bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between age and the time of surgery and prognosis after gastrectomy for gastric cancer
Authors: Moriguchi Sunao , Maehara Yoshihiko , Korenaga Daisuke , Sugimachi Keizo , Nose Yoshiaki
Published: February 2007

We did a retrospective study to assess the influence of age on the prognosis in 1,537 patients with gastric cancer and who underwent gastrectomy. The patients were classified into 7 groups by age at the time of surgery, and the relative survival rates were calculated after correcting for each patient's sex, age, and the operative calendar year, based on the life table data for the general Japanese population. The overall prognoses in patients under age 30 and over age 80 years were poor (for ages under 30 years, 30–39, 40–49, 50–59, 60–69, 70–79, and over 80 years, the 5‐year survival rates were 32.1%, 55.9%, 54.8%, 54.3%, 48.6%, 50.8%, and 31.5%, respectively). The poor prognoses in the youngest patients could be attributed to a high frequency of aggressive stage of the tumor. After curative gastrectomy, although the prognoses were excellent for every category in the first and second postoperative year, patients over age 80 years had a relatively poor prognosis after the third postoperative check‐up. The poor prognoses in the oldest patients were attributed to the number of deaths due to other diseases. We conclude that for the very young or old subjects, age is a significant prognostic factor for those treated by gastrectomy for gastric cancer. © 1993 Wiley‐Liss, Inc.
Preimmunization of mice with formalinized extracellular antigens of melanoma in combination with IL‐2 and surgical resection increased survival and tumor control in metastatic melanoma model
Authors: Shrayer David , Koness James , Kouttab Nichola , Bogaars Hendrix , Hearing Vincent J. , Gersten Douglas M. , Maizel Abby , Wanebo Harold
Published: February 2007

Recently we found that immunization with formalinized extracellular antigens (FECAs) could induce the production of specific antimelanoma antibodies and increase the defense mechanisms of antimelanoma cellular and humoral immunity. In experiments we used pathogen‐free female mice C57BL16 18‐20 g. We injected FECA (0.02 mg of protein/per S.C.— subcutaneous injection) for 1 month, once per week. Concurrently we injected S.C. human recombinant IL‐2: 100 U/g of weight (2,000 U/per mouse). Interleukin‐2 (IL‐2) was injected for 1 month, 5 daydweek. On days 7, 14, 21, and 28 we took retroorbital blood from mice for the study of anti‐FECA and anti‐IL‐2 antibody production with ELISA. Control and experimental mice were then given a subcutaneous injection with 0.5 × lo6 cells B16‐F10 melanoma in 25 p1 into the middle of the tail. By 18 days 100% developed local melanoma tumors. We resected tails of all control and experimental animals 5 mm distal the base of the tail under metaphan anesthesia. The production of antibodies to FECA and IL‐2 started after the 21st day and was higher in the group of mice immunized with FECA and with IL‐2 than in control animals. Combining preimmuni‐zation with FECA and IL‐2 and resection of local melanoma tumors decreased the mortality and the number of mice with local recurrence and metastatic melanoma tumors to the lungs. © 1993 Wiley‐Liss, Inc.
Risk of bilateral cervical lymph node metastases in papillary thyroid cancer
Authors: Noguchi Masakuni , Kinami Shinichi , Kinoshita Kazuo , Kitagawa Hirohisa , Thomas Michaei , Miyazaki Itsuo , Michigishi Takatoshi , Mizukami Yuji
Published: February 2007

We evaluated the risk of bilateral or contralateral cervical lymph node metastases in 135 patients with papillary thyroid cancer who underwent bilateral neck dissection. We confirmed that bilateral jugular lymph node metastases were frequent in patients with obvious carcinoma in both lobes of the gland, in those with cancers arising in the isthmus, in those with clinically detectable bilateral lymphadenopathy, and in those with recurrent thyroid cancer. However, only 24% of the patients who had cancer clinically confined to one lobe with no bilateral or contralateral lymphadenopathy had histologically detected bilateral or contralateral jugular lymph node metastases. But the occurrence of contralateral jugular lymph node metastases was significantly correlated with both clinical lymphadenopathy in the ipsilateral neck and contralateral paratracheal lymph node metastases. Bilateral lymph dissection might be beneficial for these patients. © 1993 Wiley‐Liss, Inc.
Changing role of splenectomy for hematologic disease
Authors: Marble Kimberly R. , Deckers Peter J. , Kern Kenneth A.
Published: February 2007

In the past decade the development of accurate imaging and the evolution of the medical management of hematologic diseases has led to changes in the indications for splenectomy for these disorders. To assess the impact of these developments, a multi‐institutional, retrospective review was undertaken. One hundred fifty‐six splenectomies were performed for hematologic disorders between July 1, 1979 and June 30, 1991. Patients were divided into 2 groups: those undergoing splenectomy from 1979–1985 (Period I), and those undergoing splenectomy from 1986–1991 (Period 11). Diseases were classified into 3 groups: cytopenic/anemic conditions, symptomatic splenomegaly, and Hodgkin's disease. Data was compared between the two periods using chi‐square analysis.

More splenectomies were performed for hematologic disorders during Period II than Period I (P < .005). This increase is secondary to a rise in the number of splenectomies performed for cytopenidanemia during Period II. In contrast, splenectomies for splenomegaly and Hodgkin's disease decreased during Period II (P < .005 and < .05). More Hodgkin's patients were upstaged on the basis of positive laparotomy findings in Period II, compared to Period I (40% versus 10%, P = .01).

Surgeons are now performing more splenectomies for cytopenic/anemic diseases, and fewer for splenomegaly and Hodgkin's disease. These results are consistent with recent trends: (1) earlier splenectomy in patients with cytopenidanemia; (2) earlier medical intervention in infiltrative splenic disorders; and (3) more reliance on radiologic staging in Hodgkin's disease and widespread use of combination chemotherapy, leaving surgical staging for those cases in which treatment would be changed by laparotomy findings. © 1993 Wiley‐Liss, Inc.
Oral cancer and human papillomaviruses: Is there a link?
Authors: Lakshmi S. , Nair S. Asha , Pillai M. Radhakrishna
Published: February 2007

Cancer of the oral cavity accounts for almost 56,000 new cases in India each year totalling almost 30% of all cancer cases in the country. Despite the numerous advances in etiology and epidemiology, the mechanisms involved in oral carcinogenesis remain obscure. Current research has provided some provocative results, suggesting an association between human papillomavirus (HPV) and development of squamous cell tumors including oral cancer. Evidence has been presented showing HPV infection of the oral mucosa and its relation to neoplastic changes. However a clear cut association as is evident in the uterine cervix is not yet available. However, considering the many similarities between oral and cervical oncogenesis, many of the HPV induced changes in the cervix may also be applicable to the oral mucosa. This paper studies the evidence for the possible role of HPV infection in oral carcinogenesis, the uterine cervix as a model for HPV mediated carcinogenesis, and tries to determine if similar mechanisms could exist in both cases. © 1993 Wiley‐Liss, Inc.
Oncocytic tumors of salivary gland type: A study with emphasis on nuclear DNA ploidy
Authors: Félix Ana , Fonseca Isabel , Soares Jorge
Published: February 2007

We studied nine cases of oncocytic tumors of salivary gland type in order to evaluate their clinico‐pathologic profiles and nuclear DNA patterns as criteria for the differential diagnosis between benign and malignant forms. The tumors were located at the parotid gland, palate, and orbit. The age of the patients ranged between 35 and 85 years and the sex ratio (F:M) was 1:0.8. Seven tumors were capsulated and typical cytology: they were composed of polyhedrical cells with large, eosinophilic, and granular cytoplasm and dark nucleus. The remaining two tumors exhibited malignancy criteria for the oncocytic tumors: atypia, pleomorphism, and mitosis. The evaluation of the nuclear DNA content was also distinct: benign tumors had a DNA diploid pattern and the malignant neoplasms displayed a DNA aneuploid pattern. These observations point to DNA nuclear assessment as an additional criterion to discriminate neoplasms with divergent clinical behavior and prognosis. © 1993 Wiley‐Liss, Inc.
Preliminary experience with a modified tenckhoff catheter for intraperitoneal chemotherapy
Authors: Nguyen Hoa N. , Averette Hervy E. , Wyble Lindsay , Sevin Bernd‐Uwe , Donato Daniel , Penalver Manuel
Published: February 2007

This study reports our preliminary experience with a modified Tenckhoff catheter for intraperitoneal chemotherapy, primarily designed to be larger, longer, and have more perfusion holes. There were 137 catheters implanted in 125 ovarian cancer patients from June 1988 to December 1990, among which 116 were actually used for intraperitoneal chemotherapy. A total of 559 cycles of intraperitoneal chemotherapy was given with a range of 1 to 16 uses per catheter. There were seven infections (6.0%), four inflow obstructions (3.4%), three bowel perforations (2.6%), and one leakage (0.8%). Among patients with catheter infection, three had delayed bowel perforation. Although the incidence of inflow obstruction was reduced from 5.5 to 3.4%, the improvement did not reach statistical significance. The frequency of delayed bowel perforation and infection were similar to the literature experience of other catheters. An unused catheter should be removed to avoid this serious complication. Further study is needed to evaluate fully the performance of this catheter system. © 1993 Wiley‐Liss, Inc.
Treatment and prognosis of primary thymic carcinoma
Authors: Yano Tokujiro , Hara Nobuyuki , Ichinose Yukito , Asoh Hiroshi , Yokoyama Hideki , Ohta Mitsuo
Published: February 2007

From 1972 to 1990, we treated eight cases of thymic carcinoma (6 squamous cell and 2 small cell carcinomas). According to the classification by Masaoka et al., they consisted of one stage I, four stage III, one stage IVa, and two stage IVb. A complete resection of the primary tumor could be done in only three patients; the others had diagnostic biopsy and then radiation treatment. Four of five patients had a prolonged regression of the primary tumors after irradiation at 40‐61.2 Gy. Six patients suffered from extrathoracic metastases. All patients received systemic chemotherapy with different regimens to counter either metastatic or locally recurrent lesions. Only two patients (with a regimen including cyclophosphamide, doxorubicin, and vincristine) obtained a partial response. The median survival of the eight patients was 70 months after surgical operation. The identification of an effective drug combination may thus improve the long‐term prognosis of thymic carcinoma since radiotherapy is able to control primary lesions, even in the case of unresectable advanced disease. © 1993 Wiley‐Liss, Inc.
Intraperitoneal cisplatin with sodium thiosulfate protection in rats with intestinal anastomoses
Authors: Wile Alan G. , Dileo Stephanie K. , Gossett Denise A. , Lao Xiao Y.
Published: February 2007

Intraperitoneal (IP) cisplatin administered at the time of intraabdominal malignancies such as gastric cancer may prevent or delay intraabdominal recurrence. Perioperative IP cisplatin raises concerns regarding systemic toxicity and retardation of wound healing. Systemic cisplatin toxicity may be reduced by administering its antidote, sodium thiosulfate (STS). A preclinical study of IP cisplatin in rats undergoing a small intestinal anastomosis was carried out. All animals that had received only cisplatin died in the postoperative period as a consequence of cisplating toxicity. Tensile strength of the intestinal anastomoses was determined on the tenth postoperative day in the surviving animals. Animals that had received intravenous (IV) cisplatin with STS had significantly lower tensile strengths than both those receiving IP cisplatin with STS and STS alone. This study demonstrates the safety of perioperative cisplatin with STS protection by the avoidance of systemic toxicity and minimizing the cisplatin‐related retardation of wound healing. © 1993 Wiley‐Liss, Inc.
Evaluation of the current incidence of nodal metastasis from prostate cancer
Authors: Bundrick W. Stewart , Culkin Daniel J. , Mata John A. , Zitman Rogeri I. , Venable Dennis D.
Published: February 2007

To determine the influences of transrectal ultrasonography, prostate‐specific antigen (PSA), and heightened public awarencess of prostate cancer stage at diagnosis, we prospectively evaluated our most recent 173 patients who had a pelvic lymphadenectomy from 1987 to 1991. All patients had clinically localized prostate cancer and underwent bilateral limited pelvic lymph node dissections (N = 173); 19 (10.7%) were found to have nodal metastasis. Pathologic tumor stage and grade information was available for 168 patients who had a simultaneous radical prostatectomy. Clinical T‐stage data revealed that only one patient had a T3 lesion. Pathologic T stage showed 7.1% to be T1a (12/168), 4.1% to be T1b (7/168), 13.7% to be T2a (23/168), 34.5% to be T2b (58/168), and 40.5% to be T3 lesions (68/168). Metastatic nodal involvement was not seen in any T1a, T1b, or T2a lesions. A Gleason's score of less than 5 lesions was predictive of no nodal metastasis. The clinical stage was upstaged pathologically in none of the T1a, 16.7% of the clinical T1b, 75% of the T2a, and 73% of the T2b, lesions. With regard to serum PSA, 27% of those patients with a level > 20 ng/ml had nodal metastasis (6/22) in this series. Although an elevated PSA was not predictive of tumor nodal metastasis, no patient with a normal PSA had nodal metastasis. Although the distribution of pathologic T stages is similar to that reported in the literature, our low incidence of nodal metastasis may suggest that prostate cancer is being diagnosed earlier. © 1993 Wiley‐Liss, Inc.
Resection margin in patients with gastric cancer associated with esophageal invasion: Clinicopathological study
Authors: Yokota Takashi , Sawai Kiyoshi , Yamaguchi Toshiharu , Taniguchi Hiroki , Shimada Shinya , Yoneyama Chihiro , Takahashi Toshio
Published: February 2007

We investigated the correlations between resection margin involvement by carcinoma and a number of clinicopathological features in patients with gastric cancer and esophageal invasion. From January 1968 to December 1988, 1,040 patients with carcinoma of the stomach underwent gastric resection. Thirty‐nine patients had tumor infiltration of the esophagus on histological examination of the resected specimens. The patients were divided into two groups on microscopic examination: those in whom the resection margin was less than 5 mm wide, and those in whom it exceeded 5 mm microscopically. There were 6 and 33 patients in the narrow and wide margin groups, respectively. There were statistically significant differences in tumor size, depth of cancer invasion, and macroscopic appearance between the two groups. The risk of resection margin involvement was high in tumors with the following features: large Borrmann type 4 tumor (macroscopic appearance and size) and infiltrative carcinoma (depth of invasion). © 1993 Wiley‐Liss, Inc.
Limb‐sparing treatment with surgery and intraoperative radiotherapy (IORT) for a second local recurrence of myxoid liposarcoma in the popliteal region, after previous surgery and high‐dose radiation
Authors: Wijffels Robbert T. M. , Mehta Dinesh M. , Spauwen Paul H. M. , Hoekstra Harald J.
Published: February 2007

A 46‐year‐old man with a second local recurrence of a myxoid liposarcoma in the fossa poplitea, after surgery and high‐dose external beam radiotherapy, was successfully treated by a limb‐sparing procedure combining marginal excision, intraoperative radiotherapy and reconstructive surgery. After a 48‐month follow‐up, there was no evidence of disease, and the function of the leg and knee was normal. © 1993 Wiley‐Liss, Inc.
A profile of serum CA 15‐3, carcinoembryonic antigen, alkaline phosphatase, and γ‐glutamyl transferase levels in patients with breast cancer
Authors: Buamah Paul K. , Bent Daniel J. , Bodger William A. H. , Skillen Andrew W.
Published: February 2007

The CA 15‐3 and CEA concentrations and the alkaline phosphatase (ALP) and ‐γ‐glutamyl transferase (Gamma GT) activities of serum from 78 patients with breast cancer have been measured. The patients included 27 with localised breast cancer, 19 who had been treated for breast cancer but were now disease‐free, 17 with liver metastases, 8 with bone metastases, and 7 with disseminated breast cancer but with neither metastases to the liver or bone. As an indicator of localised breast cancer the predictive value of an increase in CA 15‐3 concentration was 93%. As an indicator of metastatic breast cancer the predictive value of an increased CA 15‐3 was 62%, whereas the predictive values of an increase in both CA 15‐3 and CEA and an increase in CA 15‐3, CEA, and ALP 88% and 100%, respectively. A normal CA 15‐3 excluded metastatic breast cancer and a normal γ‐GT excluded liver metastases. The four tests together provide a set of markers for use in the follow‐up of patients with breast cancer. © 1993 Wiley‐Liss, Inc.
Quantitative analysis of DNA topoisomerase I activity in human and rat glioma: Characterization and mechanism of resistance to antitopoisomerase chemical, camptothecin‐11
Authors: Matsumoto Yoshihito , Fujiwara Takashi , Honjo Yasumasa , Sasaoka Noboru , Tsuchida Takahiro , Nagao Seigo
Published: February 2007

Camptothecin‐11 (CPT‐11) is a new derivative of camptothecin, a plant alkaloid antitumor agent. Previous studies indicated that antitumor activity of CPT‐11 was mediated through interaction of the drugs with its target enzyme, DNA topoisomerase I (topo I). In this study, we studied the relation between sensitivity to CPT–11 and topo I activity of glioma cells. Furthermore, we established CPT‐11 resistant cell lines in order to elucidate the potential mechanisms of drug resistance. A clear correlation between the sensitivities to CPT‐11 and topo I activities in surgical glioma specimens was demonstrated. Activities of topo I in the CPT‐11‐sensitive group (IC50 values for CPT‐11; <50 μg/ml) tended to be higher than those in the CPT‐11‐resistant group (IC50 values, ≥50). Topo I activity may serve as a novel marker to predict the sensitivity of gliomas to topo inhibitors. CPT‐11‐resistant cell lines (T98G/CPT‐11 and C6), respectively, exhibit a 5.4‐ and 7.3‐fold increase in resistance to CPT‐11. No differences in topo I activity and intracellular accumulation of CPT‐11 were observed between the parent and CPT‐11‐resistant lines. On the other hand, topo I from T98G/CPT‐11 and C6‐CPT‐11 cells was at least 4‐ and 2‐fold resistant to the inhibitory effect of the CPT‐11 on the relaxation activity of topo I, in comparison with their parent lines. This enzymological difference may be responsible for the resistance to CPT‐11. © 1993 Wiley‐Liss, Inc.
An animal model for in vivo evaluation of tumor glycolytic rates with positron emission tomography
Authors: Hawkins Randall A. , Choi Yong , Scates Steven , Rege Sheila , Hoh Carl K. , Glaspy John , Phelps Michael E.
Published: February 2007

We developed a method for evaluating tumor glycolytic rates in vivo with nude mice injected with 2‐[F‐18]fluoro‐2‐deoxy‐d‐glucose (FDG) and a dedicated animal positron emission tomography (PET) scanner. Animals were injected with NR‐6 mouse fibroblast tumor cell lines. When tumors achieved a large enough size to be macroscopically visible, quantitative measurements of FDG uptake in vivo were obtained, using both standard nonlinear regression with the FDG tracer kinetic model to generate estimates of model parameters, including KNLR, the rate constant for net phosphorylation of FDG. Additionally, we determined the values of KPAT, the rate constant for net phosphorylation of FDG measured with a non‐iterative graphical method. Estimates of K were highly correlated (r = 0.95) with both methods, and parametric images of KPAT demonstrate both the tumor location and size, but are also scaled in units of phosphorylation of FDG. The method is suitable for serial studies of tumor glucose metabolism during and after therapeutic interventions, such as chemotherapeutic trials. © 1993 Wiley‐Liss, Inc.
The spleen can influence the metastasis of AH130 hepatoma cells in rats
Authors: Toyonaca Masakazu , Hiraoka Takehisa , Tanaka Hideaki , Miyauchi Yoshimasa
Published: February 2007

The effect of pathophysiological conditions due to disturbance of the spleen is still unclear. We studied the effects of splenectomy in normal and methylcellulose‐induced hypersplenic rats on the development of pulmonary metastases created by intravenous injection of ascites containing AH130 hepatoma cells from male Hos‐Donryu rats. Growth of metastatic lesions in the lung was not affected by splenectomy in normal rats, but was increased by splenectomy in hypersplenic rats. Overall, there were fewer pulmonary metastases in rats with hypersplenism, but after splenectomy rats with hypersplenism had a significantly greater number of metastases than did normal rats. The metastases rate correlated somewhat with changes in the blood coagulation and T lymphocyte profile. There is a relationship between the spleen and formation of metastases in cancer. Formation of metastases in the lung was affected most by splenectomy in hypersplenism. To elucidate the mechanism by which metastases are formed in the lung under these pathologic conditions, further studies on the exact role of the spleen are required. © 1993 Wiley‐Liss, Inc.
Limb salvage surgery for locally aggressive and malignant bone tumors
Authors: Shih Lih‐Yuann , Chen Tain‐Shung , Lo Wai‐Hee
Published: February 2007

Since 1983, 77 patients have had limb salvage surgery for locally aggressive or malignant bone tumor of the limbs or pelvis. Twenty‐nine patients had locally aggressive, lesions with giant cell tumors the most prevalent, and 48 patients had malignant lesions, of which osteosarcomas predominated. Resection with a wide margin could be achieved in most of the patients. A mobile joint reconstruction was performed in 57 patients and an arthrodesis in 14 patients. At follow‐up, 14 patients have died of disease, 7 patients have survived with disease, and 56 patients (73%) have survived without disease. Local recurrences were encountered in 4 patients (5%). The overall functional results were classified as excellent in 11 patients, good in 45 patients, and fair in 9 patients. Twelve patients had poor results because of failure of the reconstruction or amputation due to complications. Twenty‐seven complications were encountered, among which infection was the most serious. Careful selection of patients and consideration of procedure chosen to reconstruct the defect are important for a successful outcome. This decision is based on a number of factors related to the tumor and the patient. Presently, major neurovascular involvement, displaced pathological fracture, inappropriate biopsy incision, extreme youth of the patient, and infection were considered to be contraindications to resection in our institution. Although various procedures promise functional restoration, the reconstructive procedure should be individualized and designed to meet the needs of the patient. © 1993 Wiley‐Liss, Inc.
Irrigation does not dislodge or destroy tumor cells adherent to the tumor bed
Authors: Sweitzer Kirby L. , Nathanson S. David , Nelson Lisa T. , Zachary Corinne
Published: February 2007

Local recurrences in the surgical bed after tumor resection may be due to residual tumor cells “dropping” into the wound. Irrigation with water is often used to remove these cells. We designed experiments to determine whether irrigation would prevent tumor recurrence.

Surgical wounds of uniform size in C57BL/6 mice were seeded with 5 × 102, 5 × 103, 5 × 104, 5 × 105, or 5 × 106 viable syngeneic B16‐F10 melanoma cells to test the hypothesis that irrigation with water would decrease local tumor recurrence. The tumor‐contaminated wounds were irrigated with distilled water or with saline (0.9% NaCl) immediately or 5, 30, 60, 120, or 240 min after seeding. Control wounds were seeded but not irrigated. The technique of irrigation was altered in a second group of experiments such that the amount of time the tumor cells were exposed to the water or saline was 5, 10, or 15 min. To determine the rapidity and durability of tumor cell attachment to host tissue, 1 × 104 viable B16‐F10 tumor cells were seeded in vitro onto freshly cut disks of syngeneic mouse dermis. The tissue was irrigated with saline or distilled water 0, 2, 5, 10, 15, 30, 60, 120, or 240 min later.

Tumor growth was observed in all the mice and neither the mechanical action of irrigation nor the hypotonic effect of distilled water changed the rate of growth. Scanning electron microscopy (SEM) demonstrated stable and firm attachment to mouse tissue within seconds of seeding with no noticeable dislodgement or cytotoxicity by either saline or water irrigation.

The data suggest that the commonly used technique of irrigating the bed of the resected tumor may not be of value in preventing local recurrences. © 1993 Wiley‐Liss, Inc.
Inadvertent spread of cancer at surgery
Authors: Fortner Joseph G.
Published: February 2007

Surgical cure requires that a given cancer be removed without inadvertent spillage of cancer cells by technical error. Potential mishaps include pressing a ligature, while tying, against a protruding tumor and cutting into it; inserting a hemostat into the tumor area to gain control of an escaped short pancreaticoduodenal artery stump which has retracted; grasping a lymph node with forceps which invariably fragments it spilling any cancer cells it may contain; and injecting local anesthesia into or adjacent to a lesion for biopsy. If the lesion is a cutaneous melanoma or other cancer the resulting pressure may force cancer cells into the lymphatic or bloodstream. Other misadventures include touching that portion of a biopsy needle which has been in the tumor and doing an intraoperative biopsy which allows blood or tissue fluid to flow out the opening from the tumor. Sensitivity to such dangers appears essential to avoiding spillage of cancer cells and obtaining maximal benefit from surgery. © 1993 Wiley‐Liss, Inc.
High‐grade retroperitoneal sarcomas: Role of an aggressive palliative approach
Authors: Shiloni Eitan , Szold Amir , White Donald E. , Freund Herbert R.
Published: February 2007

Between 1968 and 1988 we treated 41 patients with high‐grade soft tissue retroperitoneal sarcomas. Clinical, pathological, and treatment variables were analyzed retrospectively with regard to their influence on recurrence rate and mortality. The actuarial 5–year median survival for the whole group was 48 months, with 33% of the patients surviving 10 years. Gender, clinical presentation, tumor size, and histological types did not predict outcome by multivariate analysis.

Complete tumor resection was performed in 56% of the patients, but at 10 years after surgery only 10% of those patients remained disease free. Patients were classified into four groups according to the most aggressive surgical procedure employed: (1) total gross tumor resection; (2) subtotal resection, in which the major tumor bulk was excised (often with adjacent organs), but in which obvious residual disease remained; (3) palliative resection, in which minimal tumor resection was performed in order to alleviate symptoms; and (4) exploration only. Patients who were either explored and had no tumor removed or who underwent a palliative resection had a similarly poor prognosis, with a median survival of 12 and 20 months, respectively. To our surprise, patients after total resection had no survival benefit over patients who had undergone subtotal resection. However, both groups together had a significantly longer median survival of 241 months compared to the median survival of the patients with either no resection or only palliative resection (P < 0.02). The addition of chemotherapy or radiation therapy failed to show any advantage in this series. We claim from our experience that the impossibility of performing a complete resection should not prevent attempts at aggressive subtotal tumor excision, including the removal of adjacent organs, since this aggressive surgical approach may prolong survival significantly. © 1993 Wiley‐Liss, Inc.
Intratumoral administration of neocarzinostatin conjugated to monoclonal antibody A7 in a model of pancreatic cancer
Authors: Otsuji Eigo , Yamaguchi Toshiharu , Yamaoka Nobuki , Kitamura Kazuya , Yamaguchi Nozomi , Takahashi Toshio
Published: February 2007

We investigated the following in athymic nude mice with xenografts of a human pancreatic carcinoma: 1) clearance of the murine monoclonal antibody A7 from the carcinoma; and 2) the antitumor effect of neocarzinostatin conjugated to MAb A7 (A7‐NCS) on the carcinoma following intratumoral injection. Compared with 125I‐labeled normal mouse IgG, a significantly larger amount of 125I‐labeled A7 remained in the tumor after intratumoral injection. Neocarzinostatin conjugated to MAb A7 showed a greater antitumor activity against human pancreatic cancer than neocarzinostatin alone after intratumoral administration. The conjugate completely suppressed tumor growth macroscopically during the experiment. Tumor tissue in mice became necrotic 32 days after injection with A7‐NCS. These observations suggest that the intratumoral injection of A7‐NCS offers promise in treating pancreatic carcinoma. © 1993 Wiley‐Liss, Inc.
Immunohistochemical study of estrogen receptor and estradiol on papillary thyroid carcinoma in young patients
Authors: Inoue Hiroyuki , Oshimo Kazushi , Miki Hitoshi , Kawano Muneo , Komaki Kansei , Monden Yasumasa , Morimoto Tadaoki , Tsuyuguchi Masaru
Published: February 2007

We have immunohistochemically examined estrogen receptors (ER) and estradiol (E2) on papillary thyroid carcinoma in young femalesunderthe age of 25 years. The 10 young females in this study were compared with 64 females 30 years of age or older who underwent surgery for treatment of papillary thyroid carcinoma. We did not find any significant difference in the incidences of positive staining for E2 between the two groups. Of the specimens obtained from the young patients, 80% (8/10) showed positive staining for ER; this was significantly higher (P <0.01) than that observed in patients 30 years of age or older (25%). We think that, especially in youth, estrogen may play an important role as a promoting factor. This indication needs further study. © 1993 Wiley‐Liss, Inc.
Pulmonary metastases from adrenal cortical carcinoma: Results of resection
Authors: Kwauk Sam , Burt Michael
Published: February 2007

Adrenal cortical carcinoma is uncommon. There is little controversy concerning treatment of the primary tumor. However, data concerning the treatment of pulmonary metastases are sparse. In order to assess the results of therapy, we reviewed our 14‐year experience. Records of 24 patients admitted to our institution from 1973 to 1991 with the diagnosis of adrenal cortical carcinoma and pulmonary metastases were reviewed. Ten patients underwent pulmonary resection, 12 received chemotherapy, and 2 no therapy. In the pulmonary resection group, treatment consisted of wedge resection in 8 patients and lobectomy in 2. For the 10 patients undergoing resection of their pulmonary metastases, the 5‐year survival was 71% (median not reached at 5 years). This was significantly longer than those not resected, with no one alive at 3 years (median survival 11 months). Our data suggest that those patients who are able to have their pulmonary metastases resected survive significantly longer than those who do not. © 1993 Wiley‐Liss, Inc.
En bloc resection for cancer of the gastric cardia without thoracotomy
Authors: Tanigawa Nobuhiko , Shimomatsuya Takumi , Horiuchi Tetsuya , Masuda Yasuhiko , Ihaya Akio , Chiba Yukio , Muraoka Ryusuke
Published: February 2007

Thirty‐five consecutive patients underwent en bloc resection of cardia cancer without thoracotomy. All tumors were adenocarcinoma. The operative procedure involved wide resection of the peri‐hiatal diaphragm, dissection of the upper abdominal and lower mediastinal lymph nodes, and resection of the stomach including a portion of the lower thoracic esophagus without thoracotomy. The resection area of the diaphragm included not only the crural muscle as in other methods, but also the diaphragmatic tissue surrounding the esophageal hiatus. Through the enlarged hiatus, dissection of the mediastinum was possible up to the carina from the abdominal cavity. The mediastinal node stations were affected in 25% of patients whose tumor invaded to the serosa. Hypotension with or without atrial arrythmias and pleural tears occurred during surgery in 20 patients (57%) and in 18 patients (51%), respectively. Postoperatively, hypoxia requiring reintubation developed in 7 patients (19%), pleural effusions needed tube drainage in 16 patients (46%), atelectasis in 5 patients (14%), and anastomotic leaks in 3 patients (9%). They were all successfully treated. The cumulative 5‐year survival rate for 21 patients with stages I (2 patients), II (9), and III (10) diseases was 62%, whereas none of the patients with stage IV disease lived for more than 2 years after surgery. Because thoracotomy is avoided, the procedure is better tolerated by debilitated patients. We believe this technique is a reasonable and safe alternative to the left thoracotomy approach for resection of cancer of the gastric cardia. © 1993 Wiley‐Liss, Inc.
Esophagogastrectomy: Reoperation for complications
Authors: Matory Yvedt L. , Burt Michael
Published: February 2007

From 1961 to 1991, a total of 1,452 esophagectomies were performed for esophageal cancer at Memorial Sloan‐Kettering Cancer Center. Of these patients, 40 (2.7%) developed complications requiring a second operation during the same hospitalization. The majority of the carcinomas were located in the midesophagus or the gastroesophageal junction. The pathologic diagnosis was squamous cell carcinoma in two‐thirds of the patients. Few comorbid factors could be identified. Twenty‐nine patients (72%) had a standard Ivor‐Lewis resection, 5 (12%) had a transhiatal resection, 5 (12%) had a transabdominal approach, and 1 (3%) had a cervical approach only. Complications requiring reoperation were the following: respiratory failure in 13 patients, anastomotic leak in 6, bowel obstruction in 5, major bleeding in 4, wound dehiscence in 4, tracheo‐esophageal fistula in 3, feeding tube malposition in 2, empyema in 1, chyle leak in 1, a positive margin in 1. Twelve of these same patients had a persistent or second complication and required a third operation. Among the 40 patients in this study, the mortality was 40%. © 1993 Wiley‐Liss, Inc.
Acute appendicitis is rarely the initial presentation of cecal cancer in the elderly patient
Authors: Bizer Lawrence S.
Published: February 2007

Acute appendicitis is rarely the initial presentation of carcinoma of the cecum in elderly patients. A 20‐year retrospective review of all patients 65 years of age or older presenting with proven acute appendicitis at the Montefiore Medical Center confirms this opinion. In only 1.8% of patients was acute appendicitis the initial presentation of an underlying carcinoma of the cecum. © 1993 Wiley‐Liss, Inc.
Monoclonal antibody KP 16D3 as a prognostic marker in stage I lung adenocarcinoma
Authors: Suehiro Taketoshi , Ishida Teruyoshi , Sugio Kenji , Sugimachi Keizo , Sueishi Katsuo
Published: February 2007

Monoclonal antibody KP16D3 recognizes a 60 kDa protein associated with mucin‐nonproducing papillary adenocarcinoma, especially that originating from nonciliated bronchiolar epithelial cells of the lung. We immunohistochemically examined 56 primary lung adenocarcinomas using the monoclonal antibody KP16D3. Of these tumors, 31 (55%) were positive for KP16D3 immunoreactivity. The disease‐free survival rates showed no statistical differences between KP16D3‐positive and KP16D3‐negative patients. However, in stage I and T1 disease, the disease‐free survival rates of KP16D3‐positive patients were statistically lower than those of KP16D3‐negative patients (P < 0.05). These findings suggest that KP16D3 may be useful as a prognostic marker for patients with stage I primary lung adenocarcinoma. Conversely, use of this marker and subtyping of lung adenocarcinomas reflect the prognosis of the disease. © 1993 Wiley‐Liss, Inc.
Usefulness of argyrophilic nucleolar organizer staining for histologic grading of soft‐tissue sarcomas
Authors: Kuratsu Shigeyuki , Myoui Akira , Tomita Yasuhiko , Naka Norifumi , Uchida Atsumasa , Ono Keiro , Aozasa Katsuyuki
Published: February 2007

Accurate histologic grading is essential for making a proper therapy decision in soft‐tissue sarcomas (STS). The usefulness of the argyrophilic stain for nucleolar organizer region (AgNOR) in assessing the histologic grade of STS has been examined. One hundred and forty‐two patients with STS confined to the extremity and trunk were selected. Tumors were classified based on the criteria of Enzinger and Weiss [“Soft‐Tissue Tumors.” St. Louis: C.V. Mosby, 1983]. In addition, non‐specific classification was made based on the shape of proliferating cells occupying more than 50% of the field in the sections such as pleomorphic cell, small round cell, spindle cell, epithelioid cell, myxoid, and unclassified tumors. The mean number of AgNOR dots per nucleus of tumor cells was calculated in 200 cells (AgNOR count). Each category of non‐specific classification was divided into a high‐count group (<8 AgNOR count) and a low‐count group (>8 NOR). The low‐count group showed a significantly better prognosis than the high‐count group in small round cell and spindle cell tumors (P< 0.007 and P< 0.0005, respectively). Similar results were obtained in pleomorphic cell tumors, though they were statistically not significant because of the relatively small number of examined cases. Most patients with epithelioid cell and myxoid tumors were in the low‐count group. These findings suggest that the assessment of histologic grading of STS could be made effectively by the non‐specific classification and the aid of AgNOR Staining. © 1993 Wiley‐Liss, Inc.
Renal cell carcinoma: The size variable
Authors: Frank Walter , Cuinan Patrick , Stuhldreher David , Saffrin Robert , Ray Paul , Rubenstein Marvin
Published: February 2007

Three hundred and thirty‐seven renal cell carcinomas treated at University of Illinois Affiliated Hospitals were reviewed. There was an inverse correlation between tumor size and survival. © 1993 Wiley‐Liss, Inc.
Expression of cellular oncogenes in human gastric carcinoma: c‐myc, c–erb B2′ and c‐Ha‐ras
Authors: Kim Young‐Jin , Ghu Hoi–dong , Kim Dong‐Yi , Kim Hyun‐Jong , Kim Shin‐Kon , Park Chang‐soo
Published: February 2007

Expression of oncogenes in gastric cancer tissue was evaluated with immu‐nohistochemical staining methods using monoclonal antibodies to products of the oncogenes. Rates of expression in gastric cancer tissue were 50% for c‐myc, 72% for c‐erb B2, and 56% for c‐Ha‐ras oncogenes. Expression of these oncogenes in gastric cancer was not correlated with the histologic differentiation. The c‐Ha‐ras oncogene was positive in 19 of 26 cases with lymph node and/or distant metastasis: the positive rate was significantly higher than in cases without metastasis. Results suggest that c‐Ha‐ras oncogene is related to the prognosis of gastric cancer. The rate of expression of c‐myc and c‐Ha‐ras oncogenes in gastric cancer tissues was higher in the DNA aneuploid group than in the DNA diploid group. Expression of c‐myc and c−Ha−ras oncogenes correlated with other prognostic factors such as DNA ploidy pattern and metastasis. These oncogenes can be used to evaluate prognosis of gastric cancer patients. © 1993 Wiley‐Liss, Inc.
Malignant melanoma of the perineum
Authors: Johnson Amy , Mathai George , Robinson William A.
Published: February 2007

We conducted a retrospective review of the medical records of 18 patients diagnosed at the University of Colorado with perineal melanoma. Clinical characteristics including Clark's level, recurrence, and survival were studied. Ten patients (55.6%) had vulvar melanoma, 2 patients (11.1%) had vaginal disease, and the remaining 6 patients (33.3%) had primary rectal melanoma. All patients were treated surgically at the time of diagnosis. At a median follow‐up of 32.7 months, 15 patients had evidence of recurrence. Nine of these patients are dead and six are alive with disease. The average time to recurrence was 14 months and the most common site was the regional lymph nodes in 10 of the 14 patients (71.4%). This study confirms the poor prognosis in perineal melanoma and the only effective treatment to date is early diagnosis and complete resection. © 1993 Wiley‐Liss, Inc.
Carotid body tumors
Authors: Sanghvi Vikram D. , Chandawarkar Rajiv Y.
Published: February 2007

A retrospective study of 20 patients treated at the Tata Memorial Hospital over a period of 50 years, 1941–1991, is presented. Seventy‐five percent (15/20) of the patients presented before their fifth decade with a male‐to‐female ratio of 2:1. The commonest presenting symptom was a painless lump in the neck. Twenty‐five percent (5/20) had an incisional biopsy done elsewhere prior to referral to our institute. We performed a subadventitial excision of the tumor in 17 patients, 3 of whom were given postoperative radiation therapy. Three patients underwent complete excision of the carotid system without a vascular replacement, one of whom developed hemiparesis secondary to a cerebral infarct. There was no operative/ postoperative mortality. Cranial nerve palsy was seen in 45% (9/20) of patients; the hypoglossal nerve was most commonly affected. One patient had a recurrence, 6 years after surgery, whereas 60% of patients operated on before 1987 have completed a 5‐year disease free survival. Forty percent of patients have yet to have a 5‐year follow‐up period. Reports of newer diagnostic and therapeutic modalities are discussed. © 1993 Wiley‐Liss, Inc.
Pancreatic ductal cell carcinoma producing pancreatic elastase 1
Authors: Iwase Kazuhiro , Miyata Masahiko , Yamaguchi Tokio , Kawaguchi Takanobu , Tanaka Yasuhiro , Matsuda Hikaru
Published: February 2007

The elevation of plasma pancreatic elastase 1 in patients with pancreatic cancer is caused by concomitant pancreatitis. There is no report that pancreatic ductal cell carcinoma tissue itself produced elastase 1. A 54‐year‐old woman underwent total pancreatectomy for pancreatic ductal cell carcinoma. Her plasma elastase 1 level subsequently decreased from the preoperative value of 406 ng/dl to values ranging between 96 ng/dl and 119 ng/dl, until 6 months after the operation, when it began to increase gradually to a maximum of 300 ng/dl in association with local recurrence and hepatic metastasis. Immunohistochemical staining of elastase 1 was positive in the primary tumor resected at operation as well as in the locally recurrent and hepatic metastatic tumors obtained at autopsy. These findings suggested that elastase 1 was produced by the tumor cells in this patient. This is the first case in which pancreatic ductal cell carcinoma cells produced elastase 1. © 1993 Wiley‐Liss, Inc.
Enteroenteric intussusception due to a metastatic malignant fibrous histiocytoma
Authors: Gorman Robert C. , Jardines Lori , Brooks John J. , Daly John M.
Published: February 2007

Intussusception secondary to metastatic sarcoma is an unusual cause of small bowel obstruction. When a patient who has no history of a previous laparotomy, and has a known malignancy which metastasized hematoge‐nously, presents with small bowel obstruction, the diagnosis of intussusception should be considered. The patient should be evaluated and treated accordingly. © 1993 Wiley‐Liss, Inc.
Growth inhibition of human gastrointestinal cancer xenograft lines by treatment with CPT‐11 and VP‐16
Authors: Nagai Satoshi , Yamauchi Masaji , Satta Tetsuya , Kodera Yasuhiro , Kondou Ken , Akiyaya Seiji , Ito Katsuki , Takagi Hiroshi
Published: February 2007

A water‐soluble and stable camptothecin derivative, CPT‐11, was found to possess a strong antitumor activity against various murine tumors. In the present study, CPT‐11 was tested against ten human gastrointestinal cancer xenograft lines carried by nude mice. CPT‐11 was very effective against nine xenograft lines, with the exception of one xenograft. On the other hand, VP‐16 was ineffective against all these xenograft lines. Therefore, CPT‐11 is expected to be clinically more effective against gastrointestinal cancer than the topo II targeting agent. © 1993 Wiley‐Liss, Inc.
Thyroid nodules in female uremic patients on maintenance hemodialysis
Authors: Miki Hitoshi , Oshimo Kazushi , Inoue Hiroyuki , Kawano Muneo , Tanaka Katsuhiro , Komaki Kansei , Uyama Tadashi , Kawauchi Mamoru , Minakuchi Jun , Kawashima Syu , Monden Yasumasa
Published: February 2007

We investigated the incidence of thyroid nodules in female uremic patients on maintenance hemodialysis using a high‐frequency sonographic scanner. In 47 (21.0%) of the 224 female normal controls and 33 (55.0%) of the 60 female patients, thyroid nodules were detected. The difference in these incidences between controls and patients was significant. There were no differences in age, duration of hemodialysis, the level of blood urea nitrogen, parathyroid hormone or thyroid stimulating hormone between the patients with thyroid nodules and those without nodules. Although there is a correlation between uremia and the development of thyroid nodules, the details of the underlying mechanism of their association remain unclear. © 1993 Wiley‐Liss, Inc.
Tracheal tear during laryngopharyngectomy with gastric transposition
Authors: Deshmane Vinay H. , Divatia Jigeeshu V. , Dasgupta Dipankar , Hodarkar Shubha R. , Parikh Hemen K. , Parikh Deepak M. , Shah Sushila C. , Rao Raja S.
Published: February 2007

Tracheal rutpure occurred in 7 of 174 (4%) patients undergoing laryngopharyngectomy with gastric transposition. Tracheal tears were classified as proximal if they involved the upper two‐thirds of the trachea (five patients), or distal if they extended into the lower one‐third of the trachea (two patients) and their clinical features and management analyzed. Predisposing factors, including prior radiotherapy (three patients) and preoperative tracheostomy (1 patient) did not influence the site or severity of tracheal injury. Proximal tears were detected incidentally in four patients, but in one patient, manifested postoperatively with subcutaneous emphysema and pneumothorax. Distal tears manifested dramatically with a ventilatory leak. Adequate access for repair of distal tears may necessitate a right thoracotomy while proximal tears may be sutured through the cervical incision. Gastric transposition alone did not prevent air leak in two patients. Postoperative complications included prolapse of the stomach and bilateral pneumothoraces in one patient. Close interaction between the surgeon and the anesthesiologist ensured a successful outcome in six patients. There was one mortality. © 1993 Wiley‐Liss, Inc.