ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07219.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The role of conservative surgery (CS) as definitive treatment of invasive breast cancer has not been established. Previous studies have demonstrated high rates of local tumour recurrence if CS is not followed by radiotherapy (RT). At present, it is impossible to identify subsets of patients who may be at acceptably low risk of recurrence after CS. The treatment of breast cancer by CS alone remains an important research question as this may avoid over‐treatment by radiation for some patients.In Australia, a trial has been proposed by the ANZ Breast Cancer Trials Group, comparing CS alone to CS + RT. This paper reviews all available data on CS alone in order to stimulate debate as to the appropriateness of the trial and its end‐points. Given that all prospective randomized trials have failed to show a survival disadvantage for CS alone it is essential to consider the value of all outcomes after CS or CS + RT. The conventional end‐points proposed in the Australian study (mastectomy rate, disease‐free survival (DFS) and overall survival (OS)) are selective. Without the addition of quality of life measures, the utilities of the strategies addressed in the trial cannot be evaluated. Data are presented on the desirability (utility) of the alternative approaches of CS or CS + RT based on data obtained from a questionnaire completed by Westmead Hospital staff. This preliminary study indicates that the majority of respondents to the questionnaire perceived that the strategy of CS + RT to have a higher utility than the strategy of C

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07220.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The clinical presentation, diagnostic features and surgical management of three cases of giant cholesterol cysts involving the petrous apex of the temporal bone are presented. The ability to reach a confident pre‐operative diagnosis using magnetic resonance imaging (MRI) due to its greater soft tissue contrast resolution, multiplanar imaging capabilities and sensitivity to blood products is illustrated. The operation of transmastoid infralabyrinthine draining of the petrous apex is described and other possible approaches discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07221.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Three cases of intracranial teratomas occurring at the basal ganglia of three young male patients were reported. Their radiologic appearances closely resembled each other with multicystic tumor masses located deep in the basal ganglia. Histology showed teratocarcinoma, combined immature teratoma and germinoma, and teratoma with malignant transformation. These tumours represent a distinct clinico‐radiologic group of lesions and serve as an addition to the dearth of information reported about the histological subtypes of intracranial teratoma

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07222.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Two young patients with extensive ulcerative colitis were treated with oral steroids and developed seizures between 36 and 72 h after emergency colectomy. These cases highlight the problem of postoperative seizures, related to previous steroid administration, fluid overload, postoperative hypertension and biochemical abnormalities.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07223.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

An investigation based on dissection of cadaveric specimens was undertaken to obtain additional data on the relationships between the recurrent laryngeal nerve and the posterior fascial attachment of the thyroid gland. Ninety‐four dissections were selected for detailed study. The posterior fascial attachment on each side was found to form two bands—a vertical band described previously and a horizontal band. The horizontal band was found to be present in all cases and to be constant in position. The posterior edge of the horizontal band followed posteriorly leads to the recurrent laryngeal nerve. The nerve always had a close relationship to the horizontal band and was often adherent to it. It is suggested that the use of the horizontal band to locate the recurrent laryngeal nerve would be of particular value when the inferior thyroid artery is absent, when the nerve is non‐recurrent on the right side, or when there is distortion of the normal an

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07224.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07225.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The experience of the use of the TRC‐Mammotest machine for stereotactic fine needle biopsy (SFNB) of the breast in Perth is presented. During the period 20 October 1988 to 10 January 1990, 404 SFNB were performed on 389 women with impalpable, mammographically detected lesions of the breast. Surgical biopsy was performed in 73 cases, of which 38 were malignant, giving a benign to malignant ratio in<1:1. The sensitivity for detecting cancer was 95%, with a positive predictive value of 100%. Using a combination of the mammographic and cytologic rating for the likelihood of cancer, all the cancers were detected and no cancers have developed in those considered mammographically and cytologically benign. The importance of a combined assessment of mammography and cytology in the management of patients with mammographically detected abnormalities is stresse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07226.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study compares colorectal cancer from the King Faisal Specialist Hospital and Research Center (KFSHRC) Tumour Registry in patients under and over 40 years and contrasts the data with registry data from New Zealand (NZ).Between 1975 and 1989 622 patients were registered at KFSHRC and 528 were Saudi. Three hundred and twenty‐one were male and 207 were female. The average ages were 55.3 and 49.6. One hundred and nineteen were less than 40 years. More patients with proximal lesions were less than 40 years. Of the young patients 8.3% had small tumours (<4cm) compared with 24.9% of patients over 40. Mucinous and signet ring carcinomata were more common in the young. Tumours were less well differentiated in younger patients. There were more young patients with ‘localized’ disease and nodal involvement. Older patients had more distant metastases.Of patients registered in NZ 5.5% were young compared with 23% of Saudi patients. In both countries localized disease was more common in the young. Nodal involvement was more frequently seen in the young in the Kingdom of Saudi Arabia (KSA) whereas the opposite was true in NZ. Distant metastases were more common in the old in the KSA but there were more young patients with metastases in NZ. In both countries young females with rectal tumours were more common but this ratio was reversed in the old.This study suggests that colorectal cancer may be more aggressive in the young in KSA but there was no evidence that the disease was more aggressive in young New Zealanders. Differences in the epidemiology of the disease in the young and old were found in both coun

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07227.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07228.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY