摘要:

AbstractGastric cancer invading the subserosa with infiltrative growth was classified as part of the serosal invasion group and named prognostic serosal invasion positive [ps(+)] histologically.We analyzed clinicopathological features and prognosis of 166 Japanese patients with gastric cancer invading the subserosa, according to the growth pattern. All patients were treated in the Department of Surgery II, Kyushu University. Patients with infiltrative growth (ssγ) were younger and their tumors were frequently undifferentiated compared to findings in those with noninfiltrative growth: expansive (ssα) and intermediate growth (ssß). There was no difference in any other clinicopathological characteristic between those with infiltrative and noninfiltrative growth tumors. The 10‐year survival rate was 66.7% for the infiltrative type and 54.2% for the noninfiltrative type, with no statistically significant difference. Lymph node metastasis, curative resection, and extended lymph node dissection, but not growth pattern, proved to be independent prognostic factors, as determined by multivariate analysis.Our findings suggest that it is not the growth pattern which affects the prognosis of ss cancers. Extensive lymph node dissection should be done when lymph node metastasis is present. © Wiley‐Li

ISSN:0022-4790    

DOI:10.1002/jso.2930550402

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

年代:1994

数据来源: WILEY

摘要:

AbstractIn 127 patients with colorectal carcinoma, we measured thymidine uptake by tumor cells cultured in a semisolid medium and compared the influence of various parameters on survival by univariate and multivariate analysis.Fifty‐four of the 127 carcinomas (42.5%) incorporated>1,000 cpm of tritiated thymidine per culture dish and were designated as the high‐uptake group, while the other tumors (57.5%, 73/127) were designated as the low‐uptake group. There was no significant correlation between high or low thymidine uptake and most of the clinicopathological characteristics of the patients. Patients in the high‐uptake had a poor prognosis and a 7‐year survival rate of 32.6%, which was significantly different from the rate of 69.3% in the low‐uptake group (P<0.0005). Multivariate analysis showed that thymidine uptake was one of the variables strongly associated with survival in our study population.Thus, it is concluded that thymidine uptake by tumor cells has a high capacity of predicting prognosis, independent of its relationship to other variables. Furthermore, it seems to us that thymidine uptake can help in selecting those patients with colorectal carcinoma who are most likely to benefit from perioperative adjuvant therapy. © Wil

ISSN:0022-4790    

DOI:10.1002/jso.2930550403

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

年代:1994

数据来源: WILEY

摘要:

AbstractRenal cell carcinoma (RCC) producing α‐fetoprotein (AFP) is a rare entity and merely 7 cases have been reported so far. The present case, a 71‐year‐old woman, showed a high serum AFP level of 204 ng/ml. The RCC of the autopsied right kidney consisted mainly of spindle‐shaped or bizarre sarco‐matous tumor cells. AFP was immunolocalized only in the concomitant clear cell component. Concanavalin A (Con A)‐nonadsorption rate of serum AFP was 42%, which was an intermediate value between those of yolk sac tumors and metastatic liver carcinomas. Lens culinalis agglutinin (LCA)‐affinity study of the patient's AFP showed an unknown peak X, which was eluted between the known peaks 2 and 3. These results suggest a certain structural alteration in carbohydrate moieties of the AFP derived from this RCC. A review of the clincopathologic features of 8 patients with AFP‐producing RCC was made to understand the pathophysiology of AFP‐producing neoplasms.

ISSN:0022-4790    

DOI:10.1002/jso.2930550404

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

年代:1994

数据来源: WILEY

摘要:

AbstractAutolymphocyte therapy (ALT) is adoptive cellular therapy of cancer using ex vivo activation of autologous peripheral blood lymphocytes (PBL). Memory T cells are the principal effector population in ALT, with in vivo activity in patients with metastatic renal cell carcinoma (RCC) and melanoma, and ex vivo cytotoxicity against autologous tumor targets. However, the noncytolytic lymphocyte portion of ex vivo‐activated memory T cells (ALT cells) may also contribute as antitumor effectors. Pre‐treatment of murine and human tumor cells ex vivo with chemotherapeutic agents can enhance their susceptibility to antitumor lymphocytes ex vivo and in vivo. To determine whethercis‐diamminedichloroplatinum(II) (DDP) could enhance ex vivo antitumor effects of ALT cells by immuno‐modulation, human breast and colorectal carcinoma target cells were derived from both primary and metastatic surgical specimens and incubated in complete medium (CM) with DDP or in CM alone (control group). Viability of each group was confirmed by trypan blue—dye exclusion test. ALT cells were prepared from autologous PBL at surgery. Primary and metastatic tumor cells from each group were used as targets for ALT cells and levels of interferon‐γ (IFN‐γ) release were measured as a determination of antitumor effect and recognition. Primary tumor target cells incubated in DDP showed enhanced antitumor effects and recognition by autologous ALT cells, as measured by the IFN‐γ assay compared to non‐DDP‐treated controls. Metastatic autologous tumor target cells demonstrated less IFN‐γ release than did the primary targets, although this was enhanced by pre‐treating metastatic tumor targets with DDP. ALT cells demonstrated minimal IFN‐γ release when incubated with allogeneic tumor targets. These data suggest that autotumor recognition of metastatic tumor targets is comparable to that of primary lesions following ex vivo pretreatment of metastatic cells with nonlethal doses of certain chemotherapeutic agents. DDP may somehow alter the physical properties of target cells, rendering them susceptible to immune‐mediated attack and the combination of ALT and DDP may lead to increased therapeutic efficacy in patients with metastatic breast and

ISSN:0022-4790    

DOI:10.1002/jso.2930550405

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

年代:1994

数据来源: WILEY

摘要:

AbstractIt has been suggested that the portal vein should be occluded during intermittent hepatic dearterialization in order to induce a more complete ischemia of the tumor. In this experiment the influence of portal branch ligation in combination with repeat dearterializations on a liver tumor was investigated. Twenty‐seven rats were randomly allocated to sham treatment (n = 6); portal branch ligation (PBL) (n = 7); 120 min of repeat dearterialization (n = 7); and portal branch ligation (PBL) in combination with 50 min of repeat dearterialization (n = 7) (once a day during 5 days). The results showed that portal branch ligation alone did not alter the tumor growth compared with sham treatment (P>0.05), nor did portal branch ligation in combination with repeat dearterializations for 50 min (P>0.05). However, tumor growth delay was achieved following 120 min of repeat dearterializations without occlusion of the portal branch (P<0.01 versus all the other groups). There was a significant weight loss of the lobe undergoing PBL, whether dearterialization was added or not (P50% of tumor cells became necrotic after repeat dearterializations for 2 hr indicating a significant damage to tumor tissue. In contrast, PBL in combination with repeat dearterializations for 50 min induced extensive liver necrosis without having any influence on tumor growth. © Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930550406

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

年代:1994

数据来源: WILEY

摘要:

AbstractOn retrospective review of the tumor registry files between 1979 and 1992 at the North Iowa Medical Center, six cases of endometrioid adenocarcinoma of the prostate were identified among 1582 cases of prostatic carcinoma. Along with long‐term clinicopathologic follow‐up, immunohistochemical studies of the prostatic tumor tissues were performed. All six cases of endometrioid carcinoma, together with control cases of benign prostatic hypertrophy (BPH) and ordinary adenocarcinoma of the prostate had unequivocal diffuse positive staining for PSA and similar reactivity to ER‐D5 and PS2. Thus, endometrioid carcinoma is most likely derived from the prostate or prostatic urethral duct rather than the utricle. However, due to its unusual initial clinical manifestations, biological behavior, and distinctive histomorphology, the term “endometrioid adenocarcinoma of the prostate” is worth preserving. © Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930550407

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

年代:1994

数据来源: WILEY

摘要:

AbstractNinety‐six patients referred for radiation therapy to Washington University affiliated institutions with tumors of the extrahepatic biliary tree form the basis of this report. Patients were examined with regard to demographic factors, tumor primary site, presenting symptoms, methods of diagnosis, and methods of management. The median survival of all 96 patients in this series was 11 months. There was no significant difference between patients with gallbladder cancer and patients with cancer of the biliary ductal system. There was a statistically significant improvement in survival in those patients undergoing resection as management or as a component of the management of their tumors (P= 0.02). Patients receiving>4,000 cGy of radiation therapy had an improved survival compared to those patients receiving ≤4,000 cGy of radiation therapy (P= 0.003). While surgical resection improved survival for those patients undergoing removal of all gross tumor, this effect was noted especially in patients with gallbladder cancer. © Wiley‐Lis

ISSN:0022-4790    

DOI:10.1002/jso.2930550408

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe prolactin receptors (PRLR) were correlated with circulating prolactin arious clinicopathologic parameters to investigate its prognostic value in patients with colorectal cancer. The prolactin (by radioimmunoassay) and its receptors (by radioligand method) were estimated in a total of 71 male patients with colorectal cancer enrolled at the Gujarat Cancer and Research Institute, Ahmedabad. The patients were followed for a period of 3 years. We have observed that 51% colorectal tumors were PRLR+. Significant correlation was not observed between presence/absence of PRLR and clinicopathologic variables. Dukes' D patients were lost to follow‐up after 2–3 months; therefore, the results of prognostic significance were analysed only in patients with Dukes' A, B, and C (N = 64). Statistically significant difference in overall survival was not observed when the patients were subgrouped according to the presence/absence of PRLR and according to the cutoff level (i.e., 2%). PRLR+hyperprolactinemic (Prolactin>20.0 ng/ml plasma) patients had better overall survival than that of patients with PRLR−hyperprolactinemia, although the difference was statistically nonsignificant. However, PRLR−hyperprolactinemia patients had a more unfavourable prognosis than that of their counterparts. A similar trend was observed in patients with Dukes' B and C disease.Our preliminary study suggests an unequivocal finding, that PRLR−with concomitant hyperprolactinemia probably characterises a subgroup of patients with aggressive colorectal cancer. © Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930550409

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe clinical diagnoses of nodal status (N) and tumor invasion (T) were performed intraoperatively during 1499 consecutive operations for gastric carcinoma and compared with subsequent pathologic diagnoses. An accurate macroscopic diagnosis of N stage was difficult; overall accuracy was only 56.6%. Intraoperative assessment of T stage (particularly of serosal invasion) was correct for 93.2% of early stages of the disease with invasion confined to the mucosa or submucosa (pT1) when the pathologist assessed the T stage in the resected specimen, for 95.6% of advanced tumors invading the serosa (pT3), but for tumors of an intermediate stage with invasion involving the muscularis propria or the subserosa (pT2) in only 41.9% of cases. Macroscopic overestimation occurred in 58.1% of cases with pT2 tumors, which were characterized by carcinomas in the upper third of the stomach, tumors larger than 5 cm, carcinomas of the ulcerating type, differentiated adenocarcinomas, tumors invading the subserosa, and those accompanied by lymph node metastasis or liver metastasis. The overestimated group had a significantly poorer prognosis than the correctly assessed cases (P<0.05). Since multivariate logistic regression analysis showed that the significant risk factor related to the inaccurate intraoperative assessment of T stage was tumor size, the error in diagnosis may correlate with a greater degree of tumor spread. Surgeons should decide their therapeutic approach at the time of surgery on the basis of their intraoperative assessment of tumor spread. We recommend extensive surgery followed by adequate chemotherapy when serosal invasion is suspected at surgery. © Wiley‐Liss, I

ISSN:0022-4790    

DOI:10.1002/jso.2930550410

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

年代:1994

数据来源: WILEY

摘要:

AbstractSurgical reexploration was performed in 46 patients with epithelial nonmucinous ovarian adenocarcinoma requiring adjuvant chemotherapy whose initial therapy consisted of optimum debulking and surgical staging. All patients were placed on CAP (cisplatinum, Adriamycin, cyclophosphamide) chemotherapy for at least six courses until proved to be clinically disease free (mainly CA‐125 below 35 U/ml and normal ultrasonography or computerized tomography). All women underwent second‐look laparotomy (SLL) after completion of adjuvant therapy. We classified SLL findings in five categories, namely, no evidence of disease, cytological evidence of disease, histological evidence of disease, macroscopic evidence of disease (2 cm). SLL demonstrated 14 (30%) patients with disease. Of these, five cases had histological evidence of disease and nine had macroscopic disease; however, we found no patient with persistent disease larger than 1.5 cm. No patient in stage I demonstrated disease at SLL. All cases with macroscopic disease and three cases with histological disease were initially in stage III. We found that about one third of cases who were clinically free of disease had persistent disease at the completion of chemotherapy. Hence, we conclude that routine SLL is still of importance in the management of patients with epithelial ovarian adenocarcinoma except those with stage I disease. © Wiley‐Lis

ISSN:0022-4790    

DOI:10.1002/jso.2930550411

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

年代:1994

数据来源: WILEY