摘要:

AbstractTo evaluate the nutritional benefits of a jejunal pouch vs. esophagojejunostomy following total gastrectomy, we reviewed 24 consecutive cases of total gastrectomy: 14 males and 10 females, 39 to 85 years of age (mean 66.6 y.) undergoing 9 jejunal pouches (JP) and 15 Roux‐en‐Y esophagojejunostomy (EJ). Indications for surgery included 15 adenocarcinomas, 3 lymphomas, 1 leiomyoma, and 5 hemorrhagic gastritis. The operative mortality was 12.5%. One JP patient was lost to follow‐up. The mean survival for EJ was 13.3 months and for JP 36 months. Total gastrectomy resulted in persistent weight loss and hypoalbuminemia, and the creation of a jejunal pouch did not seem to improve significantly the nutritional status following total gastre

ISSN:0022-4790    

DOI:10.1002/jso.2930400403

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

年代:1989

数据来源: WILEY

摘要:

AbstractUsing the data base for melanoma incidence compiled by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, we compared the incidence and anatomic distribution of primary cutaneous melanomas in Hispanic and non‐Hispanic Caucasian populations and in blacks between 1973 and 1981. Cases were divided into United States whites, New Mexico (NM) whites (non‐Hispanic Caucasians), NM Hispanics, Puerto Rico (PR) residents by definition Hispanic, and US blacks. Among whites, the highest incidence was 8.0 per 100,000 and was ten times that of US blacks. The incidence among PR and NM Hispanic residents was 1.6 to 3.7 times that of US blacks. The anatomic distribution among NM Hispanics was similar to US and NM whites for both genders. In contrast, among PR residents the anatomic distribution in both genders was most common for the leg, similar to that for blacks. Spaniards who migrated to PR have more admixture with blacks from Africa than Spaniards who migrated to the mainland. This suggests a genetic predilection for the occurrence of melanoma on the lower extremity among PR residents as opposed to NM Hispan

ISSN:0022-4790    

DOI:10.1002/jso.2930400404

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

年代:1989

数据来源: WILEY

摘要:

AbstractA review of the literature on penis cancer has been undertaken. The disease is rare and most of the cumulative experience is reported in retrospective series. Multi‐institutional international collaboration will be needed to study prospectively facets of this disease where controversy presently exists. Suggested areas of research are in the treatment of early invasive tumours, the diagnosis and treatment of inguinal metastases, the improvement of radiotherapy techniques, and the development of effective chemotherapy and effective combinations of therapies. This will potentially lead to a greater degree of organ sparing. Studies of palliation, and aspects of quality of life, are also needed. Public education about the condition and genital hygiene, including the necessity for the early treatment of phimosis, may further reduce the incidence of penis cance

ISSN:0022-4790    

DOI:10.1002/jso.2930400405

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

年代:1989

数据来源: WILEY

摘要:

AbstractData from the American College of Surgeons' prostate cancer surveys covering nearly a decade of experience demonstrate that the problem of prostate cancer is unique among black men in the United States. These data show that the distribution of stage at diagnosis changed across the 10‐year interval. The data indicate that there have been improvements in the 5‐year survival rates of both black and white patients, but the prostate cancer‐specific survival of black patients remains significantly poorer than that of w

ISSN:0022-4790    

DOI:10.1002/jso.2930400406

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

年代:1989

数据来源: WILEY

摘要:

AbstractWe reviewed the records of 110 consecutive patients with advanced‐stage epithelial ovarian carcinoma treated at the Soroka Medical Center, Beer‐Sheva, Israel, from 1961‐1987. Twenty patients (18.1%) had optimal debulking at initial laparotomy, 30 patients (27.2%) had nonoptimal debulking at initial laparotomy, 20 patients (18.1%) had an “inoperable” disease at initial laparotomy, and 40 patients (36.3%) had such poorly written records that no information about the degree of resectability at initial laparotomy could be obtained. Four patients, in whom the residual tumor left at initial laparotomy had responded to chemotherapy, had a second laparotomy. In all four patients optimal debulking surgery at second laparotomy was easy to perform and was successful. The value of a second laparotomy after a few cycles of chemotherapy in order to optimally debulk the residual tumor left at initial laparotomy is discussed. It is concluded that a second attempt of debulking surgery after chemotherapy has a respectable place in the management of patients with advanced‐state epithelial ovarian carcinoma, but further researc

ISSN:0022-4790    

DOI:10.1002/jso.2930400407

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

年代:1989

数据来源: WILEY

摘要:

AbstractDuring the period between 1970‐1984, 481 patients with previously untreated non‐Hodgkin's lymphoma were referred to the Northern Israel Oncology Center, Haifa. There were 264 (54.9%) Ashkenazi Jews, 123 (25.6%) non‐Ashkenazi Jews, and 86 (17.9%) Arabs. The mean age at diagnosis was 60 ± 15 years for Ashkenazi Jews, 45 ± 22 years for non‐Ashkenazi Jews, and 36 ± 22 years for Arabs. Ashkenazi Jews had a higher rate of nodular lymphoma compared to non‐Ashkenazi Jews and Arabs. Extranodal lymphoma occurred more frequently in non‐Ashkenazi Jews and Arabs. Lymphoma of the small intestine was more common in Arabs than in Ashkenazi and non‐Ashkenazi Jews. Despite these differences in the pattern of disease, 5 year actuarial survival figures for the various ethnic gro

ISSN:0022-4790    

DOI:10.1002/jso.2930400408

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

年代:1989

数据来源: WILEY

摘要:

AbstractPrognostic indicators in 67 patients with unresectable colorectal liver metastases were analyzed. These patients were identified to have isolated hepatic metastases after extensive radiological evaluation and demonstrated good performance status without evidence of liver failure. Univariate analysis revealed 6 of 22 factors that were associated with survival: alkaline phosphatase (AP), lactic dehydrogenase (LDH), occult intra‐ab‐dominal extrahepatic disease, percent hepatic replacement by tumor (PHR), sex, and carcinoembryonic antigen (CEA). A multivariate analysis identified two independent factors that jointly influenced survival: AP and PHR. Patients with an AP>175 U/liter had a greater than threefold relative risk of dying compared with patients with AP ⩾ 175 U/liter (P= 0.0001). Patients with PHR II or III (25–75%,>75%) also had a greater than threefold relative risk of dying compared with patients with PHR 1 (<25%;P= 0.0074). Our patient population is typical of that being entered into trials examining experimental therapies. Alkaline phosphatase and extent of liver involvement by tumor are significant prognostic indicators that should be accounted for in such

ISSN:0022-4790    

DOI:10.1002/jso.2930400409

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

年代:1989

数据来源: WILEY

摘要:

AbstractBetween 1952 and 1982, 55 patients underwent bilateral radical neck dissections at the National Cancer Institute. Of these, 17 patients had simultaneous (one‐stage) bilateral dissections and 38 had nonsimulta‐neous (two‐stage) dissections. In 37 patients both internal jugular veins were removed, while one vein was preserved in 18 patients. The operative mortality was 11.8% (2/17 patients) for simultaneous bilateral neck dissections and 2.6% (1/38 patients) for nonsimultaneous staged dissections. The overall operative mortality was 5.4%. Of the 18 patients in whom one jugular vein was preserved, six patients (33%) had postoperative facial edema and swelling, while of the 37 patients in which neither jugular vein was saved, 20 patients (54%) developed significant postoperative facial edema. The overall 2‐year recurrence rate was 50%. The overall survival rates were 55% at 3 years and 39% at

ISSN:0022-4790    

DOI:10.1002/jso.2930400410

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

年代:1989

数据来源: WILEY

摘要:

AbstractThis study compares the efficacy of percutaneous transhepatic drainage (PTD) versus operative biliary decompression for patients with malignant obstructive jaundice. The utilization of preoperative PTD as a surgical adjuvant is also examined. The records of 90 patients with obstructed jaundice from two large community hospitals were reviewed. In the group of patients undergoing curative resections, no advantage was noted for the patients who received preoperative PTD. The patients receiving only surgery left the hospital 8 days sooner. For the patients undergoing palliative treatment, the group receiving only the surgery had the lowest morbidity and mortality and the longest survival rates. The patients receiving only PTD had the shortest hospital stay, but also had many complications, the highest mortality rate, and the shortest survival rate. The group receiving preoperative PTD followed by surgical decompression had more complications and stayed in the hospital longer, with no change in postoperative mortality.

ISSN:0022-4790    

DOI:10.1002/jso.2930400411

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

年代:1989

数据来源: WILEY

摘要:

AbstractA good experimental model for metastasis of human pancreatic cancer would be a valuable tool for the study of this process, which contributes significantly to morbidity and mortality. Models of experimental metastasis using injection of tumor cells into the portal or systemic circulation bypass some important steps of the metastatic process. We describe invasion and metastasis following orthotopic transplantation of human pancreatic carcinoma into nude mice. Tumor pieces were used as xenografts in this study, and metastases were observed in the regional lymph nodes, liver, lungs, and distant lymph nodes of the animals. Peritoneal implants and ascites were not observed in this study. Orthotopic transplantation of human pancreatic cancer in the nude mouse appears to be a promising model of spontaneous metastasis relevant to clinical reality.

ISSN:0022-4790    

DOI:10.1002/jso.2930400412

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

年代:1989

数据来源: WILEY