bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic factors in japanese patients with colorectal cancer: The significance of large bowel obstruction—univariate and multivariate analyses
Authors: Korenaga Daisuke , Ueo Hiroaki , Mochida Kazuyuki , Kusumoto Tetsuya , Baba Hideo , Tamura Shigeaki , Moriguchi Sunao , Sugimachi Keizo
Published: February 2007

In order to define prognostic factors in colorectal carcinoma, univariate and multivariate analyses were carried out on data from 113 Japanese patients treated in a typical general hospital in Japan. In the univariate analysis, a poor prognosis was seen in those with poorly differentiated adenocarcinoma, in tumors that perforated the visceral peritoneum or that invaded directly other organs or structures (T4), in metastasis to the nodes along the main vascular pedicle (N3), in lymphatic permeation, in blood vessel invasion, in peritoneal dissemination, in Dukes C stage, and in those with lesions presenting with large bowel obstruction. Of these, only lymph node metastasis and peritoneal dissemination had an independent prognostic significance when a multivariate Cox analysis was performed. The significant risk factors related to an obstructing tumor were determined by multivariate logistic regression analysis. The significant variables were patient's age, nodal involvement and peritoneal dissemination. Since lymph node metastasis and peritoneal dissemination proved significant in both multivariate analyses, we propose that the presence of large bowel obstruction is not an independent prognostic factor in patients with colorectal carcinoma. In poor‐risk patients who have an obstructing tumor, a staged operation should be attempted for definitive curative surgery.
Gynecological malignancies, brain tumors, and familial adenomatous polyposis
Authors: Sohrabi A. K. , Phillips Jeffrey , Watne Alvin L.
Published: February 2007

The syndrome of familial adenomatous polyposis has a wide spectrum of clinical manifestations including adenomatous polyps of the colon and small bowel, adenocarcinoma of ampulla of Vater, tumors of the central nervous system, bone lesions, and various soft tissue tumors. The one common denominator is colonic polyposis. It is not known whether this phenotypic heterogeneity is due to various genotypes, or if the entire clinical spectrum is due to one genetic defect.

We are reporting the association of gynecologic malignancies with familial adenomatous polyposis as an additional variant of this disease. This report is on two sisters from a family with familial polyposis coli who developed adenomatous polyposis of the colon, central nervous system tumors, and cancers of the ovary and uterus. The gynecological malignancies add another variant to this clinical syndrome.
Results of treatment and lessons learned from pathologically staged T4 non‐small cell lung cancer
Authors: MacChiarini Paolo , Silvano Giovanni , Janni Alberto , Mussi Alfredo , Chella Antonio , Angeletti Carlo A.
Published: February 2007

Depending on the local extension of primary non‐small cell lung cancer (NSCLC) and invaded T4 structure(s), 49 patients underwent complete (CR, n = 14) or palliative (PR, n = 13) resection or exploratory thoracotomy (ET, n = 22) between January 1982 and June 1988. Thoracic radiotherapy (TR) was given to all patients receiving PR (median dose, 43 Gy) and ET (median dose, 53 Gy). With a median follow‐up of 44 months, overall 2‐ and 5‐year survival was 25 and 5%, respectively. Patients undergoing ET plus TR had a significantly worse survival than those treated by CR (P= 0.041) and PR plus TR (P= 0.046). Only completely resected patients became long‐term survivors (5‐year survival, 29%) and significant predictors of their survival were previous weight loss, hemoglobin, and creatinine level, in univariate analysis, and previous weight loss in multivariate analysis. The site of initial treamtent failure was mainly local for PR plus TR (85%) and systemic for CR (71 %) and ET plus TR (86%). Presented results suggest that surgery might play a role for selected patients with T4 NSCLC, but advances in systemic and local therapy are necessary.
A myocutaneous flap for closure of upper arm amputations for uncontrolled axillary tumors
Authors: Norman James , Cox Charles , Cruse C. Wayne , Wells Karen , Reintgen Douglas
Published: February 2007

Tumor spread or recurrence in the axilla is usually treated with nodal dissections. At times disease recurrence is uncontrolled, causing significant morbidity including pain, bleeding, lymphedema, and neurologic symptoms. Previously, forequarter amputation has been the treatment for this problem, resulting in a significant cosmetic and functional deficit. This report describes a novel myocutaneous flap that can be used to cover soft tissue defects after major disarticulations of the upper extremity. The deltoid myocutaneous flap has been used to successfully treat three patients with uncontrolled tumors in the axilla and preserve the shoulder structures to lessen the functional deficit.
A mathematical computer simulation model for the development of colonic polyps and colon cancer
Authors: Mehl Lewis E.
Published: February 2007

Currently known information about the development and progression of colon polyps and cancer is summarized and organized into a mathematical computer simulation model that successfully predicts the natural history of colon polyp and cancer development for an average patient with (1) familial polyposis coli (2) genetic susceptibility as measured by a positive family history, and (3) negative family history with a high fat diet. The mathematical model uses four distinct types of cells (normal, transformed, polypoid, and cancerous) and two kinetic processes (mutation and promotion). Arachidonic acid metabolites play a role in the model in the promotion of cancer from polyps, and account for that promotion through: (1) their effect on encouraging more polypoid cells in mitosis to move toward cancer; and (2) their immunosuppressive effect over time. The model also shows that one defect in allowing more cells to mutate to the transformed state is sufficient to account for the chain of events leading to the clinical sequelae of familial polyposis coli. A second genetic effect at another point in the process is unnecessary. The mechanism of action of Sulindac on colon polyps is explained by the model through inhibition of production of arachidonic acid metabolites, most notably prostaglandin E.
Proliferation index in various stages of breast cancer determined by ki‐67 immunostaining
Authors: Pence Jeffrey C. , Kizilbash Ali M. , Kerns Billie‐Jo M. , Marks Jeffrey R. , Iglehart J. Dirk
Published: February 2007

To investigate factors involved in progression of breast cancer, we estimated the growth fraction of malignant cell populations in various stages of mammary cancer growth. Frozen sections were immunostained with the Ki‐67 monoclonal antibody and the proliferation index determined using static image analysis. Pure intraductal carcinoma, intraductal carcinoma coexisting with invasive disease, and metastatic sites coexisting with primary tumors were studied. The proliferation index of pure intraductal carcinomas (mean 4.5%, median 1.8%) was not significantly different from invasive mammary cancers (mean 5.1%, median 2.2%). The proliferation index determined for the in situ component of primary cancers (mean 3.8%, median 1.5%) was not significantly different from values obtained from the invasive component of growth (mean 4.2%, median 2.1%). Variability between in situ and invasive components for individual cases was minimal in tumors whose proliferation index was less than 3.0%; for tumors with higher proliferation indices, the differences were greater. However, there was no trend toward a decrease or increase in growth fraction for the two components of primary tumor growth. The mean proliferative index for primary tumors (mean 4.9%, median 4.0%) was not significantly different from the mean proliferative score from a matched group of metastatic sites in the same patients (mean 5.7%, median 5.5%). Comparison of individual cases uncovered differences in some tumors; again no consistent trends in either direction were noted. An increase (or decrease) in growth activity does not accompany the transition from intraductal (in situ) disease to invasive mammary cancer, nor does a change in growth fraction necessarily accompany progression of mammary cancer from the primary to regional metastatic site.
Five‐year survival for cisplatin‐based chemotherapy versus single‐agent melphalan in patients with advanced ovarian cancer and optimal debulking surgery
Authors: Piver M. Steven , Fanning James , Sprance Henry E.
Published: February 2007

The purpose of this study was to evaluate 5‐year survival and 5‐year progression‐free survival in previously untreated patients with advanced ovarian cancer treated with single‐agent melphalan in which very few patients underwent optimal debulking surgery (<2 cm residual) as compared with the patients treated with Cisplatin‐based chemotherapy in which most patients underwent optimal debulking surgery. Significant increases in 5‐year survival and 5‐year progression‐free survival were noted as we changed from the melphalan trial, in which only 14% underwent optimal debulking surgery, to PAC‐H, in which 57% and the PAC trial in which 90%, respectively, underwent optimal debulking surgery. However, for those patients whose tumors were optimally debulked in the three trials, there were no statistically significant differences in median survival, median progression‐free survival, 5‐year survival, or 5‐year progression‐free survival in those patients treated with melphalan, PAC‐H, or PAC. Without optimal debulking surgery, Cisplatin‐based multiagent chemotherapy offered a small survival advantage. These results are similar to that reported by Gruppo Interregionale Cooperativo Oncologico Ginecologia, in which survival curves were identical for all the subgroups of chemotherapy regimens for those patients with residual disease <2 cm at the onset of chemotherapy whether they received (1) cyclophosphamide; (2) cyclophosphamide and Adriamycin; (3) cyclophosphamide, Adriamycin, and Cisplatin; (4) cyclophosphamide, Adriamycin, and hexamethylmelamine; (5) Cisplatin and cyclophosphamide; (6) low‐dose Cisplatin; (7) high‐dose Cisplatin; or (8) carboplatin [7].
Effects of antiplatelet agents alone or in combinations on platelet aggregation and on liver metastases from a human pancreatic adenocarcinoma in the nude mouse
Authors: Tzanakakis George N. , Agarwal Kailash C. , Veronikis Dionysios K. , Vezeridis Michael P.
Published: February 2007

There is ample evidence to suggest that hematogenous metastasis may be related to the ability of tumor cells to promote aggregation of host platelets. Arachidonic acid metabolism in platelets and vessel walls may also contribute to the metastatic process. Several preliminary trials of platelet inhibitory agents have been performed. Ketoconazole (inhibitor of lipoxygenase and thromboxane synthetase), verapamil (calcium antagonist), forskolin (stimulator of platelet adenylate cyclase), and indomethacin (inhibitor of cyclooxygenase) were examined, alone and in combination, to investigate their effects on platelet aggregation and on hepatic metastases from human pancreatic tumor cells (RWP‐2) in nude mice. The tumor cells were injected intrasplenically, and the animals were divided into control, single‐drug and combination treatment groups. The agents were administered intraperitoneally 1 hr before and every 24 hr after the tumor cell injections for 6 days. Statistically significant differences were observed between the control and single‐treatment groups on the reduction of liver tumor nodules (range P < 0.001–0.032) and in the liver surface areas occupied by tumor (range P < 0.001–0.013). Furthermore, when these agents were combined, similar reductions in liver tumor nodules were noted (range P < 0.001–0.008), while even greater inhibitory effects were seen in the liver surface areas occupied by tumor (P < 0.001) compared with the single‐treatment groups. Also, the combination studies strongly inhibited RWP‐2‐induced platelet aggregation in human plateletrich plasma.
Lymphoepithelioma‐like carcinoma of the lung
Authors: Miller Barry , Montgomery Charles , Watne Alvin L. , Johnson Dan , Bailey Tim , Kowalski Ronald
Published: February 2007

Historically lymphoepithelioma was a term used to describe an undifferentiated mucosal carcinoma with a lymphocytic component arising only from the nasopharynx, although recently, lymphoepithelioma‐like carcinoma has been found to occur as a primary tumor of the lung. Thus far, five patients have been documented as having this rare anatomical presentation. The patient that is being presented is the latest case of lymphoepithelioma‐like carcinoma of the lung and will be compared clinically and histologically with the other four cases. The case is presented in order to discuss optimal methods of diagnoses and treatment for this condition.
Prognostic factors in laryngeal cancer patients submitted to surgical treatment
Authors: Kowalski Luiz P. , Franco Eduardo L. , Sobrinho Jozias De Andrade , Oliveira Benedito V. , Pontes Paulo L.
Published: February 2007

The authors studied some demographic, clinical, pathologic, and therapeutic variables in relation to the disease‐free interval (DFI) and to the overall survival of laryngeal cancer patients. The patient population consisted of 278 consecutive cases of primary laryngeal cancer who had been admitted to four head and neck surgery services in Sao Paulo and Curitiba (Brazil) between 1973 and 1986. All patients had surgical treatment. Although several variables exhibited individual associations with survival, only a few were deemed to have independent prognostic value using multivariate regression techniques based on Cox's proportional hazards model. The primary tumor stage (T index) represented the variable with the highest predictive strength with respect to survival. Hazard ratios for the risk of disease recurrence were 2.3 (T2–3vs. T1) and 4.3 (T4vs. T1). Hazard ratios for the risk of death were 1.6 (T2–3vs. T1) and 3.3 (T4vs. T1). The following additional factors were also independently associated with the DFI: age, site of primary tumor (transglottic, glottic, or supraglottic), extracapsular spread of lymph node metastasis, surgical margins, type of paratracheal node dissection, and prior tracheostomy. Except for extracapsular spread, the same factors related to the DFI were also significantly related to the overall survival. Race, sex, N‐stage, vascular embolization, and histological grade were other independent predictors of the risk of death.
Lymph node metastasis in thoracic esophageal carcinoma
Authors: Kato Hoichi , Tachimori Yuji , Watanabe Hiroshi , Iizuka Toshifumi , Terui Shoji , Itabashi Masayuki , Hirota Teruyuki
Published: February 2007

Seventy‐nine patients with thoracic esophageal carcinoma underwent transthoracic esophagectomy with neck, mediastinal, and abdominal lymphadenectomy. The operative mortality rate was 3.8%. Fifty‐seven patients (72.2%) had metastasis in the lymph nodes. Though three patients with carcinoma classified as pTis had no positive nodes, nine (50.0%) of the patients with a pT1 carcinoma had positive nodes. The 5‐year survival rate for 57 patients with positive nodes was 33.6%. Twenty‐nine patients (36.7%) had positive nodes in the neck; 47 (59.5%), in the mediastinum; and 33 (41.8%), in the abdomen. Their 5‐year survival rates were 30.0%, 24.4%, and 38.4%, respectively. The differences between these rates were not statistically significant. These results indicate that the neck lymph nodes should be regarded as part of the regional lymph nodes and that esophagectomy with wide lymph node dissection improves the long‐term survival of patients with thoracic esophageal carcinoma.
Pulmonary clear cell carcinoma
Authors: Inase Naohiko , Takayama Shigemitsu , Nakayama Morito , Miura Hirotaro , Kimula Yuji
Published: February 2007

A case of pulmonary clear cell carcinoma is demonstrated. A large left lower lobe mass, without lymphadenopathy was detected on a screening chest X‐ray, and a left lower lobectomy was performed. The tumor was composed predominantly of clear cells with some areas showing cells typical for small cell carcinoma. Ultrastructurally, the larger clear cell had cytoplasm containing many rough endoplasmic reticuli and free ribosomes, while the smaller dark cell showed a serrated nucleus and scanty cytoplasm having many free ribosomes without neurosecretory granules. This is the first report on pulmonary clear cell carcinoma with small cell carcinoma patterns, and this case will throw doubt on the conclusion of previous studies that clear cell carcinoma is not a separate entity.
Heating efficiency of radiofrequency capacitive hyperthermia for treatment of deep‐seated tumors in the peritoneal cavity
Authors: Hamazoe Ryuichi , Maeta Michio , Murakami Atsunobu , Yamashiro Hiroshi , Kaibara Nobuaki
Published: February 2007

We analyzed heating profiles from 318 hyperthermic treatments of 39 patients with recurrent or inoperable cancers of the digestive organs whose deep‐seated tumors were treated by radiofrequency (RF) capacitive heating of the abdominal region, and we investigated the heating efficiency and antitumor effect of such treatment. It was apparent that heating with a mean maximum RF output of 1,000 watts (700 watts at least), repeated four times or more, was necessary for a high rate of response by the tumor. Although it was difficult to heat tumors of the bile duct/pancreas to 42°C or more, there was a strong positive correlation between maximum output of RF energy and maximum temperature of tumors (r = 0.839, P < 0.001). The antitumor effect of RF hyperthermia was augmented with increasing output of RF energy. Therefore, the maximum level of RF output may be a useful index for expressing the heating efficiency with respect to intra‐abdominal deep‐seated tumors.
Diagnosis and management of sacrococcygeal chordoma
Authors: Bethke Kevin P. , Neifeld James P. , Lawrence Walter
Published: February 2007

Chordoma is a rare, slow‐growing but locally aggressive malignant tumor derived from the primitive notochord and located along the axial skeleton. Between 1973 and 1991, of 15 patients with chordomas treated at the Medical College of Virginia, eight originated in the sacrococcygeal area. There was a median one year interval between the onset of symptoms and diagnosis (range of four months to six years) for this latter group. Two patients had undergone coccygectomies and one patient a lumbar discectomy prior to establishing the correct diagnosis of sacral chordoma. Seven patients underwent resection and one refused therapy. The four patients who had an initial wide radical resection had a longer disease‐free survival than the three who underwent local excision. Three of four patients had metastatic disease at the time of death. Early diagnosis and aggressive initial surgical resection are necessary for long‐term survival.
Epidermoid cyst of the testicle in children
Authors: Pinski John V. , Greenfield Saul P. , Siddiqui Saeeda , Fisher John
Published: February 2007

Epidermoid cyst of the testicle is rare in children and only four previous cases have been reported. We add two cases and discuss their presentation and management. Both children presented with solid testicular masses, one of which was asymptomatic and the other was painful. Physical examination and ultrasound could not differentiate between a benign and malignant process. One child underwent radical orchiectomy and one child underwent local excision alone. Both are free of disease at follow‐up.
Treatment of small intestinal fistulas with octreotide, a somatostatin analog
Authors: Boike Guy M. , Sightler Sterling E. , Averette Hervy E.
Published: February 2007

Three patients with external small bowel fistulas were successfully treated with bowel rest, total parenteral nutrition, and the somatostatin analog, octreotide. Two of the patients had received prior multimodality therapy, including radiation, for gynecologic cancer. The time intervals to fistula closure were 2 days, 10 days, and 5 weeks after initiation of octreotide therapy. The efficacy of octreotide combined with total parenteral nutrition in the treatment of external enteric fistulas supports its routine use, especially in previously irradiated patients.
Distribution of 111 in‐bleomycin complex in small cell lung cancer cells by autoradiography
Authors: Hou De‐Yan , Maruyama Yosh
Published: February 2007

The distribution of 111 In‐bleomycin Complex (111In‐BLMC) in small cell lung cancer (SCLC) cells was studied by autoradiography. SCLC cells were exposed to 111In‐BLMC and 111Indium chloride (111InCl3) for 1 hour, 3 hours, and 4 hours; washed with fresh medium; and spread on slides. The slides were smeared with NTB2. (NTB3) emulsion by wet or dry‐mount technique and exposed 3 to 15 days. 111In‐BLMC was found to localize in the cell nucleus and nuclear membrane (78.3%); 111InCl3 located mainly in the cytoplasm (52.3%). This distribution of labeled BLM may explain the mechanism of killing SCLC cells by 111In‐BLMC.
Comparison of infections in hickman and implanted port catheters in adult solid tumor patients
Authors: Pegues David , Axelrod Peter , McClarren Carol , Eisenberg Burton L. , Hoffman John P. , Ottery Faith D. , Keidan Richard D. , Boraas Marcia , Weese James
Published: February 2007

Long term therapy of oncology patients has been facilitated by permanent indwelling central venous catheters, but catheterrelated infections remain a serious complication of their use. Using a retrospective matched cohort design, we compared the risk of catheterrelated infection in 47 adult solid tumor patients with right atrial Hickman catheters and 94 patients with totally implanted port catheters. Patients were matched for primary solid tumor, presence of metastases, age, gender, and date of catheter insertion. Seven of 47 patients with Hickman catheters developed catheterrelated infection (1.8 infections/1,000 catheter days at risk) compared with 10 of 94 patients with implanted port catheters (0.4/1000 catheter daysp< 0.0002). Hickman catheters were used more often for terminally ill patients than were port catheters which was a potential source of bias, but results were unchanged after stratifying patients on lifespan. Our study suggests that there are fewer infections in port than in Hickman catheters in adult patients with solid tumors, but prospective randomized studies are needed.
Androgen effect on prostate specific antigen secretion
Authors: Hanash Kamal A. , Mostofi Kash F.
Published: February 2007

Prolonged parenteral androgen therapy for 1 year resulted in the hypersecretion of prostate specific antigen (PSA) in a patient with no clinical evidence of prostatic carcinoma, who had been treated with diethylstilbestrol (DES) for 9 years. The PSA level declined to normal values upon temporary discontinuation of androgen therapy and increased again upon resumption of treatment. This case seems to confirm the regulatory effect of androgens of PSA secretion and to suggest a possible “rebound” elevation of PSA in patients with androgen deprivation treated with testosterone replacement. The estrogen suppressed prostatic epithelial cells were able to respond to androgen stimulation with a steady increase in the PSA secretion and positive immunohistochemical PSA staining.
Carcinoma of the thyroid in black patients
Authors: Brooks Michael E. , Rogers Norman , Ransome Rodman , Leffall Lasalle D.
Published: February 2007

In the period from January 1,1976 to December 31, 1988, we reviewed the charts of 33 patients treated for carcinoma of the thyroid at Howard University Hospital. The three non‐black patients (two Whites and one Pakistani) were excluded from the study. There were 19 females and 11 males. Of the 30 cases elevated, 10 were papillary, 7 were follicular variant of papillary, 8 were follicular, 3 were undifferentiated (anaplastic), and 2 were medullary. Ten patients had either distant metastasis (Hoffman, South Med J 80:741, 1987) or locally advanced disease in the neck (Woolner et al., Am J Surg 102:354, 1961.) at the time of diagnosis. The treatment of these lesions depended on, among other variables, the cell type, the extent of the lesion, and the personal preference of the attending surgeon. Carcinoma of the thyroid remains an uncommon lesion in Black patients. Because of its rarity, the diagnosis may often be delayed and, as a result, patients may first come to attention with a more advanced stage of this disease. To prevent this occurrence, a high index of suspicion must be maintained for all thyroid nodules, and appropriate diagnostic steps taken. Diagnostic and treatment options are discussed. © 1992 WiIey‐Liss, Inc.
Outcome of patients with lung cancer detected via mass screening as compared to those presenting with symptoms
Authors: Shimizu Nobuyoshi , Ando Akio , Teramoto Shigeru , Moritani Yoshiaki , Nishii Kenji
Published: February 2007

We performed lung cancer resection in 721 patients between 1980 and 1989. Cancers were detected via mass screening programs by annual chest X‐ray examination in the majority of cases. We evaluated the surgical results in patients with tumors detected by mass screening and compared them to those in whom the malignancy was detected by symptoms. Lesions in the mass screened group were T1 to T2 tumors in 90% of the cases, and NO in 73%. Stage I disease accounted for 65.3% in the mass screened group. The overall 5‐year survival rate was 56.2% in the mass screened group, which was significantly better than the 25.3% for the symptom group (P < 0.001). The surgical results in the lung cancer cases detected by the mass screening program had better results than the cases who presented with symptoms. © 1992 Wiley‐Liss, Inc.
Bone metastases of hepatocellular carcinoma after liver resection
Authors: Taki Y. , Yamaoka Y. , Takayasu T. , Ino K. , Shimahara Y. , Mori K. , Morimoto T. , Ozawa K.
Published: February 2007

Between January 1985 and July 1990, 323 cases of hepatocellular carcinoma underwent liver resection in our department. Bone metastases were found in 12 of these cases (3.7%). Bone metastases were mainly found in vertebral bone (58.3%) and pelvic bone (41.7%). The time interval to the development of bone metastasis after liver resection was closely related to the presence of intrahepatic metastasis and the stage at operation. In all cases, the initial clinical symptom was pain and/or motor disturbance. Radiotherapy was performed in 10 cases and transcatheter arterial embolization or surgery was performed in 4 cases. The pain or neurological symptoms improved with these therapies in all cases. Cumulative survival was 1 year in 74%, 2 years in 34%, and 3 years in 17%, respectively. © 1992 Wiley‐Liss, Inc.
Effects of surgical treatment in thymoma with myasthenia gravis: Our experience in 103 patients
Authors: Crucitti Francesco , Doglietto Giovanni Battista , Bellantone Rocco , Perri Vincenzo , Tommasini Oscar , Tonali Pietro
Published: February 2007

A retrospective study of 103 thymectomies examines the effects of the integration of surgical and medical therapy in patients affected by myasthenia gravis accompanied by thymoma. An extended thymectomy via a median longitudinal sternotomy was used in 102 patients. The operative mortality was 4.85% (5/103 patients), the 10‐year survival rate was 78% with a recurrence rate of 3.06% (3/98). Neoplastic infiltration and postoperative radiotherapy did not influence the survival rate. There was no correlation between a preoperative Osserman's class better than III and postoperative outcome. The improvement of medical treatment, and anaesthesiological and intensive care techniques resulted in a decrease of the operative mortality and long‐term death rate during the last 10 years of our 20‐year series. Extended thymectomy via sternotomy is the best intervention in patients with myasthenia gravis associated with thymoma judged by the low operative mortality and the favorable 10‐year survival rates. © 1992 Wiley‐Liss, Inc.
Arm function after axillary dissection for breast cancer: A pilot study to provide parameter estimates
Authors: Hladiuk Marianne , Huchcroft Shirley , Temple Walley , Schnurr B. Elisabeth
Published: February 2007

Sixty‐three women participated in a study in Calgary, Alberta to assess the rate of arm recovery and factors affecting it up to one year after axillary node dissection for breast cancer. Outcomes included objective measures of swelling, mobility, and strength, and subjective assessments of pain (at rest and with movement) and stiffness. Approximately 42% of women had residual impairment of at least one type one year after surgery, the most common problems being pain (16%) and reduced grip strength (16%). Except for lymphedema, measurements one year after surgery showed little change from measurements at 6 months, suggesting that the shorter follow‐up may be appropriate for assessing the long term effects of axillary dissection. Lymphedema was the only sequela which increased over time. The results provide parameter estimates for designing studies to evaluate the role of physiotherapy after axillary dissection. © 1992 Wiley‐Liss, inc.
Melanocyte chemotactic factor produced by skin metastases of a breast carcinoma
Authors: Konomi Kohki , Imayama Shuhei , Nagae Shonosuke , Terasaka Reiji , Chijiiwa Kazuo , Yashima Yutaka
Published: February 2007

A 65‐year‐old woman underwent right modified radical mastectomy for a malignant lesion which had developed just below the right nipple. Two years after the operation, skin lesions composed of dark brown to black, pigmented, papular lesions developed in the precordia. A biopsy revealed this to be a cutaneous metastasis of the previous breast carcinoma. However numerous pigment blockade melanocytes were also found in the tumor nests, located in and/or beneath the epidermis. Although a black‐colored breast carcinoma has been reported, the presence of pigment blockade melanocytes was not determined. Culture of the tumor nest recovered a population of melanocytes as well as the carcinoma cells. Boyden chamber analysis revealed the presence of a chemotactic factor for melanocytes in the culture medium. This seems to be the first documentation of melanocyte incorporation in breast carcinoma tissue. © 1992 Wiley‐Liss, Inc.
Sphincter‐preserving extended resection for locally advanced rectosigmoid carcinoma involving the urinary bladder
Authors: Fuhrman George M. , Talamonti Mark S. , Curley Steven A.
Published: February 2007

Radical en bloc resection has gained acceptance in the management of locally advanced colorectal carcinoma. Total pelvic exenteration has been advocated as treatment for rectosigmoid cancers involving adjacent genitourinary structures. We report a series of 10 patients who underwent total cystectomy with en bloc segmental colorectal resection and restoration of intestinal continuity. All margins, including the distal colorectal margin of resection, were pathologically uninvolved by tumor. The median follow‐up on these patients was 44 months and the mean survival was 42.5 months. The local recurrence rate (20%) and survival rates are comparable to those in reports describing pelvic exenteration for colorectal cancer. Our patients had normal postoperative bowel function. An extended colorectal resection, including a total cystectomy with rectal sphincter preservation, is occasionally possible when tumor‐negative resection margins can be achieved. By restoring intestinal continuity, such an operation provides an improved quality of life, and more importantly, fulfills the criteria for an oncologically sound operation. © 1992 Wiley‐Liss, Inc.
The diagnostic significance of gastrin measurement of bronchoalveolar lavage fluid for lung cancer
Authors: Zhou Qinghua , Yang Zhenhua , Yang Junjie , Tian Zipu , Zhang Huaibin
Published: February 2007

In this study, determination of gastrin concentration in bronchoalveolar lavage fluid and serum has been detected by radioimmunoassay in 30 cases of lung cancer and 24 cases of non‐cancer pulmonary diseases. The results show that the gastrin concentration and its positive rate of lavage fluids from cancer lung are much higher than those from healthy lung and serum in lung cancer patients, and those from serum and both disease and healthy lung in non‐cancer pulmonary disease patients (P < 0.01). The gastrin ratio of lavage fluids from cancer lung to serum is also significantly higher than the ratio of lavage fluid from healthy lung to serum and all the ratios in the non‐cancer pulmonary disease group. These results suggest that there is a high gastrin concentration in local tissue of lung cancer, which is signified by the high concentration of gastrin and its high positive rate in lavage fluids from the lung with cancer. Therefore, the gastrin determination in lavage fluids and gastrin ratio of lavage fluids to serum are more reliable in the differential diagnosis of benign from malignant pulmonary diseases than gastrin determination of serum alone. © 1992 Wiley‐Liss, Inc.
Biodistribution of monoclonal antibody A7 and its F(ab′)2 fragment in athymic nude mice bearing human pancreatic carcinoma
Authors: Otsuji Eigo , Yamaguchi Toshiharu , Yamaoka Nobuki , Yamaguchi Nozomi , Imanishi Jiro , Takahashi Toshio
Published: February 2007

Xenografts of a human pancreatic carcinoma cell line, HPC‐YS, which reacted with the monoclonal antibody (MAb) A7, were used to investigate the in vivo localization of radioiodinated MAb A7 after intraperitoneal injection. MAb A7 localized to the tumor 4 days and 8 days after injection with a tissue/blood ratio of 1.45 ± 0.18 and 2.04 ± 0.20, respectively. The accumulation of MAb A7 in the tumor was 5%/g and 3.3%/g of the injected dose on day 4 and on day 8, respectively. In contrast, the F(ab')2 fragment of MAb A7 localized to the tumor 4 days after intravenous injection with a tissue/blood ratio of 14.2. The accumulation of the F(ab')2 fragment in the tumor was 1.2%/g of the injected dose. These results suggested that MAb A7 might be a suitable carrier of anticancer drugs for immunotargeting chemotherapy and that the F(ab')2 fragment might be potentially useful for the immunodetection of human pancreatic carcinomas. © 1992 Wiley‐Liss, Inc.
Adenocarcinoma of the urachus
Authors: Ravi R. , Shrivastava B. R. , Chandrasekhar G. M. , Prahlad Sarojini , Balasubramanian K. V. , Mallikarjuna V. S.
Published: February 2007

During the past 5 years, three patients with adenocarcinoma of the urachus were treated at our hospital. Abdominal ultrasonography helped clinch the diagnosis in all cases. All patients underwent surgical excision of the neoplasm with partial cystectomy. The clinical, radiological, and histological findings, as well as the pathogenesis of this rare neoplasm are discussed along with the surgical management. © 1992 Wiley‐Liss, Inc.
The use of the saddle prosthesis for reconstruction of the hip joint after tumor resection of the pelvis
Authors: Van Der Lei Berend , Hoekstra Harald J. , Veth Rene P. H. , Ham S. John , Oldhoff Jan , Koops Heimen Schraffordt
Published: February 2007

Reconstruction of the hip joint by a saddle prosthesis after excision of a malignant pelvic tumor is a relatively new method, which thus far has been mainly used for revision of infected hip arthroplasties. One patient with a metastatic cystosarcoma phyllodes and one patient with a chondrosarcoma of the pelvis were treated by local resection and reconstruction with a saddle prosthesis. Although the patient with the metastatic cystosarcoma phyllodes died 9 months after surgery due to metastatic disease, both patients had early recovery, with no difference in leg length and obtained early painless complete weight bearing with satisfactory functional result. These two case reports clearly illustrate the usefulness of the saddle prostheses in limb saving surgery for malignant tumors of the pelvis. © 1992 Wiley‐Liss, Inc.
Postoperative atrial fibrillation in cancer surgery: Preoperative risks and clinical outcome
Authors: Gibbs Harry R. , Swafford Joseph , Nguyen Hoang D. , Ewer Michael S. , Ali Mohamed K.
Published: February 2007

Postoperative atrial fibrillation (AF) is a recognized complication of cancer surgery. The purpose of this study was to define preoperative risk factors for AF, and to evaluate the clinical significance of the arrhythmia. We reviewed the medical records of 43 patients with postoperative AF admitted to the surgical intensive care unit (SICU). All patients were older than 60 years, 79% had a history of cigarette smoking, and 44% had hypertension. AF occurred an average of 2.8 days following surgery, and lasted an average of 2.1 days. No significant complications developed, and there were no long‐term sequelae. This study suggests that, in cancer patients, postoperative AF is a disease of elderly patients. In addition the arrhythmia appears to be a relatively transient and benign phenomenon. Prolonged monitoring in an intensive care setting may not be necessary for asymptomatic, hemodynamically stable patients. © 1992 Wiley‐Liss, Inc.
Cisplatin plus VP‐16 combination chemotherapy in advanced refractory breast cancer
Authors: Içli Fikri , Güunel Nazan , Dinçlol Dilek , Karaoǧuz Handan , Demirkazik Ahmet
Published: February 2007

Twenty‐nine patients with advanced refractory breast cancer were treated with cisplatin 20 mg/m2/d and VP‐16 100 mg/d for 5 days every 3–4 weeks. Ten patients received mitomycin C 10 mg/m2 every 6 weeks additionally. Partial response was obtained in 10 of 26 evaluable patients (38%). The response rates for the group treated with and without mitomycin C were 40% and 37.5%, respectively. Median response duration was 5.5 months in partial responders. Median survival was 9.5 months for partial responders and 2 months for the rest of the patients. Cisplatin and VP‐16 combination can be considered as a salvage treatment in heavily pretreated patients with advanced breast cancer. © 1992 Wiley‐Liss, Inc.
En bloc caudate lobe and partial vena cava resection using a gott shunt for retrohepatic caval bypass
Authors: Gardner Bernard , Bender Scott , Praeger Peter I.
Published: February 2007

A technique of retrohepatic inferior vena cava bypass is described, useful for resection of the hepatic caudate lobe. A 77 year old female developed a solitary metastatic tumor mass in the caudate lobe compressing the Inferior Vena Cava (IVC), with cavography showing the IVC to be compressed, but patent. Without evidence of other metastatic disease radical resection of this tumor was performed. Successful resection was accomplished using a Gott shunt and porta hepatus compression for hepatic vascular isolation. No pump was used to avoid heparinization. Postoperative imaging confirmed IVC patency. The serum carcinoembryonic antigen (CEA) level fell to normal and remained so for 18 postoperative months. This introduces a new use of an atriocaval shunt for hepatic isolation during resection. © 1992 Wiley‐Liss, Inc.
Pre‐ and postoperative sequential study on the serum gastrin level in patients with lung cancer
Authors: Zhou Qinghua , Zhang Huaibin , Pang Xiaojie , Yang Junjie , Tain Zipu , Wu Zhu , Yang Zhenhua
Published: February 2007

Serial changes in serum gastrin level were detected by radioimmunoassay in 58 lung cancer patients before and after operation. In comparing these tests with those of 40 cases of noncancerous thoracic lesions and 151 normal adults, the serum gastrin from lung cancer patients is significantly higher than that of noncancerous thoracic lesions and normal individuals (P < 0.01). The gastrin level is closely related to stage of cancer, size of primary tumor, presence of lymph node metastasis, and type of histological classification. The serum gastrin was found to decrease gradually after the removal of the tumor and to return to normal on the 14th postoperative day. Those patients whose serum gastrin level can return to normal on the 14th postoperative day will have a good prognosis; if not, their prognosis will be very poor. These results suggest that serum from patients with lung cancer contains a high concentration of gastrin that can help differentiate benign from malignant thoracic lesions and evaluate prognosis of patients with lung cancer. Therefore, the cause of high serum gastrin in patients with lung cancer is likely due to the gastrin‐producing property of the lung cancer cells. © 1992 Wiley‐Liss, Inc.
Targeting cancer chemotherapy using a monoclonal antibody (NCC‐LU‐243) conjugated with mitomycin C
Authors: Kubota Tetsuro , Yamamoto Takaaki , Takahara Tetsuya , Furukawa Toshiharu , Ishibiki Kyuya , Kitajima Masaki , Shida Yasui , Nakatsubo Hiroshi
Published: February 2007

Two kinds of immunoconjugate (T‐3M and T‐11M) of murine monoclonal antibody with mitomycin C (MMC) were developed using spacers containing a disulfide (T‐3M) or thiocarbamate (T‐11M) bond. A murine monoclonal antibody (NCC‐LU‐243) raised against a human small cell lung carcinoma cell line, Lu‐24, in nude mice, is an IgG2a monoclonal antibody that recognizes a 145‐kDa protein on the cell surface membrane. T‐3M and T‐11M showed affinity for the LU‐243 antigen‐positive H‐69 cell line but not for the antigen‐negative Lu‐65 cell line in vitro. In the in vitro MTT assay, the order of efficacy of these compounds was T‐11M>T‐3M>MMC against antigen positive H‐69 and T‐11M = MMC>‐3M against antigen‐negative K562. When antigen‐positive H‐69 was transplanted into nude mice for in vivo assay, the maximum tolerated dose of T‐3M was twice as high than that of the parent compound MMC. Furthermore, T‐3M showed higher antitumor activity against antigen‐positive H‐69 than MMC conjugated with a non‐specific rabbit IgG in vivo. When the maximum tolerated doses of T‐3M and MMC were administered to H‐69‐bearing nude mice, the effect of T‐3M was superior to that of MMC, whereas no differences were observed between the antitumor activity of T‐3M and MMC against antigen‐ negative MX‐1, a human breast carcinoma. These two immunoconjugates of monoclonal antibody with mitomycin C are thought to be useful for targeting cancer chemotherapy against human small cell lung carcinomas. © 1992 Wiley‐Liss, Inc.
Surgical treatment for thoracic esophageal carcinoma in patients after gastrectomy
Authors: Kato Hoichi , Tachimori Yuji , Watanabe Hiroshi
Published: February 2007

The clinicopathologic factors in 50 gastrectomized and 831 nongastrectomized patients with thoracic esophageal carcinoma were compared. The differences in various factors were not statistically significant except for the average duration of operation, which suggests that the association of esophageal carcinoma and previous gastrectomy is a chance finding. Thirty‐four gastrectomized patients underwent abdominal lymphadenectomy and 16 did not. The postoperative survival curves for the two groups did not differ. In comparing the clinicopathologic factors between the two groups, only the tumor location differed significantly (P< .05). Nine patients (26.5%) with lesions in the mid‐ or lower thoracic esophagus in the gastrectomized group had positive nodes in the abdomen; the 5‐year survival rate was 39.4%. Among them, 8 had gastrectomy for peptic ulcer. Abdominal lymphadenectomy is recommended for those patients with mid‐ or lower thoracic esophageal carcinoma who have had previous gastrectomy without lymphadenectomy. © 1992 Wiley‐Liss, Inc.
Hepatic resection for a hepatocellular carcinoma larger than 10 cm
Authors: Furuta Toshiya , Sonoda Takashi , Matsumata Takashi , Kanematsu Takashi , Sugimachi Ano Keizo
Published: February 2007

Twenty‐one patients with hepatocellular carcinoma (HCC) larger than 10 cm diameter were treated during the 18year period from 1971 to 1988. The mean tumor size was 13 cm (range 10–18 cm). Nineteen patients (90.5%) had subjective symptoms. Eight patients (38.1%) had alpha‐fetoprotein (AFP) levels over 10,000 ng/ml, and in 18 patients (85.7%) the levels were over 20 ng/ml. Nevertheless, only three (14.3%) were detected by AFP. Scintigraphy before 1981 and ultrasonography after 1982 appears to be most helpful for detection of HCC. Nineteen lesions (90.5%) were localized in the right hepatic lobe. Large HCC showed a low incidence of histologically verified concomitant cirrhosis (33%; 7 of 21) and a relatively well preserved hepatocellular function (indocyanine green test; 13.9 ± 6.6%). Curative resection could be done for all 21 patients. There were three (14.3%) operative deaths. The 1‐, 3‐, and 5‐year survival rates were 72.2, 32.9, and 8.2%, respectively. One patient who underwent a left hepatic lobectomy has survived for over 5 years, with recurrence. There were 14 recurrences (66.7%) in 21 patients: 11 were hepatic and three were in the lungs. In patients with large HCC, surgical resection shoald be done, provided the clinical status and hepatocellular reserves are adequate. © 1992 Wiley‐Liss, Inc.
Long‐term right atrial catheters in patients with malignancies: An Indian experience
Authors: Alurkar Shirish S. , Dhabhar Boman N. , Pathak Anand B. , Gonsalves Iris , Iyer Rajaram S. , Kelkar Rohini , Pai Suresh K. , Deshpande Raman K. , Desai Prafulla B. , Advani Suresh H.
Published: February 2007

Ninety‐eight single lumen and two double lumen silicone right atrial Hickman/Broviac catheters inserted in 91 patients with various malignancies over a period of 36 months were prospectively studied. The average duration of use for all Hickman/Broviac catheters was 7,460 days with an average of 74.6 days. A total of 41 episodes of catheter‐related infections were documented in all patients (0.5 per 100 access days). Catheter related bacteremia was the most frequent type of infection (31 out of 41, 75%). Majority of the bacteremias could be controlled with routine antimicrobial therapy. Exit site infections were seen in 5 Hickman/Broviac catheters. Two catheters had to be removed because of catheter tunnel infections. Gram negative bacteremic infections were the most common, with Pseudomonas aeruginosa being the major pathogen. Silicone rubber Hickman/Broviac catheters proved to be convenient, reliable, and easily manageable devices in our experience. © 1992 Wiley‐Liss, Inc.
Mucinous biliary cystadenoma: A case report and review of the literature
Authors: Lind D. Scott , Adolph Vincent , Parker George A.
Published: February 2007

Mucinous biliary cystadenomas are rare neoplasms with protean manifestations. In most cases the mucinous material is retained within the cyst itself. We describe an asymptomatic case of a mucin secreting biliary cystadenoma in which the mucin presented as an amorphous intraluminal filling defect in the common hepatic duct on endoscopic retrograde cholan‐giopancreatography (ERCP). The neoplasm itself was confined to the posterior segment of the right hepatic lobe and was treated by formal right hepatic lobectomy. This case prompted a review of mucinous biliary cystadenomas. © 1992 Wiley‐Liss, Inc.
Gamma probe location of 111 indium‐labeled B72.3: An extension of immunoscintigraphy
Authors: Krag David N. , Haseman Michael K. , Ford Patrick , Smith Lloyd , Taylor Michael H. , Schneider Philip , Goodnight James E.
Published: February 2007

Eight colorectal and 5 ovarian cancer patients were evaluated with preoperative immunoscintigraphy and intraoperative gamma probe detection of 111indium‐labeled monoclonal antibody B72.3. Immunoscintigraphy detected the presence of tumor in every patient shown to have tumor at surgery. There was one false‐positive scan. A total of 21 pathologically verified lesions were identified at surgery in the 11 patients with tumor. Immunoscintigraphy localized 12 (57%) and intraoperative gamma probe detection located 17 (81%) of the lesions. Intraoperative probe detection located 6 of 8 lesions smaller than 1 cm and 3 lesions that were not identified on initial surgical exploration. The gamma probe offers information that is complementary to immunoscintigraphy in that (1) it aids the surgeon in locating intra‐ and extra‐abdominal lesions previously identified by immunoscintigraphy, (2) it locates lesions too small to be seen by immunoscintigraphy alone, (3) it locates lesions that otherwise might be missed at surgery, and (4) it provides objective evidence for adequacy of surgical resection of cancer in the abdominal cavity.