African American; Black People; Colonic Neoplasms; Esophageal Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Nitrosamines; Rectal Neoplasms; Sex; South Africa; Stomach Neoplasms

Topics: Adenocarcinoma; Adolescent; Adult; Child; Egypt; Female; Gastrointestinal Neoplasms; Humans; Lymphoma, Follicular; Male; Middle Aged; Rectal Neoplasms; Schistosomiasis; Sex

Topics: Biliary Tract; Bronchial Neoplasms; Esophageal Neoplasms; Ethnology; Gastrointestinal Neoplasms; Humans; Intestinal Neoplasms; Leukemia; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasms; Pancreatic Neoplasms; Prostatic Neoplasms; Rectal Neoplasms; Sex; Stomach Neoplasms

Topics: Adolescent; Aging; Breast Neoplasms; Bronchial Neoplasms; Child; Connecticut; Geriatrics; Humans; Incidence; Lung Neoplasms; Male; Neoplasms; New York; Prostatic Neoplasms; Rectal Neoplasms; Sex; Skin Neoplasms

Topics: Colonic Neoplasms; Connecticut; Denmark; England; Finland; Neoplasms; Norway; Rectal Neoplasms; Rectum; Sex; Surgical Procedures, Operative; United States; Wales

Topics: Aging; Colonic Neoplasms; Italy; Neoplasms; Pathology; Rectal Neoplasms; Rectum; Sex; Surgical Procedures, Operative