Colon Cancer Clinical Trial
Official title:
Prognosis of Colon Cancer. Clinical and Pathological-anatomical Factors Concerned With Radical Surgery
1. Radical surgery. It is supposed to improve prognosis of colon cancer. A surrogate
measure of achievement of radical surgery is the number of lymph nodes removed with the
specimen.
2. Markers. There may be variables that may make patient assessment more sound. The
project is including investigation of such markers (genes, old age, comorbidity, and
others).
3. Laparoscopic resections. This is being used more and more in cancer surgery but the
feasibility of this approach remains to be proven compared with conventional open
surgery. The project compares these according to 1) and 2).
4. Morbidity and mortality must be surveilled to keep at a minimum. Many patients have
comorbidity and are old to make this factor extra important, including perioperative
care.
5. Proper treatment of colon metastases may prolong life. Treatment of lung-metastases
will be studied in particular.
1. Radical surgery. A detailed description of procedures for each location of tumor in the
large intestine is used. By following a given procedure for each location in the large
intestine, the number of lymph nodes can be analyzed for each location to find out if
this differs and if prognosis is affected by lymph node numbers according to tumor
site.
2. Markers. Different variables are examined for use in clinical judgment to make
treatment better as well as genetic experimental analyses for comparison with clinical
outcome to better understanding of clinical behavior.
3. Laparoscopic resections. The technical challenge of laparoscopic approach has been
compared with conventional surgery without any difference being observed in trials.
However, it should be compared with radical open surgery to compare best achievements
by using number of lymph nodes as well as outcome measures in the short and long term
(mortality).
4. Comorbidity, old age itself, type of surgery and perioperative care according to the so
called fast track surgery may all play a part in reducing perioperative morbidity and
mortality. A maximum 3% mortality should be aimed for.
5. Colon cancer usually metastasize to the liver and lungs. Surgical treatment of liver
metastases has been extensively studied and the prognosis has improved. Lung metastases
has not been given similar attention but the prognosis of those operated may be good
and equal that after liver surgery. The need for pulmonary resection and factors
associated with metastases and lung metastases in particular will be studied.
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Observational Model: Case Control, Time Perspective: Prospective
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