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Colorectal cancer

The bases for a comprehensive follow-up

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Diseases of the Colon & Rectum

Abstract

The purpose of this article was to review the effectiveness of follow-up in patients with colorectal cancer submitted to curative treatment. A comprehensive follow-up involves rational initial management of the primary tumor, knowledge of prognostic factors, selection of the patient to be followed, determination of the time for follow-up, use of the most appropriate tests for early diagnosis of recurrence, and eventual curative treatment. The updated answers to all these questions are given through an extensive review of the world literature and confronted with the authors' experience of eight years of follow-up in a series of 170 colorectal cancer patients treated for cure. Although the future might be more promising, past world experience suggests only a few patients could be saved. It is concluded that there is no place for incomplete and disperse screening tests, and only comprehensive, intensive, and very well-coordinated follow-up programs should be undertaken if better results are hoped to be achieved.

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References

  1. Evans JT, Vana J, Aronoff BL, Baker HW, Murphy GP. Management and survival of carcinoma of the colon: results of a national survey by the American College of Surgeons. Ann Surg 1978;188:716–20.

    Article  PubMed  CAS  Google Scholar 

  2. Gilbertsen VA. Improving the prognosis for patients with intestinal cancer. Surg Gynecol Obstet 1967;124:1253–9.

    PubMed  CAS  Google Scholar 

  3. Goligher JC. Surgery of the anus, rectum and colon. 4th ed. London: Bailliere Tindall, 1980.

    Google Scholar 

  4. Simon JE. Occult blood screening for colorectal carcinoma: a critical review. Gastroenterology 1985;88:820–37.

    PubMed  CAS  Google Scholar 

  5. Lockhart-Mummery HE, Ritchie JK, Hawley PR. The results of surgical treatment for carcinoma of the rectum at St. Marks Hospital from 1948 to 1972. Br J Surg 1976;63:673–7.

    PubMed  CAS  Google Scholar 

  6. Rao AR, Kagan AR, Chan PM, Gilbert HA, Nussbaum H, Hintz BL. Patterns of recurrence following curative resection alone for adenocarcinoma of the rectum and sigmoid colon. Cancer 1981;48:1492–5.

    Article  PubMed  CAS  Google Scholar 

  7. Silverberg E. Cancer statistics. CA 1981;31:13–28.

    PubMed  CAS  Google Scholar 

  8. Russell AH, Tong D, Dawson LE, Wisbeck W. Adenocarcinoma of the proximal colon: sites of initial dissemination and patterns of recurrence following surgery alone. Cancer 1984;53: 360–7.

    Article  PubMed  CAS  Google Scholar 

  9. Nicholls RJ. Colorectal cancer. In: Duncan W, ed. Recent results in cancer research. New York: Springer-Verlag, 1982:101–12.

    Google Scholar 

  10. Dukes CE. The classification of cancer of the rectum. J Pathol Bacteriol 1932;35:323–32.

    Article  Google Scholar 

  11. Devesa J, Avedillo D, Moraes V, Nunez-Puertas A. Automatic preoperative classification of carcinoma of the colon and rectum. Surg Gynecol Obstet 1984;158:482–7.

    PubMed  CAS  Google Scholar 

  12. Hodgman CG, MacCarty RL, Wolff BG, et al. Preoperative staging of rectal carcinoma by computed tomography and 0.15T magnetic resonance imaging: premilimary report. Dis Colon Rectum 1986;29:446–50.

    PubMed  CAS  Google Scholar 

  13. Lock MR, Cairns DW, Ritchie JK, Lockhart-Mummery HE. The treatment of early colorectal cancer by local excision. Br J Surg 1978;65:346–9.

    PubMed  CAS  Google Scholar 

  14. Goligher JC. Neoplasm: surgical treatment. Curr Opin Gastroenterol 1986;2:22–30.

    Article  Google Scholar 

  15. Biggers OR, Beart RW Jr, Ilstrup DM. Local excision of rectal cancer. Dis Colon Rectum 1986;29:374–7.

    Article  PubMed  CAS  Google Scholar 

  16. Sugarbaker PH, Corlew S. Influence of surgical techniques on survival in patients with colorectal cancer: a review. Dis Colon Rectum 1982;25:545–57.

    PubMed  CAS  Google Scholar 

  17. Lynch HT, Bardawil WA, Harris RE, Lynch PM, Guirgis HA, Lynch JF. Multiple primary cancers and prolonged survival: familial colonic and endometrial cancers. Dis Colon Cancer 1978;21:165–8.

    CAS  Google Scholar 

  18. Jeekel J. Curative resection of primary colorectal cancer. Br J Surg 1986;73:687–8.

    PubMed  CAS  Google Scholar 

  19. Taylor I. Neoplasms: radiotherapy, chemotherapy and immunotherapy. Curr Opin Gastroenterol 1986;2:31–9.

    Google Scholar 

  20. Arnott SJ. Radiotherapy. In: Duncan W, ed., Recent results in cancer research. New York: Springer-Verlag, 1982:113–25.

    Google Scholar 

  21. Enker WE, Kemeny N, Shank B, Rotstein L. Defining the needs for adjuvant therapy of rectal and colonic cancer. Surg Clin North Am 1981;61:1295–1309.

    PubMed  CAS  Google Scholar 

  22. Taylor I, Machin D, Mullee M, Trotter G, Cooke T, West C. A randomized controlled trial of adjuvant portal vein cytotoxic perfusion in colorectal cancer. Br J Surg 1985;72:359–63.

    PubMed  CAS  Google Scholar 

  23. House AK. Adjuvant therapy in colorectal cancer (editorial). J R Soc Med 1984;77:445–50.

    PubMed  CAS  Google Scholar 

  24. Dukes CE, Bussey HJ. The spread of rectal cancer and its effects on prognosis. Br J Cancer 1958;12:309–20.

    PubMed  CAS  Google Scholar 

  25. Copeland EM, Miller LD, Jones RS. Prognostic factors in carcinoma of the colon and rectum. Am J Surg 1968;116:875–81.

    Article  PubMed  CAS  Google Scholar 

  26. Schottenfeld D. Statistical report of end results 1949–1954, 1955–1959, 1960–1964. The Memorial Hospital Cancer Registry 1971;32:39.

    Google Scholar 

  27. Whittaker M, Goligher JC. The prognosis after surgical treatment for carcinoma of the rectum. Br J Surg 1976;63:84–88.

    Google Scholar 

  28. Lockhart-Mummery HE, Ritchie JK, Hawley RR. The results of surgical treatment for carcinoma of the rectum at St. Mark's Hospital from 1948 to 1972. Br J Surg 1976;63:673–7.

    PubMed  CAS  Google Scholar 

  29. Wilson SM, Beahrs OH. The curative treatment of carcinoma of the sigmoid, rectosigmoid, and rectum. Ann Surg 1976;183: 556–65.

    Article  PubMed  CAS  Google Scholar 

  30. Dionne L, Martin M, Kibrite A, Douville Y, Pelouze G. Multidisciplinary approach in the curative treatment of colon and rectum carcinoma. In: Grundmann E, ed. Colon cancer: cancer campaign. New York: Gustav Fischer 1978:237–47.

    Google Scholar 

  31. Corman ML, Veidenheimer MC, Coller JA. Colorectal carcinoma: a decade of experience at the Lahey Clinic. Dis Colon Rectum 1979;22:477–9.

    PubMed  CAS  Google Scholar 

  32. Pihl E, Hughes ES, McDermott FT, Milne BJ, Korner JM, Price AB. Carcinoma of the colon—cancer specific long-term survival: a series of 615 patients treated by one surgeon. Ann Surg 1980;192:114–7.

    Article  PubMed  CAS  Google Scholar 

  33. Pihl E, Hughes ES, McDermott FT, Milne BJ, Korner JM, Price AB. I. Carcinoma of the rectum and rectosigmoid—cancer specific long-term survival: A series of 1061 cases treated by one surgeon. Cancer 1980;45:2902–7.

    Article  PubMed  CAS  Google Scholar 

  34. Rosen L, Veidenheimer MC, Coller JA, Corman ML. Mortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum. Dis Colon Rectum 1982;25: 202–8.

    Article  PubMed  CAS  Google Scholar 

  35. Zinkin LD. A critical review of the classifications and staging of colorectal cancer. Dis Colon Rectum 1983;26:37–43.

    PubMed  CAS  Google Scholar 

  36. Pahlman L, Glimelius B. Local recurrences after surgical treatment for rectal carcinoma. Acta Chir Scand 1984;150:331–5.

    PubMed  CAS  Google Scholar 

  37. Devereux DF, Dekers PJ. Contributions of pathologic margins and Dukes' stage to local recurrence in colorectal carcinoma. Am J Surg 1985;149:323–6.

    Article  PubMed  CAS  Google Scholar 

  38. Eisenberg B, Decosse JJ, Harford F, Michalek J. Carcinoma of the colon and rectum: the natural history reviewed in 1704 patients. Cancer 1982;49:1131–4.

    Article  PubMed  CAS  Google Scholar 

  39. Welch JP, Donaldson GA. The clinical correlation of an autopsy study of recurrent colorectal cancer. Ann Surg 1979;189:496–502.

    Article  PubMed  CAS  Google Scholar 

  40. Malcolm AW, Perencevich NP, Olson RM, Hanley JA, Chaffey JT, Wilson RE. Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum. Surg Gynecol Obstet 1981;152:131–6.

    PubMed  CAS  Google Scholar 

  41. Deveney KE, Way LW. Follow-up of patients with colorectal cancer. Am J Surg 1984;148:717–22.

    Article  PubMed  CAS  Google Scholar 

  42. Hojo K, Koyama Y. Postoperative follow-up studies on cancer of the colon and rectum. Am J Surg 1982;143:293–5.

    Article  PubMed  CAS  Google Scholar 

  43. Russell AH, Pelton J, Reheis CE, Wisbeck WM, Tong DY, Daw-son LE. Adenocarcinoma of the colon: an autopsy study with implications for new therapeutic strategies. Cancer 1985;56: 1446–51.

    Article  PubMed  CAS  Google Scholar 

  44. Tong D, Russell AH, Dawson LE, Wisbeck W. Second laparotomy for proximal colon cancer: sites of recurrence and implications for adjuvant therapy. Am J Surg 1983;145:382–6

    Article  PubMed  CAS  Google Scholar 

  45. Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP. Local recurrence following ‘curative’ surgery for large bowel cancer. I. The overall picture. Br J Surg 1984;71:12–6.

    PubMed  CAS  Google Scholar 

  46. Willett CG, Tepper JE, Cohen AM, Orlow E, Welch CE. Failure patterns following curative resection of colonic carcinoma. Ann Surg 1984;200:685–90.

    Article  PubMed  CAS  Google Scholar 

  47. Pitluk H, Poticha SM. Carcinoma of the colon and rectum in patients less than 40 years of age. Surg Gynecol Obstet 1983;57:335–7.

    Google Scholar 

  48. Adloff M, Arnaud J-P, Schloegel M, Thibaud D, Bergamaschi R. Colorectal cancer in patients under 40 years of age. Dis Colon Rectum 1986;29:322–5.

    Article  PubMed  CAS  Google Scholar 

  49. de Mello J, Struthers L, Turner R, Cooper EH, Giles GR. Miltivariate analyses as aids to diagnosis and assessment of prognosis in gastrointestinal cancer. Br J Surg 1983;48:341–8.

    Google Scholar 

  50. Wobbes TH, Beex LV, Koenders AM. Estrogen and progestin receptors in colonic cancer? Dis Colon Rectum 1984;27:591–2.

    Article  PubMed  CAS  Google Scholar 

  51. d'Istria M, Fasano S, Catuogno F, et al. Androgen and progesterone receptors in colonic and rectal cancers. Dis Colon Rectum 1986;29:263–5.

    Article  PubMed  Google Scholar 

  52. Wolmark N, Wieand HS, Rockette HE, et al. The prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer: findings from the NASBP clinical trials. Ann Surg 1983;198:743–52.

    Article  PubMed  CAS  Google Scholar 

  53. Wolmark N, Fisher ER, Wieand H, et al. The relationship of depth of penetration and tumor size to the number of positive nodes in Dukes' C colorectal cancer. Cancer 1984;53:2707–12.

    Article  PubMed  CAS  Google Scholar 

  54. Khubchandani M. Relationship of symptom duration and survival in patients with carcinoma of the colon and rectum. Dis Colon Rectum 1985;28:585–7.

    Article  PubMed  CAS  Google Scholar 

  55. Pescatori M, Maria G, Beltrani B, Mattana C. Site, emergency, and duration of symptoms in the prognosis of colorectal cancer. Dis Colon Rectum 1982;25:33–40.

    Article  PubMed  CAS  Google Scholar 

  56. Sugarbaker PH. Carcinoma of the colon—prognosis and operative choice. Curr Probl Surg 1981;28:756–801.

    Google Scholar 

  57. Steinberg SM, Barkin JS, Kaplan RS, Stablein DM. Prognostic indicators of colon tumors: the Gastrointestinal Tumor Study Group experience. Cancer 1986;57:1866–70.

    Article  PubMed  CAS  Google Scholar 

  58. Polissar L, Sim D, Francis A. Survival of colorectal cancer patients in relation to duration of symptoms and other prognostic factors. Dis Colon Rectum 1981;24:364–9.

    PubMed  CAS  Google Scholar 

  59. Ranbarger KR, Johnston WD, Chang JC. Prognostic significance of surgical perforation of the rectum during abdominoperineal resection for rectal carcinoma. Am J Surg 1982;143: 186–8.

    Article  PubMed  CAS  Google Scholar 

  60. Slanetz CA Jr. The effect of inadvertent intraoperative perforation on survival and recurrence in colorectal cancer. Dis Colon Rectum 1984;27:792–7.

    Article  PubMed  Google Scholar 

  61. Alley PG, McNee RK. Age and sex differences in right colon cancer. Dis Colon Rectum 1986;29:227–9.

    Article  PubMed  CAS  Google Scholar 

  62. Umpleby HC, Bristol JB, Rainey JB, Williamson RC. Survival of 727 patients with single carcinomas of the large bowel. Dis Colon Rectum 1984;27:803–10.

    Article  PubMed  CAS  Google Scholar 

  63. McDermott FT, Hughes ES, Pihl E, Johnson WR, Price AB. Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients. Br J Surg 1985;72:34–7.

    PubMed  CAS  Google Scholar 

  64. Blackshaw AJ, Bussey HJ, Morson BC. Neoplasmas: pathology. In: Thomson JP, Jichols RS, Williams CB, eds. Colorectal disease. London: William, Heinemann, 1981:235–57.

    Google Scholar 

  65. Durdey P, Williams NS. The effect of malignant and inflammatory fixation of rectal carcinoma on prognosis after recal excision. Br J Surg 1984;71:787–90.

    PubMed  CAS  Google Scholar 

  66. Montessori GA, Donald JC. Invasion profile of colorectal carcinoma. Dis Colon Rectum 1978;21:26–8.

    PubMed  CAS  Google Scholar 

  67. Gunderson LL, Cohen AM, Welch CE. Residual, inoperable or recurrent colorectal cancer: interaction of surgery and radiotherapy. Am J Surg 1980;139:518–25.

    Article  PubMed  CAS  Google Scholar 

  68. Cohen AM, Wood WC, Gunderson LL, Shinnar M. Pathological studies in rectal cancer. Cancer 1980;45:2965–8.

    Article  PubMed  CAS  Google Scholar 

  69. Wood CB, Gillis CR, Hole D, Malcolm AJ, Blumgart LH. Local tumor invasion as a prognostic factor in colorectal cancer. Br J Surg 1981;68:326–8.

    PubMed  CAS  Google Scholar 

  70. Nicholls RJ, York Mason A, Marson BC, Dixon AK, Kelsey Fry I. The clinical staging of rectal cancer. Br J Surg 1982;69:404–9.

    PubMed  CAS  Google Scholar 

  71. Williams NS, Durdey P, Quirke P, et al. Pre-operative staging of rectal neoplasm and its impact on clinical management. Br J Surg 1985;72:868–74.

    PubMed  CAS  Google Scholar 

  72. Rich T, Gunderson LL, Lew R, Galdibine JJ, Cohen AM, Donaldson G. Patterns of recurrence of rectal cancer after potentially curative surgery. Cancer 1983;52:1317–29.

    Article  PubMed  CAS  Google Scholar 

  73. Zhou XG, Yu BM, Shen YX. Surgical treatment and late results in 1226 cases of colorectal cancer. Dis Colon Rectum 1983;26: 250–6.

    PubMed  CAS  Google Scholar 

  74. Knudsen JB, Nilsson T, Sprechler M, Johansen A, Christensen N. Venous and nerve invasion as prognostic factors in postoperative survival of patients with resectable cancer of the rectum. Dis Colon Rectum 1983;26:613–7.

    Article  PubMed  CAS  Google Scholar 

  75. Grinnel RS. The lymphatic and venous spread of carcinoma of the rectum. Ann Surg 1942;116:200–16.

    Google Scholar 

  76. Talbot IC, Ritchie S, Leighton MH, Hughes AO, Bussey HJ, Morson BC. The clinical significance of invasion of veins by rectal cancer. Br J Surg 1980;67:439–42.

    PubMed  CAS  Google Scholar 

  77. Wied U, Nilsson T, Knudsen JB, Sprechler M, Johansen AA. Postoperative survival of patients with potentially curable cancer of the colon. Dis Colon Rectum 1985;28:333–5.

    PubMed  CAS  Google Scholar 

  78. Burnett KR, Greenbaum EI. Rapidly growing carcinoma of the colon. Dis Colon Rectum 1981;24:282–6.

    PubMed  CAS  Google Scholar 

  79. Forsslund G, Cedermark B, Öhman U, Erhardt K, Zetterberg A, Auer G. The significance of DNA distribution pattern in rectal carcinoma. Dis Colon Rectum 1984;27:579–84.

    Article  PubMed  CAS  Google Scholar 

  80. Armitage NC, Robins RA, Evans DF, Turner DR, Baldwin RW, Hardcastle JD. The influence of tumor cell DNA abnormalities on survival in colorectal cancer. Br J Surg 1985;72:828–30.

    PubMed  CAS  Google Scholar 

  81. Banner BF, Tomas-de la Vega JE, Roseman DL, Coon JS. Should flow cytometric DNA analyses precede definitive surgery for colon carcinoma? Ann Surg 1986;202:740–4.

    Google Scholar 

  82. Habib NA, Wood CB. The clinical application of molecular biology in colorectal cancer. Dis Colon Rectum 1986;29:475–80.

    PubMed  CAS  Google Scholar 

  83. Gerard A. Carcinoma of the colon and rectum: prognostic factors and criteria of response. In: Staquet MJ, ed. Cancer therapy: prognostic factors and criteria of response. New York: Raven Press, 1975:199–225.

    Google Scholar 

  84. Spratt JS Jr, Spjut HJ. Prevalence and prognosis of individual clinical and pathological variables associated with colorectal carcinoma. Cancer 1967;20:1976–85.

    Article  PubMed  Google Scholar 

  85. Syrjanen KJ, Hjelt LH. Tumor-host relationships in colorectal carcinoma. Dis Colon Rectum 1978;21:29–36.

    PubMed  CAS  Google Scholar 

  86. Pretlow TP, Boohaker EA, Pitts AM, Macfadyen AJ, Bradley EL Jr, Pretlow TG II. Heterogeneity and subcompartmentalization in the distribution of eosinophils in human colonic carcinomas. Am J Pathol 1984;116:207–13.

    PubMed  CAS  Google Scholar 

  87. Carlon CA, Fabris G, Arslan-Pagnini C, Pluchinotta AM, Chinelli E, Carniato S. Prognostic correlations of operable carcinoma of the rectum. Dis Colon Rectum 1985;28:47–50.

    PubMed  CAS  Google Scholar 

  88. Patt DJ, Brynes RK, Vardiman JW, Coppleson LW. Mesocolic lymph node histology is an important prognostic indicator for patients with carcinoma of the sigmoid colon: immunomorphologic study. Cancer 1975;35:1388–97.

    Article  PubMed  CAS  Google Scholar 

  89. Fisher B, Saffer EA, Fisher ER. Studies concerning the regional lymph node in cancer. III. Response of regional lymph node cells from breast and colon cancer patients to PHA stimulation. Cancer 1972;30:1202–15.

    Article  PubMed  CAS  Google Scholar 

  90. Riesco A. Five-year cancer cure: relation to total amount of peripheral lymphocytes and neutrophils. Cancer 1970;25:135–40.

    Article  PubMed  CAS  Google Scholar 

  91. Aarons SP, Albano WA, Harris RE, Organ CH. The peripheral lymphocyte count as an aid in the clinical staging of lung cancer. Ann Surg 1978;187:248–50.

    Article  PubMed  CAS  Google Scholar 

  92. Thynne GS, Moertel CG, Silvers A. Preoperative lymphocyte counts in peripheral blood in patients with colorectal neoplasms: a correlation with tumor type, Dukes' classification, site of primary tumor, and five-year survival rate in 1,000 patients. Dis Colon Rectum 1979;22:221–2.

    PubMed  CAS  Google Scholar 

  93. Los receptores de las células T. Lancet (Spanish ed) 1984;5:125–6.

    Google Scholar 

  94. Hernandez JL, Sanz ML, Crisci CD, et al. Lymphocyte subpopulations in colorectal cancer: preoperative evaluation. Allergol Immunopathol (Madr) 1978;6:339–44.

    CAS  Google Scholar 

  95. Elias EG, Elias LL, Didolkar MS, Hebel JR. Cellular immunity in patients with colorectal adenocarcinoma measured by autologous leukocyte migration inhibition. Cancer 1977;40:687–92.

    Article  PubMed  CAS  Google Scholar 

  96. Goldrosen MH, Han T, Jung O, Smolev J, Holyoke ED. Impaired lymphocyte blastogenic response in patients with colon adenocarcinoma: effects of disease and age. J Surg Oncol 1977;9:229–34.

    PubMed  CAS  Google Scholar 

  97. Warnatz H. Cell-mediated immune reactions in patients with colon carcinoma. In: Flad H-D, Herfarth C, Betzler M, eds. Immunodiagnosis and immunotherapy of malignant tumors: relevance to surgery. New York: Springer-Verlag, 1979:122–8.

    Google Scholar 

  98. Kronman BS, Shapiro HM, Localio SA. Newer concepts of cancer of the colon and rectum: delayed hypersensitivity responses of patients with carcinoma of the colon and other solid tumors. Dis Colon Rectum 1972;15:106–10.

    PubMed  CAS  Google Scholar 

  99. Staab HJ, Anderer FA, Brümmendorf T, Stumpf E, Fisher R. Prognostic value of preoperative serum CEA levels compared with clinical staging. I. Colorectal carcinoma. Br J Cancer 1981;44:652–62.

    PubMed  CAS  Google Scholar 

  100. Lewi H, Blumgart LH, Carter DC, et al. Pre-operative carcino-embryonic antigen and survival in patients with colorectal cancer. Br J Surg 1984;71:206–8.

    PubMed  CAS  Google Scholar 

  101. Wolmark N, Fisher B, Wieand HS, et al. The prognostic significance of preoperative carcinoembryonic antigen levels in colorectal cancer: results from NSABP clinical trials. Ann Surg 1984;199:375–82.

    Article  PubMed  CAS  Google Scholar 

  102. Lunde OC, Havig O. Clinical significance of carcinoembryonic antigen (CEA) in patients with adenocarcinoma in colon and rectum. Acta Chir Scand 1982;148:189–93.

    PubMed  CAS  Google Scholar 

  103. Pugsley W, Grace RH. The value of CEA as a determinant of prognosis in colorectal cancer. In: Givel Saegesser F., ed. Coloproctology. New York: Springer-Verlag, 1984;78–80.

    Google Scholar 

  104. Moertel CG, O'Fallon JR, Go VL, O'Connell MJ, Thynne GS. The preoperative carcinoembryonic antigen test in the diagnosis, staging, and prognosis of colorectal cancer. Cancer 1986;58: 603–11.

    Article  PubMed  CAS  Google Scholar 

  105. Beart RW Jr, O'Connell MJ. Postoperative follow-up of patients with carcinoma of the colon. Mayo Clin Proc 1983;58:361–3.

    PubMed  Google Scholar 

  106. Durdey P, Williams NS, Brown DA. Serum carcinoembryonic antigen and acute phase reactant proteins in the pre-operative detection of fixation of colorectal tumors. Br J Surg 1984;71: 881–4.

    PubMed  CAS  Google Scholar 

  107. Miller F. Serum-derived immunosuppressive substances. I. Partial purification and range of action. Transplantation 1976;21: 179–87.

    Article  PubMed  CAS  Google Scholar 

  108. Durdey P, Cooper JC, Switala S, King RF, Williams NS. The role of peptidases in cancer of the rectum and sigmoid colon. Br J Surg 1985;72:378–81.

    PubMed  CAS  Google Scholar 

  109. Cooper EH, Turner R, Steele L, Neville AM, Mackay AM. The contribution of serum enzymes and carcinoembryonic antigen to the early diagnosis of metastatic colorectal cancer. Br J Cancer 1975;31:111–7.

    PubMed  CAS  Google Scholar 

  110. Tartter PI, Slater G, Papatestas AE, Aufses AH Jr. The prognostic significance of elevated serum alkaline phosphatase levels preoperatively in patients with carcinoma of the colon and rectum. Surg Gynecol Obstet 1984;158:569–71.

    PubMed  CAS  Google Scholar 

  111. Dixon MF. Neoplasms: pathology. Curr Opin Gastroenterol 1986;2:9–15.

    Article  Google Scholar 

  112. Drewinko B, Yang LY, Leibovitz A, et al. Cellular discriminants for a biological classification of human colon carcinoma. Cancer Res 1984;44:4241–53.

    PubMed  CAS  Google Scholar 

  113. Chapuis PH, Dent OF, Fisher R, et al. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg 1985;72:698–702.

    PubMed  CAS  Google Scholar 

  114. Fielding LP, Phillips RK, Fry JS, Hittinger R. Prediction of outcome after curative resection for large bowel cancer. Lancet 1986;1:904–7.

    Article  Google Scholar 

  115. Gunderson LL, Sosin H. Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: clinicopathologic correlation and implications for adjuvant therapy. Cancer 1974;34:1278–92.

    Article  PubMed  CAS  Google Scholar 

  116. Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP. Local recurrence following ‘curative’ surgery for large bowel cancer. II. The rectum and rectosigmoid. Br J Surg 1984;71:17–20.

    PubMed  CAS  Google Scholar 

  117. Butler J, Attiyeh FF, Daly JM. Hepatic resection for metastases of the colon and rectum. Surg Gynecol Obstet 1986;162:109–13.

    PubMed  CAS  Google Scholar 

  118. McCormack PM, Attiyeh FF. Resected pulmonary metastases from colorectal cancer. Dis Colon Rectum 1979;22:553–6.

    PubMed  CAS  Google Scholar 

  119. Welch JP, Donaldson GA. Detection and treatment of recurrent cancer of the colon and rectum. Am J Surg 1978;135:505–11.

    Article  PubMed  CAS  Google Scholar 

  120. Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 1950;3:74–85.

    Article  PubMed  CAS  Google Scholar 

  121. Besbeas S, Stearns MW Jr. Osseous metastases from carcinomas of the colon and rectum. Dis Colon Rectum 1978;21:266–8.

    PubMed  CAS  Google Scholar 

  122. Weir JA. Colorectal cancer: metachronous and other associated neoplasms. Dis Colon Rectum 1975;18:4–5.

    PubMed  CAS  Google Scholar 

  123. Morson B. Polyp-cancer sequence in the large bowel. Proc R Soc Med 1974;67:451–7.

    PubMed  CAS  Google Scholar 

  124. Nava HR, Pagana TJ. Postoperative surveillance of colorectal carcinoma. Cancer 1982;49:1043–7.

    Article  PubMed  CAS  Google Scholar 

  125. Coppa GF, Eng K, Ranson JH, Gouge TH, Localio A. Hepatic resectionn for metastatic colon and rectal cancer: an evaluation of preoperative and postoperative factors. Ann Surg 1985;202: 203–8.

    Article  PubMed  CAS  Google Scholar 

  126. Gilbert JM, Jeffrey I, Evans M, Kark AE. Sites of recurrent tumor after ‘curative’ colorectal surgery: implications for adjuvant therapy. Br J Surg 1984;71:203–5.

    PubMed  CAS  Google Scholar 

  127. Veazey PR, McBride CM. Pelvic recurrence of cancer after abdominoperineal resection of the rectum. South Med J 1979;72: 1545–7.

    PubMed  CAS  Google Scholar 

  128. Cochrane JP, Williams JT, Faber RC, Slack WW. Value of outpatient follow-up after curative surgery for carcinoma of the large bowel. Br Med J 1980;280:593–5.

    PubMed  CAS  Google Scholar 

  129. Vassilopoulos PP, Yoon JM, Ledesma EJ, Mittelman A. Treatment of recurrence of adenocarcinoma of the colon and rectum at the anastomotic site. Surg Gynecol Obstet 1981;152:777–80.

    PubMed  CAS  Google Scholar 

  130. Wangensteen OH, Lewis FJ, Tonnen LA. The “second-look” in cancer surgery: patient with colic cancer and involved lymph nodes negative on “sixth-look.” Lancet 1951;1:303–7.

    Google Scholar 

  131. Wanebo HJ, Stearns M, Schwartz MK. Use of CEA as an indicator of early recurrence and as a guide to a selected second-look procedure in patients with colorectal cancer. Ann Surg 1978; 188:481–93.

    Article  PubMed  CAS  Google Scholar 

  132. Attiyeh FF, Stearns MW Jr. Second-look laparotomy based on CEA elevations in colorectal cancer. Cancer 1981;47:2119–25.

    Article  PubMed  CAS  Google Scholar 

  133. Sandler RS, Freund DA, Herbst CA, Sandler DP. Cost effectiveness of postoperative carcinoembryonic antigen monitoring in colorectal cancer. Cancer 1984;53:193–8.

    Article  PubMed  CAS  Google Scholar 

  134. Wedell J, Meier Zu Eissen P, Luu TH, et al. A retrospective study of serial CEA determinations in the early detection of recurrent colorectal cancer. Dis Colon Rectum 1981;24:618–21.

    PubMed  CAS  Google Scholar 

  135. Steele G Jr, Zamcheck N, Wilson R, et al. Results of CEA-initiated second-look surgery for recurrent colorectal cancer. Am J Surg 1980;139:544–8.

    Article  PubMed  Google Scholar 

  136. Tartter PI, Slater G, Gelernt I, Aufses AH Jr. Screening for liver metastases from colorectal cancer with carcinoembryonic antigen and alkaline phosphatase. Ann Surg 1981;193:357–60.

    Article  PubMed  CAS  Google Scholar 

  137. Enker WE, Kramer RG. The follow-up of patients after definitive resections for large bowel cancer. World J Surg 1982;6:578–84.

    Article  PubMed  CAS  Google Scholar 

  138. Wood CB, Ratcliffe JG, Burt RW, Malcolm AJ, Blumgart LH. The clinical significance of elevated serum carcinoembryonic antigens (CEA) levels in recent colorectal cancer. Br J Surg 1980;67:46–8.

    PubMed  CAS  Google Scholar 

  139. Wood CB. Neoplasms: staging and surveillance. Curr Opin Gas-troenterol 1985;1:28–31.

    Google Scholar 

  140. Martin EW Jr, Cooperman M, Carey LC, Minton JP. Sixty second-look procedures indicated primarily by rise in serial carcinoembryonic antigen. J Surg Res 1980;28:389–94.

    Article  PubMed  Google Scholar 

  141. Minton JP, Hoehn JL, Gerber DM, et al. Results of a 400-patient carcinoembryonic antigen second-look colorectal cancer study. Cancer 1985;55:1284–90.

    Article  PubMed  CAS  Google Scholar 

  142. Rognum TO. A new approach in carcinoembryonic antigenguided follow-up of large bowel carcinoma patients. Scand J Gastroenterol 1986;21:641–9.

    PubMed  CAS  Google Scholar 

  143. Koprowski H, Steplewski Z, Mitchell K, Herlyn D, Fuhrer P. Colorectal carcinoma antigens detected by hybridoma antibodies. Somatic Cell Genet 1979;5:957–71.

    Article  PubMed  CAS  Google Scholar 

  144. Kuusela P, Jalanko H, Roberts P, Sipponen P, Makela O. CA 19-9 antigen and CEA in colorectal carcinomas. Advances in cancer research. XI annual meeting, Stockholm, Sweden, Sept. 11–15, 1983.

  145. Delvillano BC, Zurawsdi VR Jr. The carbohydrate antigenic determinant 19-9 (CA 19-9): a monoclonal antibody defined tumour marker. Immunodiagnostics 1983;269–82.

  146. Holmgren J, ed. Tumour marker antigens: properties and usefulness of carcinoma associated antigens CEA, CA 19-9 and CA-50. Lund: Studentilitteratur, 1985.

    Google Scholar 

  147. Jakschik J, Boese-Landgraf J, Baer U. Effectiveness of tumor-markers in early diagnosis of recurrence in colon carcinomas. XIth Biennial Congress of the International Society of University Colon and Rectal Surgeons. Dallas, May 4–8, 1986.

  148. Sugano K, Kodaira S, Teramoto T, Watanabe M, Mara A, Abe O. A new tumour marker defined by a monoclonal antibody, NCC-ST-439: its clinical usefulness for colorectal carcinoma. XIth Biennial Congress of the International Society of University Colon and Rectal Surgeons. Dallas, May 4–8, 1986.

  149. Armitage NC, Hardcastle JD. Neoplasms: screening and diagnosis. Curr Opin Gastroenterol 1986;2:16–21.

    Article  Google Scholar 

  150. Beart RW Jr, Metzger PP, O'Connell MJ, Schutt A.J.. Postoperative screening of patients with carcinoma of the colon. Dis Colon Rectum 1981;24:585–9.

    PubMed  Google Scholar 

  151. Read DR, Hambrick E, Abcarian H, Levine H. The preoperative diagnosis of hepatic metastases in cases of colorectal carcinoma. Dis Colon Rectum 1977;20:101–6.

    PubMed  CAS  Google Scholar 

  152. Finan PJ, Marshall RJ, Cooper EH, Giles GR. Factors affecting survival in patients presenting with synchronous hepatic metastases from colorectal cancer: a clinical and computer analysis. Br J Surg 1985;72:373–7.

    PubMed  CAS  Google Scholar 

  153. Steele L, Cooper EH, Mackay AM, Losowskey MS, Goligher JC. Combination of CEA and GGT in the study of the evolution of colorectal cancer. Br J Cancer 1974;30:319–24.

    PubMed  CAS  Google Scholar 

  154. Cooper EH, Eaves G, Turner R, Nevile AM, Ward AM. Experience of multiparametric tests in the monitoring of large bowel cancer. Bull Cancer (Paris) 1976;63:541–40.

    CAS  Google Scholar 

  155. Huguet C, Azzopardi O. Valeur de dosage de la GGT dans la despistage des metsastases heptiques. Rev Med France 1970;45: 113.

    Google Scholar 

  156. Boone DJ, Routh JI, Schrantz R. Y-glutamyl transpeptidase and 5′-nucleotidase: comparison as diagnostic for hepatic disease. Am J Clin Pathol 1974;61:321–7.

    PubMed  CAS  Google Scholar 

  157. de Roos A, Hermans J, Odo Op den Orth J. Polypoid lesions of the sigmoid colon: a comparison of single-contrast, double-contrast, and biphasic examinations. Radiology 1984;151:597–9.

    PubMed  Google Scholar 

  158. Elliot MS, Levenstein JH, Wright JP. Faecal occult blood testing in the detection of colorectal cancer. Br J Surg 1984;71:785–6.

    PubMed  CAS  Google Scholar 

  159. Agrez MV, Ready R, Ilstrup D, Beart RW Jr. Metrachronous colorectal malignancies. Dis Colon Rectum 1982;25:569–74.

    Article  PubMed  CAS  Google Scholar 

  160. Guttormsen AB, Holm JC, Horn A, Søreide O. Follow-up of patients with large bowel cancer: a critical evaluation. Acta Chir Scand 1984;150:325–30.

    PubMed  CAS  Google Scholar 

  161. Kiefer PJ, Thorson AG, Christensen MA. Metachronous colorectal cancer: time interval to presentation of a metachronous cancer. Dis Colon Rectum 1986;29:378–82.

    Article  PubMed  CAS  Google Scholar 

  162. Kelvin FM, Korobkin M, Heaston DK, Grant JP, Akwari O. The pelvis after surgery for rectal carcinoma: serial CT observations with emphasis on nonneoplastic features. AJR 1983;141:959–64.

    PubMed  CAS  Google Scholar 

  163. Lee JK, Stanley RJ, Sagel SS, Levitt RG, Mclennan BL. CT appearance of the pelvis after abdomino-perineal resection for rectal carcinoma. Radiology 1981;141:737–41.

    PubMed  CAS  Google Scholar 

  164. Zheng G, Eddleston B, Schofield PF, Johnson RJ, James RD. Computed tomographic scanning in rectal carcinoma. J R Soc Med 1984;77:915–20.

    PubMed  CAS  Google Scholar 

  165. Freitas JE, Dworkin HJ. Optimizing the detection of hepatic metastases. J Nucl Med 1979;20:264–6.

    Google Scholar 

  166. Mooney B, Critchley M, Grime S, Taylor I. Portal vein liver scanning for early detection of liver metastases in colorectal cancer (abstr). Gut 1981;22:A436.

    Google Scholar 

  167. Leveson SH, Wiggins PA, Giles GR, Parkin A, Robinson PJ. Deranged liver blood flow patterns in the detection of liver metastases. Br J Surg 1985;72:128–30.

    PubMed  CAS  Google Scholar 

  168. Bartolozzi C, Ciatti S, Lucarelli E, Villari N, de Dominicis R. Ultrasound and computer tomography in the evaluation of focal liver disease. Acta Radiol [Diagn] (Stockh) 1981;22:545–8.

    CAS  Google Scholar 

  169. Finlay IG, McArdle CS. Occult hepatic metastases in colorectal carcinoma. Br J Sug 1986;73:732–5.

    CAS  Google Scholar 

  170. Havelaar IJ, Sugarbaker PH, Vermess M, Miller DL. Rate of growth of intraabdominal metastases from colorectal cancer. Cancer 1984;54:163–71.

    Article  PubMed  CAS  Google Scholar 

  171. Schulz W, Hagen Ch, Hort W. The distribution of liver metastases from colonic cancer: a quantitative post mortem study. Virchows Arch [A] 1985;406:279–84.

    Article  CAS  Google Scholar 

  172. Pressman D, Keighley G. The zone of activity of antibodies as determined by the use of radioactive tracers: the zone of activity of nephritoxic antikidney serum. J Immunol 1948;59:141–6.

    CAS  PubMed  Google Scholar 

  173. De Nardo GL, De Nardo SJ. Perspectives on the future of radioimmunodiagnosis and radioimmunotherapy of cancer. In: Burchiel SW, Rhodes BA, eds. Radioimmunoimaging and radioimmunotherapy. New York: Elsevier North-Holland 1983:41–62.

    Google Scholar 

  174. Moldofsky PJ, Sears HF, Mulhern CS Jr, et al. Detection of metastatic tumor in normal-sized retroperitoneal lymph nodes by monoclonal-antibody imaging. N Engl J Med 1984;311: 106–7.

    Article  PubMed  CAS  Google Scholar 

  175. Chatal JF, Saccarvini JC, Fumoleau P, et al. Immunoscintigraphy of colon carcinoma. J Nucl Med 1984;25:307–14.

    PubMed  CAS  Google Scholar 

  176. Goldenberg DM, Kim EE, Bennett SJ, Nelson MO, Deland FH. Carcinoembryonic antigen radioimmunodetection in the evaluation of colorectal cancer and in the detection of occult neoplasms. Gastroenterology 1983;84:524–32.

    PubMed  CAS  Google Scholar 

  177. De Land FH, Goldenberg DM. In vivo cancer diagnosis by radioimmunodetection. In: Bruchiel SW, Rhodes BA, eds. Radioimmunoimaging and radioimmunotherapy. New York: Elsevier North-Holland, 1983;329–43.

    Google Scholar 

  178. Begent RH, Keep PA, Searle F, et al. Radioimmunolocalization and selection for surgery in recurrent colorectal cancer. Br J Surg 1986;73:64–7.

    PubMed  CAS  Google Scholar 

  179. Mach JP, Buchegger F, Forni M, et al. Monoclonal antibodies against carcinoembryonic antigen for the detection of human colon carcinoma by immunoscintigraphy. In: Givel J-CL, Saegesser F, eds. Colo-proctology. New York: Springer-Verlag, 1984:66–72.

    Google Scholar 

  180. Armitage NC, Perkins AC, Pimm MV, Wastie ML, Badwin RW, Hardcastle JD. Imaging of primary and metastatic colorectal cancer using an111In-labelled antitumor monoclonal antibody (79 IT/36). Nucl Med Commun 1985;6:623–31.

    Article  PubMed  CAS  Google Scholar 

  181. Whiteley HW Jr. Advanced colon and rectum cancer. In: Stearns MW, ed. Neoplasms of the colon, rectum and anus. New York: John Wiley & Sons, 1980:101–13.

    Google Scholar 

  182. Pihl E, Hughes ES, McDermott FT, Price AB. Recurrence of carcinoma of the colon and rectum at the anastomotic suture line. Surg Gynecol Obstet 1981;153:495–6.

    PubMed  CAS  Google Scholar 

  183. Segal MM, Goldberg SM, Nivatvongs SM, et al. Abdominoperineal resection for recurrent cancer following anterior resection. Dis Colon Rectum 1981;24:80–4.

    Google Scholar 

  184. Sannella NA. Abdominoperineal resection following anterior resection. Cancer 1976;38:378–81.

    Article  PubMed  CAS  Google Scholar 

  185. Corman ML. Colon and rectal surgery. Philadelphia: JB Lippincott Co, 1984.

    Google Scholar 

  186. Martin EW Jr, Minton JP, Carey LC. CEA-directed second-look surgery in the asymptomatic patient after primary resection of colorectal carcinoma. Ann Surg 1985;202:310–7.

    PubMed  Google Scholar 

  187. Stearns MW Jr. Diagnosis and management of recurrent pelvic malignancy following combined abdominoperinal resection. Dis Colon Rectum 1980;25:359–61.

    Google Scholar 

  188. Schiessel R, Wunderlich M, Hebst F. Local recurrence of colorectal cancer: effect of early detection and agrresive surgery. Br J Surg 1986;73:342–4.

    PubMed  CAS  Google Scholar 

  189. Vassilopoulos PP, Ledesman EJ, Yoon JM, Jung O, Mittelman A. Surgical treatment of metastatic colorectal adenocarcinoma. Dis Colon Rectum 1981;24:265–71.

    PubMed  CAS  Google Scholar 

  190. Wanebo HJ, Marcove RC. Abdominal sacral resection of locally recurrent rectal cancer. Ann Surg 1981;194:458–71.

    Article  PubMed  CAS  Google Scholar 

  191. Corriere JN. The obstructed ureter in the patient with cancer. In: Miller TA, Dudrick SJ, eds. The management of difficult surgical problems. University of Texas Press, 1981.

  192. James RD, Johnson RJ, Eddleston B, Zheng GL, Jones JM. Prognostic factors in locally recurrrent rectal carcinoma treated by radiotherapy. Br J Surg 1983;70:469–72.

    PubMed  CAS  Google Scholar 

  193. Beart RW Jr, Martin JK Jr, Gunderson LL. Management of recurrent rectal cancer. Mayo Clin Proc 1986;61:448–50.

    PubMed  Google Scholar 

  194. Foster JH. Survival after liver resection for secondary tumours. Am J Surg 1978;135:389–94.

    Article  PubMed  CAS  Google Scholar 

  195. Ekberg H, Tranberg K-G, Andersson R, et al. Determinants of survival in liver resection for colorectal secondaries. Br J Surg 1986;73:727–31.

    PubMed  CAS  Google Scholar 

  196. Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer: a comparison with resective treatment. Ann Surg 1984;199:502–8.

    Article  PubMed  CAS  Google Scholar 

  197. Adson MA, Van Heerden JA, Adson MH, Wagner JS, Ilstrup DM. Resection of hepatic metastases from colorectal cancer. Arch Surg 1984;119:647–51.

    PubMed  CAS  Google Scholar 

  198. Cady B, McDermott MV. Major hepatic resection for metachronous metastases from colon cancer. Ann Surg 1985;201:204–9.

    Article  PubMed  CAS  Google Scholar 

  199. Fortner JG, Silva JS, Golbey RB, Cox EB, Maclean BJ. Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. 1. Treatment by hepatic resection. Ann Surg 1984;199:306–16.

    PubMed  CAS  Google Scholar 

  200. Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 1976;111:330–4.

    PubMed  CAS  Google Scholar 

  201. Tomas-de la Vega JE, Donahue EJ, Doolas A, et al. A ten year experience with hepatic resection. Surg Gynecol Obstet 1984; 159:223–8.

    PubMed  CAS  Google Scholar 

  202. Logan SE, Meier SJ, Ramming KP, Morton DL, Longmire WP Jr. Hepatic resection of metastatic colorectal carcinoma: a ten-year experience. Arch Surg 1982;117:25–8.

    PubMed  CAS  Google Scholar 

  203. Kortz WJ, Meyers WC, Hanks JB, Schirmer BD, Jones RS. Hepatic resection of metastatic cancer. Ann Surg 1984;199: 182–6.

    Article  PubMed  CAS  Google Scholar 

  204. Bengmark S, Hafaström L, Jeppsson B, Jönsson P-E, Rydén S, Sundquist K. Metastatic disease in the liver from colorectal cancer: an appraisal of liver surgery. World J Surg 1982;6:61–5.

    Article  PubMed  CAS  Google Scholar 

  205. Iwatsuku S, Shaw BW Jr, Starzl TE. Experience with 150 liver resections. Ann Surg 1983;197:247–59.

    Article  Google Scholar 

  206. Nims TA. Resection of the liver for metastatic cancer. Surg Gynecol Obstet 1984;158:46–8.

    PubMed  CAS  Google Scholar 

  207. Rapjal S, Dsmahapatra KS, Ledesma EJ, Mittelman A. Extensive resection of isolated metastasis from carcinoma of the colon and rectum. Surg Gynecol Obstet 1982;155:813–6.

    Google Scholar 

  208. August DA, Sugarbaker PH, Ottow RT, Gianola FJ, Schneider PD. Hepatic resection of colorectal metastases: influence of clinical factors and adjuvant intraperitoneal 5-fluorouracil via Tenckhoff catheter on survival. Ann Surg 1985;201:210–8.

    Article  PubMed  CAS  Google Scholar 

  209. Moertel CG, Fleming TR, Creagan ET, Robin J, O'Connell MJ, Ames MM. High-dose vitamin C versus placebo in the treatment of patients with advanced cancer who have no prior chemotherapy. N Engl J Med 1985;312:137–41.

    Article  PubMed  CAS  Google Scholar 

  210. Grage TB, Vassilopoulos PP, Shingleton WW, et al. Results of a prospective randomized study of hepatic artery infusion with 5-fluorouracil versus intravenous 5-fluorouracil in patients with hepatic metastases from colorectal cancer: a Central Oncology Group study. Surgery 1979;86:550–5.

    PubMed  CAS  Google Scholar 

  211. Clark CG. Implantable vascular access devices in the treatment of colorectal liver metastases. Br J Surg 1986;73:419–21.

    PubMed  CAS  Google Scholar 

  212. Taylor I. Colorectal liver metastases: to treat or not to treat? Br J Surg 1985;72:511–6.

    PubMed  CAS  Google Scholar 

  213. Thomas P. Radiotherapy in the treatment of liver metastases. In: Van de Velde CJ, Sugarbaker PH, eds. Liver metastases. Amsterdam: Martinus Nijhoff, 1984:206–13.

    Google Scholar 

  214. Moffat FL, Falk RE, Calhoun K, et al. Effect of radiofrequency hyperthermia and chemotherapy on primary and secondary hepatic malignancies when used with metronidazole. Surgery 1983;94:536–42.

    PubMed  CAS  Google Scholar 

  215. Hughes ES, McConchie IH, McDermott FT, Johnson WR, Price AB. Resection of lung metastases in large bowel cancer. Br J Surg 1982;69:410–2.

    PubMed  CAS  Google Scholar 

  216. Wilking N, Petrelli NJ, Herrera L, Regal AM, Mittelman A. Surgical resection of pulmonary metastases from colorectal adenocarcinoma. Dis Colon Rectum 1985;28:561–4.

    Google Scholar 

  217. Cahan WG, Castro El B, Hajdu SI. The significance of a solitary lung shadow in patients with colon carcinoma. Cancer 1974;33: 414–21.

    Article  PubMed  CAS  Google Scholar 

  218. Johnston MR. Median sternotomy for resection of pulmonary metastases. J Thorac Cardiovasc Surg 1983;85:516–22.

    PubMed  CAS  Google Scholar 

  219. Regal AM, Reese P, Antkowiak J, Hart T, Takita H. Median sternotomy for metastatic lung lesions in 131 patients. Cancer 1985;55:1334–9.

    Article  PubMed  CAS  Google Scholar 

  220. Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastases: a 20 year experience. Am Thorac Surg 1984;38:323–40.

    Article  CAS  Google Scholar 

  221. Wilkins EW Jr, Head JM, Burke JF. Pulmonary resection for metastatic neoplasms in the lung: experince at the Massachusetts General Hospital. Am J Surg 1978;135:480–3.

    Article  PubMed  Google Scholar 

  222. McCormack PM, Martini N. The changing role of surgery for pulmonary metastases. Ann Thorac Surg 1979;28:139–45.

    Article  PubMed  CAS  Google Scholar 

  223. Marks P, Ferrag MZ, Ashraf H. Rationale for the surgical treatment of pulmonary metastases. Thorax 1981;36:679–82.

    Article  PubMed  CAS  Google Scholar 

  224. Morrow CE, Vassilopoulos PP, Grage TB. Surgical resection for metastatic neoplasms of the lung: experience at the University of Minnesota Hospitals. Cancer 1980;45:2981–5.

    Article  PubMed  CAS  Google Scholar 

  225. Mountain CF, Khalil KG, Hermes KE, Frazier OH. The contribution of surgery to the management of carcinomatous pulmonary metastases. Cancer 1978;41:833–40.

    Article  PubMed  CAS  Google Scholar 

  226. Kemeny N, Yagoda A, Golbey, R. Methyl CCNU, 5-fluorouracil, vincristine and streptozotocin for metastatic colorectal carcinoma. ASCO abstracts, 1978.

  227. Morrow M, Enker WE. Late ovarian metastases in carcinoma of the colon and rectum. Arch Surg 1984;119:1385–8.

    PubMed  CAS  Google Scholar 

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Manuel Devesa, J., Morales, V., Enriquez, J.M. et al. Colorectal cancer. Dis Colon Rectum 31, 636–652 (1988). https://doi.org/10.1007/BF02556803

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