bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibrolamellar carcinoma of the liver in the orient
Authors: Yoshida Kazuhiko , Amemiya Atsushi , Kobayashi Susumu , Sakurai Kenji , Suzuki Masaki , Aizawa Sigeru
Published: February 2007

We describe, in a 56‐year‐old man, the first case of fibrolamellar carcinoma of the liver (FCL) in the Orient. Contrary to patients seen in the Western world, our patient has many characteristics of ordinary hepatocellular carcinoma seen in the Orient, i.e., middle age, male, HBsAg carrier, elevated α‐fetoprotein, presence of HBsAg in the hepatocytes, and chronic hepatitis. These clinicopathological findings suggest a possible relationship between exposure of HB virus and FCL.
Perioperative blood transfusion and colorectal cancer recurrence: A review
Authors: Tartter Paul Ian
Published: February 2007

Retrospective studies of the relationship between perioperative blood transfusion and colorectal cancer recurrence are reviewed. Perioperative blood transfusion was associated with preoperative anemia, operations for rectal carcinoma, presence of tumor in the right colon, prolonged procedures, and copious blood loss. Control for variables related to blood transfusion and potentially affecting disease recurrence—blood loss, duration of surgery, and magnitude of the procedure—was notably absent from the majority of studies. None of the negative studies had sufficient numbers of both transfused and untransfused patients to reject the hypothesis that blood transfusion is associated with cancer recurrence with statistical validity. No concensus emerged regarding the significance of blood transfusion for the patient with colorectal cancer, and no recommendations concerning the use of blood are justified on the basis of these studies.
Selective effect of doxorubicin suspended in lipiodol on VX2 carcinoma in rabbits
Authors: Furuta Toshiya , Kanematsu Takashi , Kakizoe Saburo , Sugimachi Kiezo
Published: February 2007

When Lipiodol Ultra‐Fluid (Lipiodol) was given through arteries feeding the tumor, this material was retained in the tumor. After mixing Lipiodol and doxorubicin (adriamycin; ADR), the effect of this antitumor agent on VX2 carcinoma inoculated into the hindlimb in 57 rabbits was investigated. Size of the tumor remarkably decreased in the rabbits treated with ADR 2 mg/kg suspended in Lipiodol and given through the femoral artery. Intraarterial injection of ADR 2 mg/kg alone led to a transient decrease in size of the tumor, but there was a regrowth. The result was comparable to a finding in a group in which half the dose of ADR (1 mg/kg) suspended in Lipiodol was given intraarterially. When ADR 2 mg/kg mixed with Lipiodol was injected directly into the tumor, growth of the tumor was not completely inhibited. Lipiodolized ADR has a prominent antitumor effect, and Lipiodol has the potential to be applied as a carrier of anticancer drugs.
Primary carcinoma of the gallbladder: TNM staging and prognosis
Authors: White Keith , Kraybill William G. , Lopez Marvin J.
Published: February 2007

In order to investigate the lethality of carcinoma of the gallbladder and several of the coexisting features, a retrospective analysis of 53 patients with this disease was undertaken. Abdominal pain, obstructive jaundice, and a right upper quandrant mass were present in approximately one‐half of the patients. Laboratory and radiological data were frequently nonspecific and did little to identify the diagnosis. The most common preoperative diagnoses were cholelithiasis or chronic cholecystitis. Cholecystectomy was the most frequently performed procedure. Fifteen wedge liver resections were performed. No radical or extended liver resections were done. Eighty‐one percent of the patients had sufficient data for staging. Five patients (11.6%) had stage I lesions, three patients (7.0%) had stage II lesions, while 17 (39.5%) and 18 (41.9%) patients had stage III and IV lesions, respectively. Mean survival was 6.4 months for the entire group. Three patients are still alive (two longer than 5 years and one at 2 years) for an overall survival of 5.7%. Both staging and grading of the tumor correlated well with patient survival. Those patients with stage I lesions survived significandy longer (23 months vs. 3 months) than those with stage IV tumors. Also, those with more favorably graded (well‐differentiated) neoplasms lived an average of 13 months longer than patients with poorly differentiated lesions.
Malignant brenner tumor of the ovary
Authors: Chen Karl T. K. , Hoffmann Klaus D.
Published: February 2007

Three cases of stage III malignant Brenner tumor of the ovary in which chemotherapy or radiotherapy favorably altered the clinical courses are reported, and the literature is reviewed.
Tolerance of rat testis to graded periods of total circulatory isolation
Authors: Lui Raphael C. , Laregina Marie C. , Herbold David R. , Johnson Frank E.
Published: February 2007

Infertility because of testicular damage is a distressing problem for survivors of cancer chemotherapy. We have previously described a cytoprotective effect of temporary testicular circulatory isolation (TCI) during doxorubicin administration in the rat. In this report we define the relationship between duration of TCI and testicular ischemie injury, using paired groups of animals with normothermic TCI and hypothermie TCI. Sixty rats were used and received TCI for varying lengths of time up to 180 minutes, with or without hypothermia. On day 56 ± 4, all rats were killed and necropsied. Testicular injury was evaluated qualitatively by histology and quantitatively by testicular weight, sperm head count, repopulation index, and epididymal index. Warm TCI for up to 60 minutes induced modest damage to germ cells, while injury was greater with cold TCI. Leydig cells and vascular tissues were essentially unaffected by TCI, although Sertoli cell abnormalities were noted in rats receiving a long duration of TCI.
Application of the immunoperoxidase method for rapid intraoperative pathological diagnosis of pancreatic cancer
Authors: Ichihara Tohru , Nakao Akimasa , Sakamoto Junichi , Nonami Toshiaki , Harada Akio , Watanabe Tadashi , Takagi Hiroshi , Nagura Hiroshi
Published: February 2007

Intrapancreatic extension of pancreatic duct cell carcinoma in 19 resectable cases was evaluated by both hematoxylin and eosin (H&E) staining and quick immunostaining using antibodies against cancer‐associated antigens —e.g., CA19‐9, DUPAN 2, and CEA—on the intraoperative frozen‐section biopsy during the course of laparotomy. By H&E staining, malignant lesions were identified in four of 19 cases (21%). By the immunostaining method, however, cancer cells were detected in 10 of 19 cases (52.6%). This immunostaining method was particularly useful in defining cancer cells surrounded by dense fibrous connective tissue, in which cancer cells are usually difficult to evaluate by H&E staining. Thus, the application of such immunostaining, together with H&E staining, on the cryostat sections of biopsy specimens may provide important information for the appropriate operative method. Retrospective study of permanent sections revealed that pathological diagnosis by quick immunostaining was more accurate than diagnosis by H&E staining.
Nasal and nasopharyngeal paraganglioma
Authors: Kuhn Joseph A. , Aronoff Billie L.
Published: February 2007

Paragangliomas of the nasal cavity and nasopharynx should be classified according to the presumed origin from the nasal, jugulotympanic, vagal, or ciliary paraganglion because of the substantial differences in clinical behavior and operative management. This paper presents the ninth published case of a primary nasal paraganglioma and reviews the previously reported cases. Primary nasal paragangliomas are generally localized, although the potential for local invasion is well documented. Malignancy or functional activity has not been described. Complete excision is curative. Jugulotympanic, vagal, and ciliary paragangliomas with extension into the nasopharynx or nasal cavity are typically more advanced at the time of diagnosis and require complete evaluation by computed tomography and arteriography to determine the tumor extent. The operative approach is dependant on the extent of tumor invasion. Irradiation and tumor embolization have been useful for unresectable or partially excised tumors.
Individual treatment for malignant melanoma
Authors: Polk Hiram C.
Published: February 2007

Much has been learned in the recent decade about the predictable biologic behavior of cutaneous malignant melanoma. Indeed, such knowledge permits highly individualized treatment based on simple demographic data on the patient, location of the lesion, and its thickness according to the Breslow scale. The thoughtful surgeon may individualize his treatment according to the likely biologic behavior of the tumor, minimizing treatment morbidity while maintaining optimum results from primary and secondary surgical treatment.
Advanced basal cell carcinoma and successful treatment with chemotherapy
Authors: Chawla Sant P. , Benjamin Robert S. , Ayala Alberto G. , Carrasco C. Humberto , Hong Waunc Kl , Martin Richard G.
Published: February 2007

The patient presented in this report has a large basal cell carcinoma on the wrist and thigh. The lesion on the wrist was nonresectable without amputation. The patient showed an impressive response to chemotherapy with systemic cyclophosphamide, adriamycin, and intra‐arterial cisplatin. The tumor could be excised by a simple excision on both sites and showed no residual tumor on the hand and only a microscopic focus on the thigh. The patient continues to be free of disease 3 years after the initiation of the therapy.
Leukocyte alkaline phosphatase and carcinoembryonic antigen in breast cancer patients: Clinical correlation with the markers
Authors: Walach Natalio , Guterman Amiram , Zaidman Jacob L. , Kaufman Suzana , Scharf Sally
Published: February 2007

Leukocyte alkaline phosphatase (LAP) scores in peripheral blood and plasma carcinoembryonic antigen (CEA) levels were determined in 208 breast cancer patients with nonmetastatic disease. Patients were followed until clinical manifestations of metastases appeared. Then the LAP score and CEA level were analyzed in relation to the clinical appearance of metastases.

Of the 208 patients studied, 58 developed metastases during the follow‐up period. The LAP scores and CEA levels of this group of patients were compared to a control group of 60 breast cancer patients who did not develop metastases. Of the two markers, LAP score seems to be considerably more useful in detecting metastatic disease.
Evolving role of surgical treatment in limited‐disease small cell lung carcinoma
Authors: Sridhar Kasi S. , Hussein Atif M. , Thurer Richard J.
Published: February 2007

The diagnostic role of surgical procedures in small cell lung carcinoma (SCLC) is well established. The therapeutic role of surgery has changed over the years. At present, curative resection is the treatment of choice in peripheral T1‐2 NoMo SCLC, and adjuvant chemotherapy may be beneficial. Surgery is also indicated in SCLC patients diagnosed by a limited pathologic sample in whom the clinical course suggests nonsmall cell lung carcinoma (NSCLC). The resection may reveal either a mixed tumor or an alternate diagnosis and may be potentially curative. Surgery, at the time of maximal response to chemotherapy in T3NoMo SCLC, may be curative and reveal the presence of NSCLC elements. The best survival is in patients found to be tumor‐free at surgery, and the worst survival is in N2 patients.
Sarcoma‐180 cells are more sensitive to heat than are mouse normal tissues: Esophagus, stomach, small intestine, large intestine, liver, spleen, and kidney
Authors: Hiramoto Yoichiro , Kusumoto Tetsuya , Maehara Yoshihiko , Sakaguchi Yoshihisa , Kido Yuichiro , Ishida Teruyoshi , Sugimachi Keizo
Published: February 2007

Sensitivity of various mouse tissues to heat was determined using mouse sarcoma‐180 (S‐180) cells and normal tissues: esophagus, stomach, small intestine, large intestine, liver, spleen, and kidney. The in vitro succinate dehydrogenase inhibition (SDI) test was used. The succinate dehydrogenase (SD) activity of tissue fragments was assayed, following exposure to a temperature of 43°C (heat treatment) or 37°C (control) for 1, 2, 5, or 10 hr. The sensitivity to heat treatment was estimated by the percentage of SD activity of the heat‐treated cells, compared to that of the control cells. The decrease in SD activity following exposure to heat varied with the tissue. The SD activity decreased to a greater extent in the S‐180 cells than in the normal tissues. In the normal tissues, the order of sensitivity to heat was stomach, spleen, large intestine, small intestine, esophagus, kidney and liver. These results show that hyperthermia is tissue selective, hence heat treatment of a malignant lesion should be carefully designed.
Results of radiation therapy in early glottic carcinoma (T1 T2 N0)
Authors: Stein Moshe , Rosenblatt Edward , Kuten Abraham , Cohen Yoram
Published: February 2007

Glottic carcinoma is curable by either surgery or radiotherapy. A total of 60 patients were treated by radiation alone at the Northern Israel Oncology Center, Rambam Medical Center, Haifa, between 1970 and 1980. Twentynine (48%) were classified as T1 N0 and 31 (52%) as T2 N0. All patients received radiotherapy primarily with curative intent, with surgery reserved for recurrences. The 5‐year actuarial survival for all patients was 90% and actuarial disease‐free survival was 95%. In ten patients (17%) there was local failure, and five of them were salvaged by surgery. There were no significant acute or long‐term complications of radiation. Factors influencing treatment outcome (anterior commissures involvement, degree of differentiation, treatment volume, and technique of irradiation) and the occurrence of second primary malignancies are discussed.
Continuous systemic 5‐fluorouracil infusion in advanced colorectal cancer: Results in 91 patients
Authors: Hansen R. , Quebbeman E. , Ausman R. , Frick J. , Ritch P. , Schulte W. , Haas C. , Beatty P. , Anderson T.
Published: February 2007

Ninety‐one patients with metastatic colorectal cancer were treated with continuous ambulatory 5‐fluorouracil (5FU) infusion 250‐300 mg/m2/day through a chronic indwelling central venous catheter. Twenty‐six of the 91 patients (29%) had received previous bolus 5FU. Fifty‐eight of the 91 patients (64%) had two or more sites of disease, and 74 of 91 patients (81%) had liver metastases. Results were complete remission in 5 of 91 (6%), partial remission in 25 of 91 (27%), stable disease in 33 of 91 (36%), and progressive disease in 28 of 91 (31%), for an overall response rate of 30 of 91 (33%); median duration of response was 7 months. Twenty‐six of 65 previously untreated patients (40%) experienced objective response. Median survival from initiation of treatment for all patients was 11 months. Forty‐one percent of patients experienced no significant toxicity and were able to continue therapy without treatment interruption. Toxicities necessitating treatment interruption included stomatitis in 35 patients (39%), hand‐foot syndrome in 33 patients (36%), and diarrhea in 10 patients (11%). No significant myelosuppression or serious catheterrelated complications were encountered. We conclude that continuous systemic venous infusion of 5FU produces a higher response rate than traditional bolus 5FU schedules, with apparent enhancement of survival and easily managed toxicity.
Adjuvant chemoimmuno‐ and immunotherapy in Dukes' stage B2 and C colorectal carcinoma: A 7‐year follow‐up analysis
Authors: Abdi Ehtesham A. , Hanson John , Harbora Denise E. , Young Donald C. , McPherson T. Alexander
Published: February 2007

A prospectively randomised controlled clinical trial of adjuvant therapy was undertaken, at a single‐centre, population‐based cancer institute, in patients with Dukes' stages B2 and C colorectal carcinoma after curative surgery. Between 1976 and 1983, 253 patients were randomised to either control (no further therapy after surgery), immunotherapy (oral bacille Calmette‐Guérin [BCG] 120 mg once a month) for 5 years or chemoimmunotherapy (oral BCG as above with methyl‐cyclohexyl‐chloroethyl nitrosourea [meCCNU] 130 mg/m2 on day 1 and 5‐fluorouracil [5‐FU] 325 mg/m2/day on days 1–5 and 375 mg/m2/day on days 36–40) repeated every 10 weeks for 8 cycles. The median follow‐up of patients is now 6.95 years. Of the control, immunotherapy, and chemoimmunotherapy groups 22.35%, 39.28%, and 28.57%, respectively, have relapsed. The log‐rank analysis of results shows no disease‐free or overall survival advantage for patients receiving adjuvant therapy compared with the control group. Patients receiving adjuvant immunotherapy for stage B2 appear to have a significantly inferior disease‐free survival compared with other groups, but their overall survival is similar. There are no significant differences in disease‐free or overall survival in the three groups of patients with stage C tumour. Of 82 patients dying, 78.05% died of progressive colorectal carcinoma, 13 patients developed a second malignancy; the remainder died of seemingly unrelated causes.
Incidence and anatomic distribution of cutaneous melanoma among United States hispanics
Authors: Bergfelt Louise , Newell Guy R. , Sider Joanne G. , Kripke Margaret L.
Published: February 2007

Using the data base for melanoma incidence compiled by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, we compared the incidence and anatomic distribution of primary cutaneous melanomas in Hispanic and non‐Hispanic Caucasian populations and in blacks between 1973 and 1981. Cases were divided into United States whites, New Mexico (NM) whites (non‐Hispanic Caucasians), NM Hispanics, Puerto Rico (PR) residents by definition Hispanic, and US blacks. Among whites, the highest incidence was 8.0 per 100,000 and was ten times that of US blacks. The incidence among PR and NM Hispanic residents was 1.6 to 3.7 times that of US blacks. The anatomic distribution among NM Hispanics was similar to US and NM whites for both genders. In contrast, among PR residents the anatomic distribution in both genders was most common for the leg, similar to that for blacks. Spaniards who migrated to PR have more admixture with blacks from Africa than Spaniards who migrated to the mainland. This suggests a genetic predilection for the occurrence of melanoma on the lower extremity among PR residents as opposed to NM Hispanics.
Penis cancer: A review by the joint radiotherapy committee of the European organisation for research and treatment of cancer (EORTC) genitourinary and radiotherapy groups
Authors: Jones W. G. , Fosså S. D. , Hamers H. , Van Den Bogaert W.
Published: February 2007

A review of the literature on penis cancer has been undertaken. The disease is rare and most of the cumulative experience is reported in retrospective series. Multi‐institutional international collaboration will be needed to study prospectively facets of this disease where controversy presently exists. Suggested areas of research are in the treatment of early invasive tumours, the diagnosis and treatment of inguinal metastases, the improvement of radiotherapy techniques, and the development of effective chemotherapy and effective combinations of therapies. This will potentially lead to a greater degree of organ sparing. Studies of palliation, and aspects of quality of life, are also needed. Public education about the condition and genital hygiene, including the necessity for the early treatment of phimosis, may further reduce the incidence of penis cancer.
Prostate cancer in blacks: An update from the American college of surgeons' patterns of care studies
Authors: Natarajan Nachimuthu , Murphy Gerald P. , Mettlin Curtis
Published: February 2007

Data from the American College of Surgeons' prostate cancer surveys covering nearly a decade of experience demonstrate that the problem of prostate cancer is unique among black men in the United States. These data show that the distribution of stage at diagnosis changed across the 10‐year interval. The data indicate that there have been improvements in the 5‐year survival rates of both black and white patients, but the prostate cancer‐specific survival of black patients remains significantly poorer than that of whites.
Predictability of in vivo chemosensitivity by in vitro MTT assay with reference to the clonogenic assay
Authors: Shimoyama Yutaka , Kubota Tetsuro , Watanabe Masahiko , Ishibiki Kyuya , Abe Osahiko
Published: February 2007

The MTT assay reported by Mosmann is a rapid and convenient colorimetric assay for cellular growth and survival in vitro. In this paper, the MTT assay was modified as a chemosensitivity test, and its potential was investigated. Using 10 human tumor xenografts in athymic nude mice, the predictability of in vitro antitumor effects of drugs using the MTT assay was compared with that using the clonogenic assay. The MTT assay showed excellent reproducibility, and the predictable rate in this assay was 86.7%, with 100% true‐positive and 77.8% true‐negative rates, almost equivalent to the 90.0% predictable rate of the clonogenic assay. This method also has several advantages with respect to rapidity, quantitation, management of many samples, and cell number required for the assay. Application of this assay to chemosensitivity testing seems to be valuable and useful.
Breast cancer risk: A review of definitions and assessments of risk
Authors: Spratt John S. , Greenberg Richard A. , Kuhns James G. , Amin Elizabeth A.
Published: February 2007

The histopathological and biochemical characteristics of cells and multicellular structure of benign and malignant breast changes have highly significant implications as to the risk of acquiring and dying of breast cancer. Consequently, every breast biopsy merits highly specific histopathological characterization as well as assay for hormone receptors. Certain aspects of a woman's personal and family history may be associated with increased or decreased risk. Clinical application of these variables to the prediction of future outcome requires an understanding of the definitions of risk. These definitions must then be applied appropriately when assessing risk. The definition of risk used must be explicitly stated and consistently used.

Provided is a review of the definitions of risk and the risk of acquiring breast cancer according to age, family history, and histopathological characteristics of benign breast biopsies. The highly variable relative risk of dying from breast cancer when diagnosed is also reviewed.
Evaluation of a short‐stay program for patients undergoing mastectomy
Authors: Wagman Lawrence D. , Terz Jose J. , Hill L. Robert , Beatty J. David , Kokal William A. , Riihimaki Daniel U. , Hyams David M. , Grant Marcia , Hart Angela , Kirshner Terri , Northrup Marge
Published: February 2007

Two hundred twenty‐eight patients were included in a retrospective study to evaluate the morbidity and feasibility of early discharge after mastectomy. Group I (early discharge, n = 75) patients were given pre‐ and postoperative instruction related to wound and drain care. Group II (concurrent control, n = 44) was given similar postoperative instruction, but received no preoperative teaching. Group III (historical controls, n = 109) underwent surgery during a period of more liberal hospitalization and discharge policies. The groups were similar in age, cultural background, operations performed, and pathologic diagnosis. Length of stay for groups I, II, and III was 5.5 ± 0.4, 3.5 ± 0.2, and 8.6 ± 0.3 days, respectively. Groups I and II had a significantly shorter stay than group III. There was no difference among the groups for the presence of wound erythema, rate of primary healing, seroma formation, or wound infection. The practice of same‐day admission and early discharge to limit length of stay for patients undergoing mastectomy is safe and effective.
Alternating methotrexate and dactinomycin in nonmetastatic gestational trophoblastic disease
Authors: Rose Peter G. , Steven Piver M.
Published: February 2007

Alternating 5‐day chemotherapy with methotrexate and dactinomycin as primary therapy for nonmetastatic gestational trophoblastic disease was studied in nine patients. The complete response rate was 100% with follow‐up of a median of 80 months. Stomatitis was universal but rarely prevented oral alimentation or delayed therapy. Overall, 94% of toxicity was mild or moderate in severity and all toxicity was reversible. This alternating non‐cross resistant regimen, reported in a total of 40 patients in the literature, is the only regimen to result in a 100% response rate. This response rate is statistically improved when compared to historical controls receiving methotrexate/folinic acid or pulse dactinomycin. No patients required hysterectomy for disease control. Cooperative prospective phase III studies are needed to determine the efficacy and toxicity of current regimens.
Clinical value of in vitro drug sensitivity testing based on short‐term effects on dna and rna metabolism in ovarian cancer
Authors: Khoo S. K. , Hurst T. , Webb M. J. , Dickie G. , Kearsley J. , Parsons P. G. , Mackay E. V.
Published: February 2007

The hypothesis that in vitro chemosensitivity testing could predict clinical outcome was tested in women with ovarian cancer. Short‐term drug effects on DNA and RNA metabolism (by inhibition of 3H‐thymidine and 3H‐uridine incorporation) were measured in primary cultures of tumor cells. In vitro inhibitory effects were found with the four drugs tested: cisplatin, adriamycin, melphalan, and methotrexate. From data based on impaired RNA and/or DNA metabolism (≥ 20% inhibition), correct prediction of “sensitivity” was 79% and that of “resistance” was 84%. An analysis of the predictive value of both assays, used singly or together, revealed a high specificity but moderate sensitivity; the best positive predictive value (94%) was obtained when both RNA and DNA metabolisms were impaired. Our results support the idea that two subsets of patients who are being considered for cytotoxic chemotherapy can be selected: those who may benefit from treatment and those who may not, regardless of the drugs tested in vitro or used in vivo.
Cyclic and sequential therapy with tamoxifen and medroxyprogesterone acetate in metastatic breast cancer
Authors: Nemoto Takuma , Patel Jashbhai K. , Rosner Dutzu , Dao Thomas L. , Halvorson H.
Published: February 2007

A clinical trial of sequential tamoxifen and medroxyprogesterone acetate (MPA) was carried out in 36 women with metastatic breast cancer in order to evaluate the therapeutic efficacy of this regimen and to determine if tamoxifen would increase progesterone receptor (PR) levels and thereby increase response to MPA. Fourteen patients (39%) responded to this treatment, with the duration of remission ranging from 2 to 24 + months (the mean and median were 11 months). In 22 patients, PR levels were measured both before and after 7 days of tamoxifen administration. In PR‐ positive patients, PR changes induced by tamoxifen did not appear to increase the response rate. In PR‐negative patients, PR became positive in 3 patients following tamoxifen treatment, with 2 of 3 responding to treatment, whereas in 11 others whose PR levels remained negative, only one response was observed. Our results suggest that potentiation by tamoxifen was not observed, since in our previous study, MPA alone was equally effective. Thus, tamoxifen and MPA should be given independently for palliation of metastatic breast cancer, and MPA should be administered following therapy with tamoxifen.
Morbidity and mortality associated with intraoperative radiotherapy
Authors: Avizonis Vilija N. , Sause William T. , Noyes R. Dirk
Published: February 2007

From May 1984 through July 1988, 67 patients have been treated with intraoperative radiation therapy (IORT) at LDS Hospital. We conducted a detailed evaluation of the morbidity and mortality related to our intraoperative experience. Major complications were classified as those requiring reoperation or resulting in death. Minor complications included all others that could not be attributed to tumor growth or recurrence.

Of twelve major complications, three resulted in death. Nonfatal complications included anastomotic leak (5), wound dehiscence (1), gastric outlet obstruction (1), and bowel obstruction (1). When compared with historical controls undergoing comparable surgery at this institution prior to the availability of IORT, complication rates were similar. We feel in our institution, intraoperative radiotherapy has not added to morbidity of aggressive abdominal surgery.
Conformational epitopes specific to carcinoembryonic antigen defined by monoclonal antibodies raised against colon cancer xenografts
Authors: Sakurai Yoichi , Hirohashi Setsuo , Ohishi Takashi , Shimosato Yukio , Kodaira Susumu , Abe Osahiko
Published: February 2007

Four monoclonal antibodies (MoAbs) reactive with carcinoembryonic antigen (CEA) were obtained by hybridizing mouse myeloma cells (P3‐X63‐Ag8‐U1) with spleen cells from nude mice (BALB/c, nu/nu) that had rejected transplanted human colonic adenocarcinomas Co‐3 and Co‐4 following intraperitoneal injection of spleen cells from immunocompetent mice (BALB/c). By solid‐phase RIA with purified CEA and its related antigens, NCC‐CO‐413 (IgG2a, kappa) was shown to react with NCA and BGP‐I as well as with CEA, whereas the reactivities of three other MoAbs, NCC‐CO‐308 (IgG1, kappa), ‐432 (IgG1 lambda), and ‐411 (IgG1, kappa) were limited to CEA. Immunohistochemical reactivities of these MoAbs to colonic carcinomas, granulocytes, and liver bile canaliculi on acetone‐fixed paraffin‐embedded sections (“AMeX” sections) confirmed the specificities of these MoAbs shown by the solid‐phase RIA. By competition solid‐phase RIA, the epitopes recognized by NCC‐CO‐308 and ‐432 were shown to be shared or located close to each other, whereas the other MoAbs were shown to recognize different epitopes. Thus, two epitopes specific to CEA and one shared by NCA and BGP‐I as well as CEA were identified. Furthermore, reactivities of MoAbs with the two CEA‐specific epitopes were easily abolished by heat denaturation or reduction of CEA, as revealed by solid‐phase RIA and SDS‐PAGE‐im‐munoblotting, indicating that these two CEA‐specific epitopes are based on the conformational structure of the CEA molecule.
Changes of peripheral t‐cell subsets in asplenic w256 tumor‐bearing rats
Authors: Ge Yigong , Gao Han , Kong Xiantao
Published: February 2007

In exploring the mechanism of the effect of splenectomy on tumor growth, splenectomized rats and other control rats were implanted subcutaneously with Walker 256 carcinosarcoma cells (5 × 105) on day 10 after splenic operation; meanwhile, peripheral T‐lymphocyte subsets were analysed successively. It was found that splenectomy enhanced the rate of tumor appearance and mean tumor diameter and disturbed the equation of T‐lymphocyte subsets in peripheral blood, i.e., a subnormal level of Th/Ts ratio. Interestingly, a significant correlation was noted between decreasing values of Th/Ts ratio and increasing average diameters of implanted tumor in splenectomized rats, but not in sham‐splenectomized or nonoperated rats with tumor growth. In spleen cells from tumor‐bearing rats, a distinct increase of B‐lymphocytes and a decrease of T cells were demonstrated. Data from this investigation provide striking evidence that a relationship exists between enhancement of tumor growth and disproportion of T‐lymphocyte subsets in peripheral blood and offer some reasonable explanation for the causes of the promotive role of tumor growth following splenectomy.
Recurrent malignant salivary gland neoplasms
Authors: Rodriguez‐Bigas M. A. , Sako K. , Razack M. S. , Shedd D. P. , Bakamjian V. Y. , Castillo N. B. , Rao U.
Published: February 2007

Recurrent salivary gland malignancies present difficult therapeutic decisions and poor prognosis in many instances, and treatment becomes of a palliative nature only. As many of the salivary gland malignancies we see are of the recurrent type, the following study was done to determine the efficacy of a vigorous attempt at retreatment. During the period January 1, 1960, through December 31, 1984, 352 patients with major and minor salivary gland tumors were evaluated at our institution. There were 149 benign lesions and 203 patients with malignant tumors. Of these, 99 patients had recurrent and metastatic tumors that had been treated initially elsewhere. Thirty‐three of these patients were able to be treated with curative intent: surgery, 21; surgery plus radiation, 9; radiation therapy alone, 2; and radiation plus chemotherapy, 1. The 5 year survival with no evidence of disease was achieved in three patients with surgery alone and two patients with surgery plus radiation therapy. The group of five patients was comprised of two patients with adenoid cystic carcinomas of the parotid, one with intermediate grade mucoepidermoid carcinoma of the parotid, one, sebaceous cell carcinoma of the parotid, and one, adenoid cystic carcinoma of an accessory salivary gland. The results of this study serve to re‐emphasize the relative poor yield of attempts at retreatment of loco‐regional recurrence of salivary gland tumors.
Analysis of prognostic factors in 568 patients treated for breast cancer by surgery
Authors: Muller Anna G. S. , van Zyl Jacobus A. , Joubert Gina
Published: February 2007

The Tygerberg Breast Clinic serves a heterogeneous population, and it is therefore possible to analyse prognostic factors influencing survival and to identify any possible differences between these groups. From 1978 to 1985, 568 breast cancer patients (52% white and 48% colored) were treated surgically in Tygerberg Hospital. Stage for stage, all patients received identical treatment. Colored patients were seen at a younger age, with more advanced disease, had lower estrogen receptor values, and more nodes involved. Cox's regression analysis of age, receptor value, stage, nodal involvement, race, menopausal status, treatment, and study period in the evaluation of disease‐free survival and overall survival confirmed stage and lymph node status as prognostic factors. Estrogen receptor status, menopausal status, age at presentation, treatment, study period, and race did not enter the regression, except in stage I, where race was a variable. A target group for directing educational intervention is identified.
Catecholamine excess: Probable cause of postoperative tachycardia following retroperitoneal lymph node dissection (RPLND) for testicular carcinoma
Authors: Bahnson Robert R. , Andriole Gerald L. , Clayman Ralph V. , Catalona William J.
Published: February 2007

Review of the postoperative course of seven patients who underwent retroperitoneal lymph node dissection (RPLND) for staging of testicular carcinoma revealed an unexplained tachycardia that was persistent for several days. Postoperative catecholamine determinations from three subsequent patients subjected to RPLND revealed dramatic increases in epinephrine, norepinephrine, dopamine, and total catecholamines. Since cardiac acceleration is mediated almost exclusively by sympathetic stimulation, this finding may explain the postoperative tachycardia observed in these patients.
Free jejunal graft for repair of cervical esophagus
Authors: Sohrabi A. , Nowzari Pourandokht , Ashairi M. , Moghari A. , Watne Alvin
Published: February 2007

We have operated upon six patients with cervical esophageal carcinoma and reconstructed these with free jejunal graft. The pathology of all six patients was squamous cell carcinoma, and no patient had apparent distant metastasis. The procedure was a two team approach. While the surgical oncology team resected the esophageal tumor, the microvascular team harvested the jejunal graft. The range of warm ischemia for the free jejunal graft was 1‐2.5 hr, and no graft was lost because of recirculation failure. The range of operative time was 5‐6.5 hr. There was no operative mortality. There were two minor cervical wound infections, both healed with conservative management. Hospital stay ranged from 10 to 15 days. The swallowing mechanism was satisfactory in all patients. We believe that the free jejunal graft is the procedure of choice for reconstruction of the cervical esophagus.
Subclinical primary liver carcinoma
Authors: Li Guo‐Hui , Li Jin‐Qing
Published: February 2007

From 1976 to 1984, 30 cases of asymptomatic primary liver cancer (subclinical primary liver cancer) have been treated in our hospital. The most important approaches used to uncover subclinical primary liver cancer were (1) the use of alpha‐fetoprotein (AFP) monitoring in patients with liver disease; (2) the use of an AFP survey among high‐risk area populations; and (3) X‐ray examination of the diaphragm and sonography examination.

The resectability rate of this series was 50%. The 3 and 5 year survival rates after hepatectomy were 62.5 and 57.1%, respectively. Hepatic arterial ligation combined with irradiation for the nonresectable cases had a better result.

We discuss here the approaches and the diagnostic criteria of subclinical primary liver cancer.
Effects of intratumoral injection of I‐125 lododeoxyuridine on ehrlich ascites carcinoma
Authors: Hong Seong Su , Ford Edith H. , Alfieri Alan A. , Bravo Sergio
Published: February 2007

Intratumoral injection of I‐125 iododeoxyuridine (IUdR), saline solution, and oil suspension was investigated using Ehrlich ascites tumors in the thighs of mice. The oil suspension was more effective in tumor growth delay than was the saline solution. Single injection of the oil suspension at the dose of 12.5 μCi resulted in 21.5 days growth delay, whereas 50 μCi of the saline solution resulted in 11.5 days growth delay relative to control growth delay.

At 40 days after treatment, higher radioactivities were observed in the tumor and the skin of the mice treated with the oil suspension, which represented the prolongation of I‐125 IUdR oil suspension within the tumor. No normal tissue toxicities were observed.
Hamartoma of the breast
Authors: Riveros Manuel , Cubilla Antonio , Perotta Francisco , Solalinde Victor
Published: February 2007

Mammary hamartomas are unusual lesions with distinctive radiologic and pathologic features. They are well circumscribed, mobile tumors showing no adherence to skin or muscle. Mammographic studies show a peripheral, luscent halo, and the mass is radiographically similar in pattern to a normal breast (“breast within a breast”). Calcification is not present. Histologically, these encapsulated lesions are composed of various breast tissue components such as ducts, lobules, stroma prominently adipose, and smooth muscle, without any particular arrangement. Local surgical resection is the treatment of choice. Hamartomas of the breast are benign lesions that need to be distinguished from other breast neoplasms such as fibroadenomas, lipomas, and cystosarcoma phyllodes.
Ocular melanoma in alberta: A 38 year review pointing to the importance of tumor size and tumor histology as predictors of survival
Authors: Hayton Susan , Lafreniere Rene , Jerry L. Martin , Temple Walley J. , Ashley Pauline
Published: February 2007

A large number of cases of ocular melanoma have been entered in The Provincial Cancer Registry of Alberta over the past 40 years. This study was undertaken in order to describe further the natural history of this disease and derive management recommendations for use at the provincial level. A retrospective chart review was carried out on all cases of ocular melanoma registered through The Alberta Provincial Cancer Registry between 1949 and 1987. Two hundred fifty‐one cases were identified: 143 were males and 108 were females. The mean age of the patients at diagnosis was 60. The majority of the melanomas arose from the choroid of the eye (82%) with the remainder arising from the iris, conjunctiva and ciliary body, respectively. According to the Callender classification for ocular melanomas, the majority of the melanomas were of the spindle cell type (53%), the others being either mixed cell (23%), epithelioid (8%), or fascicular (1%). Survival rates differed depending on the cell type. Spindle cell tumors demonstrated a mean survival time of 5.2 years; epithelioid tumors 4.8 years and the mixed cell tumors appeared to be the most aggressive with a mean survival time of 2.7 years after diagnosis. The majority of deaths from ocular melanoma occurred within 5 years of diagnosis, although 14% of patients in this review presented with metastases more than 10 years after diagnosis. Some of the cases of ocular melanoma could be classified pathologically as small, medium, or large. Patients with large ocular melanomas had a 5 year survival rate of 33% compared to 70% and 66% for patients with small and medium sized tumors. Of note, 43% of patients with large ocular melanomas who were dead from their disease within 5 years of diagnosis were also found to have mixed cell tumors. These findings call for a longer follow‐up period for ocular melanomas and point to the importance of cell type and tumor size as predictors of survival and as guides in planning prophylactic therapeutic interventions.
Role of intraoperative ultrasound in the screening of liver metastases from colorectal carcinoma: Initial experiences
Authors: Russo Antonio , Sparacino Giulio , Plaja Sergio , Cajozzo Massimo , la Rosa Carmelo , Demma Ignazio , Bazan Pietro
Published: February 2007

The aim of this study was to assess the utility of intraoperative ultrasound (IOUS) in the diagnosis and management of liver metastases from colorectal carcinoma. IOUS was performed on a consecutive series of 70 patients undergoing surgery for colorectal carcinoma, with follow‐up ranging from 6 to 24 months. In ten cases (14.3%), 13 metastatic tumours were diagnosed; only six of these had been found by preoperative workup and/or surgical inspection. Seven (53.9%) small metastatic liver lesions were identified only by IOUS. None of the lesions diagnosed by IOUS was palpable, and they were all extremely small—ranging from 4 × 6 to 12 × 16 mm. Seventy‐three locations were examined in order to compare the results of IOUS with those of other methods. The sensitivity of the former proved to be higher (P < .05) than that of conventional pre‐ and intraoperative screening.
Calcitonin gene‐related peptide in patients with endocrine tumors
Authors: Takami Hiroshi , Shikata Jun‐Ichi , Kakudo Kennichi , Ito Kunihiko
Published: February 2007

The plasma level of calcitonin gene‐related peptide (CGRP) was measured by RIA in 41 patients with endocrine tumors [22 medullary thyroid carcinomas (MTC), seven parathyroid adenomas, four benign insulinomas, five carcinoids, and three pheochromocytomas]. Of the 22 patients with MTC, all five preoperative patients had elevated CGRP levels. The correlation between CGRP and calcitonin levels was significant (P < .001) in 22 patients with MTC. Six of 19 patients with endocrine tumors other than MTC showed elevated CGRP levels. Immunohistochemical study showed that tumor tissues from all 22 cases of MTC and seven from other endocrine tumors contained immunoreactive CGRP. CGRP reactivity was found in only small numbers of tumor cells. Thus, although CGRP appeared to be a useful additional marker for MTC, the role of CGRP in the pathophysiology of endocrine tumors was not elucidated.
In vivo administration of Picibanil (OK‐432) prior to tumor harvest leads to an enhancement of tumor‐infiltrating lymphocyte (TIL) cytotoxicity
Authors: Lafreniere Rene , Borkenhagen Knut , Bryant Laurette D.
Published: February 2007

TILs can be isolated and expanded in vitro in the presence of RIL‐2. The resulting cells are highly cytotoxic in vitro and in vivo against a variety of tumor targets. Although most of the TILs bear T cell antigens on their cell surface, recent evidence suggests that natural killer (NK) cells may be part of the overall population of infiltrating cells. Based upon this evidence, we have evaluated the effects of Picibanil (OK‐432), a well‐known inducer of NK cell and T cell cytotoxicity, on TILs. OK‐432 was administered intravenously at a dose of 100 μg, previously determined to be optimal for NK stimulation, to tumor‐bearing animals. Two days later, control and experimental animals had their tumors harvested and processed in order to grow their TILs in vitro in complete medium containing RIL‐2 at a final concentration of 1,000 U/ml. The following observations were made: 1) a greater than 300% increase in overall TIL number compared to controls on day 10 of culture returning to normal by day 30; 2) a marked increase in the percent of cells expressing cytotoxic and differentiation antigens in the experimental group compared to controls, such increase seen mostly from day 7 to day 10; 3) a marked increase in the cytotoxic activity of the experimental TILs against an NK‐sensitive tumor target, the YAC‐1 lymphoma, throughout the period of growth of the TILs (3–4 times controls) and to a lesser extent against an NK‐resistant tumor target. These findings may have potential application in immunotherapeutic trials against human tumors and may help to understand the reasons for the effectiveness of OK‐432 in vivo against selected murine tumors.
Surgical treatment of solitary adrenal metastases from lung carcinoma
Authors: Raviv Gil , Klein Ehud , Yellin Alon , Schneebaum Shlomo , Ben‐Ari Gur
Published: February 2007

The adrenal gland is a frequent site for metastases from lung carcinoma. We have treated five patients with a solitary symptomatic mass in the adrenal by palliative adrenalectomy with fair results. These case reports and discussion of the literature are presented.
Improved survival after pulmonary resection of metastatic colorectal carcinoma
Authors: Sauter Edward R. , Bolton John S. , Willis Gladden W. , Farr Gist H. , Sardi Armando
Published: February 2007

While hepatic resection of metastatic colorectal carcinoma is accepted as effective in selected patients, resection of metastases to other solid organs has not gained wide acceptance. We retrospectively reviewed the records of 49 patients who had resection of isolated pulmonary (18 patients) and hepatic (31 patients) metastases from the large bowel, comparing diseasefree survival and overall survival. Tumor parameters analyzed included Dukes' stage, deoxyribonucleic acid (DNA) flow cytometry, and number of metastases. Dukes' B and diploid tumors had longer disease‐free survival and overall survival than did Dukes' C and aneuploid tumors, though the difference was not significant. Patients with a single lung metastasis had a significantly longer disease‐free survival (P = .02) than did patients with multiple metastases. Mean and median survival were longer in patients with lung metastases. Five‐year actuarial survival was 19% for patients with liver metastases and 47% for patients with lung metastases. Resection of isolated pulmonary metastases from the large intestine results in survival comparable to or better than resection of hepatic metastases. An aggressive surgical approach is warranted in patients with isolated resectable pulmonary metastases of colorectal carcinoma.
Experimental study and clinical application of a single‐row suturing esophagogastrostomy
Authors: Gao Shang‐Zhi , Wang Tu‐Sheng , Yao Zhen , Cheng Bang‐Chang , Tu Zhong‐Fan , Ling Dao‐Ming , Peng Shang‐You
Published: February 2007

A single‐row suturing anastomosis (SRA) for an esophagogastrostomy was experimentally investigated in dogs. SRA not only shortened operating time, but also led to better pathological results when compared with double‐row suturing anastomosis. Wide‐brim suturing and equal distance between the sutures, providing increased and well‐distributed blood circulation, are the key points for success of SRA. Its simplicity and safety are advantages of SRA as has been shown in 90 cases in clinical application.