bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystadenocarcinoma of the pancreas: Neo‐adjuvant therapy and CEA monitoring
Authors: Wood Dennis , Silberman Allan W. , Heifetz Laurence , Memsic Leslie , Shabot M. Michael
Published: February 2007

Cystadenocarcinoma of the pancreas is generally considered to be unresponsive to chemotherapy and radiation therapy. We present two cases of laparotomy‐proven unresectable cystadenocarcinoma which responded to intravenous 5‐fluorouracil (1,000 mg/m2/24 hr × 5 days × 2) and 4,000 rads of radiation therapy. Both patients had objective response with marked shrinkage of the tumor as determined by clinical examination and computed tomography. At reexploration both tumors had become completely resectable with histologically clear margins and negative lymph nodes. Carcinoembryonic antigen (CEA) levels were elevated in both patients at initial presentation (86 and 71 ng/ml). The CEA levels declined to 19.9 and 66.0 ng/ml, respectively, after neo‐adjuvant therapy, and both fell to normal levels after resection. Although surgical resection has been considered the only curative therapy for patients with pancreatic cystadenocarcinoma, we suggest that preoperative irradiation and chemotherapy may reduce the size of seemingly unresectable tumors. We also recommend serial CEA determinations in patients with levels initially elevated as a marker of the response to neo‐adjuvant and operative therapy.
Immunohistochemical analysis of the relationship between CEA localization and mononuclear cell infiltration in human colorectal carcinoma
Authors: Tanaka Kanji , Nagura Hiroshi , Hamada Yoshinori , Yamamura Manabu , Hioki Koshirou , Watanabe Keiichi , Yamamoto Masakatsu
Published: February 2007

Thirty cases of colorectal adenocarcinoma were immunohistochemicaliy examined to clarify the relationship between the degree of differentiation of cancer cells reflected by the mode of CEA localization and the infiltration pattern of mononuclear cells in the carcinoma tissues. Leu 1+, Leu 2a+, Leu 3a + 3b+ T lymphocytes, Leu 7+ cells, and IgA‐containing plasma cells tended to be distributed more in areas where CEA was localized over the entire surface of the cancer cells or in their surrounding stroma than where CEA was located along the apical surface or within the cytoplasm. Carcinoma cells with the pattern of CEA staining at the former site were previously shown to be less differentiated than those at the latter. There were also CEA‐containing phagocytes which were often observed where T cells and IgA plasma cells had aggregated. We speculated that the dedifferentiation of cancer cells might cause the host immune response, especially the cellular immunity, in malignant lesions.
Angiosarcoma of the breast with report of unusual site of first metastasis
Authors: Baum Janet K. , Levine Allan J. , Ingold John A.
Published: February 2007

Angiosarcoma of the breast accounts for less than 1% of all primary breast lesions. It occurs at all ages, but more frequently in younger women than does primary breast carcinoma. It often has a rapidly progressive clinical course and, as in one of the reported cases, can present with unusual sites of metastases even after a long disease‐free interval.
Enhanced killing of human small cell lung cancer by hyperthermia and lndium‐111‐ bleomycin complex
Authors: Hou De‐Yan , Maruyama And Yosh
Published: February 2007

Indium‐111‐bleomycin complex (111 In‐BLMC) is a radiopharmaceutical agent that produces tumor regression in mouse glioma in vivo and kills human small cell lung cancer (SCLC) cells in vitro. The interaction between hyperthermia and 111In‐BLMC against human SCLC (N417) cells was studied for bleomycin (BLM) (15 μ/ml) or 111In‐BLMC (40–50 μCi carried by 15 μg BLM/ml) for 5 min or 1.5, 2, or 4 hr at 37°C or 43°C exposures. Cell survival was determined by colony formation in soft aga‐rose. There was a synergistic effect for 111In‐BLMC and hyperthermia for cell killing. At 37°C, the percent survival of N417 cells for BLM alone was 25.9%, and for 111In‐BLMC it was 13.2%; at 43°C, survival was 5.3% for BLM alone and 1.2% for 111In‐BLMC by a 4 hr treatment. Effectiveness was greater when 111In‐BLMC was combined with hyperthermia.
Sodium‐24 studies in postmastectomy lymphedema
Authors: Scanlon Edward F. , Milland Francisco De P. , Hellman Leon
Published: February 2007

Seven patients were studied with 24Na to determine the relative disappearance time of the isotope from the postmastectomy lymphedematous arm as compared to the normal side. The results tend to confirm previously held convictions that the edema is usually confined to the subcutaneous fat and skin. The disappearance time (T1/2) of the radioactive sodium from the muscle of the edematous side was usually comparable to that of the control side. The data also indicate that the impairment of fluid drainage from other areas, such as the lateral chest wall, that normally drain into the axilla, is impaired similarly to that of the subcutaneous fat of the arm. Operative procedures designed to relieve the edema of the arm by providing an alternate route of drainage should provide a conduit for the fluid to an area that does not normally drain to the axilla of the affected side.
Malignant fibrous histiocytoma of bone
Authors: Kumar Rekha V. , Mukherjee Geetashree , Bhargava M. Krishna
Published: February 2007

Malignant fibrous histiocytoma (MFH) of bone is a malignant primary bone tumour that is being increasingly recognised, as more details emerge in the literature regarding its natural history and precise (although sometimes diverse) histological appearance. When the whole bulk of a malignant bone tumour fits the criteria laid down, the designation of MFH seems appropriate. Seven cases of MFH of bone were encountered from a total of 220 primary malignant bone tumours in our files over a 4‐year period. The metaphyses of long bones were the most common sites harbouring the tumour, and a wide age range was represented. Amputation was the treatment of choice in all cases. The relevant literature is reviewed.
Cecal carcinoma: A different colon malignancy?
Authors: Leenen Loek P. H. , Wobbes Theo , Hoekstra Harold J. , Werken Chris Van Der
Published: February 2007

Cecal carcinoma has been associated with a poorer prognosis than other colon carcinomas because of the presumed longstanding obscure symptoms. In a combined study of three Dutch hospitals, a total of 166 patients with cecal carcinoma were evaluated after right hemicolectomy. Special emphasis was placed on clinical symptoms related to advanced tumor growth, e.g., pain, anemia, and palpable mass. These factors and clinicopathological staging were evaluated with aid of the Cox regression model. Ninety percent of the resected specimens contained a Dukes' B or C carcinoma. Only 5% were found to have widespread metastatic disease. Overall 5 year survival rate was found to be 0.57. No statistically significant relation to pain or palpable mass was found. Anemia, however, was related to a better survival, especially in patients with a Dukes' B carcinoma. Clinicopathological staging according to Dukes' is closely related to survival. It is concluded that carcinoma of the cecum behaves similarly to other colon malignancies.
Adjuvant chemotherapy and scar irradiation in breast cancer
Authors: Içli Fikri , Dinçol Dilek , Isikman Erdoĝan , Ünal Muttalip
Published: February 2007

Twenty‐three consecutive premenopausal patients with breast cancer who had four or more positive axillary nodes were treated with six cycles of CMFP followed by irradiation limited to the mastectomy scar (CT‐SRT). The relapse‐free survival (RFS) rate was compared with a group of 15 patients who were treated with chemotherapy alone (CT). Following an average follow‐up of 30 months, the relapse rates for the CT‐SRT and CT groups were 30.4% vs. 73.2%, respectively (P < 0.05).
Symptomatic pericardial effusion in lung cancer patients: The role of fluid cytology
Authors: Edoute Yehouda , Malberger Ehud , Kuten Abraham , Moscovitcz Marian , Ben‐Haim Shlomo A.
Published: February 2007

During the years 1975‐1988, twenty lung cancer patients with symptomatic pericardial effusion were treated conservatively at our center. Echocardiography demonstrated small pericardial effusion in 2 patients, medium size effusion in 3 patients and large amount of fluid in 15 patients. Fifteen patients developed cardiac tamponade; in three of these patients, this was the presenting manifestation of lung cancer. Pericardiocentesis resulted in prompt, though temporary, symptomatic relief in all patients. Fluid cytology demonstrated suspected malignant cells in 2 patients and malignant cells in 13 patients. Based on cytology, the diagnosis of adenocarcinoma was established in six patients, small cell carcinoma in three patients, and epidermoid carcinoma in one patient. All patients were dead within 9 months from the time of diagnosis of pericardial effusion; 17 died within less than 3 months. It is concluded that pericardial effusion in lung cancer is indicative of rapid tumor progression and short survival. Fluid cytology provides an immediate and accurate means of diagnosis.
Preoperative cell‐mediated immune function and the prognosis of patients with gastric carcinoma
Authors: Akiyoshi Tsuyoshi , Koba Fumio , Arinaga Shinya , Ueo Hiroaki
Published: February 2007

The cell‐mediated immune function of 83 patients with gastric carcinoma was assessed preoperatively and the results were compared to that of 52 patients with benign lesions. The data were subjected to an analysis in order to evaluate their prognostic significance. The abilities to induce allogeneic cytotoxicity and to produce interleukin 2 (IL 2) in patients with stage IV carcinoma were significantly depressed, as compared to those in patients with benign lesions, whereas natural killer (NK) cell activity was not significantly impaired. There was no significant correlation among these immune functions. When the patients were stratified into two groups, those who had high (greater than the mean value in patients with benign lesions) and low (less than the same value) values of these immune reactivities, the survival of patients with high NK activity (⩾43%) was significantly better, as compared to that of patients with low cytotoxicity (< 43%). However, there was no correlation between the survival and allogeneic cytotoxicity in these patients. The high ability to produce IL 2 (⩾1.3 U/ml) correlated with the better survival in the patients, but not in the group of patients who underwent curative resection.
Small cell lung carcinoma: Clinicopathological, immunohistochemical, and ultrastructural study
Authors: Shy Shya‐Wen , Lee Wei‐Hwa , Chou Ming‐Chih , Lai Yieh‐Shyong , Tu Yen‐Chang
Published: February 2007

Sixty‐seven cases of small cell lung carcinoma (SCLA) in Tri‐Service General Hospital (TSGH) during the past 16 years were studied. For patients with extensive stage of disease, the mean survival time and 2‐year survival rate were 7.2 months and 3.1% versus 13.4 months and 16.7% for patients with limited stage. A better prognosis was obtained by treatment with a combination of intensive chemotherapy and radiotherapy. Immu‐nohistochemical studies were performed by the peroxidase‐antiperoxidase method. The positive rates in descending order were bombesin (80%), synaptophysin (74.3%), neurofilament (68.6%), neuron‐specific enolase (60%), low molecular weight cytokeratin (54.3%), high molecular weight cytokeratin (25.7%), chromogranin‐A (22.9%), adrenocorticotrophic hormone (0). Seven cases were examined and found to be ultrastructure; only 3 cases were found to contain neurosecretory granules. We emphasize that electron microscopy is not necessary as a routine diagnostic procedure, while light microscopy should be employed whenever possible; the immunohistochemical study should be considered within this context.
Enhanced immunoglobulin levels correlate with infectious complications after surgery in esophageal cancer
Authors: Saito Takao , Kuwahara Akihiko , Shimoda Katsuhiro , Kinoshita Tadahiko , Shigemitsu Yuji , Miyahara Masaki , Kobayashi Michio
Published: February 2007

Severe septic complications account for the high mortality of patients with esophageal cancer. We examined the levels of immunoglobulins and complements together with infection‐related complications in a large number of patients. Enhancements of IgG, IgA, C3, C4, and CH50 were evident in patients with esophageal cancer and were more predominant compared to findings in cases of gastric cancer. Average levels of IgG and IgA immediately before surgery were significantly higher in esophageal cancer patients with postoperative septic complications than in those without such problems. Preoperative radiation therapy and total parenteral nutrition did not significantly alter the levels of immunoglobulins and complements. It would thus appear that the enhancement of IgG and IgA is associated with the occurrence of infectious complications following surgery for patients with esophageal cancer.
Subrenal capsule assay as a chemosensitivity test for primary esophageal squamous cell carcinoma
Authors: Sunagawa Masakatsu , Suzuki Tomoyuki , Ito Kinichi , Endo Mitsuo
Published: February 2007

The efficiency of the subrenal capsule assay (SRCA) was studied with fresh tissue of esophageal squamous cell carcinoma. The day‐to‐day changes in 10 carcinoma cases were evaluated for 9 days. The cancer cells continued to proliferate from the 3rd to the 7th day after the implantation and then decreased. The host reaction was recognized histologically from the 3rd or 4th day to the 9th day. However, the immune reaction did not significantly influence the evaluation of SRCA until the 7th day. The immunohistochemical staining with anti‐bromodeoxyuridine monoclonal antibody revealed the existence of cancer cells at the DNA synthesizing stage (S stage) in the graft until the 7th day. In chemosensitivity test by SRCA, 21 patients were studied, and all were evaluable. 5‐FU administration produced a response in 8/21 cases (38.1%), VDS in 8/21 (38.1%), and CDDP in 3/21 (14.3%). Used in combination, CDDP + VDS was effective in 7/18 cases (38.9%) and CDDP + BLM in 6/18 cases (33.3%).
Lactation following conservation surgery and radiotherapy for breast cancer
Authors: Varsos George , Yahalom Joachim
Published: February 2007

A 38‐year‐old woman with early stage invasive breast cancer was treated with wide excision of the tumor, axillary lymph node dissection, and breast irradiation. Three years later, she gave birth to a normal baby. She attempted breast feeding and had full lactation from the untreated breast. The irradiated breast underwent only minor changes during pregnancy and postpartum but produced small amounts of colostrum and milk for 2 weeks postpartum. There are only a few reports of lactation after breast irradiation. These cases are reviewed, and possible factors affecting breast function after radiotherapy are discussed. Because of scant information available regarding its safety for the infant, nursing from the irradiated breast is not recommended.
Primary carcinoma of the gallbladder
Authors: Chao Tzu‐Chieh , Greager John A.
Published: February 2007

Seventy‐four patients with primary carcinoma of the gallbladder, diagnosed over 18 years from 1969 to 1987, were studied retrospectively. The most common presenting complaint was abdominal pain, followed by jaundice and weight loss. Surgery was performed in 61 patients and of these patients, only two had accurate preoperative diagnosis which was made by ultrasonography. Twelve of the 13 patients who were treated medically had the disease diagnosed at autopsy. One of the 13 patients had the diagnosis of gallbladder cancer by the findings of ultrasonography and abdominal computed tomography (CT) scanning. The resectability of the surgically managed group was 36.1%, and the majority of patients with advanced tumors (82.2%) were deemed unresectable. The most common histologic type was adenocarcinoma. Liver was the organ most commonly invaded (76.5%) by direct extension and/or metastases, followed by regional lymph nodes (52.9%). The overall 5‐year survival rate was 5.4%. A high index of suspicion of the disease, intraoperative examination of gallbladder specimen, and earlier, more aggressive surgical treatment may improve patient survival.
Prognosticators of second‐look laparotomy findings in patients with epithelial ovarian cancer
Authors: Ayhan Ali , Yarali Hakan , Develioǧlu Osman , Üren Aykut , Özyilmaz Filiz
Published: February 2007

Prognosticators of outcome at second‐look laparotomy (SLL) were evaluated in 49 patients with epithelial ovarian carcinoma undergoing SLL. Residual tumor volume was found to be the most significant prognosticator of outcome, with initial tumor stage being of secondary importance. Grade of tumor played no role in outcome at SLL. The results of the study led us to the conclusion that the second‐look procedure may be safely omitted in stage I patients. The importance of optimal cytoreduction during primary surgery was stressed.
Primary lymphoma of bone: A clinicopathologic study of 25 cases reported over 10 years
Authors: Desai Sangeeta , Jambhekak Nikmala A. , Soman Chitralekha S. , Advani Suresh H.
Published: February 2007

Twenty‐five cases of primary lymphoma of bone (PLB) reported over a 10‐year period were reviewed. The presenting symptom was related to involvement of a single bone with or without regional nodal disease. None showed dissemination of lymphoma in the subsequent six months. Patients affected were 7‐65 years of age. An equal predilection for the axial and appendicular skeleton was noted. Histologically, the commonest subtype was diffuse histiocytic lymphoma (DHL, 17 cases), whereas four were poorly differentiated lymphocytic (PDL) type and another four were unclassifiable. Follow‐up was available in 18 out of 25 patients for periods ranging from 7 months to 8 years. On clinicopathologic correlation we found that 75% of disease‐free patients had a DHL whereas 60% of those alive with disease had a PDL. This study reiterates the view that PLB has a good prognosis and the DHL subtype is especially amenable to complete eradication.
Conservative management of intraductal carcinoma (DCIS) of the breast
Authors: Fisher Edwin R. , Leeming Rosemary , Anderson Stewart , Redmond Carol , Fisher Bernard
Published: February 2007

Seventy‐six patients with intraductal carcinoma (DCIS) of the breast have been observed for 83 months (range 50‐141) following treatment by lumpectomy (L) only (21), L and breast irradiation (XRT) (27), or mastectomy (28). All represented examples of DCIS retrieved after pathologic examination of a much larger cohort of patients with stage I and II invasive breast cancer enrolled in NSABP protocol 6. Local breast recurrences were similar for women with DCIS and those from this cohort at a similar period of follow‐up with invasive cancer treated by L only (43% vs. 39%) and L + XRT (7% vs. 10%). The presence of moderate/ marked comedonecrosis was suggestively related to local breast recurrence (P= .07). This latter was significantly reduced for patients receiving post L XRT (P= .01). All local breast recurrences in this study and 29 of 31 recorded by others occurred at or close to the site of extirpation of the index cancer minimizing multicentricity as a contraindication for the conservative surgical treatment of DCIS. Survival rates which were similar for patients with DCIS regardless of form of local treatment were better than that observed for negative node patients with invasive cancer enrolled in protocol 6. Thus, DCIS is a less, not more, ominous disease than invasive cancer. This and other features of its natural history indicate that it would be a contradiction to treat invasive cancer but not DCIS conservatively.
Angiolymphoid hyperplasia with eosinophilia (Kimura's disease): Report of a large‐sized lesion
Authors: Jambhekar Nirmala A. , Borges Anita M. , Saxena Romil , Parikh Dipak M. , Soman Chitralekha S.
Published: February 2007

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon lesion with a predilection for skin of the head and neck region. It usually presents as one or a few smooth‐surfaced nodules which are often asymptomatic. Histologially the nodules reveal two components: abnormal proliferating vessels and a cellular infiltrate consisting of lymphocytes and eosinophils, involving both the dermis and the subcutaneous tissue. A case is presented of an unusually large recurrent lesion on the scalp.
In vitro response of a human colon tumor xenograft and a lung adenocarcinoma cell line to α‐difluoromethylornithine alone and in combination with 5‐fluorouracil and doxorubicin
Authors: Zirvi Karimullah A. , Atabek Umur
Published: February 2007

We have investigated effects of α‐difluoromethylornithine (DFMO), both as a single agent and in combination with 5‐fluorouracil (5‐FU) against a human colon tumor xenograft (T6) grown as primary tissue culture in serum‐free medium and in combination with doxorubicin (DX) against a human lung adenocarcinoma cell line (A549). DFMO showed a dose‐dependent growth‐inhibitory effect against human colon tumor xenograft and lung adenocarcinoma cells. Growth‐inhibitory activity of DFMO against T6 cells was reversed completely when the cells were treated simultaneously with putrescine (PU) (10−6 M) and DFMO (10−3 M). When 5‐FU and DFMO were used in combination against T6 cells, no antagonism or synergism between the two drugs was seen. However, in the case of A549 cells, when DFMO was used in combination with DX, there was a consistent increase in growth inhibition that surpassed the inhibition of either agent given alone.
Is there an established role for immunotherapy for any of our surgical cancers?
Authors: Elias E. George
Published: February 2007

Despite major advances in the management of the patient and in surgical and radiation therapy, cancer deaths continue to occur secondary to widespread metastases. Therefore, systemic treatments in the form of chemotherapy, hormonal therapy, and immunotherapy are constantly being investigated, both as adjuvant to the local therapeutic modalities, as well as therapeutically for unresectable metastases. While the first two systemic modalities have established themselves in cancer management, immunotherapy has been lagging behind for several reasons.
Distribution of histologic subtypes and sex ratio in various primary sites of lymphocytic lymphoma
Authors: Ohsawa Masahiko , Aozasa Katsuyuki , Saeki Kazunori , Tsujimura Takahiro , Tamai Masamitsu , Kawano Kiyoshi
Published: February 2007

To examine the distribution of histologic subtypes and sex ratio in each primary site of lymphoma, 1, 169 histologically proven cases of lymphocytic lymphoma were analyzed. The location of tumor was nodal in 615(53%) and extranodal in 517(44%), patients with the gastrointestinal tract being the most common. The incidence was predominantly in males for all histologic types and in nodal and extranodal sites, except for a predominance of females in extranodal lymphoplasmacytic(Lp‐cytic), lymphoplasmacytoid(Lp‐cytoid) tumors. Frequency of the Lp‐cytic/Lp‐cytoid type among all types of lymphoma in females was about 2.7 times more frequent in extranodal than in nodal sites. The most striking example was thyroid lymphoma in which the frequency of Lp‐cytic/Lp‐cytoid type was 36% in female and 0% in male patients. Including this type of lymphoma, frequency of low grade lymphoma in females was higher in extranodal sites than in nodal sites.
Papillary thyroid cancer and its surgical
Authors: Noguchi Masakuni , Earashi Mitsuharu , Kitagawa Hirohisa , Ohta Nagayoshi , Thomas Michael , Miyazaki Itsuo , Mizukami Yuji , Michigishi Takatoshi
Published: February 2007

The surgical management in papillary thyroid cancer has been highly controversial. In the Department of Surgery (II), Kanazawa University Hospital, the surgical management especially for cervical lymph node metastases has changed since 1973 from a conservative approach to an aggressive one. In order to determine whether an aggressive approach is warranted, a retrospective multivariate analysis was carried out on 106 cases of papillary thyroid cancer. The patients have been followed for 10–28 years. Multivariate analysis was conducted following Cox's model. By this analysis, aggressive management appeared to have no impact on survival or relapse‐free survival. However, age, sex, tumor size, and cervical lymphadenopathy were confirmed to be important prognostic factors in survival and/or relapse‐free survival. © 1992 WiIey‐Liss, Inc.
Alpha‐fetoprotein production by hepatocellular carcinoma is prognostic of poor patients survival
Authors: Izumi Ryohei , Shimizu Kohichi , Kiriyama Masato , Hashimoto Tetsuo , Urade Masaaki , Yagi Masato , Mizukami Yuji , Nonomura Akitaka , Miyazaki Itsuo
Published: February 2007

Immunohistochemistry using the avidinbiotinperoxidase complex method was performed to study the production of alphafetoprotein (AFP) in hepatocellular carcinoma (HCC) tissue specimens which were obtained surgically. The relationship between staining for AFP and serum AFP levels or pathological findings was examined. The prognosis of the patients with HCC who underwent curative hepatic resections was studied with respect to the staining for AFP in their tumors. The mean serum AFP level in patients with positive AFP staining was significantly higher than in those with negative AFP staining. No significant relationship was found between AFP positivity and tumor size, tumor encapsulation, degree of vascular invasion, or the histological differentiation grade of the tumor. The patients with AFP‐positive carcinomas had a poorer prognosis than did those with AFP‐negative carcinomas (5‐year survival rate of AFP‐positive and negative groups were 26.7% and 56.5%, respectively). © 1992 Wiley‐Liss, Inc.
Diagnostic utility of DNA content flow cytometry in follicular neoplasms of the thyroid
Authors: Harlow Seth P. , Duda Rosemary B. , Bauer Kenneth D.
Published: February 2007

Preoperative diagnosis of follicular carcinoma of the thyroid remains a clinical challenge. This study determined the DNA content parameters of ploidy and proliferative activity levels from cells of normal thyroid tissue, follicular adenomas, and follicular carcinomas to evaluate if these parameters could be used as an adjunct to fine needle aspiration in their diagnosis. Statistically significant higher proliferative activity levels were found in the carcinoma groups (mean S‐phase fraction [SPF] = 5.0%) compared to 2.9% for follicular adenomas and 1.3% for normal thyroid. DNA aneuploidy was identified in 73% of carcinomas and 36% of adenomas. Because of overlap of SPF values between groups, one could not rule out the presence or absence of malignancy based on DNA content parameters alone. These measurements may, however, be an aid to the decision making in patients who are poor surgical risks. © 1992 Wiley‐Liss, Inc.
Neoadjuvant chemotherapy with cytosine arabinoside by continuous infusion and cisplatin for resectable squamous cell carcinoma of the esophagus
Authors: Trudeau Marc , Batist Gerald , Thirlwell Michael , Boos Gerald , Shennib Hanni , Mulder David
Published: February 2007

The combination of cisplatin and cytosine arabinoside has been shown in experimental models to be synergistic. We conducted a pilot study of cytosine arabinoside and cisplatin in unresectable or metastatic cancer of the esophagus in five patients and found significant activity, also on visceral metastasis. Therefore, we decided to examine this combination in the neoadjuvant setting. Since January 1989, eight patients with squamous cell carcinoma esophageal cancer were treated with two cycles of cytosine arabinoside (50 mg/m2) by continuous infusion for 4 days and by cisplatin (100 mg/m2) on the 5th day. Their ages ranged from 54–79 years. One patient had Stage I, three had Stage II, and four had Stage HI disease. Responses assessed by endoscopy and computed tomographic (CT) scan prior to surgery were three with partial response, three with minor response, and two with no response. Only six patients were surgically resectable after chemotherapy. Toxicity consisted of grade 3 (one patient) and grade 4 (two patients) neutropenia, grade 3 (three patients) anemia, and grade 3 (two patients) and grade 4 (three patients) thrombocytopenia. All patients had subjective improvement of dysphagia 4 weeks after chemotherapy. Median survival of the whole group was 7.5 months. We concluded that there was no evidence of synergy of these drugs given in this manner in esophageal carcinoma since the response rate was no different from that achieved with cisplatin alone. © 1992 Witey‐Liss, Inc.
Soft tissue sarcomas in whites and blacks living in the United States of America
Authors: Zaki Adel , Mettlin Curtis
Published: February 2007

Five hundred four hospitals volunteered reports on 2,355 patients in a long‐term study and 645 institutes reported on 3,457 in a short‐term study. Out of 5,623 cases of soft tissue sarcoma (STS) reported in white and blacks living in the United States of America, 574 cases (10.2%) were reported in blacks. No striking differences were found between blacks and whites concerning anatomic sites, histologic types, histologic grades, or clinical stages of STS. A higher percentage of patients with recurrences were reported in whites with liposarcoma (37.7% compared to 28.9% in blacks), and leiomyosarcoma (45% in whites compared to 39.1% in blacks). On the other hand recurrences were more frequent in fibrosarcoma and rhabdomyosarcoma in black patients. No significant differences in survival was found between white and black patients with STS. © 1992 Wiley‐Liss, Inc.
Functional results following esophagogastrectomy for carcinoma of the esophagus
Authors: Deshmane Vinay H. , Sharma Sanjay , Shinde Shashank R. , Vyas Jetendra J.
Published: February 2007

Fifty patients underwent esophagogastrectomy for histologically proven carcinoma of the esophagus from January to December 1989. The Ivor Lewis procedure was performed in 29 patients and 21 resections were performed by a left thoracoabdominal approach. There was one anastomotic leak which could not be salvaged and was responsible for the sole mortality within 30 days of surgery. The hospital stay averaged 12 days, ranging from 8–26 days. Swallowing was resumed by the 6th postoperative day for liquids and 8th day for soft solids. Following surgery, 5 patients developed dysphagia, 4 of whom responded to dilatation. The anastomosis was hand sutured in all cases except one. The suture material used had no relation to the incidence of leak or stricture formation. Eight patients complained of reflux that settled with medical management. Most patients were eating without dysphagia at the last follow‐up or death. Esophagogastrectomy can be performed with a low morbidity and mortality and provides adequate palliation of the patient's most distressing symptom, dysphagia. © 1992 Wiley‐Liss, Inc.
Inferior vena cava leiomyosarcoma
Authors: Demers Marc L. , Curley Steven A. , Romsdahl Marvin M. , Karakousis Constantine P.
Published: February 2007

Leiomyosarcoma of the inferior vena cava is a rare malignancy, and radical resection with negative margins remains the only hope for cure. In this report we cite four cases of this tumor treated at The University of Texas M. D. Anderson Cancer Center with particular emphasis on the use of preoperative chemotherapy. In our patients, preoperative chemotherapy did not adversely affect operative outcomes or survival. The potential benefits of preoperative chemotherapy include control of micrometastases, reduction in tumor size before resection, and in situ evaluation of tumor response to chemotherapy for postoperative adjuvant therapy. © 1992 Wiley‐Liss, Inc.
Prognostic factors for noncurative gastric cancer: Univariate and multivariate analyses
Authors: Baba Hideo , Okuyama Toshiro , Hiroyuki Orita , Anai Hideaki , Korenaga Daisuke , Maehara Yoshihiko , Akazawa Kohei , Sugimachi Keizo , Lawrence Walter
Published: February 2007

We performed univariate and multivariate analyses of possible prognostic factors related to postoperative clinical course of patients with advanced gastric cancer. Noncurative resection was done for 119 patients with hepatic metastasis, peritoneal seeding, extensive lymph node metastasis, or direct invasion to adjacent organs, either alone or in various combinations. In the univariate analysis, 6 of 17 items such as peritoneal seeding, lymphatic invasion, vascular invasion, mode of invasion, extent of lymphadenectomy, and width of serosal invasion significantly correlated to the prognosis. The multivariate analysis indicated that three inherent pathologic factors, mode of invasion, lymph node metastasis, and hepatic metastasis, and one treatment factor, extent of lymphadenectomy, were significant variables predictive of the prognosis and that the prognosis was expected to be very poor in cases of infiltrative type, nodal involvement to tertiary nodes, presence of hepatic metastasis, and lymphadenectomy less than R3. Prognosis in terms of the extent of lymphadenectomy shows that extensive lymphadenectomy (R3) proved to be significantly effective in prolonging survival time, even after noncurative gastrectomy. We recommend extensive lymphadenectomy to prolong survival time for such patients. © 1992 Wiley‐Liss, Inc.
Prognostic assessment of superficial squamous cell carcinoma of the esophagus using karyometric analysis and nucleolar organizer regions
Authors: Maesawa Chihaya , Masuda Tomoyuki , Tamura Gen , Satodate Ryolchl , Ishida Kaoru , Saito Kazuyoshi
Published: February 2007

To investigate prognostic values for squamous cell carcinoma, we measured nuclear area (NA), nuclear shape factor (NSF), DNA content and mean number of nucleolar organizer regions (NOR), using formalin‐fixed, paraffin‐embedded tissue sections from 39 patients with superficial squamous cell carcinoma of the esophagus. NA and DNA content were significantly higher in patients with lymph node metastasis than in those without metastasis. NA and the NOR number were also significantly higher in patients with recurrence than in those surviving for more than 3 years without recurrence. To determine the optimal combination of these parameters for prognostic assessment, we used a stepwise discriminant analysis to obtain two linear discriminant functions. One (f = −0.331 × NA + 6.64 × NSF + 9.85) gave an accuracy of 87.2% in predicting lymph node metastasis, and the other (f = −0.071 × NA −2.34 × NOR + 13.0) yielded an overall accuracy of 88.9% in classifying patients into two groups with a better and worse prognosis. These results suggest that karyometric analysis and determination of the NOR number are useful for the prediction of disease outcome in patients with superficial squamous cell carcinoma of the esophagus. © 1992 Wiley‐Liss, Inc.
Staging invasive bladder tumors
Authors: Herr Harry W.
Published: February 2007

Staging of bladder tumors is based primarily on the depth of tumor invasion (T‐category). Stage is important to treatment planning and prognosis. The problem is that clinical evaluation by T‐category alone often under‐stages the pathologic extent of disease and does not reliably predict treatment results. The current analysis shows that the presence of a mass palpable on bimanual examination is of prognostic value. Incorporating tumor volume with microscopic tumor invasion may enhance the usefulness of clinical staging. © 1992 Wiley‐Liss, Inc.
The effect of the fiber components cellulose and lignin on experimental colon neoplasia
Authors: Sloan David A. , Fleiszer David M. , Richards Geoffrey K. , Murray David , Brown Rea A.
Published: February 2007

Sixty Sprague‐Dawley rats were pair‐fed one of three nutritionally identical diets. One diet contained “low‐fiber” (3.8% crude fiber); the others contained “high fiber” (28.7% crude fiber) composed of either cellulose or lignin. Although both “high fiber” diets had similar stool bulking effects, only the cellulose diet was associated with a reduction in 1,2‐dimethylhydrazine (DMH)‐induced colon neoplasms. The cellulose diet was also associated with distinct changes in the gut bacterial profile and with a lowered serum cholesterol. © 1993 Wiley‐Liss, Inc.
Complete disappearance of a leiomyosarcoma of the lower extremity following preoperative hyperthermia and intra‐arterial doxorubicin
Authors: Khalek Yihad , Vilor Mabel , Sorrentino Jose , Brown Michael , Wills John , Herrera Lemuel
Published: February 2007

Leiomyosarcoma of the extremities is an unusual tumor. Herein we report a unique and what we believe is the first case of a patient in whom there was complete disappearance of such a tumor following regional hyperthermia and chemotherapy. © 1993 Wiley‐Liss, Inc.
Breast cancer detection demonstration project data can determine whether the prognosis of breast cancer is affected by the time of surgery during the menstrual cycle
Authors: Spratt John S. , Zirnheld Jolene , Yancey John M.
Published: February 2007

The purpose of this study was to determine the feasibility of using Breast Cancer Detection Demonstration Project (BCDDP) data to ascertain whether the prognosis of breast cancer in premenopausal women is affected when surgery is performed relative to the different phases of the menstrual cycle. In the Louisville BCDDP only 40 cases were available for study, but even with this small number, the data indicate that survivorship was superior when the surgery was performed between days 7–20 of the menstrual cycle (P < 0.06). One thousand eighty‐seven premenopausal women underwent surgery for breast cancer during the first 5 years of the national BCDDP, beginning in 1972. This large number of cases, plus the long period of follow‐up should provide sufficient statistical power for us to evaluate if there is any relationship between the day of the menstrual cycle, the day surgery was performed, and prognosis. This feasibility study indicates that these women should be followed up and the appropriate statistical studies should be done. © 1993 Wiley‐Liss, Inc.
Cancer of the male breast: The Turkish experience
Authors: Engin Kayihan , Unsal Mustafa
Published: February 2007

Twenty‐six patients with male breast cancer who were admitted to the Center of Oncology and Nuclear Medicine, Istanbul, Turkey, between 1980 and 1988, were analyzed retrospectively. Median age was 60 years. Most lesions were infiltrating ductal carcinomas (92%). Of 26 lesions, 9 were staged as stage II (35%), 14 as stage III (54%), and 3 as stage IV (11%). All but five patients underwent unilateral mastectomy (81%). Postoperative treatment consisted of radiation therapy combined with chemotherapy in 11 patients (42%), chemotherapy with or without hormonal therapy in 4 (15%), radiation therapy alone in 10 (38%). Radiation therapy was delivered for a mean total radiation dose of 52 ± 2 Gy (range 30–60 Gy). Chemotherapy consisted of cyclophosphamide, methotrexate and 5‐fluorouracil (CMF) in most patients (60%). FAC regimen (5‐fluorouracil, Adriamycin, and cyclophosphamide) was given to 6 patients (40%). Six patients were known to have died of breast cancer during follow‐up (23%). Fourteen patients were NED (no evidence of disease) at last follow‐up (54%). Overall actuarial 5‐year survival was calculated to be 37%, and median actuarial survival was 46.6 months. Actuarial 5‐year disease‐free survival was 27%, and median actuarial disease‐free survival was 47.1 months. Only one patient had a local recurrence, and eight patients had 13 distant metastases (31%). Age (P = 0.023), tumor stage (P = 0.055) and nodal status (P = 0.013) were the most significant prognostic factors correlated with the overall survival. © 1993 Wiley‐Liss, Inc.
Total pelvic exenteration with preservation of fecal continence
Authors: Brodsky Jeffrey T. , Sloane Bruce B. , Khanna Om P.
Published: February 2007

Total pelvic exenteration may be required in the management of locally advanced or recurrent pelvic malignancy. Although prolonged survival may be achieved, the morbidity of this procedure is substantial. Many of the complications associated with total pelvic exenteration are related to the perineal wound, the necessity for two cutaneous stomas, and the creation of a empty pelvis that often has been previously irradiated. In selected cases, perineal preservation with restoration of coloanal continuity may significantly reduce postoperative morbidity. We report four cases of recurrent pelvic malignancy treated by total pelvic exenteration with preservation of fecal continence. © 1993 Wiley‐Liss, Inc.
A study from South India on the association between the papilloma virus and carcinoma of the penis
Authors: Kini Usha , Thomas John A. , Shariff Shameem
Published: February 2007

Specimens from 39 cases of squamous cell carcinoma of the penis were treated for the papilloma virus using the bovine papilloma virus antibody and the peroxidase—antiperoxidase technique. All 39 cases showed a viral antigen situated intranuclearly, intracytoplasmically or both intranuclearly and intracytoplasmically. No correlation could be seen between the presence of viral antigen and age of patient, duration of lesion, cell morphology and histological grade. The adjacent mucosa and skin were used as controls and showed no viral antigen. The inflammatory infiltrate was dense and predominantly “T” lymphocyte in type. © 1993 Wiley‐Liss, Inc.
Ethanol injection therapy in RBT—1 carcinoma of the rat liver evokes enhancement of metastasis
Authors: Ikeda Yasuharu , Matsumata Takashi , Adachi Eisuke , Nishizaki Takashi , Sugimachi Keizo
Published: February 2007

To search for possible untoward effects of ethanol injection into a malignant tumor, a series of experiments was carried out using the model of RBT‐1 carcinoma. Ten days after the inoculation of RBT‐1 carcinoma into the rat liver, the animals were separated into three groups: Group A, ethanol injection during relaparotomy; group B, physiological saline injection during relaparotomy; and group C, relaparotomy alone without ethanol injection. Twenty minutes after these procedures, the tumor was surgically removed and histologically examined. The incidence of vascular permeation of liver tumor cells into the hepatic vein was significantly higher in groups A and B (P < 0.05). On the 10th day after relaparotomy, the number of metastatic nodules in the lungs was significantly increased in groups A and B, compared to the findings in group C (P < 0.05). Regarding the survival time of rats after relaparotomy, there was no statistically significant difference among the three groups. These results are taken to mean that ethanol injection into a tumor may enhance metastasis. © 1993 Wiley‐Liss, Inc.
Malignant pleural mesothelioma: A clinicopathological study
Authors: Qua Josefino C. , Rao UMA N. M. , Takita Hiroshi
Published: February 2007

In this paper the results of a retrospective review of 58 patients with malignant pleural mesothelioma treated at our Institute are reported. There were 50 males and 8 females; the mean age was 56.3 years (range: 13–77). History of asbestos exposure was ascertained in 25 patients (43%). The most common finding in chest X‐ray was pleural effusion which was seen in 47/58 patients on presentation. The cytological examination of pleural effusion was most of the time nondiagnostic. Pleural biopsy was needed for the correct diagnosis. Pathologically, 26 patients (44.8%) had epithelial type, 24 patients (41.4%) had mixed type, and 8 patients (13.8%) had fibrous or sarcomatous type of pleural mesothelioma. Most of the patients on presentation had Stage I disease by Butchart's classification. The overall survival time ranged from 1 month to as long as 17 years with a median of 12.5 months. The mean survival of patients who received nonsurgical therapies was 7–13.4 months. Thirteen patients were treated surgically: three patients survived over 5 years, but the median survival was 15 months. Six patients received no treatment, and the median survival was seven months. © 1993 Wiley‐Liss, Inc.
Flow cytometric DNA analysis does not predict the radiochemoresponsiveness of esophageal cancer
Authors: Segalin Andrea , Ruol Alberto , Panozzo Marina , Bonavina Luigi , Bianchi Luigi Chieco , Peracchia Alberto
Published: February 2007

The relationship between the DNA pattern and the responsiveness to chemotherapy or chemoradiotherapy has been evaluated in 30 patients with squamous cell carcinoma of the esophagus. In 24 patients polychemotherapy with cisplatin (100 mg/m2 on day 1) and 5‐fluorouracil (1,000 mg/m2/ 24 h, continuous infusion of 120 h) every 3 weeks, was performed. Six other patients received chemoradiotherapy with cisplatin 80 mg/m2 on day 1 and 18.5 Gy (split course). Before treatment, at least three endoscopic biopsies were taken from each tumor and frozen at −85°C. Five patients were excluded from the evaluation, three because of interrupted treatment and two due to unsuitable biopsy material obtained endoscopically. The response rate to the cytoreductive treatment was 40% (10/25). DNA content was analyzed with flow cytometry. Out of 25 evaluable patients, a diploid and aneuploid tumor was present in 8 (32.0%) and 17 (68.0%) patients, respectively. According to the DNA pattern, a major response was observed in 4 of 8 patients with a diploid tumor and in 6 of 17 patients with an aneuploid tumor (P = 0.5). No relationship between the percentage of cells in the S‐phase and the response to the cytoreductive treatment was evident. Although a slightly higher percentage of major responses was found in euploid tumors, there is no evidence that flow‐cytometric DNA analysis can be helpful in the selection of patients for chemotherapy or chemoradiotherapy.© 1993 Wiley‐Liss, Inc.
Prediction of outcome in “Resectable” esophageal carcinoma
Authors: Sariego Joaquin , Mosher Steven , Byrd Michael , Matsumoto Teruo , Kerstein Morris
Published: February 2007

A retrospective review was performed of 51 patients with esophageal carcinoma, deemed “resectable” by preoperative workup (e.g., CT scan, barium swallow), who presented to Hahnemann University Hospital between 1980 and 1991. This represented 21.8% of the total number of patients (234) with esophageal cancer who presented during that time period. At exploration, only 21 of the 51 patients (41%, or 9% overall) were truly resectable; 59% had more extensive disease than was appreciated preoperatively and that precluded resection for cure. Of the 21 patients resected for cure, 24% were alive at two years and only 5% were alive at 3 years. Neither age, gender, tumor type nor location in the esophagus significantly affected overall survival. Furthermore, none of these parameters, taken as independent variables, were able to predict true resectability at the time of operation. © 1993 Wiley‐Liss, Inc.

We conclude that preoperative assessment of resectability, even in those patients who appear to be good candidates for cure, remains imprecise at best. Given an operative mortality rate of 6–8% (in most series) and an overall 3‐ to 5‐year survival rate of less than 10% (even in patients thought to have had curative resections), we reinforce the fact that meticulous patient selection and multimodality management strategies remain the keys to making any impact on this disease. © 1993 Wiley‐Liss, Inc.