摘要:

AbstractWe retrospectively investigated 186 non‐small cell lung cancer cases with N2 disease in order to clarify the significance of skip metastasis. Of the 186 patients with N2 disease, negative N1 nodes recognized to be skip metastasis were seen in 62 patients (33%). The incidence of skip metastasis was not statistically different regarding histology, T status, or M status. The incidence of the skip metastatic site consisted of 35 cases (56%) at sites 1, 2 and 3, while 8 cases (13%) were found at sites 8 and 9. Among the patients with right lung cancer, the skip metastatic incidence for site 7 (subcarinal) was higher in patients with either middle lobe or lower lobe cancer than in those with upper lobe cancer (P<0.05). The 5‐year survival rates of all N2 patients in comparison to those with skip metastasis were 22% and 24%, respectively. When the sites of mediastinal lymph nodes were classified as superior, aortic, and inferior, the 5‐year survival rates of the patients with superior skip metastasis, aortic metastasis, and inferior metastasis were 23%, 36%, and 15%, respectively. No statistical difference was observed. The 5‐year survival rate of the skip N2 patients with only aortic region involvement was 50% (n=7). However, no statistically significant difference was found between the two groups (P=0.08). Our results thus suggested that mediastinal involvement for the aortic region alone might have a better prognosis than the others. We thus conclude that a dissection of the complete hilar and mediastinal lymph nodes should be the procedure of choice in standard operations for non‐small cell lung cancer because of the high frequency of skip metastasis. © 1994 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570302

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

年代:1994

数据来源: WILEY

摘要:

AbstractIn the treatment of soft tissue sarcomas, hypothermia has been demonstrated to enhance tumor necrosis from radiation therapy. The current study reports the clinical course of patients treated with this neoadjuvant therapy regimen. Forty‐four patients with deep, undisturbed, nonmetastatic, high grade soft tissue sarcomas completed a neoadjuvant treatment protocol with combined hyperthermia and radiation therapy followed by wide surgical resection. Negative surgical margins were obtained in 40 patients. There was one local recurrence, thus yielding a local control rate of 97.5%. All other failures were either through regional lymphatic spread or pulmonary metastasis. As a group, the patients at 36 months had a 72% overall and a 58% disease‐free survival. The most common pathologic diagnosis was malignant fibrous histiocytoma (MFH), which demonstrated a 36‐month survival of 52% vs. 82% for others (P=0.02). Tumor size was not prognostically significant for disease free or overall survival (P=0.13). Those patients with surgical margins<1 cm had a significantly lover disease‐free survival and overall survival in a multivariate analysis (P=0.02 andP=0.006, respectively). Overall survival did not correlate with either the number of hyperthermia treatments received or the amount of tumor necrosis. Although this neoadjuvant protocol results in excellent local control rates, overall survival rates are comparable to adjuvant therapy employing radiation alone. © 1994 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570303

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

年代:1994

数据来源: WILEY

摘要:

AbstractMurine retroviral vector producer cells (VPC) can selectively transfer genes stably into proliferating cells. We injected LacZ gene producing VPC directly into normal rat liver. There was no measurable gene transfer into the surrounding hepatic parenchyma with X‐GAL staining. Rejection of the xenogeneic murine VPC occurred 7‐14 days after injection. Toxicity of this delivery method was evaluated with the herpes simplex‐thymidine kinase (HS‐tk) gene, which confers sensitivity to the antiherpes drug, ganciclovir (GCV). HS‐tk VPC were injected and allowed to grow in normal liver for 7 days before GCV treatment. There was no clinical or histologic evidence of toxicity with GCV treatment. These findings suggest that the direct injection of murine VPC into xenogeneic human tumors may survive sufficiently long without immunosuppression to transfer genes to tumor cells in situ without attendant toxicity. © 1994 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570304

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

年代:1994

数据来源: WILEY

摘要:

AbstractA total of 23 papers published between 1981 and 1992, reporting a total of 1,353 patients, were reviewed for intraoperative and postoperative complications of transhiatal esophagectomy. Intraoperative complications included massive bleeding, tracheal injuries, cardiac arrhythmias, and incidental splenectomies. Even though the chest was not opened, the commonest postoperative complications were pulmonary. Leakage from the cervical anastomosis was seen in as many as 15% of all patients, but almost all resolved spontaneously. Postoperative benign strictures were seen in almost as many patients. Hoarseness due to recurrent laryngeal nerve injury, symptomatic gastro‐esophageal reflux, chylothorax, Horner's syndrome, subphrenic abscess, hiatal hernia, and biliary cutaneous fistula were some of the other postoperative complications. An overview of these complications is presented, along with suggested methods of avoiding them and their treatment. The overall mortality for the 1,353 patients was 7.17%. © 1994 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930570305

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe aim of this study was to elucidate what factors affect the survival of patients with advanced gastric carcinoma. The relationship between the survival of 282 patients over a period of 15 years and 12 prognostic factors was investigated. In univariate analysis, lymph node involvement, depth of invasion, gross form, type of operation, maximum tumor diameter, and lymphatic invasion were found to correlate significantly with survival. Lymph node involvement, gross form, type of operation, and depth of invasion were selected by the Cox proportional hazard model with variable selection methods and found significant. Lymph node involvement was shown to correlate most significantly with survival by both univariate and multivariate analyses. Kaplan‐Meier survival curves could indicate that the survival rates of the selected factors were worsening in proportion to the relative risk ratios. These results suggest that further contrivance of therapies should be considered for patients in high risk categories. © 1994 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930570306

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

年代:1994

数据来源: WILEY

摘要:

AbstractAccording to the criteria established by Cahan et al., we report 14 radiation induced sarcomas occurring in the treated volume after radiation therapy for adenocarcinoma of the breast. All these sarcomas were treated by wide surgical resection. In spite of a macroscopic free margin, only patients who underwent major amputation could hope to be cured. All the centrally located sarcomas recurred. © 1994 Wiley‐Liss, I

ISSN:0022-4790    

DOI:10.1002/jso.2930570307

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe possible usefulness of bleomycin incorporated with biodegradable poly‐d,l‐lactic acid (BLM‐PLA) for targeting chemotherapy for esophageal cancer was studied in vivo. Local levels of BLM after administration were compared with those after injection of BLM‐SOL, an aqueous solution of BLM. BLM‐PLA or BLM‐SOL was administered into the upper mediastinum under a right thoracotomy in 36 mongrel dogs. On days 10, 20, and 30 after administration, connective tissues, lymph nodes, lung, liver, kidney, and spleen were removed, and BLM activity was measured. High activity of BLM was detected for 30 days after BLM‐PLA administration in both the connective tissues and the lymph nodes, compared with BLM‐SOL administration. BLM activity was low in the other organs after BLM‐PLA administration. BLM in the blood was significantly lower after administration of BLM‐PLA than BLM‐SOL. The results indicate that BLM‐PLA may become a useful tool in targeting chemotherapy for esophageal cancer.

ISSN:0022-4790    

DOI:10.1002/jso.2930570308

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

年代:1994

数据来源: WILEY

摘要:

AbstractTumors depend on their blood supply for growth. The blood supply to metastatic neoplasia of lung is usually from the pulmonary circulation or both the pulmonary and systemic circulation. The antineoplastic effect of pulmonary artery occlusion was investigated in a rat model of methylcholanthrene‐induced metastatic pulmonary sarcoma. Left pulmonary artery ligation was performed on day 7 after tumor inoculation, and animals were sacrificed on day 14. The tumor burden of the left lung decreased 44% when compared with the control group. The survival of non‐tumor‐bearing rats undergoing left pulmonary artery ligation for 24 hours followed by right pneumonectomy after 2 weeks was also studied. No significant lung damage after a period of left pulmonary artery ligation was seen, as evidenced by both survival after contralateral right pneumonectomy and histology. Balloon occlusion of pulmonary artery, together with regional chemotherapy for patients with lung metastases, may warrant investigation. © 1994 Wiley‐L

ISSN:0022-4790    

DOI:10.1002/jso.2930570309

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

年代:1994

数据来源: WILEY

摘要:

AbstractSixty‐nine patients who underwent nephroureterectomy for upper urinary tract transitional cell carcinoma were included in the study. The following data were collected for each patient: grade and stage of renal/ureteral tumor, tumor location, timing of tumor appearance and recurrence in the bladder, grade and stage of each of the recurrent tumors, and number of recurrences. Follow‐up ranged between 2 and 15 years. Thirty‐three patients (47.8%) developed metachronous bladder tumors. The appearance of the bladder tumors was related to tumor grade and multifocality of the upper urinary tract TCC. Of the 33 patients, 19 had 1 tumor appearance in the bladder, 6 had 2 recurrences, and 8 had 3 recurrences. The 5‐year survival rate for patients with no subsequent bladder tumors was 57% compared to 22% for those who had subsequent tumors. It is concluded that the appearance of bladder tumors following nephroureterectomy characterizes a group of patients with biologically more active disease with unfavorable prognosis. © 1994 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570310

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

年代:1994

数据来源: WILEY

摘要:

AbstractClostridium difficiletoxin A was evaluated for an antitumor effect in vivo on HCT 116 human colon carcinoma cells growing subcutaneously in nude mice. A mean reduction in tumor volume of at least 65%, by measurement in three dimensions, was observed in mice who received two 9‐ to 13‐day courses of daily intraperitoneal injections of toxin A as compared to mice receiving diluent alone. Reversible adverse effects of toxin A were noted in some animals, consisting primarily of liver toxicity and skin rash. HCT 116 cells in toxin A‐treated mice grew as flattened tumors with ulcerated centers compared to rounded tumors without ulceration in controls. Histologic examination of tumors from representative mice revealed that two thirds of the tumor in a treated mouse was necrotic compared to only one third in a control, suggesting greater antitumor efficacy of toxin A than estimated by tumor measurements alone. © 1994 Wiley‐L

ISSN:0022-4790    

DOI:10.1002/jso.2930570311

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

年代:1994

数据来源: WILEY