摘要:

AbstractA large number of cases of ocular melanoma have been entered in The Provincial Cancer Registry of Alberta over the past 40 years. This study was undertaken in order to describe further the natural history of this disease and derive management recommendations for use at the provincial level. A retrospective chart review was carried out on all cases of ocular melanoma registered through The Alberta Provincial Cancer Registry between 1949 and 1987. Two hundred fifty‐one cases were identified: 143 were males and 108 were females. The mean age of the patients at diagnosis was 60. The majority of the melanomas arose from the choroid of the eye (82%) with the remainder arising from the iris, conjunctiva and ciliary body, respectively. According to the Callender classification for ocular melanomas, the majority of the melanomas were of the spindle cell type (53%), the others being either mixed cell (23%), epithelioid (8%), or fascicular (1%). Survival rates differed depending on the cell type. Spindle cell tumors demonstrated a mean survival time of 5.2 years; epithelioid tumors 4.8 years and the mixed cell tumors appeared to be the most aggressive with a mean survival time of 2.7 years after diagnosis. The majority of deaths from ocular melanoma occurred within 5 years of diagnosis, although 14% of patients in this review presented with metastases more than 10 years after diagnosis. Some of the cases of ocular melanoma could be classified pathologically as small, medium, or large. Patients with large ocular melanomas had a 5 year survival rate of 33% compared to 70% and 66% for patients with small and medium sized tumors. Of note, 43% of patients with large ocular melanomas who were dead from their disease within 5 years of diagnosis were also found to have mixed cell tumors. These findings call for a longer follow‐up period for ocular melanomas and point to the importance of cell type and tumor size as predictors of survival and as guides in planning prophylactic therapeutic interventi

ISSN:0022-4790    

DOI:10.1002/jso.2930420403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractA histopathologic study was done on tissues from 117 patients with colorectal carcinoma, and we compared data on 57 patients who died of a recurrence within 2 years (group I) with 60 others who survived for over 10 years (group II). All patients were surgically treated and followed for over 10 years. Particular attention was directed to the very advancing margin of the tumor, and we examined invading modes of sprouting tumor cells, reactive fibrosis, and inflammatory infiltration around the tumor, in addition to the other clinicopathologic features. In group II, extensive sprouting of individual tumor cells occurred less often, and intense reactive fibrosis and marked inflammatory infiltration around the tumor were more frequent than in group I in which conspicuous lymphatic and vascular permeations were often present. We propose that the invading mode of sprouting tumor cells and the presence or absence of reactive fibrosis and inflammatory infiltration at the advancing margin of the colorectal tumor are of prognostic value.

ISSN:0022-4790    

DOI:10.1002/jso.2930420404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe clinical records of 94 patients with regionally advanced melanoma (nodal disease or regional satellites) were reviewed to determine the value of preoperative bone and liver imaging. Of 68 bone scans obtained, none were suggestive of metastases. Of 97 liver imaging studies (computed tomography, scintiscan, or sonography) in 88 patients, only two were found to have demonstrable metastases. Liver enzyme elevation was present in both of these patients. Bone and liver imaging in the absence of signs or symptoms of dissemination by history, physical examination, chest x‐ray, and enzyme determination for regionally advanced melanoma appears to be of little value unless the patient is involved in a protocol stud

ISSN:0022-4790    

DOI:10.1002/jso.2930420405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractA review of 208 cases of surgically treated squamous cell carcinoma of the esophagus revealed 16 (7.7%) with hypercalcemia. There was no evidence of bone metastases in 13 (6.3%) of the patients with hypercalcemia. Pathogenesis of this hypercalcemia without bone metastases was suggested to be multifactorial. Anastomotic leakage and malnutrition because of fasting were the most possible causes of mild hypercalcemia, and moderate to severe hypercalcemia was thought to be due to subclinical and clinical recurrence of the tumor, probably with PTH‐like hormonal activity. Overall survival rates in the groups with and without hypercalcemia were 18.2 and 61.7% at the 12th postoperative month and 9.1 and 37.8% at the 24th month, respectively. Thus hypercalcemia is a significant prognostic factor linked to an unfavorable clinical course even in patients with no evidence of bone metastase

ISSN:0022-4790    

DOI:10.1002/jso.2930420406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractTwenty‐two patients with locally advanced or metastatic head and neck tumors received a total of 84 courses of a combination of cisplatin, bleomycin, and Methotrexate (PBM) for a median of four courses per patient (range, 1‐7). Among these 22 patients there were four patients (18%) who achieved complete remission (CR) and 13 patients (60%) who had a partial remission (PR). The overall remission rate (CR + PR) thus reached 78%; five patients (22%) progressed while on therapy. The mean duration of objective response (CR + PR) was 8 months; CR lasted a median of 18 months (range, 2‐48). Survival was not influenced by tumor histology or by previous surgery. The presence of locoregional disease did adversely affect survival from the onset of chemotherapy (P= 0.1). The rate of survival was also affected by primary tumor site; patients with nasopharyngeal primaries survived longer than all other patients (22 vs. 11 months,P= 0.06). Toxicity to chemotherapy consisted mainly of nausea and vomiting and stomatitis. Three patients developed fever while leukopenic. One patient experienced irreversible renal damage, and another suffered from bleomycin‐induced pulmonary fibrosis. The high response rate obtained in our group of patients did not have a substantial impact on overall survival. Aggressive, multimodality approaches should be considered in the treatment of these patients when p

ISSN:0022-4790    

DOI:10.1002/jso.2930420407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractDuring a 10‐year period (1976‐1985), a total of 596 cervical lymph node biopsies for diagnostic purposes were performed at our institution. Thirty‐five percent of these nodes were involved with malignant lymphoma, and 20.5% showed metastatic deposits. Nondiagnostic reactive hyperplastic changes were noted in 23% of the cases. Several other inflammatory and neoplastic conditions were encountered. Comparison of our data with several series from different countries with review of relevant literature are pres

ISSN:0022-4790    

DOI:10.1002/jso.2930420408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractSince the first report of inflammatory pseudotumor of the liver in 1953, 12 cases have been reported in the literature. The authors report herein five cases of inflammatory pseudotumor of the liver in our hospital. These tumors were resected and the diagnosis confirmed pathologically. Three of the patients were male and two female. Four of these patients had been misdiagnosed as having primary liver cancer by sonography and CT scan. Our experience has shown that if the patient had a long clinical course, few clinical symptoms, good general condition, and a negative alphafetoprotein assay, if the tumor was well encapsulated and the liver presented without cirrhosis, the patients should be suspected of having inflammatory pseudotumor of liver. In this series, all five patients underwent hepatectomy. There were no complications after operation. Surgical resection should be considered as the main therapeutic method for inflammatory pseudotumor of liver. If the patient proves unsuitable for surgical treatment, steroid therapy should be the treatment of choice. In this paper 12 cases of inflammatory pseudotumor of liver reported in the literature are reviewed and discussed.

ISSN:0022-4790    

DOI:10.1002/jso.2930420409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe aim of this study was to assess the utility of intraoperative ultrasound (IOUS) in the diagnosis and management of liver metastases from colorectal carcinoma. IOUS was performed on a consecutive series of 70 patients undergoing surgery for colorectal carcinoma, with follow‐up ranging from 6 to 24 months. In ten cases (14.3%), 13 metastatic tumours were diagnosed; only six of these had been found by preoperative workup and/or surgical inspection. Seven (53.9%) small metastatic liver lesions were identified only by IOUS. None of the lesions diagnosed by IOUS was palpable, and they were all extremely small—ranging from 4 × 6 to 12 × 16 mm. Seventy‐three locations were examined in order to compare the results of IOUS with those of other methods. The sensitivity of the former proved to be higher (P<.05) than that of conventional pre‐ and intraoperative

ISSN:0022-4790    

DOI:10.1002/jso.2930420410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe modern treatment of breast cancer has evolved over the past 100 years based on clinical observations. Therapeutic principles, from the choice of surgical procedure to the management of disseminated disease, have also changed. The axillary tumour burden, that is, the number of histologically positive nodes (N+) plays an important role as a prognostic factor. However, in histologically Negative nodes (N−), it is necessary to discriminate individuals at high risk despite negative nodes. This presentation analyses retrospectively the prognostic factors for long‐term failures in N−patients. These prognostic factors need to be studied in detail, and controlled clinical trials should be carried out to detect high risk N−patients and consider them for adjuvant chemo

ISSN:0022-4790    

DOI:10.1002/jso.2930420411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractTwo patients with metastatic gastrointestinal adenocarcinoma in the breast are reported. Metastases in the breast are usually painless upper outer quadrant masses. On mammography they are typically well‐circumscribed lesions without microcalcifications. A breast mass in a patient with a history of cancer, even if clinically or mammographically benign, should raise suspicion of a metastasis. Pathological features include a histologic pattern similar to the primary neoplasm and an absence of in situ carcinoma which characterizes primary breast cancer. Surgical excision for local control and systematic therapy is the most appropriate treatmen

ISSN:0022-4790    

DOI:10.1002/jso.2930420412

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY