bluuebunny/crossref_metadata_2025 huggingface dataset:
Separate annular strictures of the rectosigmoid colon secondary to unsuspected prostate cancer
Authors: Culkin Daniel J. , Demos T. C. , Wheeler J. S. , Castelli M. , Canning J. R.
Published: February 2007

Rectal involvement from prostate cancer occurs in 1.5–11% of cases. A rarer presentation is that of a separate metastasis to the high rectosigmoid colon causing an annular stricture. We present our experience with six such cases who presented with gastrointestinal symptoms. Two of the cases had undergone intestinal resections. All 6 patients had radiographic evidence of an annular stricture in the rectosigmoid area. Retrospective review revealed evidence of metastatic disease in all cases in the form of abnormalities in one or more of the following: intravenous urography, radionuclide bone scan, liver spleen scan, acid phosphatase, or alkaline phosphatase. The mean survival was 9.3 months. This rare presentation of prostate cancer may be difficult to distinguish from primary colorectal cancer and therefore needs to be ruled out to avoid intestinal resections.
Intrahepatic bile duct cystadenocarcinoma: Case report and imaging diagnosis
Authors: Boillot O. , Domergue J. , Fabre J. M. , Guillon F. , Lestra P. M. , Barneon G. , Bruel J. M. , Baumel H.
Published: February 2007

The authors report the 30th case in the literature of cystadenocarcinoma of the liver and the second case arising in the caudate lobe. This case illustrates the 2 main questions raised by this tumor: the importance of differentiating benign and malignant cystadenoma and bile duct cyst on sonographic and scanographic aspects and the surgical management of these tumors of the liver, especially in this malignant centrohepatic case.
Malignant melanoma metastatic to the thyroid as initial evidence of disseminated disease
Authors: Sheppard Brett C. , Moseley H. Stephens
Published: February 2007

A 48‐year‐old Caucasian male with a 3 mm sub‐ungual right middle finger melanoma underwent cisplatin forequarter perfusion, ray amputation, and ipsilateral axillary node dissection. Two months post‐operatively he presented with a thyroid mass as initial evidence of disseminated disease. Subsequent workup also demonstrated pulmonary metastases. A total thyroidectomy radical neck dissection and multi‐agent chemotherapy has controlled the disease in his neck. As far as we are aware, this is the first case report of malignant melanoma metastatic to the thyroid. The potentially beneficial role of surgery in the management of metastatic melanoma and the relation of melanoma to the hormonal axis is discussed.
Abdominal operations for intraabdominal metastases from extraabdominal primary tumors
Authors: Mäkelä Jyrki T. , Kiviniemi Heikki O. , Haukipuro Karl A. , Laitinen Seppo T.
Published: February 2007

Forty consecutive patients with an extraabdominal primary tumor, later treated surgically for intraabdominal problems, were investigated. The most common causes of abdominal operations were intestinal obstruction (N = 17), intraabdominal tumor mass (N = 8), and intraabdominal hemorrhage (N = 5). The overall postoperative mortality was 25%, morbidity 48%, median survival 3 months, and cumulative 5 year survival 3%. The mortality after emergency procedures, 67%, was significantly higher (P < 0.01) than after elective operations, 18%. Conditions requiring enterostomy (N = 14) were associated with a mortality of 36%, whereas the figures in resected (N = 13) and bypassed (N = 7) patients were 14% and 17%, respectively. Wound infection (N = 5) and pulmonary infection (N = 5) were the most common complications, and pulmonary infection was fatal in three of the five cases. Of the patients, 22 (55%) were discharged from hospital to their home; ten (25%) of them had postoperatively a 3 month relief of cancer symptoms and four (10%) a 6 month relief. Nine patients (25%) have survived for over 1 year and one (3%) for over 5 years. It is concluded that abdominal procedures seldom prevent further cancer growth within these patients and that symptoms are relieved only in one in every four patients. According to strict criteria, these operations are useful and can add to patient comfort.
The value of endoluminal ultrasonography and computed tomography in the staging of rectal cancer: A preliminary study
Authors: Pappalardo G. , Reggio D. , Frattaroli F. M. , Oddi A. , Mascagni D. , Urciuoli P. , Ravo B.
Published: February 2007

A prospective study was carried out in 14 patients with rectal cancer. Tumors were staged preoperatively by endoluminal ultrasonography (EU) and computed tomography (CT). Patients were followed postoperatively for 2 years by the same modalities. Extramural spread was 100% (9/9), accurately assessed by EU and 77.8% (7/9) with CT. Lymph node sensitivity was 87.5% for EU and 37.5 for CT (P < 0.05). Overall accuracy of lymph node metastases was 85.7% for EU and 57.1% for CT (P < 0.1). In conclusion, the study shows EU to be statistically more accurate for nodal metastases than CT; therefore, its routine use can be recommended in the preoperative staging of rectal carcinoma in those patients for whom a sphincter‐saving procedure is considered.
Complications following surgery for cancer of the larynx and pyriform fossa
Authors: Sarkar Sudeep , Mehta Samir A. , Tiwari Jitendra , Mehta Ashok R. , Mehta Mona S.
Published: February 2007

The hospital records of patients undergoing major surgery for cancer of the larynx and hypopharynx at the Tata Memorial Hospital, Bombay, from 1981 to 1985 were reviewed. Different variables were correlated with the incidence of major complications and were analysed to find out significant factors contributing to increased complication rates. Complications included wound infection, pharyngocutaneous fistulae, flap necrosis, carotid blowout, and neo‐esophageal stenosis. Postoperative deaths and delayed fatalities were also recorded. The overall fistulae rate was 34.7%, and wound infection occurred in 28% of patients. Prior radiotherapy and the need for pharyngeal reconstruction were found to be significant in determining postsurgical complications. Age. sex, site, stage, cartilage and soft tissue infiltration, preoperative tracheostomy, involvement of resection margins by tumor, and the dose of radiotherapy were not found to influence the complication rates.
Benign schwannoma and parathyroid adenoma occurring in the nonradiated neck: Report of two cases
Authors: Bentt Lavern R. , Silberman Allan W. , Braunstein Glenn D.
Published: February 2007

The late occurrence of multiple neoplasms in the previously radiated neck is a well‐known association. However, multiple tumours in the nonradiated neck remain a rare finding. This paper presents two cases of the infrequently seen schwannoma occurring with a parathyroid adenoma without antecedent history of radiation or neurofibromatosis.
Neuron‐specific enolase during chemotherapy of small cell lung cancer
Authors: Buamah P. K. , Drake S. R. , Smedley H. M. , Bodger W. A. H. , Skillen A. W.
Published: February 2007

Serum neuron‐specific enolase (NSE) has been measured in 28 patients with small cell lung cancer (SCLC) and 90 patients with other forms of lung cancer (NSCLC), i.e., 28 with adenocarcinoma and 62 with squamous cell carcinoma. Increased NSE (>12.0 μg/liter) was found in 71.4% of SCLC patients and in 22.2% of NSCLC patients. The predictive value of an increased NSE in identifying SCLC was only 50%, whereas the predictive value of a normal NSE in differentiating SCLC for NSCLC was 91%. Serial studies during chemotherapy of SCLC patients showed that the doubling time of NSE ranged from 7 to 127 days and the mean apparent half‐life (AHL) of NSE to be 14 days. AHL values in excess of 20 days suggest that the tumour is not in full remission. We believe that measurement of serum NSE and calculation of the AHL and DT are valuable in identifying the effectiveness of chemotherapy in patients with SCLC.
Evidence for the existence of different types of large bowel tumor: Suggestions from the clinical data of a population‐based registry
Authors: De Leon Maurizio Ponz , Sacchetti Carla , Sassatelli Romano , Zanghieri Gianni , Roncucci Luca , Scalmati Alessandra
Published: February 2007

The clinical findings of a population‐based colorectal tumor registry have been analyzed to determine elements of supporting or not supporting the existence of different types of large bowel cancer. Age‐specific incidence rate of the 409 registered patients rose sharply with increasing age in all segments of the large bowel; however, regarding left colon and rectum, the male: female ratio showed a marked male preponderance, more evident in the more advanced age groups. Histopathology, studied in 87% of patients, revealed adenocarcinoma as the most frequent feature; however, adenocarcinoma with concomitant adenoma (i.e., presumably arising in adenoma) was observed in 14.3% of cancers of the left colon, in 17.7% of rectal tumors, but in only 5.7% of neoplasms of the proximal colon (P < 0.05 and P < 0.01, respectively, vs. left colon and rectum). Some histological features (carcinoid and mucinous carcinoma) were observed in right‐side tumors only. Analysis of the familial occurrence of cancer showed that a significantly larger proportion of patients with neoplasms located in proximal colonic segments had three or more first‐degree relatives affected by (or deceased from) cancer of all sites. Similarly, colorectal tumors among relatives were more frequent in patients with right‐side cancer. The location of the 793 polyps observed during 3 years of registration showed that more than 70% of adenomas were located beyond the splenic flexure, overlapping the distribution of cancers. In conclusion, the differences of sex ratio at different colonic subsites, the higher fraction of adenocarcinomas with adenomas in cancer of the more distal tracts of the large bowel, and the more marked familial occurrence of colorectal cancer in patients with right‐side neoplasms tend to support the view that cancer of the proximal colon, cancer of the distal colon, and cancer of the rectum may actually be three different types of tumors.
Brachytherapy in the treatment of solitary colorectal metastases to the liver
Authors: Donath D. , Nori D. , Turnbull A. , Kaufman N. , Fortner J. G.
Published: February 2007

It is well‐established that 30–40% of patients with solitary liver metastases from primary colorectal tumors can be cured by resection. Conventional radiation therapy has had only a palliative role in treating liver metastases because the dose that the liver will tolerate is far below a tumoricidal dose. In contrast, brachytherapy allows one to deliver a tumoricidal dose to the tumor while limiting the dose to surrounding normal tissue to the tolerance dose. As a pilot study, 125I seeds were implanted into unresectable hepatic metastases, or positive margins of resection, at the time of surgery. This report concerns six patients whose liver lesions were the only known site of disease and in whom precipitous drops in carcinembryonic antigen (CEA) levels followed the implants. Recurrence was observed in only one of the 11 implanted sites, with a median follow‐up of 12 months.
Stromal neoplasms of the breast: A comparative flow cytometric study
Authors: El‐Naggar Adel K. , Mackay Bruce , Sneige Nour , Batsakis John G.
Published: February 2007

We analyzed 42 mammary spindle cell neoplasms (10 conventional fibroadenomas, 8 giant fibroadenomas, 17 cystosarcoma phyllodes, and 7 stromal sarcomas) by flow cytometry to assess the diagnostic and prognostic relevance of DNA content analysis in the pathologic evaluation of these lesions. Our data indicate that all fibroadenomas were diploid, cystosarcoma phyllodes displayed diploid and aneuploid DNA content irrespective of their histological categorization, and that stromal sarcomas were all aneuploid and clinically aggressive. Diploid cystosarcoma phyllodes were biologically indolent, whereas most of the aneuploid neoplasms killed their hosts (P = 0.03). The present study indicates that a DNA content abnormality is a reliable marker of malignancy in these neoplasms, and it may identify subsets of patients with variable biologic courses within the histopathologic spectrum of cystosarcoma phyllodes.
Primary lymphoma of bone: Experience of 39 cases at the tata memorial hospital, India
Authors: Susnerwala Shabbir S. , Dinshaw Ketayun A. , Pande Subodh C. , Shrivastava Shyam K. , Consalves Mary Ann , Advani Suresh H. , Gopal Ramakrishna
Published: February 2007

Primary lymphoma of bone (PLB) is an uncommon clinical entity and a rare presentation of non‐Hodgkin's lymphoma. At the Tata Memorial Hospital, over a period of 10 years from 1976 to 1985, 39 cases with a diagnosis of PLB were seen. Twenty‐seven cases completed the prescribed treatment and were evaluable for treatment response. Eight patients (21%) presented in clinical stage I (E), four patients (10%) in stage II (E), and 27 patients (69%) in stage IV (E). All of the evaluable patients except two were treated with combination chemotherapy, which consisted of cyclophosphamide, vincristine, and prednisolone in 18 patients, and seven patients received Adriamycin in addition. The majority of patients received six courses of chemotherapy extending over 8 to 12 months. External radiotherapy was given to all except one patient, who had surgery as local treatment. Five patients had generalised relapse, one of which had in addition a local relapse. Five were resistant to treatment. Overall and disease‐free survival by Kaplan‐Meier method at 60 months are 66% and 56%, respectively.
Effective palliation for inoperable esophageal cancer using intensive intracavitary radiation
Authors: Fleischman Erik H. , Kagan A. Robert , Bellotti John E. , Streeter Oscar E. , Harvey James C.
Published: February 2007

In a pilot study between May 1988 and May 1989, ten consecutive patients with advanced esophageal cancer were treated with a short intensive course of intraluminal curietherapy without external beam irradiation at the Kaiser Permanente‐Los Angeles Medical Center. Nine of ten patients achieved effective palliation comparable to that of standard external beam teletherapy from other series. Most patients had already failed other palliative modalities including chemotherapy, laser debridement, dilation, and electrocautery. The duration of response was generally longer than with these techniques. All patients completed therapy, and tolerance was excellent. Intraluminal irradiation is an attractive, effectual therapeutic alternative, especially in patients with advanced local or distant disease unlikely to tolerate 5 to 7 weeks of external beam therapy.
Multicentric adult secretory breast carcinoma: DNA flow cytometric findings, prognostic features, and review of the world literature
Authors: Richard Gene , Hawk J. C. , Baker A. S. , Austin Robert Marshall
Published: February 2007

A case of multicentric secretory breast carcinoma in a 39‐year‐old white female is described. Mammograms, DNA analysis, touch preparation cytology, and positive estrogen receptors are reported for the first time in this rare favorable mammary carcinoma. A review of the 33 reported cases with follow‐up in adult females, including the present case, has revealed lymph node metastases in nine (27%), recurrence in four (12%), and distant metastases leading to death in two cases (6%). In patients treated with less than simple mastectomy there has been local recurrence in 4 (33%) of 12 cases and in three of the four cases (75%) greater than or equal to 2.0 cm. Increased size and lack of gross circumscription of the neoplasm and presentation in the adult age group appear to identify cases with an increased risk of disease progression. In patients over 20 years old, especially with neoplasms greater than 2 cm in diameter, modified radical mastectomy has to date achieved the most favorable outcome. Minimal experience (two cases) is available regarding treatment with limited surgery and radiation therapy, and there is no available data regarding possible benefit from adjuvant chemotherapy.
An appraisal of pancreatectomy for advanced cancer of the pancreas based on survival rate and postoperative physical performance
Authors: Miyata Masahiko , Nakao Kazuyasu , Takao Tetsuto , Kuwata Keishi , Nakashima Nobukazu , Dousei Tsutomu , Hayashi Katsuhide , Kawashima Yasunaru
Published: February 2007

The follow‐up results of surgical procedures for cancer of the pancreas at three affiliated hospitals during the past 15 years (1974‐1989) were ret‐rospectively analyzed to evaluate the merit of pancreatectomy in surgical treatment of advanced stages of this disease. Included were 4 cases of stage I, 14 cases of stage II, 19 cases of stage III, 43 cases of localized stage IV, and 35 cases of generalized stage IV. Pancreatectomy was performed in 67 cases; 100%, 92.9%, 89.5%, 67.4%, and 11.4% of the stage I, II, III, localized IV, and generalized IV cases, respectively. For the localized stage IV cases, in which the cancerous lesions were advanced but limited to the peripancreatic region, 29 pancreatectomies, 12 bypass operations, and 2 exploratory laparotomies were performed. This group included 17 curative and 12 noncurative pancreatectomies. The 50% survival periods were 257 days after curative pancreatectomy, 226 days after noncurative pancreatectomy, 120 days after bypass operation, and 33 days after exploratory laparotomy. The difference in overall survival rate between curative and noncurative pancreatectomies was not significant. The overall survival rates after both curative and noncurative pancreatectomies were significantly higher than the rate after bypass operation. The postoperative physical performance status after pancreatectomy was significantly better than after the palliative procedures. No significant difference in the status was found between patients after standard and extended pancreatectomies. There was no signifigant difference in the survival rates or the physical performance status between the pancreatectomy group and the palliative surgery group for the generalized stage IV cases, in which the cancerous lesions extended beyond the peripancreatic region. On the basis of these findings, it is concluded that pancreatectomy extends the postoperative survival period without impairment of the physical performance status in patients with advanced cancer of the pancreas. Even when the pancreatectomy proves to be a noncurative resection, this aggressive surgical approach may be of benefit to this group of patients. It should be noted, however, that pancreatectomy is not beneficial to patients whose lesions have already become generalized.
Immune reactivity in bronchogenic carcinoma and its relation to 5‐year survival rate
Authors: Watanabe Yoh , Shimizu Jyunzo , Hashizume Yasuo , Tsunamura Yukio , Yamada Tetsuji , Iwa Takashi , Sakai Shunnosuke , Murayama Tsugiya , Koshimura Saburo , Saito Motoo
Published: February 2007

We performed a prospective study on the correlation of various parameters of the immune response with the 5‐year survival rate in patients with bronchogenic carcinoma. Parameters were initially examined before starting treatment. Delayed hypersensitivity skin tests, lymphoblastogenesis, natural killer (NK) cell activity, and interleukin‐2 (IL‐2) production were employed to assess immune competence. Each reaction was classified into four or five grades in accordance with intensity; the 5‐year survival rate of the patients showing each grade of the immune response was calculated. A correlation between response before treatment and the survival rate was most clearly noted for lymphoblastogenesis. The skin tests and the NK cell activity showed poorer correlations, and no exact correlation was noted between the IL‐2 production and the immune response.
Renal vein leiomyosarcoma
Authors: Pelton Jeffrey J. , Palazzo Juan P. , Peterson Robert O. , Eisenberg Burton L.
Published: February 2007

The 11th case of primary leiomyosarcoma of the renal vein is reported. Unique features of this case included concomitant resection of an isolated hepatic metastasis, intraoperative radiation therapy, and the use of electron microscopy and immunohistochemical stains in confirming the diagnosis. A review of the previously reported cases shows a tendency toward slow tumor growth and infrequent recurrence (18%). Metastases are common (82%), primarily to the lung and liver. Aggressive surgical resection and adjuvant radiation therapy, including intraoperative radiation therapy, are recommended. Adjuvant chemotherapy should be considered, although its benefits at present are unclear.
Adrenal carcinosarcoma
Authors: Decorato John W. , Gruber Harold , Petti Mario , Levowitz Bernard S.
Published: February 2007

The clinical and pathologic features of a case of adrenal carcinosarcoma are reported. Although synchronous malignancy of the adrenal gland has been described, no case of an adrenal tumor combining both carcinomatous and sarcomatous elements has been previously documented. This neoplasm is extremely aggressive with distant metastasis arising from the sarcomatous component, and rapid progression despite multimodal therapy.
In vivo selection and characterization of a murine mammary tumor subline with high potential for spontaneous lymph node metastasis
Authors: Colombo Lucas L. , Gomez Daniel E. , Puricelli Lydia , Vidal Marìa Del Carmen C. , Ponzio Roberto , De Kier Joffe Elisa Bal
Published: February 2007

A transplantable mammary adenocarcinoma, grown in Balb/c mice, with a marked enhancement in its draining lymph node metastatic ability (MM3LN), was obtained through an in vivo procedure from a variant tumor moderately metastatic to lymph nodes (MM3). Both MM3 and MM3LN presented a similar latency and tumor growth rate and reached the same tumor mean diameter at death. MM3LN tumor‐bearing mice exhibited a larger mean survival time. The new variant showed a 2.5‐fold higher incidence of tumor‐draining lymph node metastases than MM3 line, with no differences in the incidence of lung metastases. Morphology as well as cytogenetic and in vitro adhesion properties were studied in order to characterize the new subline. This murine tumor model has potential application in the study of the metastatic process in lymphoid tissue.
Colon carcinoma associated with ureterosigmoidostomy
Authors: Badalament Robert A. , Cirulli Christopher , Zerick William , Lucas Joel G. , Drago Joseph R.
Published: February 2007

A patient developing a colonic adenoma 38 years following ureterosigmoidostomy is presented. The mechanisms of neoplastic transformation associated with ureterosigmoidostomy is now better understood. This knowledge is being applied to develop modifications both of the surgical technique and the management of patients with this form of urinary diversion, and is a subject of discussion.
Effects of FUdR on primary‐cultured colon carcinomas metastatic to the liver
Authors: Schroy Paul C. , Cohen Alfred , Winawer Sidney J. , Friedman Eileen A.
Published: February 2007

Hepatic arterial infusion of fluorodeoxyuridine (FUdR) has demonstrated efficacy in the treatment of metastatic colorectal carcinoma of the liver, In this study, the direct cytotoxic effect of FUdR was measured on ten metastatic and two primary‐site colorectal carcinomas in a primary culture assay system. Overall, clinically achievable concentrations of FUdR (0.4 to 4 μM) induced partial cell kill in 75% of tumors, including a > 50% reduction in viable tumor cell number in only two tumors and <50% in the remaining seven. Total cell kill was not observed in any tumor. Three tumors were resistant to these FUdR concentrations. Tumor sensitivity correlated with the size of the tumor growth fraction. Increasing the exposure time to FUdR from 3 to 7 days approximately doubled the magnitude of the response. 5‐Fluorouracil and cisplatin, at clinically achievable concentrations, were more toxic to metastatic tumor cells than FUdR. Because of the limited chemosensitivity of metastatic colorectal tumor cells to FUdR in vitro, we postulate that other mechanisms besides direct cytotoxicity contribute to the clinical efficacy of FUdR in vivo.
Cryoprobe as a “handle” for resection metastatic liver tumors
Authors: Welling Richard E. , Lamping Kathleen
Published: February 2007

Resection of metastatic liver tumors can be a difficult and risky procedure. Using a cryoprobe as a “handle” can greatly facilitate resection by providing a taut surface for transection and improving visualization of ductal and vascular structures. In addition, this technique may decrease the risk of contaminating surrounding tissues with cancer cells, and may inhibit tumor recurrence within the margins of resection.
Extended neck dissection
Authors: Shaha Ashok R.
Published: February 2007

From the time Crile described radical neck dissection in 1906, this surgical procedure became popular in the management of metastatic cancer in the neck. Over the past two decades, the modified neck dissection has been effectively utilized for conservation of function and cosmesis while achieving the same oncologic goals. However, there are several instances where the above standard procedures are not adequate for resection of malignant tumors. Although there is a definite trend toward conservation procedures, extended neck dissection is often necessary especially in patients with N2 and N3 disease. Apart from the standard structures removed in radical neck dissection, the other structures removed in extended neck dissection include skin, the digastric muscle, hypoglossal nerve, vagus nerve, sympathetic chain, ramus mandibularis, carotid artery, tracheo‐esophageal nodes, etc.

Over the past seven years, we have performed 40 extended neck dissections. All the patients had N2 or N3 disease in the neck. Nine patients had unknown primaries. Thirteen patients had their primary tumors in the oral cavity and 11 in the laryngopharynx. Five patients had primary tumor in the salivary glands and two patients had metastatic melanoma. Patients who underwent extensive skin excision had pectoralis myocutaneous flap reconstruction.

All patients received postoperative radiation therapy. One patient died of cardiac problems 4 weeks after operation. Local control was achieved in 70%. The most difficult region for local control was the disease behind the mastoid process, and the most difficult problems were patients with involvement of the subdermal lymphatics. Our data suggests that there are definite situations where extended neck dissection is indicated with satisfactory local control of the nodal disease.
Gamma‐detecting probe and autoradiographic studies of radiolabeled antibody B72.3 in CX‐1 colon xenografts
Authors: Sampsel James W. , Hinkle George , Nieroda Carol , Ignaszewski Judi , Thurston Marlin , Martin Edward W.
Published: February 2007

Nude mice bearing CX‐1 colon tumors were injected with 50 μCi 125I‐labeled monoclonal antibody (MAb) B72.3. Radioactivity in tumors was studied with the gamma detecting probe (GDP) on days 1, 3, 7, and 10 after MAb injection. On each day, two mice were sacrificed and sections were examined with autoradiography (ARG), immunoperoxidase methods (IMP), and routine stains.

Mean probe counts showed increasing tumor to background ratios and ARG demonstrated a rogressive increase in radionuclide in the tumors. The distribution of 125I was primarily around the vascular spaces on day 1, but by day 3 and progressively it appeared in tumor gland lumina and necrotic areas. A regional correlation was shown between radionuclide in vascular spaces and its sequestration in tumor elements.
Carcinoid tumors
Authors: Nwiloh Jonathan O. , Pillarisetty Sitaram , Moscovic Edward A. , Freeman Harold P.
Published: February 2007

The authors carried out a retrospective study of 32 patients (23 M, 9 F) with carcinoid tumors who were diagnosed and treated at Harlem Hospital Center, New York, from 1967 to 1988. All the patients were black and the commonest sites were the ileum (28.1%), rectosigmoid and rectum (21.9%), and the appendix and lung (15.6% each). Metastasis correlated with site, size, and depth of the primary tumor and occurred in 12 patients (38%), most frequently to the regional lymph nodes and liver. Carcinoid syndrome developed in 12.5% (3 F, 1 M). Surgical resection for cure or palliation was the mainstay of treatment. Overall 5 year survival rate was 66%, and for those with metastases was 0%. The poorer survival rates are probably related to the socioeconomic status of our patient population. The only observed racial difference compared to other series is the preponderance of males, and the disproportionately higher ratio of females with the carcinoid syndrome.
Comparison of characteristics of esophageal squamous cell carcinoma associated with head and neck cancer and those with gastric cancer
Authors: Kuwano Hiroyuki , Morita Masaru , Tsutsui Shin‐Ichi , Kido Yuichiro , Mori Masaki , Sugimachi Keizo
Published: February 2007

In ongoing reviews of 339 patients with surgically treated primary squamous cell carcinoma, there were 19 (5.6%) with concurrent gastric cancer and 11 (3.2%) with head and neck cancer. The incidences of intra‐esophageal multiple occurrence of esophageal cancer are 27.3% and 26.3% in those with associated head and neck cancer and gastric cancer, respectively, and higher than 7.1% in those without such a concurrent cancer. There was no difference in the clinicopathological characteristics of those with concurrent head and neck and gastric cancers, except for the higher incidence of metachronous occurrence in the former. These findings suggest that, in cases of esophageal cancer associated with concurrent head and neck cancer and gastric cancer, intraesophageal multiplicity of the esophageal carcinoma is frequent and that preoperative serial evaluations is most important to design treatment and estimate the prognosis.
Immune competent cells of regional lymph nodes in colorectal cancer patients: I. Flow cytometric analysis of lymphocyte subpopulation
Authors: Adachi Wataru , Sugenoya Akira , Iida Futoshi
Published: February 2007

Lymphocyte subpopulations of the regional lymph nodes in 20 colorectal cancer patients were measured by flow cytometry to analyze nodal lymphocytes phenotypically. Eleven patients with cholelithiasis were used as controls. Comparison of lymphocyte subpopulations between colorectal cancer and control groups revealed a significantly increased rate of Leu‐12+ cells in the cancer patients. Furthermore, a significant increase of Leu‐3a+ Leu‐8− cells and a significant decrease of Leu‐3a+ Leu‐8+ cells were also found in the paracolic nodes of the cancer patients. However, Leu‐2a+ Leu‐15− cells were not different between the both groups. Meanwhile, in the cancer patients, the rates of Leu‐4+, Leu‐3a+, and Leu‐3a+ Leu‐8− cells were higher in the paracolic nodes compared with the intermediate nodes. Additional investigation of the correlation between clinicopathological features of the tumors and lymphocyte subpopulations, showed that Leu‐12+ cells were related to the tumor size and Leu‐2a+ 15− cells related to the histopathological type. The foregoing results indicate that the rates of both B and helper T cells, which may specifically participate in the antibody production, increase in the regional lymph nodes of colorectal cancer patients.
Characterization and histopathological correlation of cytosol proteins of benign and malignant breast tumors
Authors: Khanna Hari D. , Das Debasis , Kashyap Jagadish N. , Gupta Saroj , Khanna Sushila
Published: February 2007

Significant differences in cytosol protein level exist between normal/benign and cancerous breast tissues. There is a positive correlation between the cytosol protein level and histological grade of carcinoma. Well‐differentiated carcinoma have a lower value of cytosol protein than poorly differentiated carcinoma. In slab gel electrophoregrams, the total numbers of bands are almost identical in normal, benign, and malignant conditions. In addition, 37 Kd protein band is consistently present in malignant cases and always absent in normal or benign cases. More extensive biophysical examination of this band may provide further insight into the protein alterations in cancer cells at the molecular level.
Surgical resection of a solitary liver metastasis in a 46‐year‐old patient with a malignant thymoma
Authors: Marasco William J. , Hergreuter Charles A. , Pritchard Elaine , O'Hara Carl J. , Steele Glenn D.
Published: February 2007

Clinical history, surgical treatment, and pathologic findings of a solitary liver metastasis of a malignant thymoma in a 46‐year‐old female are reported. An extensive literature review has revealed no record of surgical resection of liver metastasis in a patient with invasive thymoma.
Endometrial carcinoma: A pathologic evaluation of 142 cases with and without associated endometrial hyperplasia
Authors: Ayhan Ali , Yarali Hakan , Ayhan Ayşe
Published: February 2007

The association of some cases of endometrial carcinoma (EC) with hyperestrogenism is well known. The prognostic significance of concomitant endometrial hyperplasia (EH) in EC were evaluated in 142 patients with clinical stage I EC in whom lymph node assessment was carried out in 121 patients. The presence of EH was significantly associated with better differentiated tumor having lesser degrees of myometrial invasion, low segment‐adnexal‐lymphovascular space and pelvic/para‐aortic lymph node involvement. However, the presence of EH was not significantly associated with the less virulent histologic subtypes. The possible existence of two types of EC–a hormonal‐dependent EC associated with EH, and an independent EC not associated with EH–is discussed and the prognostic significance of concomitant EH stressed.
Correlation between estrogen receptor status and histological malignancy in human breast cancer
Authors: Komaki Kansei , Mori Toshiaki , Morimoto Tadaoki , Sasa Mitsunori , Monden Yasumasa , Ii Kunio
Published: February 2007

Sixty‐two breast carcinoma patients underwent mastectomy and were analyzed for correlations between estrogen receptor (ER) status of the tumor and the histological findings of tumor, age, nodal status, and tumor size. An immunocytochemical assay for the detection of ER in breast carcinomas was used to evaluate the staining intensity index (SII) of the ER level of the tumors, which was calculated from the staining intensity of cancer cells and the percentage of ER‐positive cancer cells. The histological differentiation of carcinomas showed a strong correlation with the SII. A statistically significant (F = 10.580, P < 0.0005) negative correlation was found between the grade of malignancy and the SII. Patients under 50 years of age tended to have a lower SII, whereas patients over 49 years of age tended to have a higher SII. The tumor size, and nodal status showed no correlations with the SII in any of the patients. The histological differentiation of the tumor cells showed a strong correlation with the heterogeneity of the distribution of ER‐positive cells in breast cancers.
Cost analysis of microsurgical reconstruction in the head and neck
Authors: Miller Michael J. , Swartz William M. , Miller Robert H. , Harvey Joseph M.
Published: February 2007

In a cost‐conscious environment, pressure exists to justify the use of expensive techniques such as reconstructive microsurgery in head and neck patients. Therefore, the costs and effectiveness of 39 consecutive free tissue transfers in patients with head and neck defects due to neoplasia (77%), trauma (13%), or congenital causes (10%) were assessed by reviewing clinical and billing records. The technical success rate was 95% with a 29% rate of complications. Most patients returned to preoperative levels of social activities, and none admitted dissatisfaction with their results. Average cost was $27,000 per case with 16 days of hospitalization. Average cost for aerodigestive tract tumors was $37,400 with 21 days of hospitalization. Costs were directly related to the etiology of the defect and incidence of complications. Applying cost‐effectiveness principles we believe that these costs are justified by the high level of patient satisfaction and enhanced quality of life.
Effects of a three‐drug antineoplastic protocol of wound healing in rats: A biomechanical and histologic study on gastrointestinal anastomoses and laparotomy wounds
Authors: Salm Richard , Wullich Bernd , Kiefer Günter , Fiebig Heinz‐Herbert , Farthmann Eduard Heinrich
Published: February 2007

Using biomechanical and histologic approaches, the effect of perioperative administration of a drug protocol containing 5‐fluoruracil, Adriamycin, and mitomycin C (FAM) on the healing of gastrointestinal anastomoses and laparotomy wounds in rats was examined. Application of FAM immediately before operation resulted in significant impairment of wound healing in the early postoperative period. Once the proliferation of fibroblasts and collagen synthesis had led to an increase of mechanical strength, no negative effect on wound healing could be detected applying the same chemotherapeutic agents. These findings indicate the early inflammatory phase of the wound healing process to be most vulnerable to the chemotherapeutic effects. This has significant implications if the theoretical advantages of starting adjuvant chemotherapeutic treatment in the immediate postoperative period are implemented.
Perioperative chemotherapy in oral cancer
Authors: Rao Raja S. , Parikh Deepak M. , Parikh Hemen K. , Bhansali Mehul B. , Fakih Abdul R.
Published: February 2007

This is an interim report of a study of perioperative adjuvant chemotherapy following radical surgery for oral cancer, based on the hypothesis of Goldie and Coleman. 135 patients of alveolobuccal carcinoma, clinically stage III and IV, were entered on the protocol. After a curative resection, they were randomized. The test arm received methotrexate 50 mg/m2 on the 3rd, 10th, and 17th postoperative days. The control arm was only observed. This analysis at 12 months showed a disease free survival of 71% in the test arm vs. 45% in the control arm, which is statistically highly significant (P <0.01). Analysis of recurrence pattern showed that recurrence at the primary site was dramatically reduced during the first 6 postoperative months (P<0.01). Our study provided further clinical evidence in support of the concepts of Goldie and Coleman that the timing of chemotherapeutic drugs is very critical for a successful end result.
Latissimus dorsi musculocutaneous flap for elbow extension
Authors: Pruzansky Mark , Kelly Mark , Weinberg Hubert
Published: February 2007

The latissimus dorsi mycocutaneous flap has developed a reputation for its versatility in both skin and soft tissue coverage and for restoration of elbow function in both flexion and extension. In a case presented, a large extra‐abdominal desmoid was removed along with the entire deltoid and three‐quarters of the triceps. The latissimus dorsi was elevated with a large overlying skin island and rotated on its neurovascular pedicle into the defect in the posterior shoulder and upper arm to replace the resected triceps and deltoid muscle, and to provide coverage in this region.
Ten‐year survivors after surgical treatment and perioperative irradiation for esophageal carcinoma
Authors: Mori Masaki , Ohno Shinji , Shimono Reishi , Kuwano Hiroyuki , Sugimachi Keizo
Published: February 2007

Ten of 150 patients with primary squamous cell carcinoma of the esophagus and surgically treated, survived for more than 10 years. All 10 underwent a complete resection of the primary tumor and extensive lymph node dissection plus perioperative irradiation. The clinicopathologic findings in these 10 patients were reviewed. Five were female. Seven of the tumors exceeded 6 cm in length; seven were early stage, and the remaining three were advanced stage tumors. Lymph node metastases were evident in three, lymph vessel permeation was recognized in four, and no vascular vessel permeation was seen in any tumor. Two tumors had a characteristic appearance of carcinoma with lymphoid stroma, suggesting a good prognosis. In six for which cytophotometric DNA analysis could be done, four were type II, two were type III, and none was type IV. Thus, a complete resection of the primary tumor and extensive lymph node dissection can lead to a long survival time even for those with an advanced primary esophageal carcinoma.
Upper abdominal cancer surgery in the very elderly
Authors: Alexander H. Richard , Turnbull Alan D. , Salamone Joseph , Keefe Deborah , Melendez Jose
Published: February 2007

From January 1981 to December 1987, 59 major upper abdominal operations were performed on 57 patients aged 80 to 90 years at Memorial Sloan‐Kettering Cancer Center. Procedures for primary adenocarcinoma of the stomach, distal esophagus, pancreas, or hepatobiliary system were performed with curative intent or for palliation in 34 of 59 patients (58%) and bypass with limited or no resection in 13 of 59 patients (22%) patients. Emergency operations were performed in six (10%) patients for gastric bleeding, perforation, or outlet obstruction. Six (10%) patients underwent laparotomy for benign biliary obstruction (1), splenectomy for secondary thrombocytopenia (2), or gastrectomy for sarcoma (2) or lymphoma (1). Hospital mortality was 15% overall and 9% for major resections, 15% for bypass, and 67% for emergency procedures. Major complications occurred in 10 (20%) elective procedures. Mortality was associated with respiratory or cardiac failure while complications most commonly included arrhythmias and wound infection. Mean postoperative hospitalization was 18 days overall and 45 patients (76%) were discharged home. Median survival following major resection was 17.5 months but less than 2 months after bypass procedures. A protocol of pre‐operative evaluation, intra‐operative hemodynamic monitoring and postoperative intensive care has been formalized for use in elderly or poor‐risk patients.
Adenosquamous carcinoma of the pancreas: A clinicopathologic study
Authors: Yamaguchi Koji , Enjoji Munetomo
Published: February 2007

A total of eight patients with adenosquamous carcinoma of the pancreas were studied clinicopathologically. Histochemical and immunohistochemical studies were also done. The 8 patients were composed of 4 men and 4 women with a mean age of 56 years, which was 9 years younger than for other pancreatic carcinoma. The site of origin and size of the tumors were similar to those of usual pancreatic carcinoma. Histopathologically, all eight tumors showed an abrupt transition between adenocarcinoma and squamous cell carcinoma. Squamous cell carcinoma was located at the periphery of the tumors. Histochemistry and immunohistochemistry disclosed a different nature for both components. The cumulative 1‐year survival rate of the 8 patients was 21.4%, compared to 42.1% of 72 with adenocarcinoma of the pancreas. The survival curve of the 8 patients with adenosquamous carcinoma was significantly less favorable than that of 36 patients with well‐differentiated adenocarcinoma of the pancreas. These facts support the view that squamous cell carcinoma in adenosquamous carcinoma of the pancreas is squamous cell metaplasia of the pre‐existing adenocarcinoma. The clinical course of adenosquamous carcinoma of the pancreas was unfavorable.
Radical hysterectomy with lymphadenectomy for treatment of early stage cervical cancer: Clinical experience of 278 cases
Authors: Ayhan Ali , Sel Tuncer Z. Çuk
Published: February 2007

This study includes 278 cases of stage I and II cervical cancer subjected to radical hysterectomy and lymphadenectomy. The clinical experience of 278 cases is reviewed. Of these cases, 215 were in stage I, and 63 were in stage II. Intraoperative complications occurred at a rate of 9.7% and involved injuries to the great vessels, lower urinary tract, nerves, and rectum. Operative mortality was found to be 0.3%. Postoperative complications were observed in 20.1% of patients. Fistulae were observed in 8 (2.8%) patients. The overall survival rate was 83.8%. The 5‐year survival rates for stages IA, IB, IIA, and IIB were 100.0%, 87.9%, 71.0%, and 64.0%, respectively. Pelvic lymph node metastases varied from 0% for stage IA to 40.0% for stage IIB and paraaortic involvement varied from 0% for stage IA to 50.0% for stage IIB. Radical surgery seems to be the treatment of choice for patients with early invasive cervical cancer.
Histiocytic neoplasias: Immunohistochemical evaluation of their frequencies among malignant lymphoma and related conditions in Japan
Authors: Aozasa Katsuyuki , Ohsawa Masahiko , Saeki Kazunori , Horiuchi Keisuke , Tamai Masamitsu , Kohro Takashi , Kurata Akihiko
Published: February 2007

Through histologic review of 1,766 cases with malignant lymphoma and related conditions, 35 cases (2%) were selected as probable histiocytic neoplasias. Proliferating cells in these cases had voluminous, granulated cytoplasm, and round to irregularly shaped nuclei often with bi‐ or multinucleated forms showing monomorphous or polymorphous proliferation accompanying small lymphocytes, plasma cells, and, less frequently, eosinophils. Cases showing proliferation of convoluted cells with numerous benign‐appearing histiocytes or large cells with clear cytoplasm were excluded under a diagnosis of T‐cell lymphoma. To evaluate the immunologic character of proliferating cells, immunohistochemistry using antibodies Mx‐Pan B, MB‐1, MT‐1, UCHL‐1, lysozyme, α1‐arantitrypsin, α1‐antichymotrypsin, S‐100α, S‐100α, Leu M1, epithelial membrane antigen, and Ki‐1 were carried out in 23 cases. Naphthol‐ASD‐chloroacetate reaction and toluidine blue stain were also performed. These procedures revealed that 12 cases (52%) were B‐cell type, three cases (13%) T‐cell type, six cases (26%) true histiocytic type, and two cases null type. Therefore, the frequency of cases with true histiocytic neoplasias among cases with malignant lymphoma and related conditions in Japan may be 0.5%.
Thyroid cancer and multiple primary malignancies in Israel
Authors: Stein Moshe , Lachter Jesse , Bartal Arieh , Rennert Gad , Kuten Avraham
Published: February 2007

The exact risk of multiple primary neoplasms in patients with thyroid cancer is difficult to ascertain from the data available in the literature. Three thousand seventy‐two patients with thyroid cancer, listed in the Israel Cancer Registry during a 16‐year time span, were studied to determine the true incidence of another primary cancer. Ninety‐two cases were reported as having an additional primary cancer. The prevalence of multiple primary malignancies was 3%. The frequency was higher among patients of European rather than of Asian or African origin. The second primary cancers in order of decreasing frequency were of the breast, lung, colorectum, head and neck, and lymphoma/myeloma. Most of the deaths were due to the additional cancer. The 5‐year survival rate was highest for head and neck and lowest for lung cancer patients. These results emphasize the need for greater awareness of the possibility of developing additional cancers, and indicate the need to incorporate strategies for the prevention, early detection, and treatment of multiple primary neoplasms.
A feasibility study of the SDI test for the evaluation of gastrointestinal cancer sensitivity to anticancer drugs
Authors: Yamauchi Masaji , Satta Tetsuya , Ito Akihiro , Kongo Tatsuhei , Takagi Hiroshi
Published: February 2007

The succinic dehydrogenase inhibition (SDI) test has been widely used to evaluate the sensitivity of cancer cells to anticancer agents. Recently, the techniques for tissue culture have progressed; the ability to make formazan has improved with the use of methylthiazol tetrazolium bromide (MTT) instead of triphenyl tetrazolium chloride (TTC) in this assay. Therefore, we modified the SDI test in order to evaluate the drug response to gastrointestinal cancer and applied it in a clinical study. In this assay, the optimal concentration levels of mytomycin‐C and Adriamycin for the clinical materials are 10 μg/ml, that is, 10 times higher than for the cancer cell line, and that of Cisplatin is 30 μg/ml, for Cisplatin is unstable in the culture medium. To evaluate its antitumor effect, it was found necessary to expose the cancer cells to 5‐fluorouracil (5‐FU) for 3 days. We applied this assay for the clinical materials; the evaluable rate of this assay is 83.3%. The peculiarity of this assay is its high evaluable rate. These results suggest that this test may be useful for clinical application.