摘要:

AbstractWhile hepatic resection of metastatic colorectal carcinoma is accepted as effective in selected patients, resection of metastases to other solid organs has not gained wide acceptance. We retrospectively reviewed the records of 49 patients who had resection of isolated pulmonary (18 patients) and hepatic (31 patients) metastases from the large bowel, comparing diseasefree survival and overall survival. Tumor parameters analyzed included Dukes' stage, deoxyribonucleic acid (DNA) flow cytometry, and number of metastases. Dukes' B and diploid tumors had longer disease‐free survival and overall survival than did Dukes' C and aneuploid tumors, though the difference was not significant. Patients with a single lung metastasis had a significantly longer disease‐free survival (P= .02) than did patients with multiple metastases. Mean and median survival were longer in patients with lung metastases. Five‐year actuarial survival was 19% for patients with liver metastases and 47% for patients with lung metastases. Resection of isolated pulmonary metastases from the large intestine results in survival comparable to or better than resection of hepatic metastases. An aggressive surgical approach is warranted in patients with isolated resectable pulmonary metastases of colorectal carc

ISSN:0022-4790    

DOI:10.1002/jso.2930430303

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

年代:1990

数据来源: WILEY

摘要:

AbstractAdrenal imaging using radiopharmaceuticals is a functional test that can contribute significantly to surgical management and follow‐up of patients with either benign or malignant conditions of the adrenal cortex and medulla. Imaging of the cortex is achieved by iodine‐131‐labeled iodomethyl nor‐cholesterol (NP‐59), while adrenal medulla imaging can be successfully accomplished by131I‐metaiodobenzylguanidine (MIBG), which localizes in the adrenergic nerve terminal with norepinephrine. Both tests carry high sensitivity and specificity for functional tumors and hyperplasia, and often better than CT scanning. This article reviews the current status and clinical utility of nuclear imaging of the adrenal cortex in congenital hyperplasia, low renin hypertension and aldosteronism, and Cushing's syndrome. Adrenal medulla imaging is reviewed in light of our experience at the University of Texas M.D. Anderson Cancer Center in pheochromocytoma, neuroblastoma, and other neuroectodermal tumors. Investigation of131I‐MIBG therapy of metastatic tumors of neuroectodermal origin potentially offers a means of at least controlling symptoms of hormonal secretion in t

ISSN:0022-4790    

DOI:10.1002/jso.2930430304

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

年代:1990

数据来源: WILEY

摘要:

AbstractAlthough often acknowledged, the impact of the surgical treatment of cancer on the spouse of the adult cancer patient is a largely unexplored area. The present study examined distress, coping, and appraisal among spouses (N = 36) and patients (N = 43) assessed prior to and following surgery. The results indicated that at both the presurgical and postsurgical period, spouses were exhibiting significantly greater distress than patients. Surprisingly, spouses' levels of distress remained fairly constant across the presurgery to postsurgery period, while the patients distress decreased. Escape and avoidance behaviors were found to be maladaptive for spouses coping with their partners' surgical treatment. Appraisal was also found to be a critical factor in understanding individual reactions to the stress of cancer surgery. Spouses of cancer patients undergoing surgical treatment appear to be an underacknowledged population at risk.

ISSN:0022-4790    

DOI:10.1002/jso.2930430305

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

年代:1990

数据来源: WILEY

摘要:

AbstractIn order to analyse the possible mode and pathways of adrenal metastases from lung cancer, the frequency of adrenal metastases ipsilateral and contralateral to the site of the primary cancer was investigated based on autopsied lung cancer cases. In 405 of 1,607 such cases, adrenal metastases could be found: on both sides, 234; ipsilateral only, 105: contralateral only, 66 cases. In the early stages of tumor progression, a striking difference can be seen between the two sides. Ipsilateral metastases were of significantly higher incidence in early metastatic tumor stages, but later, in cases having six or more involved organs, the ipsilateral/contralateral quotient reaches 1. It is postulated that in the early stages adrenal metastases from lung cancer probably develop mainly by lymphogenous, but later mainly by hematogenous routes.

ISSN:0022-4790    

DOI:10.1002/jso.2930430306

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

年代:1990

数据来源: WILEY

摘要:

AbstractFrom 1964 to 1988, 231 patients underwent local excision as the single treatment of melanoma with a thickness of ≤ 1.5 mm. We investigated the prognostic value of several factors on cancer‐specific survival and cancer‐specific disease‐free survival, from time of excision on, by performing life‐table analysis on 206 evaluable patients. Recurrence developed in 11 patients; local recurrence occurred in four patients, hematogenic spread in three patients and lymph node metastases in another four patients. Six patients died as a result of the disease. Tumors with a thickness of ≤ 1.5 mm have an excellent prognosis regardless of the localization of the melanoma. At 15 years cancer‐specific survival was 92.3% and cancer‐specific disease‐free survival was 86.9%. Recurrence was successfully treated with hope for cure in 4 patients. This figures does not justify aggressive follow‐

ISSN:0022-4790    

DOI:10.1002/jso.2930430307

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

年代:1990

数据来源: WILEY

摘要:

AbstractBetween 1974 and 1988, 115 patients admitted to our surgical unit underwent resection of nonsmall‐cell lung cancer in the presence of mediastinal lymph node involvement (N2 disease). The overall 5 year survival rate was 18%, and the rates in patients with curative and noncurative operation were 26% and 9%, respectively (P<0.05). Based on the morphological evidence of N2 disease, the patients were placed in three groups: those with microscopic metastasis, moderate metastasis, and gross metastasis, the incidences being 29%, 28%, and 43%, respectively. The survival rates were 41%, 6%, and 16%, respectively. The difference among microscopic vs. moderate and microscopic vs. gross metastasis was statistically significant (P<0.01). Survival rates in patients with intranodal and extranodal invasion, as seen in the histologic examinations, were 34% and 11%, respectively (P<0.01). The incidence of gross metastasis and/or extranodal invasion was higher in those who underwent noncurative operation. Postoperatively adjuvant irradiation was not effective in prolonging the survival in patients with curative operation, but the local residual disease was controlled. Therefore, our working criteria are, if N2 lung cancer is present, a complete resection of the primary tumor and the mediastinal lymph nodes should be done. Patients with microscopic metastasis and intranodal invasion can expect a fairly long surviva

ISSN:0022-4790    

DOI:10.1002/jso.2930430308

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

年代:1990

数据来源: WILEY

摘要:

AbstractA single‐row suturing anastomosis (SRA) for an esophagogastrostomy was experimentally investigated in dogs. SRA not only shortened operating time, but also led to better pathological results when compared with double‐row suturing anastomosis. Wide‐brim suturing and equal distance between the sutures, providing increased and well‐distributed blood circulation, are the key points for success of SRA. Its simplicity and safety are advantages of SRA as has been shown in 90 cases in clinical appl

ISSN:0022-4790    

DOI:10.1002/jso.2930430309

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

年代:1990

数据来源: WILEY

摘要:

AbstractNeoplastic transformation has been associated with a variety of structural changes, among which are changes in membrane carbohydrates. Not much is known, though, e.g., how early in the tumourogenic event these changes take place and what effect these changes have on cell growth, invasion, and ability to metastasize. We were able to identify the B‐D‐Gal(1–3)DGal‐NAc as a membrane carbohydrate component present in malignant laryngeal tissue, but not on adjacent normal mucous membrane. This carbohydrate structure was found to be present in metastatic as well as in nonmetastatic tumours. It was also found in well‐differentiated as well as poorly differentiated carcinomas. We suggest that changes in carbohydrate components on the cell membrane of the laryngeal cancer cell are an early event in tumour progression and probably are not related to the degree of invasion or the ability to me

ISSN:0022-4790    

DOI:10.1002/jso.2930430310

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

年代:1990

数据来源: WILEY

摘要:

AbstractForty‐eight patients with newly‐diagnosed testicular seminomas were followed for a mean of 7 years after treatment. At the time of diagnosis, seminoma was confined to testis in 74% (36) and was metastatic to retroperitoneal lymph nodes in 15% (7) and to distant nodal sites or parenchymal organs in 10% (5). Ninety‐six percent remained free of disease, 94% in first complete remission (CR) and 2% after treatment of first recurrence. Long‐term disease‐free survival in CR per stage was 97% (35/36) for Stage I, 100% for Stage II, and 80% (4/5) for Stage III. However, three patients, who received prior chest radiation therapy (RT), died from acute myocardial infarction 2, 9, and 10 years after treatment and while free o

ISSN:0022-4790    

DOI:10.1002/jso.2930430311

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

年代:1990

数据来源: WILEY

摘要:

AbstractA case is presented in which multiple nodules of recurrent cancer appeared about the scar 25 years after radical mastectomy. They were accompanied by an inflammatory reaction. Breast cancers may recur as long as 50 years after surgery. Such late recurrence is accomplished by the cancer cell entering a “dormant” state in which little or no de novo DNA transcription occurs and only enough RNA is translated into proteins to maintain the vegetative functions that sustain cell viability. Features favoring the evolvement of dormancy are discussed as well as the nature of the cocoon‐like shell which affords such cancer cells protection from the host's cellular and serological defenses. Speculation, promoted by the new cellular biology, as to the cause of secondary inflammatory cancers, is presented. A possible mechanism for the reactivation of these quiescent cells is suggested. The altered immune reactions of host and cancer cells provide an explanation for the controversies plaguing surgeons regarding the treatment and prognosis of breast c

ISSN:0022-4790    

DOI:10.1002/jso.2930430312

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

年代:1990

数据来源: WILEY