ISSN:0022-4790    

DOI:10.1002/jso.2930540102

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

年代:1993

数据来源: WILEY

ISSN:0022-4790    

DOI:10.1002/jso.2930540103

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

年代:1993

数据来源: WILEY

摘要:

AbstractIt has been thought that NCC‐ST‐439 antigen (ST‐439) is a tumor‐related carbohydrate antigen. The authors conducted serum and immunohistochemical studies to investigate the clinical significance of ST‐439 in breast cancer. The level of serum ST‐439 was elevated in advanced and recurrent breast cancers. In comparison with CEA and CA15–3, ST‐439 was superior in sensitivity but inferior in specificity to these markers. The level of serum ST‐439 showed no correlation with the levels of CEA or CA15–3. In the combination assay of these three markers, 80.6% of recurrent cases and 33.8% of primary cases were positive. Immunohistochemically, the expression of ST‐439 was observed in 28.1% of noncancerous mammary duct epithelium and in 38.1% of the cancerous portion. From the above, we concluded that ST‐439 was a tumor‐related antigen and could be a tumor marker with high sensitivity in breast cance

ISSN:0022-4790    

DOI:10.1002/jso.2930540104

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

年代:1993

数据来源: WILEY

摘要:

AbstractTo search for possible untoward effects of ethanol injection into a malignant tumor, a series of experiments was carried out using the model of RBT‐1 carcinoma. Ten days after the inoculation of RBT‐1 carcinoma into the rat liver, the animals were separated into three groups: Group A, ethanol injection during relaparotomy; group B, physiological saline injection during relaparotomy; and group C, relaparotomy alone without ethanol injection. Twenty minutes after these procedures, the tumor was surgically removed and histologically examined. The incidence of vascular permeation of liver tumor cells into the hepatic vein was significantly higher in groups A and B (P<0.05). On the 10th day after relaparotomy, the number of metastatic nodules in the lungs was significantly increased in groups A and B, compared to the findings in group C (P<0.05). Regarding the survival time of rats after relaparotomy, there was no statistically significant difference among the three groups. These results are taken to mean that ethanol injection into a tumor may enhance metastasis. © 1993 Wiley‐Lis

ISSN:0022-4790    

DOI:10.1002/jso.2930540105

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

年代:1993

数据来源: WILEY

摘要:

AbstractThe prognostic factors for solitary hepatocellular carcinomas with a maximum tumor diameter of ⩽3 cm were investigated in 59 of 231 patients who underwent curative hepatic resections at the Department of Surgery II, Nagoya University Hospital between January 1981 and December 1991. The 3‐ and 5‐year survival rates of these 59 patients were 61% and 41%, respectively. As prognostic factors, tumor maximum diameter, vascular invasion, capsule formation, cell differentiation, tumor localization, hepatic functional reserve, extent of hepatic resection, and macroscopic surgical margin were selected in this study. Of the patients with a tumor size>1.5 cm, those who underwent major hepatic resections (hepatic lobectomy or segmentectomy) tended to have better survival than patients who received minor hepatic resections (hepatic subsegmentectomy or limited resection). Although most patients with a tumor size ⩽1.5 cm underwent minor hepatic resections, they had a good survival rate. According to Cox's multivariate analysis, the extent of hepatic resection was significantly correlated with long‐term prognosis of patients with a solitary hepatocellular carcinoma ⩽3 cm in diameter, but the macroscopic surgical margin was not. Cell differentiation, vascular invasion, capsule formation, and tumor localization were all correlated with the long survival. These results suggest that the selection of an adequate operative procedure is an important factor for the long‐term prognosis of patients with small, solitary hepatocellular carcinomas. © 1993 W

ISSN:0022-4790    

DOI:10.1002/jso.2930540106

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

年代:1993

数据来源: WILEY

摘要:

AbstractRegional recurrence of melanoma is usually treated with surgical resection alone. Unfortunately sites of failure following surgical resection are poorly documented. Little information exists regarding local failure following surgery. In order to define local control, a retrospective analysis was performed of all patients undergoing a potentially curative lymph node dissection for metastatic melanoma. From 1978 to 1988, 48 patients underwent lymph node dissection with removal of all known disease (15 axillary, 25 groin and 8 radical neck dissections). Seven patients had stage II disease with simultaneous resection of the primary lesion and nodal dissection. The remaining 41 patients had stage I disease with dissection delayed until nodal metastasis became apparent. Of these 48 patients, 25 experienced local failure for an overall local control rate of 48%. Univariate and multivariate analysis showed only age to be a statistically significant prognostic indicator of local failure with a rate of 31% for patients>50 years of age vs. 66% for patients>50 years of age (P= 0.02). Nodal size, number of nodes involved, extracapsular extension, initial stage, location, or sex did not influence prognosis. Although not statistically significant, time to recurrence was much shorter in patients with extracapsular extension, 5 months vs. 16 months. With an overall local failure rate of 52% following a potentially curable therapeutic nodal dissection further local treatment should be considered. © 1993 Wiley‐Liss, I

ISSN:0022-4790    

DOI:10.1002/jso.2930540107

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

年代:1993

数据来源: WILEY

摘要:

AbstractThirty‐five consecutive patients underwent en bloc resection of cardia cancer without thoracotomy. All tumors were adenocarcinoma. The operative procedure involved wide resection of the peri‐hiatal diaphragm, dissection of the upper abdominal and lower mediastinal lymph nodes, and resection of the stomach including a portion of the lower thoracic esophagus without thoracotomy. The resection area of the diaphragm included not only the crural muscle as in other methods, but also the diaphragmatic tissue surrounding the esophageal hiatus. Through the enlarged hiatus, dissection of the mediastinum was possible up to the carina from the abdominal cavity. The mediastinal node stations were affected in 25% of patients whose tumor invaded to the serosa. Hypotension with or without atrial arrythmias and pleural tears occurred during surgery in 20 patients (57%) and in 18 patients (51%), respectively. Postoperatively, hypoxia requiring reintubation developed in 7 patients (19%), pleural effusions needed tube drainage in 16 patients (46%), atelectasis in 5 patients (14%), and anastomotic leaks in 3 patients (9%). They were all successfully treated. The cumulative 5‐year survival rate for 21 patients with stages I (2 patients), II (9), and III (10) diseases was 62%, whereas none of the patients with stage IV disease lived for more than 2 years after surgery. Because thoracotomy is avoided, the procedure is better tolerated by debilitated patients. We believe this technique is a reasonable and safe alternative to the left thoracotomy approach for resection of cancer of the gastric cardia. © 1993 Wiley‐L

ISSN:0022-4790    

DOI:10.1002/jso.2930540108

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

年代:1993

数据来源: WILEY

摘要:

AbstractFrom 1961 to 1991, a total of 1,452 esophagectomies were performed for esophageal cancer at Memorial Sloan‐Kettering Cancer Center. Of these patients, 40 (2.7%) developed complications requiring a second operation during the same hospitalization. The majority of the carcinomas were located in the midesophagus or the gastroesophageal junction. The pathologic diagnosis was squamous cell carcinoma in two‐thirds of the patients. Few comorbid factors could be identified. Twenty‐nine patients (72%) had a standard Ivor‐Lewis resection, 5 (12%) had a transhiatal resection, 5 (12%) had a transabdominal approach, and 1 (3%) had a cervical approach only. Complications requiring reoperation were the following: respiratory failure in 13 patients, anastomotic leak in 6, bowel obstruction in 5, major bleeding in 4, wound dehiscence in 4, tracheo‐esophageal fistula in 3, feeding tube malposition in 2, empyema in 1, chyle leak in 1, a positive margin in 1. Twelve of these same patients had a persistent or second complication and required a third operation. Among the 40 patients in this study, the mortality was 40%. © 1993 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930540109

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

年代:1993

数据来源: WILEY

摘要:

AbstractA heightened awareness of the risks of blood transfusion and the previously reported common administration of blood products (31–55%) following thoracic surgery prompted us to evaluate our recent transfusion practices. Of 355 patients who underwent a thoracotomy or median sternotomy from July 1987 through September 1991, 91 (25.6%) were transfused a mean 3.1 units of blood within the first 30 postoperative days. Transfused and nontransfused patients were compared with respect to age, body surface area, preoperative hemoglobin, estimated operative blood loss, and estimated postoperative hemoglobin. Univariate analyses of variance indicate significant (P<0.01) differences between the two groups of patients for preoperative hemoglobin, blood loss, and estimated postoperative hemoglobin. Transfusion frequencies by year of operation are: 1987, 36%; 1988, 31%; 1989, 33%; 1990, 23%; 1991, 15%. We conclude that our transfusion requirements are lower than reported rates and that clinical parameters may help predict the need for subsequent transfusio

ISSN:0022-4790    

DOI:10.1002/jso.2930540110

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

年代:1993

数据来源: WILEY

摘要:

AbstractOne hundred seventy‐one patients with epithelial ovarian cancer were treated on a prospective protocol of weekly cisplatin induction (1 mg/kg weekly for four courses) followed by monthly cisplatin (50 mg/m2), Adriamycin (50 mg/m2), and cyclophosphamide (750 mg/m2). Seventy‐five patients with FIGO stage III or IV disease who underwent optimal cytoreductive surgery (<2 cm residual disease) were treated on this protocol and had weekly as well as monthly serum CA125 levels measured. A retrospective analysis was performed in order to determine if a ⩽50% fall in elevated serum CA125 levels during weekly cisplatin induction therapy would be predictive of findings at second look operation, normalization of serum CA125 levels (0.05). Logistic regression analysis demonstrated that a ⩽50% fall observed in CA125 levels during four weekly courses of chemotherapy served as an independent predictor of normalization of serum CA125 levels (<35 u/ml) following two courses of multiagent chemotherapy (P= 0.009) and improved median progression‐free interval (P= 0.04). Eighteen patients demonstrated a rise in serum CA125 levels during weekly induction cisplatin chemotherapy. Only one of these patients (5.5%) demonstrated a surgical complete response at the end of standard therapy. © 1993 Wil

ISSN:0022-4790    

DOI:10.1002/jso.2930540111

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

年代:1993

数据来源: WILEY