bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of liposomal interleukin‐2 on ascites‐forming rat hepatoma
Authors: Konno Hiroyuki , Maruo Yuji , Matin A. F. , Tanaka Tatsuo , Nakamura Satoshi , Baba Shozo , Yamashita Akira , Tadakuma Takushi
Published: February 2007

Interleukin‐2 was entrapped in liposomes (Lip‐IL‐2) and injected into rats. The intraperitoneal injection of Lip‐IL‐2 into rats bearing an ascites‐forming rat hepatoma (AH‐66) significantly increased the survival time when compared with rats administered free IL‐2 or saline‐containing liposomes. The number of peritoneal excudate cells (PEC) increased markedly after intraperitoneal injection of Lip‐IL‐2 and consisted mainly of macrophages. The level of tumor necrosis factor a (TNF‐α) and the intensity of free radicals increased in the ascites at 48 hrs after Lip‐IL‐2 administration, whereas TNF‐α was not detected and the intensity of free radicals did not increase after free IL‐2 administration. Our findings suggested that entrapment of IL‐2 into liposomes enhanced its potential for cancer therapy, presumably by activating macrophages to produce TNF‐α and free radicals. © 1992 Wiley‐Liss, Inc.
The value of nuclear morphometry in the management of patients with colorectal polyps that contain invasive adenocarcinoma
Authors: Mitmaker Benjamin , Kyzer Shlomo , Begin Louis R. , Gordon Philip H.
Published: February 2007

Haggitt's classification is a useful guide in the management of patients with large bowel polyps which contain invasive adenocarcinoma in that patients with levels 1 to 3 require no operation. Nuclear morphometry has been shown to be a useful prognostic discriminant for patients with invasive carcinoma of the large bowel. The nuclear shape factor of 44 polyps with invasive carcinoma was studied to determine whether this parameter was of value to define those patients with Haggitt level 4 who should have a resection. The shape factor of 50 interphase nuclei was obtained through the use of image analysis by tracing the nuclear profiles as digitized on a video screen. The nuclear shape factor was defined as the degree of circularity of the nucleus, a perfect circle recorded as 1.0. Our previous experience showed a nuclear shape factor greater than 0.84 was associated with a poor outcome. The overall mean shape factor was 0.71 (0.59–0.85). There was a tendency for the patients with residual disease to have values in the upper range. Our findings suggest that nuclear morphometry fails to add any predictive information in this clinical situation. © 1992 Wiley‐Liss, Inc.
Late relapse and mortality in stage I large bowel cancer
Authors: Hill George J. , Ghosh Bimal C.
Published: February 2007

The outcome was determined for patients with Stage I cancers of the large bowel (colon, rectum, and anus) who were treated from 1982–1989. In 119 consecutive patients, the 5‐year survival was approximately 70% (72% by the absolute direct method; 67% by the actuarial life table method). Although the overall 5‐year survival was similar to numerous other published reports, it was disturbing to observe that 41 % of the living patients had relapsed. Furthermore, although 88/119 (67%) were alive at last report, 2–7 years after treatment, only 23 (19%) were believed to be free of cancer. We conclude that follow‐up for more than 5 years and the assessment of disease‐free survival are required to evaluate the outcome from Stage I large bowel cancer. © 1992 Wiley‐Liss, Inc.
Mullerian adenosarcoma of the uterus with sarcomatous overgrowth
Authors: Hallak Mordechai , Peipert Jeffrey F. , Heller Paul B. , Sedlacek Thomas V. , Schauer Gail M.
Published: February 2007

A case of mullerian adenosarcoma of the uterus with sarcomatous overgrowth is described. The patient was also found to have bilateral polycystic ovaries. This 25 year‐old white female presented with irregular vaginal bleeding and was diagnosed as having mullerian adenosarcoma with sarcomatous overgrowth by dilatation, curettage, and biopsy. Total abdominal hysterectomy, bilateral salpingo‐oophorectomy with lymph node sampling were performed. © 1992 Wiley‐Liss, Inc.
Hepatic resection following systemic chemotherapy for metastatic colorectal carcinoma
Authors: Fowler Wyatt C. , Eisenberg Burton L. , Hoffman John P.
Published: February 2007

Increasingly effective systemic chemotherapy has improved responses in patients with previously unresectable colorectal hepatic metastases. In the future, response to chemotherapy may define a new population of patients that may benefit from hepatic resection. A retrospective review to determine the safety and effectiveness of potentially curative hepatic resection of metastatic. colorectal carcinoma after systemic chemotherapy identified 11 such patients with resections between July 1987 and October 1991. Five patients had unresectable disease confined to the liver, two had hepatic and limited extrahepatic metastases, two had hepatic recurrences after previous hepatic metastasectomy, and two had initially resectable liver metastases. These patients were resected after a mean of 8 months of systemic chemotherapy. Complications, usually minor, occurred in five patients (45%). There were no deaths. Three patients are disease free at 15, 18, and 31 months (mean 21) after hepatic resection. Eight patients have recurred with a median time to recurrence of 8 months. Five patients have subsequently died of recurrent disease. This study suggests that hepatic resection following systemic chemotherapy can be performed safely and may benefit selected patients. © 1992 Wiley‐Liss, Inc.
Malignant melanoma in a child with oculocutaneous albinism
Authors: Levine Edward A. , Ronan Salve G. , Shirali Swati S. , Gupta Tapas K. Das , Karakousis Constantine P.
Published: February 2007

Malignant melanoma is extremely rare in patients with albinism. To date, in the English language literature, there have been only sixteen documented cases of malignant melanoma in albino patients. These cases include thirteen cutaneous, one oral, one ocular, and one anal; only one of these was in a child. Here, we present the case of the youngest known albino patient to have cutaneous malignant melanoma. © 1992 Wiley‐Liss, Inc.
Accurate specimen preparation and examination is mandatory to detect lymph nodes and avoid understaging in colorectal cancer
Authors: Crucitti Francesco , Doglietto Giovanni Battista , Bellantone Rocco , Sofo Luigi , Bossola Maurizio , Ratto Carlo , Nucera Paolo , Silvestri Evelina , Crucitti Antonio , Vecchio Fabio Maria , Dobelbower Ralph
Published: February 2007

Lymph node involvement in colorectal cancer, one of the most important prognostic factors, can be sometimes underestimated. In this study the authors report the results of two different techniques of specimen preparation and examination. In 240 patients (Group I), histologic examination was performed using a conventional procedure. In Group II (60 cases) the resected bowel and its mesentery were separately stretched, pinned on to a cork board, and fixed. The mesentery was divided according to node location (intermediate and principal) and evaluated by sight and palpation to identify lymph nodes. The bowel segment was divided from 5 cm proximally to 5 cm distally to the tumor every 10 mm in serial 3 mm slices. Three and 10 mm slices were then carefully examined by sight and palpation. Isolated lymph nodes embedded in groups (10‐12 per paraffin block) were stained and investigated for neoplastic involvement. The specimen examination procedure used in Group I1 resulted in identification of a higher number of lymph nodes (mean = 41.1) and nodal metastases (mean = 10) compared to the standard technique used in Group 1 (mean = 11.3 and 2.4, respectively—P < .05). The percentage of N+ cases also was increased in Group II (48.3%) when compared to that in Group I (30.4%; P < .05). The new technique is simple, inexpensive, and efficacious for the detection of lymphatic metastases in colorectal cancer. © 1992 Wiley‐Liss, Inc.
Proliferative activity in gastric cancer determined with cell cycle‐related monoclonal antibodies Ki‐67 and p105: Analysis by flow cytometry
Authors: Kimura Hironobu , Yonemura Yutaka , Miyazaki Itsuo
Published: February 2007

The proliferative activity of gastric cancer cells was determined by DNA flow cytometric (FCM) analysis and labeling rates of Ki‐67 and monoclonal antibodies and proliferation‐associated nuclear antigen (p105) au‐toantibodies in 28 patients with fresh human gastric cancer cells. By setting the cutoff line at the level as used in a negative control study without primary antibody in the same sample, the Ki‐67 and p105 labeling rates were calculated by the dual fluorescence analysis. A total of 43 experiments was performed on FCM analysis for each antigen: 28 with Ki‐67 and 15 with p105. The mean Ki‐67 labeling rate of gastric cancer cells was 45.1% (13.9‐76.3%). The Ki‐67 labeling rates were significantly higher for larger size tumor, peritoneal metastasis, and advanced clinical stage. A significant correlation was found between Ki‐67 labeling rate and p105 labeling rate (P < 0.05). Bivariate FCM may be an easy method for obtaining useful information of cell kinetics. © 1992 Wiley‐Liss, Inc.
Colorectal carcinoma in young patients
Authors: Marble Kimberly , Banerjee Saumitra , Greenwald Lori
Published: February 2007

Utilizing Tumor Registry records dating from 1935 to 1988, 50 patients diagnosed with colorectal adenocarincoma at the age of 40 years or younger were retrospectively studied with respect to sex, race, family history, delay in diagnosis, primary tumor location, tumor differentiation, mucin production, stage at presentation, and the effect of these factors on 5‐year survival. This younger group of patients was compared to a computer‐generated, randomly selected group of 50 patients 40 years of age or older. There was no difference with respect to sex, racial distribution, family history, symptoms at presentation, or expediency of physician diagnosis between the two groups. Younger patients waited significantly longer to seek medical attention than did their older counterparts. However, those patients who delayed presentation had no higher incidence of advanced disease than those patients who presented earlier. Younger patients had a higher incidence of poorly differentiated, advanced, rightsided tumors. This is in contrast to a predominance of well‐differentiated, less advanced, rectosigmoid lesions in the older patients. There was no age‐related difference in the incidence of mucin‐producing tumors. Overall 5‐year survival was 75% in older patients, in contrast to only 51% in younger patients (P = 0.01). We conclude in this study that it is advanced stage at presentation that is the most significant prognostic indicator in patients of all ages. The high incidence of poorly differentiated, right‐sided tumors is responsible for the majority of young patients presenting with advanced disease, resulting in their poorer prognosis. © 1992 Wiley‐Liss, Inc.
Synergistic effects of intratumor administration of cis‐diamminedichloroplatinum(II) combined with local hyperthermia in melanoma bearing mice
Authors: Kitamura Kaoru , Kuwano Hiroyuki , Matsuda Hiroyuki , Toh Yasushi , Masuda Hidetaka , Sugimachi Keizo
Published: February 2007

The synergistic effect of local hyperthermia (LHT) with intratumor injection (i.t.) of cis‐diamminedichloroplatinum (II) (DDP) was studied using a rodent model with implanted B16 melanoma tumors. The hindfoot of the C57BL/6 mouse bearing the tumor was placed in a water bath at 42.5 ± 0.2°C (intratumor temperature was at 42.3 ± 0.1°C) for 30 minutes just after local (i.t.) or systemic (intraperitoneal;i.p.) administration of DDP (1‐3 mg/kg once in experiment I and 1‐3 mg/kg three times in experiment II). The tumor growth ratio (TGR) at 7 days after treatment in the group given DDP 3 mg/kg (i.t.) with LHT was 1.1 in experiment I and 0.5 in experiment II, and there was a statistically significant difference in both experiments compared to findings in other groups (P < 0.01). The mean survival time was 42.1 days in experiment I and 50.2 days in experiment II, with a significant difference in the latter (P < 0.001). Thus regional injection chemotherapy given concomitantly with local hyperthermia promotes the anticancer effects and improves the prognosis without either severe renal injury or the promotion of hematogenic metastasis. © 1992 Wiley‐Liss, Inc.
Biological monitoring of cancer chemoprevention
Authors: Pillai Radhakrishna , Garewal Harinder S. , Wood Steven , Watson Ronald R.
Published: February 2007

A major limiting factor in the successful implementation of cancer chemoprevention trials has been the determination of endpoints to measure efficacy and success. The use of the ultimate goal of such trials, namely, cancer incidence, as an endpoint has serious feasibility problems, including the need for large numbers of participants, long follow‐up periods, and high costs. The application of biological markers as intermediate endpoints to reveal responses to chemopreventive agents within a short time and to act as surrogates for cancer is an attractive concept worthy of intense investigation. This study reviews some potential biological markers, including genetic, cellular, biochemical, and immunological, as well as their possible application to cancer chemoprevention. © 1992 Wiley‐Liss, Inc.
Surgical treatment of colon and rectum adenocarcinoma in elderly patients
Authors: Vivi Ayder A. , Lopes Ademar , Cavalcanti Silvio De F. , Rossi Benedito M. , Marques Lourdes A.
Published: February 2007

The results are presented of disease‐free interval and overall survival in 53 elderly patients with colon or rectum adenocarcinoma treated with curative surgery. The average age was 75.3 years (median = 75.0); 21 patients were male and 32 were female. Tumor location was as follows: rectum 18 (34%), sigmoid 17 (32.1%), right colon 14 (26.4%), and transverse colon 4 (7.5%) All patients were surgically treated following the classical patterns for tumor resection. After pathological examination, which included the histological grade differentiation, the disease stage was reevaluated following the pTNM system. Overall and disease‐free survival at 5 years, for all patients, independent of histological grade differentiation and disease stage, were 75.3% and 55.5%, respectively. Overall survival at 5 years for patients with grades I and II histological differentiation was 74.1% and 85.0%, respectively. None of the grade III patients (2 cases) survived more than I year. The 5 years disease‐free survival for patients with histological grade differentiation I and II was 56.8% and 60%, respectively. There was no statistically significant difference in overall survival for patients with stages SI, SII, and SIII, but the disease‐free survival at 5 years by stages was found to be significant with rates of 100%, 67.6%, and 22.6%. Postoperative mortality was 4 (7.5%). The postoperative mortality and survival rates obtained in this group of patients encourage us not to consider age as a limiting factor for curative surgical treatment. © 1992 Wiley‐Liss, Inc.
Management of long‐term postirradiation periclavicular complications
Authors: Wang Edward H. M. , Sekyi‐Otu Ato , O'Sullivan Brian , Bell Robert S.
Published: February 2007

Four cases of periclavicular postirradiation sarcoma and two cases of clavicular osteoradionecrosis with pathologic fractures are reported. All six cases presented more than 10 years after irradiation for breast cancer (five) or nasopharyngeal carcinoma (one). A review of radiotherapy received showed that they were subjected to unconventional radiation schedules (hypofractionation or high dose per fraction treatment). An approach to diagnosis and management of periclavicular lesions arising long after therapeutic irradiation is presented and the unique problems encountered with periclavicular surgery are discussed. © 1992 Wiley‐Liss, Inc.
Experimental chemotherapy for xenograft cell lines of human bile duct and gall bladder cancers in nude mice
Authors: Tsubono Michihiko , Nio Yoshinori , Tseng Chen‐Chiu , Kawabata Kazuya , Masai Yoshikazu , Hayashi Hitoshi , Fukumoto Manabu , Tobe Takayoshi
Published: February 2007

Most biliary tract cancers are advanced and inoperable when first diagnosed. Even if surgery can be performed, the postsurgical prognosis of these diseases is poor. In the present study, we investigated effective chemotherapies for a human bile duct cancer xenograft cell line (undifferentiated carcinoma, BDC‐SN) and a gall bladder cancer xenograft cell line (well‐differentiated adenocarcinoma, GBC‐GN), which were transplanted into nude mice. Eight anticancer agents (CDDP, 5‐FU, VDS, MMC, ADR, EPIR, CQ, and VP‐16) and their various combinations were evaluated at 2–4 times the clinical dose. When used singly, CDDP, 5‐FU, and VDS were effective against BDC‐SN, and only CDDP was effective against GBC‐GN. Among the various 2‐agent combinations, CDDP + 5‐FU was the most effective against both BDC‐SN and GBC‐GN. However, 3‐agent combinations consisting of CDDP + 5‐FU + another agent were less effective than the CDDP + 5‐FU double regimen and caused significant loss of weight as well as high mortality. These results suggest that CDDP + 5‐FU may be the most useful regimen against biliary tract cancers in clinical application. © 1992 Wiley‐Liss, Inc.
Bowel perforation due to metastatic lung cancer
Authors: Gitt Steven M. , Flint Patricia , Fredell C. Herbert , Schmitz Gerald L.
Published: February 2007

Lung cancer infrequently metastasizes to the bowel. When this occurs, the symptoms may vary from mild to emergent in nature. Three patients are presented illustrating the life threatening complications that may occur due to bowel metastases of lung carcinoma. A review of the literature reveals that only four of 24 reported patients have survived bowel perforation due to metastatic lung carcinoma. One of the three patients presented herein survived to be discharged home. Patients with known lung carcinoma who develop abdominal complaints should be investigated aggressively to prevent life‐threatening complications by early intervention. © 1992 Wiley‐Liss, Inc.
Prediction of operative mortality based on impairment of host defense systems in patients with esophageal cancer
Authors: Saito Takao , Shimoda Katsuhiro , Kinoshita Tadahiko , Shicemitsu Yuji , Miyahara Masaki , Kobayashi Michio , Shimaoka Akira
Published: February 2007

To determine whether operative risk based on impaired defense systems can be predicted, we examined 21 markers in 32 patients with esophageal cancer seen between 1983 and 1985 and related them to postoperative deaths. A discriminant analysis proved useful in determining whether the patient would be at risk of operative mortality, based on impaired defense systems. This model, the host defense index (HDI), was then used clinically to evaluate findings in 64 patients seen between 1986 and 1991. During this period, a change in policy for performing transthoracic esophagectomy on and perioperative care for patients with impaired defense systems was associated with a decrease in operative mortality. Thus, the HDI is beneficial to predict the risk of operative mortality based on impaired defense systems in patients with esophageal cancer. © 1993 Wiley‐Liss, Inc.
A comparison of the logistic regression and the cox proportional hazard models in retrospective studies on the prognosis of patients with castric cancer
Authors: Moriguchi Sunao , Hayashi Yoshio , Nose Yoshiaki , Maehara Yoshihiko , Korenaga Daisuke , Sugimachi Keizo
Published: February 2007

To define the independent prognostic factors reducing survival time for gastric cancer, we compared the logistic regression and the Cox proportional hazard models applied to patients who underwent curative gastrec‐tomy. All patients were evaluated after being followed for long fixed periods. Of 1,019, 269 (26.4%) died of tumor recurrence within a 5‐year period and 36 (3.5%) died over 5 years after the original surgery. With regard to survival time, multivariate analyses using the Cox proportional hazard model in a stepwise manner adjusted for the sex, age, and 10 other factors, suggested that size of tumor (P<0.01, relative risk [rr] = 1.0962), degree of gastric wall invasion (P< 0.01, rr < 1.3520), and status of lymph node metastasis (P< 0.01, rr = 1.6572) were the most independent prognostic factors. As well as, using the stepwise logistic regression model, size of tumor, (P< 0.01, odds ratio [or] = 1.115), degree of gastric wall invasion (P< 0.01, or = 1.428), and status of lymph node metastasis (P< 0.01, or = 2.182) were also the most independent risk factors for recurrence within 5 years after surgery. Although regression coefficients are not all the same, these three factors proved significant in both multivariate analyses. This equation for risk factors for prognosis is approached when searching for an appropriate method of retrospective studies using multivariate analyses. © 1993 Wiley‐Liss, Inc.
Significant clinical response of activated carbon adsorbed‐peplomycin against esophageal cancer: A pilot study
Authors: Kitamura Kazuya , Hagiwara Akeo , Sasabe Tsunetoshi , Kojima Osamu , Takahashi Toshio
Published: February 2007

Activated carbon particle adsorbed‐peplomycin (PEP‐CH) was administered to three patients who had advanced esophageal cancer and its clinical usefulness was evaluated. The PEP‐CH was injected endoscopically into the tumor or the adjacent normal esophageal tissue. Case 1 and case 3 were treated by topical injection of PEP‐CH with or without surgery and case 2 was subjected to the PEP‐CH treatment with radiation. The barium swallow and endoscopic examination exhibited a marked tumor reduction in all the patients at the end of the PEP‐CH treatment. Although a marked clinical response was seen, case 1 died of postoperative complication. Two patients were capable of oral food intake after the treatment, which had been impossible before the treatment. There were no serious adverse side effects caused by the PEP‐CH treatment in all the patients. PEP‐CH should prove valuable as a new form of chemotherapy for the treatment of esophageal cancer patients. © 1993 Wiley‐Liss, Inc.
Intracavitary radiation in the treatment of advanced esophageal carcinoma: A comparison of high dose rate vs. low dose rate brachytherapy
Authors: Harvey James C. , Fleischman Erik H. , Bellotti John E. , Kagan A. Robert
Published: February 2007

Twenty‐two patients were irradiated using two different dose schedules of intracavitary irradiation for palliation of locally advanced or metastatic carcinoma of the esophagus. Irradiation was given solely with either manually afterloaded low/Intermediate dose Cesium‐137 (LDR) or high dose rate Iridium‐192 (HDR) delivered via remote afterloader. This study was designed to test the effectiveness of HDR intracavitary brachytherapy in the relief of dysphagia and the maintenance of esophageal patency and to compare with our previous experiences with LDR intracavitary brachytherapy. Accelerated treatments were especially suited for patients with poor physical condition or short life expectancy unlikely to complete a full course of external beam irradiation without treatment interruption. Two thousand cGY in three fractions of LDR was compared with 1,250 cGY in one fraction HDR with essentially equal results. © 1993 Wiley‐Liss, Inc.
Alteration of the systemic antitumor activity of melphalan by sodium cyanate in MOPC‐460D myeloma‐bearing BALB/C mice
Authors: Shenouda George , Hutchinson Maureen , Noë Adrian , Panasci Lawrence
Published: February 2007

Sodium cyanate is a selective inhibitor of protein synthesis in a variety of mammalian tumor cells without a corresponding effect on normal tissue of the tumor‐bearing animals. In the present study, we investigated the potential role of sodium cyanate in the augmentation of the antitumor activity of melphalan in MOPC‐460D myeloma‐bearing BALB/c mice. The simultaneous intraperitoneal injection of sodium cyanate, 250 mg/kg, and melphalan, 12 mg/kg, followed by another dose of sodium cyanate, 200 mg/kg, administered 18 hours later, resulted in a tumor growth inhibition index (TGII) of 207%. In contrast, melphalan or sodium cyanate administered separately at the same dose induced a TGII of 133% and 1.570, respectively, when compared to control animals. Furthermore, a direct comparison of the volume of tumor implants in mice treated with the combination of sodium cyanate and melphalan vs. those treated with melphalan alone showed a statistically significant growth inhibition in favor of the sodium cyanate and melphalan combination on days 35, 39, and 42 from initiation of treatment. The data presented here suggest that the antitumor activity of melphalan could be increased, with moderate toxicity, by the concomitant intraperitoneal administration of sodium cyanate in BALB/c mice bearing measurable subcutaneous MOPC‐460D tumor transplants. This is the first report of an increase in melphalan antitumor activity by sodium cyanate at a tumor location distant from the site of injection. © 1993 Wiley‐Liss, Inc.
Dependence of the thymidylate synthase inhibition rate on the interval after the last administration of tegafur in sigmoid colon cancer patients
Authors: Nozue Mutsumi , Koike Naoto , Kawamoto Tohru , Toko Kisako , Sindou Takashi , Orii Kazuo , Kondou Tadashi , Mun Yumi , Nithou Manabu , Todoroki Takeshi , Fukao Katashi
Published: February 2007

The thymidylate synthase (TS) inhibition rate was measured after tegafur (FT) administration (1.5 g/day, at least 10 days) in 7 sigmoid colon cancer patients. The TS inhibition rate decreased as the interval between the time of the last administration and the time of the tumor resection increased longer. This study provides basic data for considering methods of drug administration and assessment of modification, for example, by leucovorin. © 1993 Wiley‐Liss, Inc.
Primary osteosarcoma of the breast
Authors: Muller Anna Gertruida S. , Van Zyl Jacobus Alwyn
Published: February 2007

The typical clinical and diagnostic imaging features of primary osteosarcoma of the breast are presented. © 1993 Wiley‐Liss, Inc.
High dose rate lntraluminal radiation in a combined modality treatment plan for carcinoma of the esophagus
Authors: Peddada Anuj V. , Harvey James C. , Anderson Paul J. , Davidson William , Smith Damon E. , Kagan A. Robert
Published: February 2007

We have previously reported results for treatment of adenocarcinomas and squamous cell carcinomas of the mid and distal esophagus as well as the use of intraluminal high‐dose rate radiation (HDR‐RT) for palliation of carcinoma of the esophagus. In this report we describe the results of a chemotherapy/HDR‐RT/esophagectomy management program. Examination of the surgical specimens revealed a complete response in only 13% of patients and locoregional recurrence was disappointing. There were no operative deaths nor were there major complications attributable to the preoperative treatment. Two‐year survival was 33%, only slightly better than that previously achieved by us with either primary surgery or primary external beam radiation among “curative” candidates with locoregional disease. HDR in combination with our selected chemotherapy regimen is insufficient for locoregional control and must be supplemented either by esophagectomy or external beam radiation for even modest long‐term survival. © 1993 Wiley‐Liss, Inc.
Serum and tissue trace elements in colorectal cancer
Authors: Gupta Sanjeev K. , Shukla Vijay K. , Vaidya Madho P. , Roy Salil K. , Gupta Saroj
Published: February 2007

Serum copper, zinc, and Cu/Zn ratio were measured using atomic absorption spectrophotometry in 30 patients with colorectal cancer and compared with 30 healthy control subjects. In the patients with colorectal cancer, the tissue copper and zinc levels were also measured in paired histologically normal and malignant colorectal tissue samples obtained at surgery. The mean serum copper levels were higher in patients with colorectal cancer (165.99 vs. 98.84 μg/dl) (P < 0.001). The mean serum zinc levels were lowered only in advanced (Dukes stages C and D) colorectal cancer compared to controls (89.94 vs. 115.08 μ/dl) (P < 0.001). However, the Cu/Zn ratio progressively increased with the advancing stage of malignancy (1.86 vs. 0.86) (P < 0.001). The cancerous colorectal tissue showed a higher concentration of both copper (2.78 vs. 1.79 μg/g) (P < 0.001) and zinc (27.16 vs. 18.98 μg/g) (P < 0.01) compared to non‐cancerous colorectal tissue. The exact mechanism responsible for the alterations in trace element levels in patients with colorectal cancer is largely unclear and requires further evaluation. However, the serum copper level and the Cu/Zn ratio are of value in estimating the extent of the carcinoma as well as in determining the prognosis of these patients. © 1993 Wiley‐Liss, Inc.
Prognostic significance of tumor‐host interaction in clinical gastric cancer: Relationship between dna ploidy and dendritic cell infiltration
Authors: Kakeji Yoshihiro , Maehara Yoshihiko , Korenaga Daisuke , Tsujitani Shunichi , Haraguchi Masaru , Watanabe Akihiro , Orita Hiroyuki , Sugimachi Keizo
Published: February 2007

DNA ploidy of tumor cells and the degree of infiltration of dendritic cells were determined in 93 gastric cancer tissue specimens, and the mechanisms of tumor‐host interaction on the prognosis were investigated. DNA ploidy patterns were grouped into low and high ploidy, and the degree of infiltration of dendritic cells (DC) was graded into marked and slight infiltration. In the low ploidy group, the 5‐year survival rates in patients with marked and slight DC infiltration were 80.7% and 61.5%, respectively (P < 0.05). In the high ploidy group, however, there were no significant differences. In cases of low ploidy, the incidence of lymph node metastasis was significantly lower in the marked DC infiltration group compared with findings in the slight DC group. Thus, markedly infiltrating dendritic cells in gastric cancer tissue may lead to prolongation of survival time for patients with a carcinoma of the low ploidy profile, by preventing widespread nodal involvement. © 1993 Wiley‐Liss, Inc.
Breast conservation versus mastectomy: Patient preferences in a community practice in kentucky
Authors: Tate Peter S. , McGee Edgar M. , Hopkins Sidney F. , Rogers Edwin L. , Page George V.
Published: February 2007

Recent studies have indicated a relatively low rate of breast‐sparing surgery for carcinoma in the Southeastern United States. From 1987 through 1991, 289 patients from Eastern and Central Kentucky with breast carcinoma were treated by the authors. Despite being fully informed of treatment options of breast cancer, 82% of patients with stage II disease or less and no medical contraindications to breast conservation preferred mastectomy. Overall, 10% of patients underwent breast‐sparing surgery, although this figure had risen to 20% by 1991. The most frequent reasons for preference of mastectomy were fear and inconvenience of radiotherapy and a perception that survival would be diminished if mastectomy was not done. © 1993 Wiley‐Liss, Inc.
Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues
Authors: Sadoski Corinne , Suit Herman D. , Rosenberg Andrew , Mankin Henry , Efird Jimmy
Published: February 2007

The relationship between status of the surgical margin and local control of soft tissue sarcoma of the extremities by preoperative radiation therapy has been assessed in 132 consecutive patients from 1974 to 1988. The 5‐year actuarial local control rate was 94% for all patients; the rates were 97% and 82% for the 104 tumors with negative marigins and the 28 tumors with positive margins, respectively. The local control rate was independent of the extent of the negative margin. For primary sarcomas, the local control rates were 96%, 97%, and 100%, respectively, for margins that were negative at ≤1 mm or > 1 mm, or the specimens were negative for tumor; for positive margins the results was 83%. The overall local control rate was lower (not significant) for recurrent than for primary sarcomas: 88% vs. 94%. On the other hand, when stratifying by margin status, no difference was observed in local control results, i.e.: (1) 97% and 91% for primary and recurrent tumors with negative margins, respectively, and (2) 83% and 80% for primary and recurrent tumors with positive margins, respectively. Local control was not significantly higher in those patients who were treated by surgical resection (S), radiation (RT), and re‐excision of the previous tumor bed than in those whose radiation therapy was started after the biopsy and followed by one surgical resection. For primary sarcomas that were resected with negative margins the results were: 100% of 15 patients treated by S‐RT‐S and 96% of 75 patients treated by RT‐S. © 1993 Wiley‐Liss, Inc.
Staging of carcinoma of the esophagus and cardia: A comparison of different staging criteria
Authors: Ellis F. Henry , Watkins Elton , Krasna Mark J. , Heatley Gerald J. , Balogh Karoly
Published: February 2007

The third edition [1988] of the Manual for Staging of Cancer of the American Joint Committee on Cancer (AJCC) was developed to permit finer discrimination between stages than was true of the previous edition [1983]. This study was designed to determine whether or not this goal was achieved. Pathologic staging of the specimens removed from 265 patients with carcinoma of the esophagus or cardia undergoing esophagogastrectomy between 1970 and 1988 was performed according to criteria published in the second and third editions and their survival data compared. The new staging criteria of the AJCC provides no better discrimination of stages according to survival than was true of the earlier version, the 5‐year survival of stage IIA patients being similar to that of stage I patients (37.5 ± 6.7% vs. 50.8 ± 17.7%), and the survival of stage IIB patients being similar to that of stage III patients (16.2 ± 8.1% vs. 13.6 ± 3.7%). However, depth of wall penetration and extent of lymph node involvement were reliable independent predictors of survival. We propose a modified version of the Skinner WNM staging plan that provides a modest increase in staging fragmentation. © 1993 Wiley‐Liss, Inc.
Adjuvant regional isolated perfusion with melphalan for patients with clark V melanoma of the extremities
Authors: Vrouenraets Bart C. , Kroon Bin B. R. , Klaase Joost M. , Van Gell Bert N. , Eggermont Alexander M. M. , Franklin Hilary R.
Published: February 2007

From 1978 to 1990, 32 patients with Clark V melanoma were treated by wide excision of the primary and adjuvant regional isolated perfusion with melphalan. M.D. Anderson stage of disease was stage I in 22 and stage IIIb in 10 patients. Five‐year survival rates were 58% and 27%, respectively. Seven patients developed a recurrence in the perfused limb [stage I, 2, stage IIIb, 5 patients (P = 0.03)], and 4 of 17 patients developed regional lymph node metastases. Of the well‐known prognostic variables, only ulceration of the primary tumor significantly influenced survival (P = 0.03). We did not see any improvement in survival rates compared with literature data on nonperfused patients. In the absence of data on locoregional recurrence rates in nonperfused Clark V melanoma patients, we cannot say whether adjuvant perfusion diminished this risk. Therefore, the results of the prospective randomized EORTC/WHO trial in primary high‐risk extremity melanoma have to be awaited. © 1993 Wiley‐Liss, Inc.
An experimental recurrence model for malignant fibrous histiocytoma induced by 4‐hydroxyaminoquinoline 1‐oxide in the rat
Authors: Tanuma Masaji , Goto Kunihiko , Nagura Hiroshi , Sakurai Minoru
Published: February 2007

To clarify the relationship between local recurrence of mesenchymal tumors and their malignant potentiality, we made an experimental recurrence model for malignant fibrous histiocytoma (MFH) induced by 4‐hydroxyaminoquinoline 1‐oxide in the rat by repeated exicisional operations. By the repeated exicision, the number of recurrent tumors increased, and the doubling time of tumor growth was shortened. The mean doubling time of primary tumors was 6.6 days, that of the first locally recurrent tumors was 4.3 days, and that of the second locally recurrent tumors was 3.3 days. However, mitotic count and 5‐bromo‐2‐deoxyuridine (BrdU) labeling index did not change. this study proved experimentally that MFH shows more rapid growth through repeated local recurrences, and this experimental model may provide a better understanding of the local recurrence of MFH. © 1993 Wiley‐Liss, Inc.
A phase I/II study of intraoperative radiotherapy in advanced unresectable or recurrent carcinoma of the rectum: A radiation therapy oncology group (RTOG) study
Authors: Lanciano Rachelle M. , Calkins Alison R. , Wolkov Harvey B. , Buzydlowski Jan , Noyes R. Dirk , Sause William , Nelson Diana , Willett Christopher , Owens Jay C. , Hanks Gerald M.
Published: February 2007

The Radiation Therapy Oncology Group (RTOG) initiated a phase I/II study of intraoperative radiotherapy (IORT) in advanced or recurrent rectal cancer to assess therapeutic efficacy, toxicity, and establish quality control guidelines prior to beginning a phase III trial. From October 1985 through December 1989, 87 patients with histologically proven adenocarcinoma of the rectum or rectosigmoid with recurrent/persistent disease after surgery or those primarily inoperable were entered by 14 institutions. Of 86 evaluable patients, 42 patients received IORT either alone (n = 15) or in combination with external beam (n = 27). Local control was dependent on the amount of residual disease prior to IORT, with 2‐year actuarial local control of 77% if no gross residual disease remained vs. 10% with gross residual disease (P = 0.0001). For the recurrent/residual group (n = 33), this observation was also significant with a 2‐year actuarial local control rate of 64% if no gross residual remained vs. 10% with gross residual disease (P = 0.004). Local control translated into an improved survival for all patients and the recurrent/residual group with 2‐year actuarial survival of 88% and 89% if no gross residual disease remained vs. 48% and 45% with gross residual disease, respectively (P = .0005, 0.006). Six patients (14.6%) experienced four grade 3 and three grade 4 complications as a possible result of IORT during follow‐up with a 2‐year actuarial risk of major complications of 16%. We conclude that IORT is feasible within a cooperative group and can be performed with acceptable complication rates. A phase III trial to demonstrate a therapeutic advantage for IORT over external beam alone is currently in progress. © 1993 Wiley‐Liss, Inc.
The influence of surgical margins on advanced cancer treated with intraoperative radiation therapy (IORT) and surgical resection
Authors: Pelton Jeffrey J. , Lanciano Rachelle M. , Hoffman John P. , Hanks Gerald M. , Eisenberg Burton L.
Published: February 2007

Intraoperative radiation therapy (IORT) has been used successfully in the treatment of malignancies, alone and as an adjunct to surgical resection. This study examined a single institution's experience with combined IORT and surgical resection in the treatment of advanced cancer. The records of 41 consecutive patients undergoing intraoperative radiation therapy (IORT) at the Fox Chase Cancer Center, from My 1987 through March 1990, were retrospectively reviewed. All patients had locally advanced disease, of whom 73% had failed previous multimodality therapy and 44% had undergone prior radiation therapy (XRT). The 2‐year actuarial survival for the entire cohort was 72%. Disease‐free survival was 47% at 1 year and 5% at 2 years. The only important prognostic factor predicting outcome was status of the surgical margin. Positive surgical margins decreased the 2‐year actuarial survival from 100% to 59%, and increased the local failure rate from 21% to 52%. Margin status had no effect on the later development of metastatic diseae. Higher IORT doses, field sizes >7 cm, and multiple IORT fields were used for larger tumors and larger amounts of residual disease. These parameters alone did not correlate with improved local control. This analysis suggests the usefulness of aggressive surgical resection with IORT in extending survival for locally advanced or recurrent cancer. Negative margin status is the best predictor of a favorable outcome and should be used to select patients who may benefit from IORT. The use of radiation sensitizing agents should be explored in patients with positive margins, since in‐field failure continues to be the major pattern of failure. IORT in conjunction with aggressive surgical resection should continue to be studied in prospective randomized clinical trials. © 1993 Wiley‐Liss, Inc.
Patterns of presentation in brain tumors in the United States
Authors: Zaki Adel , Natarajan Nachimuthu , Mettlin Curtis J.
Published: February 2007

This study included 11,111 cases with confirmed primary brain tumors reported by 679 different hospitals in the United States in 1980 and in 1985. The combinations of symptoms and signs in relation to the site of the brain tumors, supratentorial vs infratentorial, were studied. Only one symptom was present in 32.9% and 26.7% of cases with supratentorial and infratentorial tumors. No neurologic sign was detected at the time of diagnosis in 20% and 14.6% of cases with supratentorial and infratentorial tumors, respectively. Considering the clinical stage at diagnosis, no neurologic sign was detected in 21.4% of patients presenting in stages I and II; compared with 11.5% in those presenting in late clinical stages (III & IV). The study confirmed the importance of meticulous history taking for early referral for diagnosis of brain tumors. © 1993 Wiley‐Liss, Inc.
Effect of insulin‐like growth factor 1 on host response to tumor
Authors: Dong Yuan‐Lin , Fleming R. Y. Declan , Huang K. Fon , Herndon David N. , Yan Tina Z. , Waymack J. Paul
Published: February 2007

Oncology patients suffer multiple detrimental metabolic alterations. Among these are catabolism of tumor free body mass to supply nutrients to feed the tumor. This results not only in enhanced tumor growth but also poor wound healing and immunosuppression of the tumor host. Efforts are therefore being directed at finding methods for improving the nutritional status of the tumor host without enhancing tumor growth. We investigated the ability of two hormones, insulin‐like growth factor‐1 (IGF‐1) and insulin, to improve physiologic function in tumor‐bearing animals. Tumor‐bearing animals received a continuous infusion of IGF‐1 (2.20 mg/kg/ day), insulin (820 μm/kg/day) or placebo via an osmotic minipump for 7 days. All animals were pair fed to eliminate nutritional intake as a variable. The placebo group lost 31.37 ± 4.3 g of tumor free body mass during the study period. The insulin treated group lost 26.34 ± 7.42 g and the IGF‐1 group lost 5.07 ± 3.25g (P < 0.001, ANOVA). IGF‐1 treatment failed to alter plasma glucose, lactate, or total amino acid concentration and failed to alter hepatic ketone body concentrations, but did improve hepatic mitochondria redox potential. Finally, IGF‐1 improved splenic weight by 110% and splenic lymphocyte count by 300%. In conclusion IGF‐1 appears to offer potential in supporting tumor free host body mass without stimulating tumor growth. © 1993 Wiley‐Liss, Inc.
Vaginal melanoma and the role of regional chemotherapy
Authors: Beg Mansoor H. , Muchmore James H. , Carter R. Davilene , Krementz Edward T.
Published: February 2007

Vaginal melanoma is a rare cancer usually diagnosed as a locally advanced disease. Aggressive surgical management of the primary tumor and local‐regional recurrences, combined with the use of adjuvant radiation and chemotherapy, improves disease‐free interval and, perhaps, survival times. Techniques of regional chemotherapy allow the delivery of high doses of chemotherapy to the tumor bed, while minimizing systemic toxicities. These treatments can be used to decrease tumor size, render bulky tumors resectable, and decrease the need for radical procedures. Additionally, they may help eradicate clinically inapparent local‐regional disease and have a favorable effect on survival times. © 1993 Wiley‐Liss, Inc.
Giant cell fibroblastoma
Authors: Nair Reena , Kane Shubhada V. , Borges Anita , Advani Suresh H.
Published: February 2007

A report of a 11/2‐year‐old male child diagnosed as a case of giant cell fibroblastoma is described and the available literature on this neoplasm is reviewed. The tumor consists of a mixture of spindle cells and multinucleated giant cells in a myxoid or collagenous background. The pathological findings and clinical course suggest that these tumors be classified with fibromatoses of childhood. Removal of the tumor with wide excision is sufficient and these patients do not require any form of chemotherapy. © 1993 Wiley‐Liss, Inc.
Benefits of a multidisciplinary approach to breast care
Authors: August David A. , Carpenter Lynne C. , Harness Jay K. , Delosh Tom , Cody Robert L. , Adler Dorit D. , Oberman Harold , Wilkins Edwin , Schottenfeld David , McNeely S. Gene , Lichter Allen S.
Published: February 2007

The University of Michigan Breast Care Center (BCC) was established in 1985 to provide comprehensive, multidisciplinary diagnosis and treatment of benign and malignant breast disease. This work presents an overview of our experience in the BCC and assesses the clinical, academic, financial, and educational effectiveness of the program. A database was used to generate a list of all patients seen in the BCC between February 1, 1985 and December 31, 1991. Participating departments provided information regarding outpatient, inpatient, clinical and consultative activities, and referral patterns attributable to BCC endeavors. BCC educational and academic activities were reviewed and profiled. Clinical information was culled from the BCC database, hospital records, and the hospital tumor registry. The BCC has resulted in a fivefold increase in breast care related activity at the University of Michigan Medical Center. Over half of the patients treated in the BCC with primary operable breast cancer receive breast‐conserving therapy. The BCC performs a unique educational function, providing the primary breast care experience for house staff as well as one third of the third year medical school class. The BCC supports over 20 clinical research protocols, and patient enrollment in clinical trials has increased dramatically since 1985. The BCC also provides support to basic science researchers receiving over 2.5 million dollars in peer reviewed direct cost support. These data suggest that a multidisciplinary approach to patient care as embodied by the BCC can be clinically, financially, and academically superior and productive. This model warrants further investigation not only in the field of breast care, but also in other clinical situations that require multidisciplinary input and therapy. © 1993 Wiley‐Liss, Inc.
Increased tumor localization by monoclonal antibody A7 after F(ab')2 fragmentation in athymic nude mice bearing human pancreatic carcinomas
Authors: Otsuji Eigo , Yamaguchi Toshiharu , Yamaoka Nobuki , Kotani Tatsuya , Tsurumi Hiroshi , Kitamura Kazuya , Yamaguchi Nozomi , Takahashi Toshio
Published: February 2007

Much recent research has been directed toward the use of monoclonal antibodies (MoAbs) for the immunodetection of solid tumors. In pancreatic cancer, conventional immunoscintigraphy using intact MoAbs remains disappointing. In this study, 125I‐labeled F(ab')2 fragments produced by pepsin digestion of MoAb A7 were injected intravenously into nude mice bearing human pancreatic cancer, HPC‐YS, xenografts that have previously been shown to react specifically with MoAb A7. The tumor tissue/blood ratio of 125I‐labeled F(ab')2 fragments of MoAb A7 increased with time and was much higher than those for normal tissues. Moreover, the tumor tissue/blood ratio of 125I‐labeled F(ab')2 fragments was greater than that of intact MoAb A7, although the F(ab')2 accumulation was less than that of intact MoAb A7 in the tumor. These results suggest that F(ab')2 fragments of MoAb A7 may be suitable carriers of radionuclides for immunodetection of human pancreatic cancer. © 1993 Wiley‐Liss, Inc.