摘要:

AbstractA retrospective review to elucidate the rationale of preoperative irradiation was made on 18 carcinomas of the head of the pancreas area. After 50 Gy/25 fractions of 10 MV X‐ray was given, all 18 tumors decreased from 3.3±0.8 cm to 2.0±0.7 cm. At the surgical operation, 16 patients (89%) received pancreatic resection, without operative death. Histologically, in 13 of these 16 cases, the population of severely degenerative cancer cells (SDCC) was more than 1/3 of all cancer cells, and SDCCs were likely to locate at the periphery (advancing point of carcinoma). These histological patterns were considered as favorable to improve the operative curability. However, in the remaining three cases, the SDCC population was less than 1/3. In addition, nonaffected (i.e., viable) cancer cells were detected at the periphery, and this is an extremely adverse condition for subsequent surgery. Chronic pancreatitis in the noncancerous area was present in these three cases, but not in the 13 cases. Therefore, the most significant factor that predicts the radioresistance especially at the periphery of the carcinoma was considered to be coexisting chronic pancreati

ISSN:0022-4790    

DOI:10.1002/jso.2930400303

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

年代:1989

数据来源: WILEY

摘要:

AbstractSeveral recent reports have described an increase in the incidence of preinvasive carcinoma of the breast. To determine the incidence of preinvasive breast cancer at our institution, the results of 469 consecutive outpatient breast biopsies performed at Walter Reed Army Medical Center between July 1, 1985, and January 1, 1987, were reviewed. During this time period, 256 biopsies were performed on palpable masses, and 213 needle localization biopsies were performed on mammographically suspicious lesions. The overall incidence of cancer was 15.4%. Needle localization biopsies yielded a diagnosis of cancer in 17.8% of cases, as did 13.3% of biopsies performed on palpable masses. Eight of 38 (21.1%) carcinomas identified by mammography were preinvasive at the time of diagnosis. Only one of 34 (2.9%) cancers identified because of a breast mass was preinvasive. We conclude that screening mammography is an invaluable tool for the detection of preinvasive carcinoma of the breast and that the increased use of mammography will result in an increase in the incidence of detection of this lesion.

ISSN:0022-4790    

DOI:10.1002/jso.2930400304

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe diagnostic role of surgical procedures in small cell lung carcinoma (SCLC) is well established. The therapeutic role of surgery has changed over the years. At present, curative resection is the treatment of choice in peripheral T1‐2NoMoSCLC, and adjuvant chemotherapy may be beneficial. Surgery is also indicated in SCLC patients diagnosed by a limited pathologic sample in whom the clinical course suggests nonsmall cell lung carcinoma (NSCLC). The resection may reveal either a mixed tumor or an alternate diagnosis and may be potentially curative. Surgery, at the time of maximal response to chemotherapy in T3NoMoSCLC, may be curative and reveal the presence of NSCLC elements. The best survival is in patients found to be tumor‐free at surgery, and the worst survival is in N2patie

ISSN:0022-4790    

DOI:10.1002/jso.2930400305

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

年代:1989

数据来源: WILEY

摘要:

AbstractBetween January 1967 and July 1986, 171 patients with malignant stenosis of the esophagus and cardia were subjected to curative or palliative surgical treatment. Specifically, there were 84 primary esophageal carcinomas, 5 cases of malignant esophageal stenosis caused by an extraesophageal malignant tumor (inter alia bronchial carcinoma), and 82 primary carcinomas of the cardia. The average age of the patients as a whole was 63.7 years, and the sex ratio (male:female) was 4.0:1. In 18 esophageal carcinoma patients and 21 patients with carcinoma of the cardia curative resection was possible, but in 132 patients merely palliative surgery was performed, most frequently esophageal intubation and gastrostomy. The specific operations with a curative objective performed upon the esophageal carcinoma patients were abdominothoracic esophageal resection with upward displacement of the stomach (n = 16) or interposition of a colonic segment (n = 2), whereas in the patients with carcinoma of the cardia, proximal resection was performed in 13 cases, either subtotally or as a cardiofundectomy, and total gastrectomy in 8 cases. For the subsequent reconstruction of the passage the interposition of a jejunal segment was most frequently used. The clinical mortality for the curative resections was 33% for the 18 esophageal carcinoma patients and 9.5% for the 20 patients with carcinoma of the cardia. The long‐term survival rates are depressing: of the patients who underwent curative resection 47.6% were still alive after one year, 28.6% after 2 years and 14.3% after 5 years. Of the patients treated only palliatively on account of an already advanced stage of the tumor, 91.5% died within the first year; only 4.9% of patients from this group were still alive after 2 year

ISSN:0022-4790    

DOI:10.1002/jso.2930400306

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

年代:1989

数据来源: WILEY

摘要:

AbstractSensitivity of various mouse tissues to heat was determined using mouse sarcoma‐180 (S‐180) cells and normal tissues: esophagus, stomach, small intestine, large intestine, liver, spleen, and kidney. The in vitro succinate dehydrogenase inhibition (SDI) test was used. The succinate dehydrogenase (SD) activity of tissue fragments was assayed, following exposure to a temperature of 43°C (heat treatment) or 37°C (control) for 1, 2, 5, or 10 hr. The sensitivity to heat treatment was estimated by the percentage of SD activity of the heat‐treated cells, compared to that of the control cells. The decrease in SD activity following exposure to heat varied with the tissue. The SD activity decreased to a greater extent in the S‐180 cells than in the normal tissues. In the normal tissues, the order of sensitivity to heat was stomach, spleen, large intestine, small intestine, esophagus, kidney and liver. These results show that hyperthermia is tissue selective, hence heat treatment of a malignant lesion should be carefully

ISSN:0022-4790    

DOI:10.1002/jso.2930400307

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

年代:1989

数据来源: WILEY

摘要:

AbstractGlottic carcinoma is curable by either surgery or radiotherapy. A total of 60 patients were treated by radiation alone at the Northern Israel Oncology Center, Rambam Medical Center, Haifa, between 1970 and 1980. Twentynine (48%) were classified as T1N0and 31 (52%) as T2N0. All patients received radiotherapy primarily with curative intent, with surgery reserved for recurrences. The 5‐year actuarial survival for all patients was 90% and actuarial disease‐free survival was 95%. In ten patients (17%) there was local failure, and five of them were salvaged by surgery. There were no significant acute or long‐term complications of radiation. Factors influencing treatment outcome (anterior commissures involvement, degree of differentiation, treatment volume, and technique of irradiation) and the occurrence of second primary malignancies are disc

ISSN:0022-4790    

DOI:10.1002/jso.2930400308

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

年代:1989

数据来源: WILEY

摘要:

AbstractNinety‐one patients with metastatic colorectal cancer were treated with continuous ambulatory 5‐fluorouracil (5FU) infusion 250‐300 mg/m2/day through a chronic indwelling central venous catheter. Twenty‐six of the 91 patients (29%) had received previous bolus 5FU. Fifty‐eight of the 91 patients (64%) had two or more sites of disease, and 74 of 91 patients (81%) had liver metastases. Results were complete remission in 5 of 91 (6%), partial remission in 25 of 91 (27%), stable disease in 33 of 91 (36%), and progressive disease in 28 of 91 (31%), for an overall response rate of 30 of 91 (33%); median duration of response was 7 months. Twenty‐six of 65 previously untreated patients (40%) experienced objective response. Median survival from initiation of treatment for all patients was 11 months. Forty‐one percent of patients experienced no significant toxicity and were able to continue therapy without treatment interruption. Toxicities necessitating treatment interruption included stomatitis in 35 patients (39%), hand‐foot syndrome in 33 patients (36%), and diarrhea in 10 patients (11%). No significant myelosuppression or serious catheterrelated complications were encountered. We conclude that continuous systemic venous infusion of 5FU produces a higher response rate than traditional bolus 5FU schedules, with apparent enhancement of survival and easily m

ISSN:0022-4790    

DOI:10.1002/jso.2930400309

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

年代:1989

数据来源: WILEY

摘要:

AbstractFrom August 1985 to January 1987, 30 patients were treated with radical nerve‐sparing prostatectomy with epidural anesthesia. Transrectal ultrasound evaluation was available for the vast majority of these patients. Utilizing the anatomic techniques of early dorsal vein ligation, hypogastric artery control, and epidural anesthesia, blood loss was kept to a minimum, with 22 patients requiring no transfusions in this series. In addition, with the use of ultrasound, PSA (prostatic‐specific antigen) determination, and pelvic CAT scan, 22 of the 30 patients (75%) had organconfined disease. Twenty patients were potent preoperative and 14 are potent postoperative, for a potency rate of

ISSN:0022-4790    

DOI:10.1002/jso.2930400310

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

年代:1989

数据来源: WILEY

摘要:

AbstractWe reviewed our experience at the Western Reserve Care System with totally implantable drug delivery systems (IDDS) in cancer patients with vascular access problems. Fifty‐one ports were placed in 50 patients. Forty‐nine of the IDDS were placed under local anesthesia. One patient developed a hemothorax during placement. Two catheters were removed because of infection. Two catheters found to be occluded responded to flushing with streptokinase. All catheters remained functional up to the time of treatment completion or of the patient's death. The low morbidity and high success rates of IDDS should encourage placement early in the course of chemother

ISSN:0022-4790    

DOI:10.1002/jso.2930400311

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

年代:1989

数据来源: WILEY

摘要:

AbstractThirty‐three patients with small cell carcinoma of the lung were treated surgically, and immunohistochemistry of the cell differentiations was examined in detail. The overall 5‐year survival rate was 38% and the rates in patients with stage I or stage III were 57% and 11%, respectively (P<0.05). Survival rates in patients with the oat cell type and intermediate type were 24% and 44%, respectively, but with no significant difference. This carcinoma seemed to originate from primitive multipotential stem cells, i.e., those of a neuroendocrine or epithelial nature. Histochemically and immunohistochemically, argyrophilic granules and neuron‐specific enolase, neuroendocrine markers, were detected more frequently in the oat cell type rather than in the intermediate type. In contrast, keratin, epithelial membrane antigen, and carcinoembryonic antigen, epithelial origin markers, were present more frequently in the intermediate type than in oat cell type. However, the difference was significant only in case of detection of argyrophilic granules and the carcinoembryonic antigen (P<0.05). Our current recommendation is that surgical resection should be done in the earlier stage in both subtypes. A more favorable prognosis can be expected when adjuvant chemotherapy is presc

ISSN:0022-4790    

DOI:10.1002/jso.2930400312

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

年代:1989

数据来源: WILEY