摘要:

AbstractSixteen consecutive patients entered in a prospective study of non‐neurogenic soft tissue tumours had lesions in the axilla. Delayed diagnosis and inappropriate biopsy prior to referral to a surgical oncologist were frequent findings. Sarcoma and fibromatosis were diagnosed in 14 cases, and the approaches used for these two diseases were fundamentally different. The functional outcome with limb salvage surgery in these patients is presente

ISSN:0022-4790    

DOI:10.1002/jso.2930420203

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe development of pre‐neoplastic and neoplastic changes has been documented in the urinary tract of the rat after portacaval shunting (PCS) and has been attributed variously to circulating carcinogens, the development of bladder stones, or deficiency of vitamin A. Therefore, an investigation of the pathogenesis of bladder tumors after PCS was undertaken in 120 PCS and 120 sham‐operated male Sprague Dawley rats. Ten rats from each group were sacrificed at monthly intervals for 1 year after surgery. The incidence of calculus formation in the bladder increased from 20% at 2 months to 80% at 12 months after PCS. Hyperplastic mucosal changes occurred 3 months after surgery. After 5 months, distinct papillomas developed, and after 7 months, increasingly severe papillary changes and squamous metaplasia were evident. Interestingly, these urothelial changes were seen both in animals with and without bladder stones. Significantly decreased serum vitamin A levels were observed at 6 months (54.0 ± 8.8 IU/dl, n = 10) (P, 01), and 12 months (41.0 ± 7.9 IU/d1, n = 10) (P<.01), compared to those in sham‐operated controls of 126.0 ± 12.5 IU/dl (n = 10) and 122.7 ± 19.2 IU/dl (n = 10). In addition, PCS resulted in a significantly increased activity of urothelial ornithine decarboxylase (ODC), a marker of neoplastic changes, at 6 months (3.1 ± 0.4 nmoles CO2in 60 min/mg protein, n = 5) (P<.05) and 12 months (8.1 ± 0.6 nmoles CO2in 60 min/mg protein, n = 5) (P<.05), when compared to ODC activity in controls (0.9 ± 0.2 nmoles CO2in 60 min/mg protein, n = 5). These data suggest that the development of urinary bladder tumor after PCS in the rat may be due to vitamin A deficiency rather than to bladder calculi or urinary

ISSN:0022-4790    

DOI:10.1002/jso.2930420204

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

年代:1989

数据来源: WILEY

摘要:

AbstractRecurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty‐three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re‐emphasize the relative poor yield of attempts at retreatment of loco‐regional recurrence of salivary gland t

ISSN:0022-4790    

DOI:10.1002/jso.2930420205

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

年代:1989

数据来源: WILEY

摘要:

AbstractAlthough the introduction of well‐established risk factors has made the clinical course and prognosis of malignant melanoma disease much more predictable, in a considerable number of patients the disease's course is still not as expected. One group to which this applies are stage I melanoma patients who develop metastatic disease after 10 years or more of a disease‐free interval. In our series of 94 such patients, 6 developed late relapse of their disease. The subsequent survival of these patients did not relate to any of the primary tumors' characteristics, but to the pattern of the late recurrence. Four patients with visceral metastases were dead within 1 to 5 years following relapse, one patient with lymph node involvement is alive with metastases, and another patient with skin metastases has no signs of disease following surgery and immunotherapy. Our conclusion is that malignant melanoma patients should be placed under close follow‐up for the rest of their

ISSN:0022-4790    

DOI:10.1002/jso.2930420206

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

年代:1989

数据来源: WILEY

摘要:

AbstractTo determine whether or not the cytotoxic effects of hyperthermia are directed primarily to malignant cells, we examined changes in thermosensitivity during hepatocarcinogenesis in rats, as induced by 3′‐methyl‐4‐dimethylaminoazobenzene (3′‐Me‐DAB). The findings were compared with those in livers of rats fed a commercial diet. The cell viability was determined using the succinate dehydrogenase inhibition (SDI) test. The succinate dehydrogenase (SD) activity of liver cells, when exposed to heat (43°C) for 2, 5, or 10 hr, decreased in a time‐dependent manner, in each tissue. The decrease in SD activity was evident in 3′‐Me‐DAB liver for 5 hr of heat treatment on day 57, compared with findings in the normal liver. Significant differences were present for 2, 5, and 10 hr on days 93 and 136. Thus a chemically induced hepatoma is more sensitive to heat than are the normal cells. As this thermosensitivity gradually increased during the hepatocarcinogenesis, the malignant cells are particularly vuln

ISSN:0022-4790    

DOI:10.1002/jso.2930420207

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

年代:1989

数据来源: WILEY

摘要:

AbstractRat livers were perfused at 37°C, 41°C, 42°C, 42.5°C, and 43°C for 2 hr. Among perfusate constituents analyzed were urea, total amino acids, N‐acetyl‐β‐glucosaminidase (NAG), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), malonaldehyde (MDA), glutathione (GSH), oxidized glutathione (GSSG), allantoin, potassium, phosphate, and glucose. After perfusion, livers were homogenized and analyzed for xanthine oxidase (XO) activity, GSH content, and lysosomal lability. Perfusate AST, LDH, NAG, potassium, glucose, and phosphate increased significantly with time, and there were significant differences in the final values between 37°C and 42°C, 42.5°C, and 43°C (P<.05). GSH levels increased significantly at all temperatures after 90 and 120 min, whereas GSSG levels differed significantly at 60, 90, and 120 min for 37°C vs. 42°C, 42.5°C, and 43°C (P<.05). Mean MDA levels at 37°C differed from those at 41°C and 43°C (P<.05) at each temperature. Allantoin levels increased significantly with time of perfusion; mean levels at 37°C were significantly different from mean levels at each temperature at 60,90, and 120 min. GSH liver tissue levels decreased with perfusion at hyperthermic temperatures; mean values at 41°C, 42°C, 42.5°C, and 43°C differed from 37°C mean values (P<.01). Type O XO increased after 120 min perfusion from 6.4% ± 2.0% at 37°C to 55% ± 30%, 43% ± 27%, and 63% ± 29% at 42°C, 42.5°C, and 43°C, respectively. Lysosomal lability increased after perfusion at 42.5°C. There was a significant increase in nonsedimentable NAG activity at 42.5°C (P<.05). These data support the premise that hyperthermic toxicity to the liver may be a consequence of oxidative stress brought about by enhanced adenosine triphosphate (ATP) consumption and conversion of XO to type O. Such conversion results in superoxide formation and subsequent depletion of cellular GSH, labilization of the

ISSN:0022-4790    

DOI:10.1002/jso.2930420208

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

年代:1989

数据来源: WILEY

摘要:

AbstractA retrospective analysis was undertaken of the association between blood transfusion and long‐term results for 218 patients with stage III gastric cancer who were curatively treated by partial gastrectomy. One hundred and fifty‐two patients received blood transfusion within the perioperative period. The postoperative 5‐year survival rates were 49.3% for the transfused patients and 62.1% for the non‐transfused patients (P<0.05). Furthermore, the postoperative survival of patients who had been transfused preoperatively was significantly lower than that of the non‐transfused patients. The preoperatively transfused group of patients were found to have tumors that were larger than those of the non‐transfused group. On the basis of the above data, it appears that the prognosis of patients with advanced gastric cancer is poorer when such patients receive preoperative blood transfusion than when patients do not receive transfusions, and that this adverse effect in the transfused patients is probably attributable to the larger size of their tumors, even though the stage of advancement of gastric cancer is the same in both groups

ISSN:0022-4790    

DOI:10.1002/jso.2930420209

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe intraoperative diagnostic dilemma of pancreatic cancer vs. chronic pancreatitis often remains unresolved. In the literature, diagnosis based on intraoperative pancreatic biopsy is a matter of controversy. Our study comprised 70 patients with a suspected space occupying pancreatic process who were operated on with the primary goal of arriving at a speedy and precise diagnosis, according to which the appropriate surgery for the specific patient would be performed. Frozen section showed that 44 patients had malignancy of the pancreas; in three patients, there was a false‐negative result. In four patients, the histological picture was consistent with chronic pancreatitis. In the remaining 19 patients, biopsy was not performed and the diagnosis was made on the basis of intraoperative inspection and palpation of pancreas. On reviewing the patients, we found that the surgical risk involved in biopsy is quite low and that a high price was paid for diagnosis by inspection and palpation alone. The risk vs. benefit aspect of intraoperative pancreatic biopsy is discusse

ISSN:0022-4790    

DOI:10.1002/jso.2930420210

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

年代:1989

数据来源: WILEY

摘要:

AbstractTwenty‐five patients with FIGO stage IIIB carcinoma of the cervix were entered into a prospective, double‐blinded randomized study to evaluate the possible radiation potentiating properties (i.e., improved survival) of the S phase cell cycle specific inhibitor of DNA synthesis hydroxyurea (H). In contrast to our previous randomized trial of patients with FIGO stage IIIB carcinoma of the uterine cervix who were documented to be without paraaortic lymph node metastasis by pretherapy staging paraaortic lymphadenectomy [Piver et al.: J Surg Oncol 35:129–134, 1987], these patients either refused surgical staging or, because of medical conditions, could not undergo pretherapy paraaortic lymphadenectomy. Patients were to receive 6,000 cGy/6 weeks to the pelvis by megavoltage radiation therapy followed by 2,500 cGy to point A by intracavitary and vaginal radium/cesium. The median pelvic cGy for the Hu patients was 5,967 cGy and for the placebo patients 6,013 cGy. Leukopenia (WBC<2,500/mm3) significantly increased in patients given hydroxyurea as compared with those given placebo (P<0.0001). There was no statistically significant difference relative to anemia, thrombocytopenia, radiation skin reactions, diarrhea, or radiation induced complications requiring surgical correction. The estimated 5 year disease‐free interval was 54% for the hydroxyurea patients (median not reached) and 18% for the placebo patients with a median of 11 months. Because of these results, those of our previous reports, and those of the Gynecologic Oncology Group, we believe that hydroxyruea plus pelvic radiation should be the standard against which new potential radiation sensitizers are

ISSN:0022-4790    

DOI:10.1002/jso.2930420211

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe Tygerberg Breast Clinic serves a heterogeneous population, and it is therefore possible to analyse prognostic factors influencing survival and to identify any possible differences between these groups. From 1978 to 1985, 568 breast cancer patients (52% white and 48% colored) were treated surgically in Tygerberg Hospital. Stage for stage, all patients received identical treatment. Colored patients were seen at a younger age, with more advanced disease, had lower estrogen receptor values, and more nodes involved. Cox's regression analysis of age, receptor value, stage, nodal involvement, race, menopausal status, treatment, and study period in the evaluation of disease‐free survival and overall survival confirmed stage and lymph node status as prognostic factors. Estrogen receptor status, menopausal status, age at presentation, treatment, study period, and race did not enter the regression, except in stage I, where race was a variable. A target group for directing educational intervention is identifie

ISSN:0022-4790    

DOI:10.1002/jso.2930420212

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

年代:1989

数据来源: WILEY