bluuebunny/crossref_metadata_2025 huggingface dataset:
Clear cell carcinoma of the liver with spontaneous regression of metastases
Authors: McDermott William V. , Khettry Urmila
Published: February 2007

The purpose of this report is to establish in some detail a case of spontaneous regression of metastases secondary to a clear cell hepatocellular carcinoma. A review of the hepatocellular carcinomas from this department has been previously reported, and this particular study focuses on the two lesions that have the microscopic classification referred to above. One young female patient was 23 at the time of resection of the clear cell carcinoma of the liver plus diffuse intrahepatic metastases. She has been followed carefully over the years and has been seen as recently as June 1993. At that time, studies including ultrasonic and CT scan examinations of liver were carried out, all of which were negative for any evidence of residual disease. The evidence presented in this report would seem to establish conclusively that a spontaneous regression of the metastases from a clear cell carcinoma of the liver had occurred without any medication and without any obvious alteration in diet or state of health. © 1994 Wiley‐Liss, Inc.
Flow cytometric measurement of proliferation‐associated nuclear antigen p105 and DNA content in immuno‐proliferative small intestinal disease (IPSID)
Authors: Demirer Taner , Uzunalimoglu Ozden , Anderson Tom , Koethe Susan M. , McFadden Patrick W. , Demirer Seher , Uzunalimoglu Bedri , Kucuk Omer
Published: February 2007

Immunoproliferative small intestinal disease (IPSID), most common in Mediterranean countries, is characterized by lymphomatous infiltration of the small intestine and is usually associated with the synthesis of anomalous immunoglobulin alpha heavy chains. Flow cytometric analysis of DNA content, S phase fraction, and quantitative analysis of the proliferation‐associated nuclear antigen, P105, were performed in 23 patients with IPSID to determine if they could be used as prognostic indicators in this disease. Eighteen patients had low‐grade, two had intermediate‐grade, and three had high‐grade lymphoma. Eight patients had clinical stage IE disease, 12 had stage IIE, and three had stage IIIE disease. Eleven patients survived >5 yr (good prognosis), four survived between 2–5 yr (intermediate prognosis), and eight survived 2 yr or less (poor prognosis). The S phase fraction of patients with poor prognosis was significantly higher than those with intermediate or good prognosis (P < 0.004). Flow cytometric evaluation of S phase fraction may offer important prognostic information in patients with IPSID and could be useful in the clinical management of patients with this highly variable clinical syndrome. Further studies evaluating the value of DNA flow cytometry in larger groups of patients with IPSID are warranted. © 1995 Wiley‐Liss, Inc.
Usefulness of platelet‐derived growth factor as a prognostic factor in pulmonary adenocarcinoma
Authors: Takanami Iwao , Yamamoto Yasuki , Kodaira Susumu , Imamura Tetsuo
Published: February 2007

Platelet‐derived growth factor (PDGF) in the resected pulmonary adenocarcinoma tissue of 88 patients was detected immunohistochemically by the avidin‐biotin‐peroxidase technique to determine whether or not it is a prognostic parameter. The 88 patients were divided into PDGF (‐) and PDGF (+) groups according to the stainability of the factor. The PDGF (‐) group included 39 patients and the PDGF (+) group 49. The 5‐year survival rate was 53% for the PDGF (‐) group and 17% for the PDGF (+) group (P < 0.01). These findings indicate that the stainability of PDGF can be a prognostic parameter for pulmonary adenocarcinoma. © 1995 Wiley‐Liss, Inc.
Concurrent chemotherapy (5‐fluorouracil and cisplatin) and radiation therapy for inoperable squamous cell carcinoma of the esophagus potentially followed by surgery
Authors: Tsujinaka Toshimasa , Shiozaki Hitoshi , Kido Yoshihiro , Murata Atsuo , Nishijima Jun‐Ichi , Inoue Masatoshi , Iijima Shohei , Inoue Takehiro , Mori Takesada
Published: February 2007

Twenty‐four previously untreated patients with primary inoperable squamous cell carcinoma of the esophagus showing no evidence of hematogenous metastasis were treated with concurrent chemotherapy and radiation therapy (CRT) followed by surgical resection if possible. The chemotherapy regimen consisted of 5‐fluorouracil 750 mg/m2 on days 1–4 and 21–24, and cisplatin 70 mg/m2 on days 1 and 21. Radiation therapy was administered over days 1–26 (200 cGy/day five times per week with an initial planned dose of 40 Gy). Five patients (8%) showed complete response (CR), 14 patients (58%) had partial response (PR), and 19 had good local control (CR 2, PR 17). Eleven cases (48%) underwent esophageal resection with no operative mortality. Curative resection was accomplished in eight cases (35%). Toxicities observed in CRT were leukopenia (grades 3 and 4) 38%, nausea and vomiting (grades 2 and 3) 67%, esophagitis 42%, and fever 42%. The median survival time (MST) for 11 neoadjuvant cases was 349 days (P < 0.05) compared to 212 days for palliative treatment (six cases) and 126 days for no treatment (six cases) after CRT. The MST of eight patients who received curative resection had not been reached after a 17‐month median follow‐up time. Concurrent chemotherapy with 5‐fluorouracil plus cisplatin and radiation proved to be a safe regimen yielding a satisfactory response and minimal toxicity in this particular group of patients. Extensive surgery was thus determined to be feasible after CRT and to contribute to prolonging survival. © 1995 Wiley‐Liss, Inc.
Results of surgical treatment of pulmonary metastases
Authors: Shimizu Junzo , Oda Makoto , Hayashi Yoshinobu , Morita Katsuya , Arano Yoshihiko , Matsumoto Isao , Go Tetsuhiko , Murakami Shinya , Watanabe Yoh
Published: February 2007

From 1970 to 1993, 155 thoracotomies for metastatic lung tumors were performed on 113 patients in the Department of Surgery, Kanazawa University School of Medicine. Overall 30‐day mortality amounted to 0.9% (1/113). The cumulative 3‐ and 5‐year survival rates were 39.4% and 29.1%, respectively. The overall median survival was 24 months. The 5‐year survival rate for carcinoma was 37.2% and for sarcoma it was 14.5% (P < 0.01). The other significant predictors of better long‐term survival with metastatic lung tumors were solitary lesions, disease‐free interval (DFI) > 24 months, and tumor size ≤ 20 mm in diameter. There was no significant difference in survival based on the method of pulmonary resection. Repeat thoracotomy for recurrent metastases was performed in 27 patients, whose 5‐year survival rate after the first lung resection was 35.5%. For bilateral pulmonary metastases, we recently performed simultaneous bilateral thoracotomy via median sternotomy on 25 patients and transsternal simultaneous bilateral thoracotomy on 8 patients. The latter procedure provides a wide operative field and better survival. We conclude that resection of metastatic lung tumors is safe and effective, and that repeat thoracotomy is warranted in selected patients with recurrent pulmonary metastases. © 1995 Wiley‐Liss, Inc.
Incidence and management of major urinary complications after pelvic exenteration for gynecological malignancies
Authors: Bladou Franck , Houvenaeghel Gilles , Delpéro Jean‐Robert , Guérinel Gérard
Published: February 2007

Urinary fistulae and obstruction following pelvic exenteration are frequent and life‐threatening complications. They increase the mortality and morbidity rates of large exereses performed during pelvic exenteration for gynecological cancers. From a series of 97 patients who underwent pelvic exenteration for gynecological cancers we report the incidence, risk factors, and management of major urinary complications. Eighty patients had had previous surgery and/or pelvic radiation therapy at the time of pelvic exenteration. A urinary diversion was performed in 63 patients. Major early urinary complications were: urinary fistula in seven patients and ureteral obstruction in four patients (11.3% of the patients). Ten patients had a late urinary complication: stenosis of the cutaneous ureteral meatus (five), stenosis of the ureteroileal anastomosis following ileal loop (two), and urinary fistulae (three). Cancer recurrence was found in 4 of these 10 cases. Major early urinary complications were significantly increased in patients who had received previous pelvic radiation therapy (P < 0.05) and in patients who had had an intestinal conduit for urinary diversion (P < 0.05). Reoperation was done in six of seven cases of early urinary fistula (urinary undiversion four, nephrectomy one, ureteral reimplantation one). Three of four ureteral obstructions were managed with percutaneous nephrostomy and ureteral stent.

We recommend the use of nonirradiated bowel segment for urinary diversion as transverse colon or jejunal conduit in patients who have received previous high doses of pelvic radiotherapy. For the management of urinary complications post pelvic exenteration, reoperation is required for most urinary fistula but ureteral obstructions can be managed with percutaneous nephrostomy and ureteral stent. © 1995 Wiley‐Liss, Inc.
Neural cell adhesion molecule and perineural invasion in gallbladder cancer
Authors: Seki Hitoshi , Koyama Kenji , Tanaka Jun‐Ichi , Sato Yasuhiko , Umezawa Akiko
Published: February 2007

To clarify the role of neural cell adhesion molecule (NCAM) in perineural invasion, NCAM expression was studied by immunohistochemical staining in 26 cases with gallbladder cancer. In gallbladder cancer, the incidence of perineural invasion and that of positive NCAM expression was 42% and 31%, respectively, which are less frequent than those of bile duct cancer in our previous report. Perineural invasion was observed in 88% of the patients with positive expression of NCAM and in 22% of those with negative expression. The former is similar to that of bile duct cancer but the latter is significantly lower. Eighty percent of the cancer cells that invaded the perineural space were positive for NCAM, when the primary tumor was positive for NCAM expression. Therefore, in gallbladder cancer, positive cells in NCAM expression likely invade the perineural spaces. However, the perineural invasion of negative cells in NCAM expression is not likely to occur as compared to bile duct cancer.

In conclusion, perineural invasion in gallbladder cancer is not as common as in bile duct cancer, but the role of NCAM in perineural invasion is more important in gallbladder cancer than in bile duct cancer. © 1995 Wiley‐Liss, Inc.
Effects of doxorubicin on cancer cells after two‐thirds hepatectomy in rats
Authors: Ikeda Yasuharu , Matsumata Takashi , Utsunomiya Tohru , Yamagata Motoyuki , Takenaka Kenji , Sugimachi Keizo , Karakousis Constantine P.
Published: February 2007

A rat model of liver metastases generated by intraportal injection of syngeneic tumor cells after two‐thirds hepatectomy was used to determine the optimal regional chemotherapeutic modality for early hepatic metastases. WKA rats had viable tumor cells injected directly into the portal vein after two‐thirds hepatectomy. Ten rats were used as a control; the remaining groups were given doxorubicin (4/3 mg/kg) injected directly into the hepatic artery at 24 hr, 72 hr, and 7 days (after liver regeneration) postoperatively. The mean survival period in each group was 21.0, 20.0, 20.5, and 20.7 days, respectively, compared with those treated with doxorubicin (4 mg/kg) injection at 24 hr, 72 hr, and 7 days postoperatively, with a mean survival period in each group of 20.0, 21.6, and 25.6 days, respectively. When a comparison was made with regard to the doses of doxorubicin administered, statistically significant differences in survival rates were recognized between the rats that had doxorubicin (4 mg/kg) injection 7 days postoperatively and the others (P < 0.01). Based on these findings, we believe that appropriate adjuvant chemotherapy should be given after the liver regeneration phase. © 1995 Wiley‐Liss, Inc.
Pancreatic cancer treatment in the U.S. veteran from 1987 to 1991: Effect of tumor stage on survival
Authors: Wade Terence P. , Kraybill William G. , Virgo Katherine S. , Johnson Frank E.
Published: February 2007

To assess the outcomes after pancreatic cancer treatment in a nationwide hospital system, patients treated in Department of Veterans Affairs (DVA) hospitals from 1987 to 1991 were studied by tumor stage, the most significant reported influence on survival. Tumor registrars from DVA hospitals provided information that allowed TNM staging in 598 patients, and duration of survival from treatment to death was known in 96+% of cases.

Survival was 9 months longer after 64 resections for stage I–II (localized) pancreatic cancer than after 149 other treatments (P < 0.05, ANOVA), but resection did not increase mean survival in 49 patients with stage III (lymph node metastases) disease. Twenty‐one patients with ampullary, duodenal, bile duct, or cystic cancers had a significantly increased survival at any stage. Percutaneous biliary intubation had inferior results to operative therapy at all stages, but this may be due to the selection of sicker patients for nonoperative therapies. © 1995 Wiley‐Liss, Inc.
Clinicopathologic study of patients with Borrmann type iv gastric carcinoma
Authors: Kitamura Kaoru , Beppu Richiko , Anai Hideaki , Ikejiri Koji , Yakabe Shigeru , Saku Motonori , Sugimachi Keizo
Published: February 2007

Between 1979 and 1993, 665 Japanese patients with advanced gastric cancer underwent surgery at our hospital. These patients were divided into two groups, consisting of 102 patients with Borrmann type IV carcinoma, and the remaining 563 patients with all other types of gastric carcinoma, which were then compared clinicopathologically.

In the patients with Borrmann type IV carcinoma, 77.4% of the lesions demonstrated poorly differentiated adenocarcinoma, and 99 patients were classified as Stage III or IV. The resection rate was 87.2% (89/102) with only 39 curative operations despite the fact that 70 total gastrectomies were performed. The incidence of peritoneal dissemination (29.4%) and serosal invasion (97.0%) was significantly higher in these patients. Microscopic lymph node metastasis was positive in 86.5%. The 5‐year survival rate was 23.4% in the patients with a curative operation and 5.0% in those with a noncurative operation (p < 0.01). Peritoneal dissemination was most frequently noted in the recurrence patterns.

We conclude that early detection and a curative operation are both essential to improve the prognosis of patients with Borrmann type IV gastric cancer. The addition of a potent postoperative chemotherapy regimen is also recommended. © 1995 Wiley‐Liss, Inc.
Treatment of pseudomyxoma peritonei in a geriatric patient population
Authors: Sullivan Mack H. , Sugarbaker Paul H.
Published: February 2007

Pseudomyxoma peritonei of appendiceal origin is a disease characterized by the progressive accumulation of mucus ascites within the abdomen and pelvis. Metastatic disease outside the peritoneal cavity is unusual. Gastrointestinal function is lost from external compression of stomach, small bowel, and large bowel. New surgical and regional chemotherapy treatments were used to provide palliation of two patients aged 88 and 85 years. The selection criteria and methodologies for treatment of geriatric patients with pseudomyxoma peritonei are presented. © 1995 Wiley‐Liss, Inc.
Comparison of nephrectomy and/or doxorubicin treatment in rabbit renal VX‐2 carcinoma
Authors: Gadeholt‐Göthlin Gro , Göthlin Jan H.
Published: February 2007

To compare survival after local intra‐arterial and intravenous administration of doxorubicin, VX‐2 carcinoma was implanted in one kidney of 48 rabbits. Treatments were given 9–14 days after tumor implantation. Survival after doxorubicin was significantly longer than the controls, whereas no difference was established between intra‐arterial or intravenous treatment. Overall only 9 of 32 doxorubicin‐treated rabbits were cured at autopsy after 18 months. It was assumed that circulating tumor cells from tumor implantation resulted in “primary” lung metastases. To kill circulating tumor cells intravenous doxorubicin was given immediately before implantation in 40 rabbits, followed by combinations of nephrectomy and doxorubicin. Doxorubicin without nephrectomy cured 8 of 16 rabbits, whereas doxorubicin combined with nephrectomy cured 4 of 16.

Doxorubicin improved survival in responders, but likelihood of response was limited. Nephrectomy did not improve survival, most likely due to metastatic seeding at implantation. Intravenous doxorubicin immediately before did not prevent metastatic spread in connection with tumor implantation. © 1995 Wiley‐Liss, Inc.
Diagnostic accuracy and role of fine needle aspiration cytology in management of thyroid nodules
Authors: Agrawal Shefali
Published: February 2007

The diagnostic accuracy of fine needle aspiration cytology (FNAC) was evaluated in thyroid nodules in 100 consecutive cases, who subsequently underwent thyroidectomy between the years 1989–1991. FNAC as a diagnostic test for thyroid nodules demonstrated an accuracy of 90.9%, a sensitivity of 76.5%, a specificity of 95.9% with a false positivity of 2%, false negativity of 4%, positive and negative predictive values of 86.7% and 92.2%, respectively. A correct classification of the carcinoma type on the basis of FNAC was possible only in 69% patients. As a result, FNAC is the first line of investigation in most nontoxic nodular goiters and often the only procedure necessary to obtain an accurate diagnosis. However, it is recommended only as an adjunct to clinical judgment and is not intended to replace it. © 1995 Wiley‐Liss, Inc.
Lymph node cancer of the mediastinal or hilar region with an unknown primary site
Authors: Kohdono Satoshi , Ishida Teruyoshi , Fukuyama Yasuro , Hamatake Motoharo , Takenoyama Mitsuhiro , Tateishi Masahiro , Sugimachi Keizo
Published: February 2007

We herein report three cases of lymph node cancer of the mediastinal or hilar region, in which the primary sites could not be determined in spite of performing various systemic examinations. Two cases revealed a large cell anaplastic carcinoma in the mediastinal lymph node, while the other demonstrated a small cell carcinoma in the hilar lymph node. However, based on radiographic and pathological examinations, the primary sites could not be found in either the head and neck, lung, or abdominal organs. All cases underwent surgical resections for lymph node cancer, while two patients also received adjuvant therapy. Two patients experienced recurrence soon after treatment. Despite the rarity of this disease, lymph node cancer must always be kept in mind when an enlargement of either the mediastinal or hilar lymph node is detected in patients with an unknown primary site, and a poor prognosis is generally expected. © 1995 Wiley‐Liss, Inc.
Ex vivo activated memory t‐lymphocytes as adoptive cellular therapy of human soft‐tissue sarcoma targets with potentiation by Cis‐diamminedichloroplatinum (II)
Authors: Gold Jay E. , Masters Ted R. , Bloom Norman D. , Shafir Michail K. , Klein Michael J. , Kenan Samuel , Osband Michael E.
Published: February 2007

Autolymphocyte therapy (ALT) is tumor‐specific, adoptive cellular therapy of neoplastic disease using nonspecific ex vivo activation of autologous peripheral blood lymphocytes (PBL), which are composed primarily of memory T‐cells (ALT‐cells) and are active in patients with metastatic renal cell carcinoma and melanoma. Ex vivo pretreatment of tumor target cells with certain chemotherapeutic agents can enhance susceptibility to lysis by antitumor lymphocytes. To determine if cis‐diamminedichloro‐platinum(II) (CDDP) enhances ex vivo antitumor cytotoxicity of ALT‐cells and if this lysis is mediated by T‐ and/or NK‐cells and is human leukocyte antigen (HLA)‐restricted, human soft tissue sarcoma (STS) target cells were derived from primary and metastatic surgical specimens and were incubated with and without CDDP. ALT‐cells were prepared from autologous PBL obtained prior to surgery. Primary (PSTS) and metastatic (MSTS) target cells from each group were labelled with chromium 51 (51Cr) and used as targets for ALT‐cells, CD45‐depleted ALT‐cells, CD56 (NK)‐depleted ALT‐cells, and PBL in a standard (4‐hour) and delayed (18‐hour) 51Cr) release assay. Interferon‐gamma (IFN‐γ) release was measured as an indication of antitumor effect and recognition by the noncytolytic lymphocytes in ALT‐cells. Primary tumor target cells incubated in CDDP showed enhanced lysis as measured by the 51Cr release assay compared to non‐CDDP‐treated controls. Metastatic tumor target cells showed less lysis than the primary targets, although this was enhanced by pretreating metastatic tumor targets with CDDP. Lysis of all tumor targets was significantly greater when ALT‐cells were used as the effector cells rather than PBL. Depletion of memory T‐cells abrogated ex vivo lysis. Depletion of NK cells (CD56+) affected ex vivo lysis of autologous targets during the 4‐hour but not the 18‐hour assay. Ex vivo ALT‐cell lysis and IFN‐γ release against only the autologous tumor targets confirmed tumor specificity in one patient. Restriction of ALT‐cell lysis and IFN‐γ release against HLA‐A2+ autologous and one allogeneic HLA‐A2+ STS tumor target, but not other non‐STS targets, was demonstrated in another patient. These data suggest that CDDP may help render STS susceptible to tumorspecific, immune‐mediated attack and that the combination of ALT and CDDP may lead to effective tumor‐specific chemoimmunotherapy in patients with metastatic STS. © 1995 Wiley‐Liss, Inc.
Use of ileal urinary diversion in conjunction with intraoperative radiotherapy
Authors: Slaton Joel W. , Kropp Kenneth A. , Selman Steven H. , Merrick Hollis W. , Dobelbower Ralph R.
Published: February 2007

Intraoperative radiotherapy (IORT) was introduced in the 1970s as a new modality of cancer therapy. It has been especially useful after local irradiation or surgical failure. We report on the use of IORT in 13 patients with pelvic tumors requiring urinary diversion. All 13 were managed with ileal conduits. Despite the associated problems of prior abdominal procedures (11/13 patients), prior external beam radiation to the pelvis (11/13 patients), systemic chemotherapy (4/13 patients), and prolonged operative time (> 10 hours), perioperative mortality (1/13) and morbidity rates were low. We conclude that in cases of prior colonic resection and pelvic radiation, potentially irradiated ileum can be safely used for urinary diversion. © 1995 Wiley‐Liss, Inc.
Needle localization breast biopsy: A model for multidisciplinary quality assurance
Authors: Howe J. R. , Kraybill W. G. , Monsees B. , Destouet J. , Dehner L. P. , Seib J.
Published: February 2007

As part of the quality assurance role of the Cancer Committee at Barnes Hospital, an institutional audit of Needle Localization Breast Biopsy (NLBB) was performed. Mammographic, operative, and surgical pathology reports from 370 consecutive patients at our institution undergoing both mammography and needle localization biopsy over a 34‐month interval were reviewed. Carcinoma was diagnosed pathologically in 103 patients (28%), and 27% of these proved to be noninvasive. Sixteen patients were found to have histologic or clinical involvement of the axillary nodes; no patients with Tis lesions were found to have axillary nodal involvement. Of the patients, 73% were found to have either Stage 0 or Stage I disease, and 61% with an established malignancy had mastectomy (67% of patients with invasive carcinoma, 44% of those with carcinoma‐in‐situ), whereas 39% had some form of conservation therapy (33% of patients with invasive lesions, 56% of those with carcinoma‐in‐situ). Our results have been compared with other published studies, and important clinical indicators for evaluating the results of individual centers performing NLBB are discussed. It is concluded that NLBB is a safe and effective method of biopsying nonpalpable breast lesions, which allows for the identification of early stage breast carcinomas. In the present environment of concerns about the quality of care and costs, it is the responsibility of each center performing NLBB periodically to evaluate their results with this multidisciplinary procedure and to bring about change in those areas found to be deficient. © 1995 Wiley‐Liss, Inc.
Quantitative comparison of xenotransplantation of a human soft tissue sarcoma into the subcutaneous tissue of normal, postincision, and postincision plus indomethacin‐treated nude mice
Authors: Huang Peigen , Allam Ayman , Taghian Alphonse , Ruka Wlodzimierz , Freeman Jill , Duffy Michael , Suit Herman D.
Published: February 2007

The purpose of this study was to test the hypotheses that (1) surgical wounding can enhance the xenotransplantability of a human soft tissue sarcoma (HSTS26T) into subcutaneous (s.c.) tissue of nude mice, and (2) Indomethacin may reduce the xenotransplantability of this human tumor in the surgical wounding animal model by suppressing angiogenesis. The experimental method was to employ the quantitative transplantation assays (TD50, the number of tumor cells that, on average, would be expected to induce a tumor in 50% of the recipients). After an incisional wound (1.0‐1.2 cm long) was made on the right leg of each experimental mouse, tumor cells were inoculated into the surgical wound, or into the contralateral leg at 24 and 72 hr postincision, and in another group tumor cells were inoculated into the wound at 72 hr postincision, plus daily s.c. injection of indomethacin, 2 mg/kg body weight for 8 consecutive days in a separate experiment. Nonincisional mice received the same inoculation as the control groups. The TD50s of surgically wounded groups were 3.5‐10.7 times lower than that of the control groups. Significantly lower TD50 values were found in groups of cells inoculated into the surgical wound at 72 hr postincision (P < 0.05 or P < 0.01) and into the contralateral leg at 24 hr postincision (P=0.05). No significant difference was found between the TD50 values in mice that received cells inoculated at 72 hr postincision plus indomethacin treatment, and those with no wound controls. Our conclusion is that the surgical wound can enhance the xenotransplantability of HSTS26T in nude mice. Indomethacin can decrease this enhancing effect level similar to that in no‐wound controls and may prevent tumor recurrence in a surgical wound. © 1995 Wiley‐Liss, Inc.
Influence of lipiodolization on a cirrhotic liver
Authors: Nishizaki Takashi , Takenaka Kenji , Ikeda Toshihiko , Yoshida Kisaku , Sugimachi Keizo
Published: February 2007

Lipiodolization—selective regional cancer chemotherapy using Lipiodol plus an anticancer drug (LPD)—can prolong survival time of patients with an unresectable hepatocellular carcinoma (HCC). To enhance understanding of LPD's influence on the cirrhotic liver, we carried out related studies. Forty‐three cirrhotic patients with HCC were treated with LPD (epirubicin in a dose of 15–40 mg/m2 and Lipiodol of 0.02–0.25 ml/kg). Seven cirrhotic patients with HCC were subjected to hepatic angiography alone, and these subjects selected randomly served as controls. Among the 43 treated with LPD, 23 belonged to Child's class A, 15 to class B, and 5 to class C. Blood samples were taken before angiography (pre) and at 24 hours after angiography (post) from each patient. Post/pre ratio of the following parameters were compared between patients of the two groups: sGOT, sGPT, and LDH as a marker for hepatocyte injury; t. bilirubin and hepaplastin test (HPT) as hepatocyte function; alkaline phosphatase and γ‐GTP to examine bile duct injury; and serum hyaluronic acid level to determine an endothelial cell functions. Post/pre ratio of serum GOT, GPT, LDH levels, and HPT in patients treated with vs. without LPD were 1.32 ± 0.59 vs. 0.92 ± 0.09 (P < 0.001), 1.18 ± 0.43 vs. 0.88 ± 0.09 (P < 0.001), 1.11 ± 0.20 vs. 1.00 ± 0.07 (P < 0.05), and 0.95 ± 0.10 vs. 1.09 ± 0.12 (P < 0.01), respectively. There were no significant differences in post/pre LPD ratio of other parameters, rates of complications, and hospital stay after LPD for patients with Child's class A, B, and C. Hepatocytes are apparently the primary site of injury in cases of LPD. LPDs, using epirubicin in a dose of 15–40 mg/m2 and Lipiodol in a dose of 0.02–0.25 ml/kg, proved to be safe for cirrhotic patients with HCC. © 1995 Wiley‐Liss, Inc.
Family with nonmedullary thyroid neoplasms
Authors: Kobayashi Kaoru , Tanaka Yoshiyuki , Ishiguro Shingo , Mori Tohru , Shigemasa Chiaki , Mitani Yasuo
Published: February 2007

This report concerns a family in which papillary thyroid carcinoma appeared in the father and two daughters and follicular adenoma in a granddaughter. The father died of systemic metastasis of papillary thyroid carcinoma. The two daughters and glanddaughter felt well postoperatively. We speculate that some gene‐related factors might play an important role in familial occurrence of papillary thyroid carcinoma and follicular thyroid adenoma in the family. © 1995 Wiley‐Liss, Inc.
Immunolocalization of hepatic metastases of human colonic cancer by chimeric anti‐TAG72 antibody in scid mice
Authors: Qi Yumin , Moyana Terence , Matte Gilbert , Wilkinson Alex , Bresalier Robert , Xiang Jim
Published: February 2007

TAG72 is a well‐characterized, human tumor‐associated antigen present in >85% of human colonic cancers. In this study, we established an animal model of hepatic metastases of human colonic carcinoma. The high‐mucin variant cell line, designated HM7, was derived from the human colonic carcinoma cell line LS174T. Following intrasplenic injection, HM7 was able to induce much greater hepatic metastases in SCID mice compared to its parental cell line LS174T. Numerous hepatic metastases were evident 18 days subsequent to the intrasplenic injection of tumor cells. Using the chimeric anti‐TAG72 antibody ccM4, immunohistochemistry demonstrated strong expressions of the TAG72 antigen in these metastases. Our biodistribution and imaging data also showed that the radiolabelled ccM4 antibody was able to localize hepatic metastases in the SCID mice. Based upon these findings, w anticipate that the herein described SCID mouse model will prove most useful in studying hepatic metastases of human colonic carcinoma by using anti‐TAG72 therapeutic immunoreagents.
PSA‐detected prostate cancer: Contrasts with palpable disease
Authors: Matthews Gerald J. , Fracchia John A.
Published: February 2007

The clinical and pathologic characteristics of 100 consecutive men with clinically localized prostate cancer and staged by radical prostatectomy were reviewed. Men with impalpable prostate‐specific antigen (PSA) detected cancers (T1c) were contrasted against men with palpable disease (TB). Lesions were clinically staged as T1c in 53 men and TB in 47 men. Mean serum PSA for men with T1c cancers was 11.8 ± 0.7 ng/dL (normal: 0 > 4) and 14.1 ± 1.7 ng/dL for men with TB disease. Histologic evaluation revealed a mean Gleason's sum of 6.4 ± 0.2 (scale: 2 > 10) for T1c lesions and 6.6 ± 0.2 for men with TB cancers (P = NS). DNA content was diploid in 67% of T1c cancers and 62% of TB lesions (P = NS). An overall 43% clinical staging error was observed. Extraprostatic extension was demonstrated in 36% of T1c cancers and 51% TB lesions (P = NS). PSA‐detected cancers were indistinguishable from palpable lesions by all measures evaluated. Prostate cancers detected in asymptomatic men by an elevated PSA should be considered biologically significant lesions.
Hyperthermochemoradiotherapy is effective for small cell carcinoma of the esophagus
Authors: Mimori Koshi , Mori Masaki , Kuwano Hiroyuki , Sugimachi Keizo
Published: February 2007

Esophageal small cell carcinoma is a highly aggressive disease, and no effective treatment has yet been reported. We present here two cases of esophageal small cell carcinoma preoperatively treated with a combination of hyperthermia, irradiation, and an intravenous infusion of cis‐diamminedichloroplatinum (CDDP). The first case concerned a 67‐year‐old Japanese woman. Hyperthermochemoradiotherapy (HCR) was performed before surgical treatment. A histopathologic study of the resected specimen showed no residual viable cancer cells either in the esophagus or in the dissected lymph node. The second case involved a 59‐year‐old Japanese man who received HCR therapy before surgical treatment. This patient survived for 33 months, the longest known period of survival for small cell carcinoma of the esophagus. These cases indicate that preoperative hyperthermochemoradiotherapy may be considered one promising adjuvant therapy alternative for this aggressive disease.
Malignant germ cell tumors of the ovary: A study of 20 cases
Authors: Piura Benjamin , Dgani Ram , Zalel Yaron , Nemet Dan , Yanai‐Inbar Ilana , Cohen Yoram , Glezerman Marek
Published: February 2007

In a study of 20 patients diagnosed with malignant ovarian germ cell tumors between 1961 and 1993, clinical and pathologic findings were evaluated. Of the 20 patients, seven (35%) had dysgerminoma, two (10%) endodermal sinus tumor, three (15%) malignant teratoma, one (5%) malignant struma ovarii, one (5%) primary ovarian carcinoid, two (10%) benign teratoma with malignant transformation, and four (20%) combination germ cell tumor. Twelve patients (60%) had stage IA, five (25%) stage IC, and three (15%) stage IIIC. Twelve patients (60%) underwent conservative surgery and eight (40%) had at least bilateral salpingo‐oophorectomy. At follow‐up, 18 patients (90%) were alive free of disease, one (5%) had died of disease, and one (5%) had died of intercurrent disease. The actuarial 5‐year survival rate was 93.3%. It is concluded that for young women who wish to preserve child‐bearing capacity, regardless of the stage of the tumor, fertility‐preserving surgery with complete surgical staging followed, if necessary by cisplatin‐based combination chemotherapy is an appropriate and definitive treatment in the absence of involvement of the contralateral ovary and uterus. For patients in whom child‐bearing capacity is not an issue, surgery should include total abdominal hysterectomy and bilateral salpingooophorectomy with complete staging, followed if necessary by chemotherapy.
Hyperthermic isolated regional perfusion with cisplatin in the local treatment of spontaneous canine osteosarcoma: Assessment of short‐term effects
Authors: Van Ginkel Robert J. , Hoekstra Harald J. , Meutstege Freek J. , Oosterhuis Jan W. , Uges Donald R. A. , Koops Heimen Schraffordt
Published: February 2007

To increase the effect of cisplatin on locoregional osteosarcoma, the shortterm effect of hyperthermic isolated regional perfusion (HIRP) with cisplatin (30 mg/L extremity volume) was studied in 28 dogs with spontaneous osteogenic sarcoma, using clinical, radiological, and histological parameters. Thirty days postoperatively, mortality was 14.3%. Total platinum levels at the start of perfusion were 28.2 ± 14.3 mg/L. A significant improvement (P< 0.001) in clinical score was observed in the overall group at 6 and 12 weeks after perfusion. The radiological parameter showed a stationary X‐ray 2 weeks after perfusion and an improved X‐ray 6 weeks after perfusion. Overall histological scores showed a moderate effect according to the Huvos classification. No additional therapeutic effect, according to the three parameters, could be demonstrated by increasing the perfusate temperature by 1°C. HIRP with cisplatin is feasible in the local treatment of spontaneous osteosarcoma in dogs with acceptable locoregional toxicity. However, the histological results were modest, with none of the dogs showing a complete response 6 weeks after perfusion. Therefore, the search for the ideal perfusion agent with substantial contribution to the limb‐sparing treatment in human osteosarcoma continues.
Tumor ploidy as a risk factor for disease recurrence and short survival in surgically‐treated dukes' B2 colon cancer patients
Authors: Nori Dattatreyudu , Merimsky Ofer , Samala Engracio , Saw Daisy , Cortes Engracio , Chen Ellen , Turner James W.
Published: February 2007

The risk factors for colon cancer recurrence following a curative intent surgery include the presence of metastatic disease, the tumor location and size, number of positive lymph nodes, the presence of adhesions, perforation, bowel obstruction, depth of invasion, histological grade, percentage of S‐phase content, and cell kinetic profile.

The DNA content of colon cancers in 20 Dukes' B2 patients in follow‐up evaluation at our center, who relapsed, either locally or systemically following surgical treatment was measured by image analysis. The data were pair‐matched for age, sex, tumor site, and grade with 20 Dukes' B2 patients who had no evidence of disease.

Aneuploidy occurred in 16 (80%) patients with recurrence, as compared with only in 8 (40%) in the control group. Aneuploidy was associated with significantly higher tumor recurrence rate (P = 0.024) and shorter overall survival (P 0.002).

Our data may point out a possible indication for systemic adjuvant chemotherapy in Dukes' B2 colon cancer patients who have aneuploid tumors on image analysis. This warrants further investigation in a prospective controlled randomized study.
Early experience with videothoracoscopic hydrodissection pleurectomy in the treatment of malignant pleural effusion
Authors: Harvey James C. , Erdman Christopher B. , Beattie Edward J.
Published: February 2007

Parietal pleurectomy is our preferred procedure for management of malignant pleural effusion. However, the morbidity of a major thoracotomy has precluded all but highly selected patients from the conventional (open) procedure. Recently, we have been able to perform parietal pleurectomy by means of a video‐assisted, thoracoscopic technique. We have retrospectively analyzed the results of this procedure performed on 11 patients between March 1993 and February 1995. These patients ranged in age from 40 to 87 years of age, with a mean age of 61.5 years. Primary tumors were non‐small cell lung cancer (5), breast cancer (4), mesothelioma (1), and unknown (1). There was one operative mortality (9.1%). All were relieved of symptoms of pleural effusion. Median survival was 128 days. Early experience indicates we are accomplishing an operation equivalent to that formerly performed by “open” technique. If continued results are similar to our initial experience, we will be able to offer this superior palliation of malignant pleural effusion to a wider range of patients.
Von recklinghausen's disease associated with a primary malignant schwannoma of the breast
Authors: Malas Simon , Krawitz Hedley E. , Sur Ranjan K. , Uijs Ronald R. , Nayler Simon J. , Victor Levin C.
Published: February 2007

A case of a primary malignant schwannoma of the breast is reported. This case and the review of the literature illustrate the problems of diagnosing and treating this rare malignancy.
Simultaneous occurrence of medullary carcinoma and papillary carcinoma and papillary carcinoma of the thyroid
Authors: Kobayashi Kaoru , Teramoto Seiichi , Maeta Hiroyuki , Ishiguro Shingo , Mori Tohru , Horie Yasushi
Published: February 2007

We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. Immunoreactivity of calcitonin, carcinoembryonic antigen, neuron specific enolase and thyroglobulin made a sharp distinction between both neoplasms of the thyroid. It appears reasonable to consider that simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in this case does not have embryological or genetical significance. © 1995 Wiley‐Liss, Inc.
Partial cystectomy for invasive bladder cancer
Authors: Dandekar Niteen P. , Tongaonkar Hemant B. , Dalal Amish V. , Kulkarni Jagdeesh N. , Kamat Murali R.
Published: February 2007

Thirty two patients—23 males and 9 females with a mean age of 52.5 years—underwent planned partial cystectomy for histologically proved muscle invasive bladder cancer. Twenty patients had transitional cell carcinoma and 12 had adenocarcinoma of the bladder. One patient had well‐differentiated, 18 had moderately differentiated, and 13 had poorly differentiated tumours. The tumour size was <2 cm in 7 patients, 2–4 cm in 19 patients, and >4 cm in 6 patients. Patients with single primary muscle invasive tumours situated in the upper half of the bladder were considered eligible for partial cystectomy. The presence of multicentric urothelial disease, of dysplasia, or carcinoma‐in‐situ in bladder mucosa away from the tumour on multiple random punch biopsies was considered contraindications to partial cystectomy. All patients underwent partial cystectomy with bilateral pelvic lymphadenectomy. The tumour‐free margins of resection were confirmed by intraoperative frozen section examination. The bladder was closed primarily in all patients, although three patients required re‐implantation of the ureter. No patient received adjuvant radiation or chemotherapy. Five patients had pathological stage Bl (T2), 18 had B2 (T3A), and 9 had C (T3B) disease. No patient had metastatic pelvic lymph nodes. There was one postoperative death due to unrelated medical cause. Five patients had minor complications that resolved with conservative measures. All patients had adequate bladder capacity of >250 cc at 6 months after surgery, and none had symptoms attributable to reduced bladder capacity. The overall actuarial survival was 80.1% at 5 years. The 5‐year survival for patients with stage T2 tumours was 100%, for stage T3A 88.5%, and for stage T3B 45.7% (P = 0.028). The 5‐year survival for patients with tumour size < 2 cm was 100% compared to 83. 1% for 2‐4 cm and 50% for size more than 4 cm (P = 0.078). There was no significant difference in survival for patients with transitional cell carcinoma (83.8%) and adenocarcinoma (74.1%) (P = 0.511). Patients with well‐differentiated tumours had a 5‐year survival of 100% as compared to 94.4% for moderately and 53.5% for poorly differentiated tumours (P < 0.001). Fourteen patients relapsed—12 in the bladder and 2 in the lungs without relapse in the bladder. Of the 12 patients who relapsed in the bladder, 5 had noninvasive (stage Ta/Tl) relapses and were salvaged with transurethral resection of the tumours. Seven patients had invasive tumours at relapse that were related to tumour stage and grade. Four of these could be salvaged with radical total cystectomy, where as the remaining three and the two patients with distant relapses died due to disseminated disease. © 1995 Wiley‐Liss, Inc.
Small hepatocellular carcinoma of single nodular type: A specific reference to its surrounding cancerous area undetected radiologically and macroscopically
Authors: Maeda Takashi , Takenaka Kenji , Adachi Eisuke , Matsumata Takashi , Shirabe Ken , Honda Hiroshi , Sucimachi Keizo , Tsuneyoshi Masazumi
Published: February 2007

A total of 128 surgically resected small hepatocellular carcinomas, measuring less than or equal to 3 cm in diameter, were studied by both macroscopic and histologic examinations. In 95 single nodular‐type tumors of the 128 lesions, eight tumors were associated with the cancerous areas of well differentiated hepatocellular carcinoma around the nodule. These surrounding cancerous areas went undetected by both the preoperative radiological examinations and the gross findings of resected specimens. Based on the immunohistochemical findings, the labeling index, both of the proliferating cell nuclear antigen (PCNA) and of the Ki‐67 in the surrounding cancerous areas, were lower than that of the main nodules but higher than in the nontumorous liver parenchyma in seven of eight cases. These results suggest that the main nodule was generated from the surrounding cancerous area, supporting the hypothesis of a stepwise progression of HCC. Even if the tumor seems to be a small and single nodular type, it is recommended that its surrounding areas should be closely examined and the surgical cutting margin should be made more than 1.0 cm away from the main nodule at hepatic resection. © 1995 Wiley‐Liss, Inc.
Total gastrectomy for early gastric cancer
Authors: Kitamura Kazuya , Yamaguchi Toshiharu , Okamoto Kazuma , Taniguchi Hiroki , Hagiwara Akeo , Sawai Kiyoshi , Takahashi Toshio
Published: February 2007

A total gastrectomy was performed in 49 patients with early gastric cancer, and the effectiveness of this procedure was evaluated by reviewing the hospital files of the patients. The reasons for this total gastrectomy were as follows: (1) lymph node dissection for 22 patients, (2) surgeon's choice in reconstruction for 10 patients, (3) modification of the surgery from subtotal to total gastrectomy for seven patients, (4) synchronous multiple cancers for seven patients, and (5) cancer in a stomach remnant for three patients. Of 49 patients, 42 had the cancerous lesions in the upper portion of their stomachs. Lymph node involvement occurred in 5 patients, but not in the supra‐ or infrapyloric lymph nodes. Postoperative complications such as anastomotic leakage, reflux esophagitis and pancreatic fistula occurred in five, four, and two patients, respectively. Postoperative death, including two patients who died within 30 days after the surgery, occurred in 5 patients. Our study showed that total gastrectomy resulted in excessive unnecessary surgery in 39 out of 49 patients (79.6%). We conclude that a total gastrectomy should not be performed on patients with early gastric cancer except for synchronous multiple cancers and for cancers in a stomach remnant. © 1995 Wiley‐Liss, Inc.
Acute appendicitis secondary to metastatic nasopharyngeal carcinoma
Authors: Hsu Kuan‐Long , Wang Kwo‐Syin , Chen Leung , Chou Fong‐Fu
Published: February 2007

This is a review of a rare case of acute appendicitis secondary to metastatic nasopharyngeal carcinoma (NPC) that had never before been reported in the literature. The clinical presentation did not differ from usual cases of acute appendicitis, but the pathology caused us to re‐evaluate the NPC Stage of the patient. © 1995 Wiley‐Liss, Inc.
Argyrophilic nucleolar organizer region (AgNOR) area per nucleus as a prognostic factor in breast cancer
Authors: Nakayama Kouichi , Abe Rikiya
Published: February 2007

Whether argyrophilic nucleolar organizer region (AgNOR) is a predictor of prognosis in breast cancer is controversial. The semiquantitative procedure used to calculate interphasic argyrophilic dots optically is neither reliable nor reproducible. We measured the mean area of AgNOR dots, the mean AgNOR area per nucleus (MA), and the mean AgNOR number per nucleus (MN) by automated image analysis in specimens from 131 patients with breast cancer. Higher MA (>7.41 pun2), detected in 22 (16.8%) of 131 patients, did not correlate with clinicobiologic variables, except for DNA ploidy status. Overall survival was significantly better in patients with lower MA than in those with higher MA. On multivariate analysis, MA was a significant independent factor, followed by nodal status.

These findings indicate that expression of AgNOR should be evaluated in terms of area occupied and that the mean area of AgNOR per nucleus (MA) is an important prognostic factor in the overall survival of breast cancer patients. © 1995 Wiley‐Liss, Inc.