ISSN:0022-4790    

DOI:10.1002/jso.2930590302

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

年代:1995

数据来源: WILEY

摘要:

AbstractPreviously, we reported an effective chemotherapeutic combination regimen for non‐small cell lung carcinoma (NSCLC): cisplatinum, doxorubicin, cyclophosphamide, CCNU, and vincristine (PACCO).Forty‐one patients with a diagnosis of NSCLC Stages III‐A and III‐B were entered into the protocol of neoadjuvant PACCO chemotherapy. Following two courses of chemotherapy, the patients were evaluated for surgical therapy. The overall response rate to the chemotherapy was 60%. Subsequently, 65% of the patients underwent surgical resection. The overall estimated median survival was 18 months. The survival of patients in III‐A was 36 months and that of III‐B was 18 months (95% confidence lower bounds for III‐A: 8 months and for III‐B: 13 months). There was one chemotherapy‐related mortality but no surgical mortality.Neoadjuvant chemotherapy with PACCO regiment offers an alternative to chemoradiation therapy, without increasing the surgical mortality, and should be validated in a randomized clinical trial. For successful neoadjuvant chemotherapy of Stage III NSCLC, chemotherapy combination which would give a high response rate without significant side effec

ISSN:0022-4790    

DOI:10.1002/jso.2930590303

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

年代:1995

数据来源: WILEY

摘要:

AbstractBetween 1985 and 1991, we randomly assigned 77 women over the age of 70 years with stage I‐3a breast cancer to undergo a modified radical mastectomy or tumour excision followed by tamoxifen. Median follow‐up was 45 months.Patients treated by tumour excision and tamoxifen had a significantly better survival (P= 0.04). The disease‐free survival of the tumour excision and tamoxifen group was close to significantly better (P= 0.10).Only two patients in the tamoxifen group required an axillary dissection on follow‐up for progressive nodal enlargement. Two patients underwent a local mastectomy for locally recurrent disease.We conclude that tumour excision followed by continous tamoxifen is an acceptable, safe alternative to a modified radical mastectomy in patients over 70 years

ISSN:0022-4790    

DOI:10.1002/jso.2930590304

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

年代:1995

数据来源: WILEY

摘要:

AbstractIn a study of 20 patients diagnosed with malignant ovarian germ cell tumors between 1961 and 1993, clinical and pathologic findings were evaluated. Of the 20 patients, seven (35%) had dysgerminoma, two (10%) endodermal sinus tumor, three (15%) malignant teratoma, one (5%) malignant struma ovarii, one (5%) primary ovarian carcinoid, two (10%) benign teratoma with malignant transformation, and four (20%) combination germ cell tumor. Twelve patients (60%) had stage IA, five (25%) stage IC, and three (15%) stage IIIC. Twelve patients (60%) underwent conservative surgery and eight (40%) had at least bilateral salpingo‐oophorectomy. At follow‐up, 18 patients (90%) were alive free of disease, one (5%) had died of disease, and one (5%) had died of intercurrent disease. The actuarial 5‐year survival rate was 93.3%. It is concluded that for young women who wish to preserve child‐bearing capacity, regardless of the stage of the tumor, fertility‐preserving surgery with complete surgical staging followed, if necessary by cisplatin‐based combination chemotherapy is an appropriate and definitive treatment in the absence of involvement of the contralateral ovary and uterus. For patients in whom child‐bearing capacity is not an issue, surgery should include total abdominal hysterectomy and bilateral salpingooophorectomy with complete staging, followed if necessary by

ISSN:0022-4790    

DOI:10.1002/jso.2930590305

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

年代:1995

数据来源: WILEY

摘要:

AbstractBetween 1977 and 1990 we operated on 33 patients with medullary thyroid carcinoma. We performed total thyroidectomy in 31 patients and central node dissection and/or lateral modified node dissection in 21 patients (63.3%). Two patients underwent radiotherapy after subtotal resection and tracheostomy. No perioperative death occurred. Twenty‐five patients were followed (mean follow‐up, 63.8 months) and 8 others were unavailable for follow‐up. Three patients (1 with multiple endocrine neoplasia type IIB, 2 sporadic with distant metastases) died of their disease at 12, 18 and 36 months after initial operation. Of the remaining 22 patients, 4 with stage II disease were normocalcitoninemic even with pentagastrin stimulation, following total thyroidectomy and bilateral modified neck dissection and central node dissection. Eighteen other patients continued to have elevated calcitonin levels postoperatively. Only 10 patients with known cervical metastatic disease were reoperated upon. We performed extensive node dissection in all. In addition we resected recurrent tumor from the thyroid bed in 4 patients. Despite these extensive reoperations no patient became normocalcitoninemic. At the completion of the study (December 1991), 22 of the 25 patients followed were alive: 4 patients with normal calcitonin levels, baseline and after pentagastrin stimulation, and 18 with persistent mildly elevated calcitonin levels but no other evidence of disease. Our experience supports a very aggressive surgical approach at the time of the first operation for patients with medullary thyroid carcinoma. A lesser operation usually resulted in residual medullary thyroid carcinoma in the neck. We demonstrate the difficulty of achieving a cure by reoperation once the tumor becomes demonstrable by localization st

ISSN:0022-4790    

DOI:10.1002/jso.2930590306

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

年代:1995

数据来源: WILEY

摘要:

AbstractTo increase the effect of cisplatin on locoregional osteosarcoma, the shortterm effect of hyperthermic isolated regional perfusion (HIRP) with cisplatin (30 mg/L extremity volume) was studied in 28 dogs with spontaneous osteogenic sarcoma, using clinical, radiological, and histological parameters. Thirty days postoperatively, mortality was 14.3%. Total platinum levels at the start of perfusion were 28.2 ± 14.3 mg/L. A significant improvement (P<0.001) in clinical score was observed in the overall group at 6 and 12 weeks after perfusion. The radiological parameter showed a stationary X‐ray 2 weeks after perfusion and an improved X‐ray 6 weeks after perfusion. Overall histological scores showed a moderate effect according to the Huvos classification. No additional therapeutic effect, according to the three parameters, could be demonstrated by increasing the perfusate temperature by 1°C. HIRP with cisplatin is feasible in the local treatment of spontaneous osteosarcoma in dogs with acceptable locoregional toxicity. However, the histological results were modest, with none of the dogs showing a complete response 6 weeks after perfusion. Therefore, the search for the ideal perfusion agent with substantial contribution to the limb‐sparing treatment in human osteosarcoma co

ISSN:0022-4790    

DOI:10.1002/jso.2930590307

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

年代:1995

数据来源: WILEY

摘要:

AbstractThe prognostic value of nuclear DNA content and argyrophilic nucleolar organizer regions (AgNOR) is still controversial in colorectal cancer. Sixty patients with colorectal cancer were studied by flow cytometric DNA analysis and AgNOR measurement, and their prognostic significance was tested. DNA index was closely linked to depth of invasion and lymph node metastasis, while AgNOR count did not correlate with such parameters. The survival curve was stongly influenced by depth of invasion, lymph node metastasis, and Dukes' stage but was not affected by DNA ploidy and AgNOR count. These results indicate that neither DNA ploidy nor AgNOR count correlates with survival of patients, although DNA ploidy is linked to progression of colorectal cancer.

ISSN:0022-4790    

DOI:10.1002/jso.2930590308

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

年代:1995

数据来源: WILEY

摘要:

AbstractFlow cytometric assay of nuclear DNA in endoscopic biopsy specimens was evaluated in colon cancer patients. When the cells were divided into diploid cells and aneuploid cells, aneuploidy was observed in 63% (58 of 92) of the colon cancer patients. However, no clear relation was observed between the frequency of aneuploidy and the invasive depth, size, or histological type of colon cancer. Noncancerous portions of the colon tissues including colon adenoma or normal mucosa were mostly (96%, 87 of 91) diploid. Nuclear DNA content could be analyzed in the fresh biopsy specimens of colon cancer tissues and such investigation might be possibly valuable for further biological characterization of colon cancer in the usual procedure of clinical diagnosis for colonic malignancy before surgical operation or other treatment.

ISSN:0022-4790    

DOI:10.1002/jso.2930590309

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

年代:1995

数据来源: WILEY

摘要:

AbstractThis review compares the two major staging systems for renal cell carcinoma: the TNM and Robson systems. For purposes of worldwide clinical and scientific consistency, the TNM system is recommended. However, the primary tumor size cutoff of 2.5 cm. does not prognostically differentiate between stages I and II. A review of 337 patients with renal cell carcinoma, of whom 122 had stage I or II disease revealed that a 2.5‐cm cutoff did not predict survival differences, while cutoffs of 5.0, 7.5, and 10.0 cm did. Because 7.5 cm most closely approximates the mean renal cell cancer diameter as noted by SEER data, it is recommended that the TNM primary tumor cutoff be changed to 7.5 c

ISSN:0022-4790    

DOI:10.1002/jso.2930590310

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

年代:1995

数据来源: WILEY

摘要:

AbstractA review of the world literature regarding carcinoma of ectopic breast tissue along with the addition of one cases is reported. A total of 90 cases of carcinoma of ectopic breast tissue were found, 64 of which occurred in the axilla. The combined survival beyond the 4‐year post‐treatment period was 9.4%. No survival advantage was found for radical or modified radical mastectomy over that of local excision combined with axillary dissection or radiation. The addition of radiation therapy to either type of mastectomy provided no additional benefit. The correct preoperative diagnosis was rarely made. Outcome was reported in 42 cases; 28 survived longer than 1 year, with 12 recurrences at the time of reporting, and 6 were alive with no evidence of disease at 4 years or longer. Improved prognosis requires diagnostic suspicion and early biopsy of unidentified lesions of the axilla or embryonic milk l

ISSN:0022-4790    

DOI:10.1002/jso.2930590311

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

年代:1995

数据来源: WILEY