Different techniques of proximal gastric vagotomy were used from 1970 to 75 in 267 patients with duodenal ulcer. A 1-4 years clinical follow-up showed an unacceptable high rate of recurrent ulcer (23-24%) in patients having skeletonization of the lower 2 cm of the esophagus, regardless of the extent of preserved antral innervation (6-9 cm). Extension of the esophageal dissection resulted in a lower recurrence rate (8%) and a higher frequency of complete vagotomies as expressed by the average acid response to insulin. No constant relationships were found between reductions of basal acid output and peak acid output to histamine 10 days after proximal gastric vagotomy and the risk of recurrent ulcer.
Eighteen tumor samples from 11 patients with metastatic colorectal cancer were cytogenetically analyzed after short-term culturing. Of the 13 metastases examined, 11 were from lymph nodes, 1 from the peritoneum and 1 from the lung. In 5 of the 11 patients, matched samples from the primary tumor and lymph node metastases were analyzed. Cytogenetic similarities between the primary and secondary lesions were found in all 5 cases, indicating that many of the chromosomal aberrations presumably occurred before disease spreading took place. Compared with the primaries, the metastases appeared to exhibit decreased clonal heterogeneity but, concurrently, an increase in the karyotypic complexity of individual clones. Among the aberrations recurrently found in metastatic lesions were del(1)(p34), i(17)(q10), -18, -Y, -21, +7 and +20, all of which have been seen repeatedly in previous series of primary colorectal carcinomas, and del(10)(q22) and add(16)(p13), which so far have not been associated with primary tumors and which may play a particular pathogenetic role in the metastatic process.
Colorectal cancer is diagnosed in more than 3000 people every year in Denmark, with a population of 5 million, and 2000 die from this disease every year. The aetiology of the disease is complex, but an increasing number of cancers have been related to genetics and Denmark is contributing with a well-established register of familial adenomatous polyposis and a recently founded register for hereditary non-polyposis colorectal cancer, both with major international relationships. The Danish tradition of epidemiology and clinical trials has also been demonstrated in population screening trials for colorectal cancer in average-risk persons as well as high-risk groups with precursors of the disease. The present review places Danish contributions within the prophylaxis of colorectal cancer during the last decade in an international context.
