摘要:

AbstractThe ability to redefine risk factors and to predict prognosis in patients with malignant melanoma at the time they manifest nodal metastasis can be a benefit to the patient emotionally and to the physician therapeutically. A retrospective review of 1,273 patients with stage II malignant melanoma was performed at our institution. The most significant prognostic factors in a simultaneous hazard Cox multivariate analysis, predicting melanoma‐related mortality among stage II patients, were the number of positive nodes (P<0.0001), age (P = 0.0004), site of the primary lesion (P = 0.0036), disease‐free interval (P = 0.016), thickness of the primary lesion (P = 0.017), and sex of the patient (P = 0.0616). We have developed a model for predicting survival of stage II patients, designed for use in the clinic setting. Its application in a computer system makes it accessible and understandable. The most favorable risk group (18% of the population) has actuarial 5‐ and 10‐year survival rates of 58% and 49%, respectively, from the time of the nodal metastasis. The least favorable risk group (7% of the population) has 5‐ and 10‐year survival rates of 15% and 10%, respectively. There are three intermediate risk groups. All groups differ prognostically (P<0.04). The principal adjuvant therapy offered to these patients was specific active immunotherapy, which appears to have a 10‐20% survival benefit in stage II patients with greater than one positive node, when compared with institutional controls. The apparent survival benefit of the immunotherapy supports continued clinical investigation of its therapeu

ISSN:0022-4790    

DOI:10.1002/jso.2930390302

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe nude mouse has been used to evaluate the effect of gastrin on xenografted tissues, but little is known about long‐term actions of gastrin on native organs in this species. We investigated the impact of chronically administered synthetic pentagastrin on the nude mouse. Six groups of mice (eight animals each) received intraperitoneal injections twice daily for 14 days with saline or pentagastrin at 0.5, 5, 50, 500, or 5,000 g/kg. Behavior, overall health, and body weight were unaffected by this treatment. Of the seven organs examined at necropsy, only the pancreas showed a weight gain in response to pentagastrin treatment, and this occurred only at the highest dose. Total DNA content of the pancreas decreased in a dose‐related manner, indicating hypoplasia, whereas pancreatic RNA content increased, indicating hypertrophy. No effect on the stomach was observed. This work indicates that the nude mouse is less sensitive than other species to visceral growth regulation by pentagastrin, and that toxicity is

ISSN:0022-4790    

DOI:10.1002/jso.2930390303

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

年代:1988

数据来源: WILEY

摘要:

AbstractA total of 64 episodes of bacteremia and fungemia were documented in 25 allogeneic bone marrow transplant recipients. Coagulase‐negative staphylococci were the most common pathogens recovered, with 34 of the 39 isolated being methicillin resistant.Streptococcus viridans(11 episodes), diphtheroids (5 episodes), andPseudomonas aeruginosa(4 episodes) accounted for the majority of the other pathogens causing bacteremia. Six episodes of fungemia were also seen. Coagulase‐negative staphylococci were demonstrated in 31 of 36 (86%) throat cultures, 25 of 35 (71%) stool cultures, and 6 of 7 (86%) Hickman or Broviac catheter exit site surveillance cultures prior to the development of bacteremia caused by these organisms. Throat surveillance cultures positive for 5.viridansalso showed a correlation (88%) with subsequentS. viridansbacteremia. However, surveillance cultures for aerobic gram‐negative bacilli, diphtheroids, and fungi did not correlate with subsequent septicemia. Organisms isolated in throat surveillance cultures correlated with subsequent bacteremia caused by these organisms in only 15% of all the cultures taken, while only 14% of stool cultures predicted bacteremia. The utility of surveillance cultures is limited because of low cost‐effectiveness and a high rate of false‐positiv

ISSN:0022-4790    

DOI:10.1002/jso.2930390304

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

年代:1988

数据来源: WILEY

摘要:

AbstractBlood transfusions have previously been shown in retrospective studies of oncologic surgical patients to be associated with an increased incidence of tumor metastases and decreased long‐term survival rate. The possibility that these findings were due to patients with larger, more aggressive tumors requiring the transfusions could not be excluded. To eliminate this possibility, the effect of transfusions on tumor growth in a rat sarcoma model was tested. In this study it was shown that allogeneic transfusions increase the rate of tumor growth and decrease mean survival times. This effect was not demonstrated when syngeneic transfusions were used. These data indicate that the diminished long‐term survival seen in transfused patients undergoing tumor resection may be due to an impaired immunologic response to the tumor. Avoidance of this effect might be possible through the use of human syngeneic (autologous) transfusi

ISSN:0022-4790    

DOI:10.1002/jso.2930390305

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

年代:1988

数据来源: WILEY

摘要:

AbstractIt has been demonstrated that tumor‐bearing animals elaborate a low molecular weight (<10,000 daltons) factor capable of inhibiting in vitro lymphocyte function. It was postulated that removal of this factor would have a favorable effect on host immune response that would translate into improved tumor control. A study was conducted in rabbits bearing the VX‐2 carcinoma. Ultrafiltration (UF) was performed 10 days following IV tumor inoculation. UF was achieved by passing blood through an Amicon Diafilter® (molecular weight cutoff 10 kD) positioned between the arterial and venous cannulae after heparinization. Two plasma volumes of ultrafiltrate were removed with continuous saline replacement. Two groups of animals received the nonspecific immunoadjuvant, Detox, at time of therapy. Survival in the UF group (N = 9) was compared to untreated tumor‐bearing animals (N = 10), sham‐operated animals (N = 6), animals receiving Detox (N = 7), and animals receiving UF plus Detox (N = 6). UF imparted a survival advantage when compared to controls (mean 35 days vs. 25 days, P.05). However, UF + Detox demonstrated maximal survival benefit (mean 40 days, P<.01). We conclude that UF is an effective anticancer modality in this preclinical model. This study suggests that efforts aimed at eliminating suppressor molecules in cancer patients may be of benefit, especially when combined with biological response modifiers such

ISSN:0022-4790    

DOI:10.1002/jso.2930390306

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

年代:1988

数据来源: WILEY

摘要:

AbstractThe results after 6 years of a prospective clinical trial of adjuvant chemotherapy with a regimen of two drugs—cyclophosphamide and 5‐fluorouracil (CF)— for 2 years in 97 women with stage II or III breast cancer are reported. Eligible patients were free from distant metastases. All patients began adjuvant therapy within 4 weeks of surgery; therapy consisted of radical, modified, or extended radical mastectomy. No postoperative radiotherapy was given. The results are compared with a historical control group from previous consecutive patients treated by surgery alone. Patients were stratified by age (younger than 50 or older than or equal to 50) and nodal status (one to three positive axillary nodes vs. four or more positive nodes). The estimated 6‐year survival was 60% for CF patients vs. 31% for control patients (P= 0.001). The estimated 6‐year disease‐free survival was 53.6 and 30.3% for CF and control, respectively (P= 0.007). There was a trend toward longer disease‐free survival (DFS) and survival (S) in patients treated with CF, but this was not significant in all the subgroups. Disease‐free survival was statistically significant in the subgroup of women ≥ 50 years old with one to three positive nodes (P= 0.038); survival in the patients ≤ 49 years old with four or more positive nodes (P= 0.0036); and in patients ≥ 50 years old with one to three lymph nodes i

ISSN:0022-4790    

DOI:10.1002/jso.2930390307

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

年代:1988

数据来源: WILEY

摘要:

AbstractEight cases of squamous cell carcinoma of the thyroid are reviewed. The clinical features and natural history of our cases are presented. All tumours showed an aggressive biological behaviour. Two patients showed association with well‐differentiated thyroid cancer. It is difficult to conclude whether these tumours are de novo occurrences or were a result of a complete replacement of a previously existing condition after a change in histologic characte

ISSN:0022-4790    

DOI:10.1002/jso.2930390308

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

年代:1988

数据来源: WILEY

摘要:

AbstractOne hundred fifty patients with nasopharyngeal carcinoma were treated at the Tata Memorial Hospital from January 1980 to December 1984. Lymphoepithelioma was the most common histologie subtype. Advanced disease in stages III and IV was seen in 22.66% and 72% of the patients, respectively. Complete remission was obtained in 80 of 120 patients (66.66%) with radiation alone and in 19 of 30 patients (63.3%) who received preradiation chemotherapy and radiation. Age, sex, and histology did not influence the rate of complete remission. The N0‐1nodal status group had a significantly better response of 81% and 36% survival, as compared with the N2_3group with a 55% response and 20% survival. Only 30 of those who received radiation alone and 10 of those who received preradiation chemotherapy are disease‐free for a median period of 24 months. Twenty‐six relapses have occurred within a median period of 12 months. The 5‐year actuarial disease‐free survival is 13%. This indicates the need for an early diagnosis and combined aggressive treatment to improve

ISSN:0022-4790    

DOI:10.1002/jso.2930390309

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

年代:1988

数据来源: WILEY

摘要:

AbstractLeiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Symptoms are gastrointestinal bleeding or abdominal pain resembling peptic disease. Three cases of duodenal leiomyomas are described, and the importance of endoscopy is emphasized as a diagnostic tool. Surgical resection of the tumor is the recommended therapeutic procedure, and the difficulty in deciding at the pathological examination whether the leiomyoma is benign or malignant demands prompt follow‐up of patients after surger

ISSN:0022-4790    

DOI:10.1002/jso.2930390310

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

年代:1988

数据来源: WILEY

摘要:

AbstractWe describe, in a 56‐year‐old man, the first case of fibrolamellar carcinoma of the liver (FCL) in the Orient. Contrary to patients seen in the Western world, our patient has many characteristics of ordinary hepatocellular carcinoma seen in the Orient, i.e., middle age, male, HBsAg carrier, elevated α‐fetoprotein, presence of HBsAg in the hepatocytes, and chronic hepatitis. These clinicopathological findings suggest a possible relationship between exposure of HB virus a

ISSN:0022-4790    

DOI:10.1002/jso.2930390311

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

年代:1988

数据来源: WILEY