bluuebunny/crossref_metadata_2025 huggingface dataset:
Invasive colorectal adenomas: Surgery versus colonoscopic polypectomy
Authors: Pines Amos , Bat Leon , Shemesh Eliahou , Ron Elaine , Horowitz Ada , Chetrit Angela , Bubis Jose J.
Published: February 2007

Of 6,426 colonoscopies performed in 1978–1987, 66 invasive colorectal adenomatous polyps were removed in 58 examinations. The study group included 36 (62%) men and 22 (38%) women with an age range of 42–96 years. Forty‐three patients had invasive pedunculated polyps and 15 had invasive sessile polyps. Following the colonoscopic polypectomy, secondary surgical resection was done in 19 patients with pedunculated polyps and in 13 patients with sessile polyps. The operative specimens showed that the colonoscopic polypectomy removed the entire cancerous focus in all patients with pedunculated polyps, including those with stalk invasion. In contrast, most cases with sessile polyps turned out on operation to be Dukes' B or C carcinoma. Follow‐up (mean 4.4 years) was available for 53 (93%) patients: none of 24 unoperated patients with pedunculated polyps suffered from local recurrence. We conclude that colonoscopic polypectomy is sufficient for invasive pedunculated polyps, provided that histology shows that the resection margins are free of tumoral cells. Surgery is recommended for all invasive sessile polyps.
Malignant struma ovarii: Report of two cases and selected review of the literature
Authors: Zakhem Antoine , Aftimos George , Kreidy Raghid , Salem Philip
Published: February 2007

Malignant struma ovarii is an extremely rare tumor. Two new cases are described and current perspectives provided. Both cases are examples of the mixed form of the disease, and both were treated by surgery alone. One patient underwent total hysterectomy and bilateral salpingo‐oophorectomy; the other had unilateral salpingo‐oophorectomy. Both patients remained free of recurrent disease at 20 and 33 months from diagnosis. The controversies relating to therapy and diagnosis are discussed in detail.
Do adrenal metastases from lung cancer develop by lymphogenous or hematogenous route?
Authors: Károlyi Peter
Published: February 2007

In order to analyse the possible mode and pathways of adrenal metastases from lung cancer, the frequency of adrenal metastases ipsilateral and contralateral to the site of the primary cancer was investigated based on autopsied lung cancer cases. In 405 of 1,607 such cases, adrenal metastases could be found: on both sides, 234; ipsilateral only, 105: contralateral only, 66 cases. In the early stages of tumor progression, a striking difference can be seen between the two sides. Ipsilateral metastases were of significantly higher incidence in early metastatic tumor stages, but later, in cases having six or more involved organs, the ipsilateral/contralateral quotient reaches 1. It is postulated that in the early stages adrenal metastases from lung cancer probably develop mainly by lymphogenous, but later mainly by hematogenous routes.
Dormancy and breast cancer
Authors: Meltzer Adolph
Published: February 2007

A case is presented in which multiple nodules of recurrent cancer appeared about the scar 25 years after radical mastectomy. They were accompanied by an inflammatory reaction. Breast cancers may recur as long as 50 years after surgery. Such late recurrence is accomplished by the cancer cell entering a “dormant” state in which little or no de novo DNA transcription occurs and only enough RNA is translated into proteins to maintain the vegetative functions that sustain cell viability. Features favoring the evolvement of dormancy are discussed as well as the nature of the cocoon‐like shell which affords such cancer cells protection from the host's cellular and serological defenses. Speculation, promoted by the new cellular biology, as to the cause of secondary inflammatory cancers, is presented. A possible mechanism for the reactivation of these quiescent cells is suggested. The altered immune reactions of host and cancer cells provide an explanation for the controversies plaguing surgeons regarding the treatment and prognosis of breast cancer.
Role of brachytherapy in malignant melanoma: A preliminary report
Authors: Chadha Manjeet , Hilaris Basil , Nori Dattatreyudu , Shiu Man H. , Anderson Lowel L.
Published: February 2007

From August 1979 to May 1986, various brachytherapy techniques were applied at Memorial Sloan Kettering Cancer Center (MSKCC) in an adjuvant setting with/without surgery and external radiation therapy in the management of advanced malignant melanoma. Thirty‐three patients underwent brachytherapy procedures. The patients' ages ranged from 35 to 82 years, with a median age of 56 years. Fourteen patients had disease localized to the implant site, whereas 19 patients also had disseminated disease elsewhere. The indications for implant were residual gross disease (21), microscopically positive margins (3), and histologically negative but clinically close margins of resection (9). Local control at the implant site was noted in 80% of patients at 6 months and 42% of patients at 1 year; two patients had reached 54 months and 72 months with no evidence of disease. Local control was 100% (9/9) in patients with histologically negative but clinically close margins of resection, and 48% (11/23) with microscopically positive margins and/or gross residual disease. Complications were seen as follows: delay in wound healing (1). wound infections (4), radiation enteritis (1), small bowel obstruction (1). The present study suggests that brachytherapy combined with surgery can achieve a good local control in patients with negative but clinically close margins of resection. In patients with gross residual disease who are at a high risk for local recurrence, approximately one‐half can be locally controlled with this approach. These preliminary results should be tested in a prospective controlled study.
Pancreatic somatostatinoma: A case report and review of the literature
Authors: Konomi Kohki , Chijiiwa Kazuo , Katsuta Toshiro , Yamaguchi Kohji
Published: February 2007

A 56‐year‐old man underwent distal pancreatectomy, splenectomy, and partial resection of the splenic flexure of the colon because of tumor in the tail of pancreas and the splenic hilus. The patient presented with symptoms of general malaise, anorexia, weight loss, mild diarrhea, and borderline diabetes mellitus, although there was no cholelithiasis. The diagnosis remained unclear until immunohistochemical studies of the resected specimen revealed somatostatin and synaptophysin, suggesting a somatostatinoma. Twenty‐three reported cases of pancreatic somatostatinoma are reviewed and their clinical features discussed. The role of immunohistochemical studies in the diagnosis of somatostatinoma is described.
Fine‐needle aspiration cytology of abdominal masses
Authors: Khanna Ajay Kumar , Misra Mahendra Kumar , Khanna Anuradha , Misra Vijay Kumar , Khanna Sushila
Published: February 2007

An investigation of the role of blind fine‐needle aspiration cytology (FNAC) in the assessment of palpable abdominal masses was carried out on 196 patients: 124 hepatic, 30 retroperitoneal, and 42 other masses. All of the smears were stained either by Papanicolaou stain or by hematoxylin and eosin stain. The results of FNAC were confirmed by further investigations in all cases. FNAC correctly diagnosed 166 (84.6%) cases. Twenty (10.2%) reports were false negative, and 10 (5.1%) smears were unsatisfactory for any diagnosis. Of 124 hepatic masses, the correct diagnosis was obtained in 106 (85.4%), false‐negative reports in 14 (11.2%), and unsatisfactory smears in 4 (3.2%). There were no false‐positive reports. For all of the lesions, the sensitivity of FNAC was 87.8%; specificity, 100%; positive predictive value, 100%; and negative predictive value, 52.4%. Five (2.5%) patients had considerable pain after the procedure.
Somatostatin analogue and tissue cultures in the study of a human malignant glucagonoma
Authors: Ahlman Håkan , Åhlund Lars , Dahlström Annica , Grimelius Lars , Theodorsson Elvar
Published: February 2007

A patient with metastasizing glucagonoma producing multiple molecular forms of glucagon is reported. The patient responded to symptomatic treatment with a somatostatin analogue (SMS 201–995). Glucagonoma tumour cells were studied in two tissue culture systems: intraocular transplants of immunosuppressed rats and long‐term cell cultures. In both systems, several region‐specific glucagon antisera gave a positive immunoreaction with tumour cells indicating synthesis of multiple molecular species. Intraocular tumour transplants released glucagon into the chamber fluid. In animals with unilateral transplants, glucagon was also detected in the contralateral eye chamber, indicating passage from the transplants via unknown mechanisms. Treatment of tumour cells during culture with SMS 201–995 inhibited rapidly the spontaneous release of glucagon without evident cytotoxic effects. The inhibitory effect decreased with time.
Pdn‐21: Possible tumor marker for medullary thyroid carcinoma
Authors: Takami Hiroshi , Shikata Jun‐Ichi , Horie Hitoshi , Sekine Kyouichi , Ito Kunihiko
Published: February 2007

The plasma level of PDN‐21 was measured by RIA in 10 patients with medullary thyroid carcinoma (MTC). All 10 patients with MTC had extremely elevated PDN‐21 levels. The correlations between PDN‐21, calcitonin gene‐related peptide, and calcitonin, (all of which are calcitonin gene products) were significant (P < .001) in the 10 MTC patients. This study suggests that PDN‐21, as well as calcitonin, may be a useful marker for the detection of patients with MTC.
Expression of Lewisa, Lewisb, and sialated Lewisa antigens in early and advanced human gastric cancers
Authors: Inagaki Hiroshi , Sakamoto Junichi , Nakazato Hiroaki , Bishop Anne E. , Yura Jiro
Published: February 2007

An immunohistochemical analysis of the expression of Lewisa, Lewisb, and sialated Lewisa blood group antigens was performed on specimens of human non‐involved stomach (n = 91), early gastric cancers (n = 41), and advanced gastric cancers (n = 50). In non‐involved stomach, Lewisa and Lewisb were detected mainly in surface epithelium, although sialated Lewisa was scarcely expressed. These blood group‐related antigens were rarely observed in deep glands. In gastric cancers, Lewisa showed a tendency to be expressed in well or moderately differentiated carcinomas, and this was observed to be more marked in advanced tumors. There was no obvious difference in positive ratios of Lewisb between degrees of differentiation of the cancers. Sialated Lewisa was not detected in early cancers, and its frequent expression in well‐ or moderately differentiated, advanced carcinomas suggested an association with both cancer differentiation and progression. These results indicate that knowledge of the expression of blood group antigens may help interpret the antigenic alterations occurring in the course of carcinogenesis, differentiation, and progression of gastric cancers.
Fine needle aspiration biopsy in clinical management of head and neck tumors
Authors: Flynn Michael B. , Wolfson Stewart E. , Thomas Steven , Kuhns James G.
Published: February 2007

Ninety‐five percent (195) of 203 fine needle aspiration biopsies (FNAB) of head and neck specimens contained adequate tissues for histologic evaluation. No complications or needle tract recurrences were identified. Out of 135 patients whose surgical excision followed FNAB, 5% (7/135) of the biopsies were nondiagnostic. Correlation of cytologic and histologic findings of the remaining 128 FNAB revealed a sensitivity rate of 82% (46/56), a specifity rate of 99% (71/72), and a positive predictive of value of 98% (46/47). The diagnostic accuracy of FNAB was better with salivary gland and cervical node specimens than with thyroid, skin, and subcutaneous specimens. Fine needle aspiration biopsy may be considered as the first diagnostic step in the evaluation of the mass of the head and neck region, if the nondiagnostic aspiration rate is low and the diagnostic accuracy is high.
Adenocarcinoma of the vermiform appendix
Authors: Harris Gary J. , Urdaneta Luis F. , Mitros Frank A.
Published: February 2007

Primary adenocarcinoma of the appendix is rare. Eleven patients with this rare neoplasm have been evaluated at our institution over a 50‐year period. We have reviewed the presentation and clinical course of these patients, and have compared them with those described in the literature. The presenting signs and symptoms, physical findings, and treatment were similar to those described in the literature. However, the 5‐year survival of 20% is lower than most series, and reflects the advanced stage of disease at the time of diagnosis in this group of patients. Despite the low 5‐year survival, we feel that aggressive therapy (right hemicolectomy) is necessary to obtain long‐term survival.
Establishment of an esophageal squamous cell carcinoma tumor line and development of serum squamous cell carcinoma‐related antigen in athymic nude mice
Authors: Terashima Masanori , Ikeda Kenichiro , Ishida Kaoru , Saito Kazuyoshi
Published: February 2007

A serially transplantable tumor line (IMEs‐1) derived from human esoph‐ageal squamous cell carcinoma (SCC) of a 71‐year‐old female was established in nude mice. The histology of IMEs‐1 closely resembled that of the original tumor and tumor doubling time was 3.2 days. Production of SCC‐related antigen (SCCRA) and carcinoembrionic antigen (CEA) in the serum of tumor‐bearing mice was observed.

To evaluate the usefulness of SCCRA for esophageal cancer, the relationship between the serum levels of SCCRA and tumor burden in athymic nude mice bearing IMEs‐1 was studied.

The mean serum levels of SCCRA, as determined by radioimmunoassay, gradually rose in direct proportion to the tumor growth gauged by tumor volume.

However, the serum levels of CEA did not increase until the last few weeks of the assay. These results suggest the possibility of using SCCRA as a tumor marker for esophageal SCC. In addition, this nude mouse assay system will provide a theoretical model to study the usefulness of SCCRA.
Characterization of four newly established human colorectal adenocarcinoma cell lines from chinese patients
Authors: Cheng Jhy‐Young , Meng Ching‐Liang , Lin Iih‐Chang , Tzeng Ching‐Cherng , Chin Li‐Te , Shen Kuo‐Liang
Published: February 2007

Four colon adenocarcinoma cell lines, CC‐M2, CC‐M3, CC‐M4, and CC‐M2NM, have been established from surgical specimens of 18 unselected patients without the use of “feeder” cells and additional growth factors (e.g., insulin, hydrocortisone, etc.) in the culture medium. The methods of primary cultivation of tissue explants are described. Studies of determination of morphology, growth curve, plating efficiency, chromosomal analysis, CEA and beta‐HCG synthesis, and tumorigenicity, were done to characterize the cell lines. Significant variations have been found in one of the four cell lines, both in vitro and in vivo studies. There are distinct phenotypes in the established cell lines which may be useful in studying the cell differentiation and progression of colorectal cancer.
Changes in the DNA ploidy patterns of human colorectal carcinomas, subsequent to culture or xenografting
Authors: McA. Foster Hamish , Tay Diana L. M. , Whitehead Robert H.
Published: February 2007

DNA ploidy patterns were measured by flow cytometry in 7 human carcinomas and compared with the DNA histograms of 3 cell lines and 25 xenografts and derived from them. Four of the carcinomas showed DNA ploidy changes on initial xenografting or early passaging, while 2 carcinomas showed stable ploidy patterns over several xenograft passages. One xenograft derived from a cell line showed a marked, but stable, increase in DNA content over the original human carcinoma. Two of the 3 cell lines were DNA aneuploid, and at least 1 line was apparently derived from a minor subpopulation in the original carcinoma. The possible mechanisms and implications of these changes are discussed.
Cyclophosphamide and ifosfamide combination as neoadjuvant chemotherapy for locally advanced nonsmall‐cell lung cancer: A meta‐analytic review
Authors: Rosell Rafael , Moreno Isabel , Maestre José , Olazabal Angel , Carles Joan , Barnadas Augustin , Abad‐Esteve Albert , Ribelles Nuria , Canela Mercedes
Published: February 2007

Twenty‐three patients with marginally resectable and unresectable nonsmall‐cell lung cancer (stages IIIA and IIIB) were treated by neoadjuvant chemotherapy. All patients received three cycles of preoperative chemotherapy with two alkylating agents, cyclophosphamide 2.5 g/m2 intravenously (i.v.) and ifosfamide 3.5 g/m2 i.v., mesna 12 g/m2 was given additionally to prevent drug hematuria. Six of 23 patients (26%) had partial response. Of the seven patients who underwent thoracotomy, two were completely resected, but with macroscopic residual disease. Mean time to progression for the whole group was 7 months. Fifteen patients had progression of disease, with local metastases only in six, and distant metastases in eight. After administering 52 chemotherapy cycles, cyclophosphamide‐ifosfamide doses were cut down, as eight of 16 patients required hospitalization for fever during neutropenia nadirs. This two‐ alkylating (non‐cisplatin) regimen, unlike cisplatin‐based regimens, was ineffective, and further trials are not recommended.
Adjuvant chemotherapy enhances long‐term survival of patients with advanced gastric cancer following curative resection
Authors: Maehara Yoshihiko , Moriguchi Sunao , Sakaguchi Yoshihisa , Emi Yasunori , Kohnoe Shunji , Tsujitani Shunichi , Sugimachi Keizo
Published: February 2007

We examined the effectiveness of postoperative adjuvant chemotherapy with mitomycin C (MMC), 1‐(2‐tetrahydrofuryl)‐5‐fluorouracil (tegafur), plus PSK, an immunomodulator, for patients with advanced gastric cancer who underwent histological curative resection. The effect of chemotherapy on prognostic serosal (ps) invasion [ps(−) or ps(+)] and lymph node metastasis [n(−) or n(+)] was examined. One hundred eighteen patients were in the no‐chemotherapy group and 137 were on the drugs. The median follow‐up time for the 86 survivors at the time of analysis was 13.8 years. With regard to prognostic factors, there were no differences between the two groups. Generalized Wilcoxon test of the two survival patterns revealed a P value of .0351, and the survival rate for 15 years was 45.7% for patients in the no‐chemotherapy group and 56.9% for those of the chemotherapy group. In particular, adjuvant chemotherapy was effective for patients with ps(−)n(+) (P <.05) and ps(+)n(−) ( P <.05), but not for those with ps(−)n(−) and ps(+)n(+).

Our findings show that the concomitant prescription of MMC, tegafur, and PSK improves the 15‐year survival rate for patients with advanced gastric cancer, following curative resection. As the survival rate is low for the patients with ps(+)n(+), an even more aggressive postoperative chemotherapy is recommended.
Complications of stapled anastomoses in anterior resection for rectal carcinoma: Colorectal anastomosis versus coloanal anastomosis
Authors: Burke Emmett R. C. , Welvaart Kees
Published: February 2007

Postoperative results of 48 patients who underwent anterior resection using the EEA‐stapler were evaluated. In all but 2 cases the indication for surgery was colorectal carcinoma. In 24 patients an anastomosis was created above the 5 cm level (above the anal verge: colorectal anastomosis) and in 24 at the 0‐5 cm level (coloanal anastomosis). There was no perioperative mortality. The only complication observed in the colorectal anastomosis group was one case of late anastomotic stenosis. In the coloanal anastomosis group there were 4 cases with early anastomosis leaks, 3 cases with late stenosis and 5 cases with various degrees of late fecal incontinence, ultimately resulting in a permanent diverting stoma in 5 (10.4%) patients.

We conclude that for rectal tumors the EEA‐stapled anterior resection provides excellent functional results in most cases. Stapled coloanal anastomoses more often demonstrate various (early and late) complications. Nevertheless in spite of chronic discomfort, many patients still prefer their complaints to a permanent stoma.
Immune‐competent cells of regional lymph nodes in colorectal cancer patients: II. Immunohistochemical analysis of leu‐7+ cells
Authors: Adachi Wataru , Usuda Nobuteru , Sugenoya Akira , Iida Futoshi
Published: February 2007

Distribution of Leu‐7+ cells in cancer tissues and regional lymph nodes was immunohistochemically examined to estimate the role of NK cells in colorectal cancer patients. Leu‐7+ cells were rarely observed both in the primary and distant metastatic lesions, but the number of these cells was large in the germinal center of the lymph nodes. Studies of Leu‐7+ cell population in the lymph node indicated that intermediate nodes in n0 and n1 groups showed significantly higher values than those in the control group. Comparative study of the population in identical patients revealed a significantly higher rate in the intermediate nodes than in the paracolic nodes both in n0 and n1 groups.

These data suggest that Leu‐7+ cells might be related to the defense mechanism of regional lymph nodes against tumor.
Long survival and prognostic factors in hepatocellular carcinoma
Authors: Zhao Guolong , Su Suey , Borek Deborah , Friesen Stanley , Holmes Frederick
Published: February 2007

We studied survival and prognostic factors in all cases of hepatocellular carcinoma seen at a Midwestern teaching hospital from 1947 through 1986. Of the 70 cases, 56 were diagnosed during life and 14 at autopsy. There were 47 males and 23 females with age at diagnosis ranging from 14 to 88. Median survival for the 56 patients diagnosed during life was 106 days. Only 11 patients lived longer than one year. Two patients were long survivors and presumed cured, one living 27 years after diagnosis and surgical treatment and the other 19 years. Cox regression model showed young age at diagnosis and low stage of disease at diagnosis to be significant predictors of long survival. White patients survived nearly twice as long as black patients but the difference was not significant. Gender and year of diagnosis did not appear to be important determinants of survival. Pathologic material was still available for one of the two long survivors and the histology was that of fibrolamellar carcinoma of young adults.
Hemicorporectomy: A collective review
Authors: Ferrara Bernard E.
Published: February 2007

Hemicorporectomy or translumbar amputation has been described as the most revolutionary of all operative procedures. Frederick E. Kredel, who first voiced the concept of the operation in 1950, referred to it as halfectomy. Demonstration of his cadaver studies established the feasibility of the operation. Amputation is effected through the lower lumbar area of the body. Necessary life functions are preserved in the upper torso.

Kredel envisioned hemicorporectomy as a curative operation for locally advanced cancer, limited to the pelvis, not encompassable by standard operative intervention. Additional indications are intractable decubitus ulcers with malignant change, particularly in paraplegics; pelvic organs, and bone infection with nonhealing fistulae; and crushing trauma to the pelvis.

The first hemicorporectomy operation was reported in 1960. Thirty‐four operations have been recorded in the world literature. Two heretofore unreported cases are added, raising the total to 36. Review of these 36 cases confirms the conviction that hemicorporectomy is a humane and ethical alternative to the suffering encumbered by advancing, painful, malodorous malignant disease not treatable by conventional means.

While cure rates are not substantial, the best results are reported in paraplegics with intractable decubitus ulcers with or without malignancy. Rehabilitation is prolonged and costly. Most survivors have been restored to preoperative occupations or other gainful employment.
Adjuvant, specific, active immunotherapy for resectable squamous cell lung carcinoma: A 5‐year survival analysis
Authors: Takita Hiroshi , Hollinshead Ariel C. , Adler Richard H. , Bhayana Joginder , Ramundo Michael , Moskowitz Robert , Rao UMA N. M. , Raman Sankaranarayanan
Published: February 2007

In 1976 Stewart et al. (Annals of the New York Academy of Sciences277:436–466) reported the effectiveness of adjuvant specific active immunotherapy of lung carcinoma in improving the postoperative survival of stage I lung carcinoma patients in a phase II study using lung carcinoma‐associated antigen (TAA) and complete Freund's adjuvant (CFA). A phase III study was then designed by the authors to see the effects of specific active immunotherapy compared to the conventional management (no treatment) and to nonspecific immunotherapy.

From 1976 to 1981, 85 patients with resectable (stages I and II) squamous cell lung carcinoma were entered into a randomized study: 1) control group; 2) specific immunotherapy group–three monthly doses of 500 μg of TAA emulsified with CFA; 3) nonspecific immunotherapy group—three monthly doses of CFA emulsified in saline. All the patients in the study received skin tests with 100 μg of the same TAA used for the immunotherapy.

Recently, a 5‐year follow‐up of all the patients became available: The life table 5‐year survival of group 1 was 34%, of group 2 was 75%, and of group 3 was 53%. The median survivals for the three groups were group 1, 38 months; group 2, 106 months; and group 3, 71 months. The difference was significant atP=.007 (Cox‐Mantel test).
Postoperative adjuvant chemotherapy in non‐small cell lung cancer: Prognostic value of DNA ploidy and postrecurrent survival
Authors: Ichinose Yukito , Hara Nobuyuki , Ohta Mitsuo , Motohiro Akira , Kuda Tomoharu , Aso Hiroshi
Published: February 2007

Eighty‐six patients with non‐small cell lung cancer who underwent curative operations were postoperatively randomized to control and adjuvant chemotherapy groups. In the adjuvant chemotherapy group, patients received cisplatin‐based combination chemotherapy 3 or 4 weeks after operation and the average cycle of chemotherapy was 2.3 (from 1 to 6 cycles). In this trial, no evidence of improved survival or delayed recurrence was seen in the treated patients. In multivariate analysis of prognostic variables, the most important factor was the pathological stage of the disease and, second, DNA ploidy of the primary tumor. Although histology (squamous vs. non‐squamous cell carcinoma) had a trend to influence the survival, it was not a significant factor. A total of 33 patients had recurrences: 17 and 16 patients were in control and adjuvant chemotherapy groups, respectively. Postrecurrent survival in the adjuvant chemotherapy group was significantly shorter than that in the control group, as determined by the generalized Wilcoxon and log rank tests. Median survival time after recurrence in the control and adjuvant therapy groups was 18.5 and 7.5 months, respectively. These results suggest that DNA ploidy of primary tumors should be considered as a prognostic factor in future trials of adjuvant therapy. Furthermore, analysis of postrecurrent survival in the adjuvant chemotherapy trial, as well as that of overall and disease‐free survivals should be done.
Leukocyte alkaline phosphatase score in patients with cerebrovascular disease and in patients with primary and metastatic brain tumors
Authors: Walach Natalio , Guterman Amiram , Rabinowitz Haim , Kaufman Suzana , Habot Beni
Published: February 2007

Leukocyte alkaline phosphatase (LAP) activity in peripheral blood was determined in 54 patients with cerebrovascular disease (CVD), 11 patients with primary brain tumor, and 23 patients with metastatic brain tumor. The LAP score of the primary brain tumor patients (155 ± 40) was significantly higher (P<0.03) than the LAP score for cerebrovascular disease patients (96 ± 87). The LAP score levels of the metastatic brain tumor patients (251 ± 55) was significantly higher as compared with both the cerebrovascular disease (P<0.001) and primary brain tumor groups (P<0.001). The LAP score could serve as an additional, although non‐specific, marker to assist in the differentiation between cerebrovascular disease and brain tumors.
Granular cell neoplasm of the extrahepatic biliary tree: Morphological, ultrastructural, and immunohistochemical study and review of the literature
Authors: Lafreniere Rene , Demetrick Douglas J. , Benediktsson Hallgrimmur
Published: February 2007

A recent case of a biliary granular cell tumor of the cystic duct prompted a literature review and an extensive pathological examination of the tumor in question. A total of 44 cases have been described mostly in black females. Most cases present with biliary symptoms, and simple surgical resection allows complete control of this benign condition. Granular cell tumors are most likely derived from neural crest cells.
Bilateral malignant phyllodes tumours
Authors: Ball ADRIAN B. S. , Fisher Cyril
Published: February 2007

We report a rare example of bilateral primary malignant phyllodes tumours. The diagnosis was supported by the identification of a benign epithelial element in each lesion. The case illustrates the typical dimorphic features of malignant phyllodes tumours. A contralateral tumour should not be regarded as metastatic without histological confirmation.
Expression of HLA‐DR and secretory component antigens and lymphocyte infiltration in human gastric nonmalignant and malignant tissues: An immunohistochemical study
Authors: Hirozane Noburo , Tanaka Kanji , Nakane Yasushi , Yamamura Manabu , Hioki Koshirou , Nagura Hiroshi , Yamamoto Masakatsu
Published: February 2007

The relation between HLA‐DR and secretory component (SC) expression and the degree of lymphocyte infiltration was immunohistochemically examined in human gastric mucosa with or without intestinal metaplasia and gastric carcinoma tissues. Gastric mucosa without obvious inflammation showed neither expression of HLA‐DR or SC nor remarkable lymphoid infiltration. In contrast, gastric mucosa with chronic inflammation, tissues with incomplete type of intestinal metaplasia, and carcinoma demonstrated both HLA‐DR and SC in almost the same area and also prominent lymphoid infiltration in the surrounding stroma. This simultaneous expression of HLA‐DR and SC was not observed in complete type of intestinal metaplasia. The results indicate a close relationship between expression of HLA‐DR and SC and the presence of lymphocyte infiltration in gastric mucosa, areas of incomplete type of intestinal metaplasia and in gastric carcinomas.
Squamous carcinoma of the distal esophagus: A survival study
Authors: Harvey James C. , Kagan A. Robert , Frankl Harold , Davidson William , Rosenbaum D. , Fleischman Erik H.
Published: February 2007

A survival study for squamous carcinomas of the distal esophagus treated by the Southern California Permanente Medical Group in the interval of 1954 to 1988 was undertaken. We found radiation therapy and surgery equally efficacious in terms of cure for patients without distant disease and performance status sufficient to tolerate treatment. We did not find survival benefit for patients treated with palliative surgery, and plan less invasive endoscopic means along with chemotherapy and radiation for palliation, reserving surgery for special circumstances.
Results of multiple pulmonary resections for metastatic osteogenic sarcoma after two decades
Authors: Beattie Edward J. , Harvey James C. , Marcove Ralph , Martini Nael
Published: February 2007

A 20‐year follow‐up of children who had complete resection of pulmonary metastases from osteogenic sarcoma of the extremities was undertaken. Four of six 10‐year survivors survived more than 19 years even with multiple metastases and as many as nine thoracotomies. Fifty percent of the 10‐year survivors developed second primary cancers during the second decade of follow‐up.
Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients
Authors: Spijkervet Fred K. L. , Van Saene Hendrik K. F. , Van Saene Joris J. M. , Panders Arend K. , Vermey Albert , Mehta Dinesz M. , Fidler Vasek
Published: February 2007

Recently it has been reported that chlorhexidine 0.1 % rinsing was not successful in eradication of gram‐negative bacilli in patients who have head and neck cancer. These bacilli could play a role in irradiation mucositis. This study reports the effect of lozenges containing 2 mg polymyxin E, 1.8 mg tobramycin, and 10 mg amphotericin B qid on the oropharyngeal flora in 15 irradiated head and neck cancer patients. The results were compared with those of a previous study in two groups of 15 patients comparing chlorhexidine rinsing with placebo. In all patients using lozenges, eradication of gram‐negative bacilli and yeasts was achieved within 3 weeks. A significant increase of enterococci was found. Mucositis was significantly reduced compared with the previous two groups. All patients showed erythema only, whereas 80% of both the placebo and chlorhexidine rinsing patients suffered from severe mucositis, with signs of pseudomembranes developing from the third week of conventional irradiation protocol. The effect of selective elimination of gram‐negative bacilli from the oropharynx and the prevention of severe mucositis may be explained by the eradication of these bacteria and/or neutralization of salivary endotoxin, released by gram‐negative bacilli, mediating the inflammatory processes.
Serum trace elements and Cu/Zn ratio in breast cancer patients
Authors: Gupta Sanjeev K. , Shukla Vijay K. , Vaidya Madho P. , Roy Salil K. , Gupta Saroj
Published: February 2007

Serum copper, zinc, and the Cu/Zn ratio were measured in 55 patients with breast disease (20 with benign breast diseases and 35 patients with breast cancer) and 30 controls. The mean serum copper levels were higher in breast cancer than in benign breast diseases (167.3 μg/dl) vs. 117.6 μg/dl) (P<).001) and controls (167.3 μg/dl vs. 98.8 μg/dl) (P<0.001). Patients with advanced breast cancer had higher serum copper levels than did patients with early breast cancer (177.9 μg/dl vs. 130.4 μg/dl) (P <0.001). The mean serum zinc levels were lowered only in patients with advanced breast cancer as compared with controls (88.6 μg/dl vs. 115.1 μg/dl) (P < 0.001). Serum zinc levels were not decreased in patients with early breast cancer and benign breast diseases. The Cu/Zn ratio was increased in breast cancer patients (1.91 vs. 0.86) (P < 0.001) but not in patients with benign breast diseases. The precise mechanisms responsible for the alterations in trace element levels in breast cancer patients are still unclear and require further evaluation. However, the serum copper levels and the Cu/Zn ratio may be used as biochemical markers in these patients.
Mixed mesodermal tumours of the ureter
Authors: Kini Usha , Shariff Shameem , Thomas John A.
Published: February 2007

This report is of a 78 year‐old male with a mixed mesodermal tumour of the left ureter.

A comparison of all reported patients with such neoplasms has been made in the discussion, in an attempt at characterization of this neoplasm.
Biliary and pancreatic metastases of breast carcinoma: Is surgical palliation indicated?
Authors: Pappo Itzhak , Feigin Elad , Uziely Beatrice , Amir Gail
Published: February 2007

Obstructive jaundice developed in a patient concomitantly with the diagnosis of breast carcinoma. Abdominal exploration disclosed a metastatic tumor in the head of the pancreas, the distal bile duct, and the gallbladder. A cholecystectomy and choledochojejunostomy were performed and later, because of intestinal obstruction, the patient underwent gastrojejunostomy. Pathological examination demonstrated metastatic lobular carcinoma of breast with strongly positive staining for estradiol. Additional hormonal therapy has been given to the patient since the operation. The patient is alive 16 months after the diagnosis of her disease.

This case suggests that a vigorous diagnostic approach should be adopted in every jaundiced patient with metastatic breast cancer in order to exclude causes of jaundice other than diffuse metastatic involvement of the liver. Patients with extrahepatic biliary metastasis should be treated by aggressive surgical treatment, combined with systemic therapy which can offer them significant palliation and better survival.
Analysis of iodine‐125 interstitial therapy in the treatment of localized carcinoma of the prostate
Authors: Comella Leonard G. , Steinberg Seth M. , Ellison Mark F. , Reeves Woodrow W. , Flanigan Robert C. , McRoberts J. William
Published: February 2007

Definitive treatment of localized carcinoma of the prostate has included radical surgery, external beam radiation therapy, and interstitial radiation therapy. The interstitial agent most commonly used is Iodine‐125. Forty‐eight patients were treated with interstitial radiation therapy using Iodine‐125 implants with a median follow‐up of 55 months. Forty‐three percent of the evaluable patients had progressive disease with approximately 50% progressing at 5 years by Kaplan‐Meier analysis. Overall actuarial survival in the group was 80% at 5 years. This and several other studies suggest that control of prostate cancer with Iodine‐125 seeds may be suboptimal as compared with other treatment modalities, especially the radical retropubic prostatectomy. Analysis of treatment parameters is presented along with a discussion of the current status and future prospects for treatment of localized carcinoma of the prostate with interstitial radiation therapy.
Chordoma: A 20‐year clinicopathologic review of the experience at groote schuur hospital, Cape Town
Authors: Chetty Runjan , Levin C. Victor , Kalan Manhar R.
Published: February 2007

Eighteen chordomas (11 females and 7 males) were seen over a 20‐year period; 61% of the tumors occurred in the sphenoid region. The youngest patient was 3 years old and had a family history of chordoma. Histologically, the tumors were divided into classical (epithelial) and chondroid variants, which in this series, had no effect on outcome. Follow‐up on 12 patients ranged from 3 to 170 months, and they were treated with various combinations of surgery and radiotherapy. One patient was administered the neutron beam and died after 94 months. The mean survival of this series is 73.4 months, with a survival rate of 50% (6 out of 12 patients alive). Surgical resection offers the best chance of survival, but chordomas have a propensity to metastasize, hence have a poor prognosis.
Primary renal lymphoma
Authors: Harris Gary J. , Lager Donna J.
Published: February 2007

Lymphoma arising in the kidney is rare. Although 31 cases have been reported in the literature, it is likely that most of these neoplasms do not arise in the kidney. This report describes two cases of primary renal lymphoma and compares their clinical presentation, diagnostic modalities, treatment, and survival with the previously reported patients who satisfied our criteria for the diagnosis of primary renal lymphoma.
Prognostic significance of the number of metastatic lymph nodes in patients with gastric cancer
Authors: Makino Masato , Moriwaki Seiji , Yonekawa Masao , Oota Michio , Kimura Osamu , Kaibara Nobuaki
Published: February 2007

To confirm the prognostic significance of the number of the metastatic lymph nodes (MLN) in cases of gastric cancer, the results of surgical treatment of 668 patients with primary gastric cancer were analyzed retrospectively. Five‐year survival rates were calculated with reference to the number of MLN, namely, none (89.2%), one to three (77.4%), four to six (55.8%), and seven or more (36.2%). Furthermore, even when the cancer had invaded the serosa, 5‐year survival was significantly more frequent in patients with one to three MLN (71.7%) than in those with four to six (35.5%) or more than six (31.5%) (P < 0.01), and the 5‐year survival was close to that of patients with no MLN (70.5%). Not only qualitative but also quantitative evaluation of lymph node metastasis is essential for estimating the prognosis of patients with gastric cancer.
Cytoreduction and sequential resection: A hope for unresectable primary liver cancer
Authors: Tang Zhao‐You , Yu Ye‐Qin , Zhou Xin‐Da , Ma Zeng‐Chen , Lu Ji‐Zhen , Liu Kang‐Da , Lin Zhi‐Ying , Yang Bing‐Hui , Fan Zhen , Hou Zhen , Zhang Ming
Published: February 2007

For decades, unresectable primary liver cancer (PLC) determined by operation was incurable. However, a retrospective study of 24 years' materials with unresectable PLC indicated that 5‐year survival of unresectable PLC has increased from 0% in 1966‐1977 (n = 137) to 16.9% in 1978‐1989 (n = 345). This encouraging improvement was mainly a result of cytoreduction therapy followed by sequential resection. Multimodality combination treatment with hepatic artery ligation, plus hepatic artery infusion with chemotherapy, plus radioimmunotherapy (or radiotherapy) yielded the highest sequential resection rate (30.6%) and 5‐year survival (28.0%) as compared with double combination and single modality treatment. The 5‐year survival of 33 patients receiving sequential resection after cytoreduction therapy was 63.2%. It is suggested that cytoreduction and sequential resection might offer a hope for surgically verified unresectable PLC.
Detection of micrometastatic tumor cells in bone marrow of breast carcinoma patients
Authors: Eva Singletary S. , Larry Lillie , Tucker Susan L. , Spitzer Gary
Published: February 2007

To determine the incidence and clinical signifance of micrometastases in the bone marrow of breast carcinoma patients, we performed an immunoalkaline phosphatase assay using anticytokeratin (AE1, AE3, MAK‐6) and antiepithelial (113F1, 260F9, 317G5) antibodies on the bone marrow aspirates of 71 stage IV disease patients with either recurrent regional or distant metastases. Although we detected tumor cells within the bone marrow of 38% of these patients with this assay, no significant correlation was seen with patient's age, menopausal status, bone scan, bone marrow core histology, response to induction chemotherapy, number of metastatic sites, dominant site of metastasis, or subsequent clinical outcome. The clinical parameters that were associated with improved survival were one dominant site of metastatic disease and regional soft tissue recurrence without distant disease.
Aggressive malignant hemangiopericytoma in the neck
Authors: Volpe A. George , Sullivan John G. , Chong Frank K.
Published: February 2007

Hemangiopericytomas are rare vascular tumors, one fourth of which occur in the head and neck. These lesions are characteristically slow growing and slow to metastasize. We describe an otherwise healthy patient with a hemangiopericytoma on the left side of his neck that metastasized to his chest wall within 3 months after the tumor was first observed. The metastasis occurred while the patient was receiving radiation therapy. The patient died soon afterward. This case illustrates the aggressive malignant potential of hemangiopericytomas.
Pancreatoduodenal carcinoma: A clinicopathologic study of 304 patients and immunohistochemical observation for CEA and CA19‐9
Authors: Yamaguchi Koji , Enjoji Munetomo , Tsuneyoshi Masazumi
Published: February 2007

A total of 304 patients with pancreatoduodenal carcinoma were studied clinicopathologically and immunohistochemically in order to clarify features of carcinoma of four different sites of origin; carcinoma of the ampulla of Vater (Am), the distal common bile duct (DCBD), the head of the pancreas (PH), and the extra‐ampullary duodenum (Du). The mean greatest diameter of 87 PH was 3.5 cm compared with 2.7 cm of 149 Am and 2.7 cm of DCBD. Histopathologically, 40% of Am were papillary adenocarcinoma, while about half of DCBD, PH and Du were tubular adenocarcinoma. PH invaded lymphatic (85%), vascular (62%), and perineural (95%) spaces and metastasized lymph nodes (72%) more frequently than Am (77%, 35%, 24%, 50%), DCBD (47%, 61%, 65%, 45%), and Du (76%, 29%, 35%, 65%), respectively. More than 50% of PH invaded the resected margins, whereas in only 2% of Am, the surgical margins were affected by malignant cells. Immunohistochemically, PH was more frequently positive for both carcinoembryonic antigen (CEA) (98%) and carbohydrate antigen (CA) 19‐9 (91%) than Am (83%, 62%), DCBD (94%, 58%), and Du (56%, 11%), respectively. The stromal staining type of CEA and CA19‐9 was more frequently seen in PH (27%, 44%) than in Am (9%, 31%), DCBD (11%, 8%) and Du (0%, 0%), showing a more dedifferentiated nature of PH. The cumulative 3‐year survival rate of 87 patients with PH (15%) was worse than that of 149 with Am (42%, P < 0.001), of 51 with DCBD (25%) and of 17 with Du (58%, P < 0.001). The survival curve of 87 with PH was worse than that of 51 with DCBD, of 149 with Am (P < 0.001) and of 17 with Du (P < 0.001). Cox regression analysis, using eleven profound prognostic variables, revealed that venous invasion, perineural infiltration, surgical margin, and histopathologic type were profound pronostic factors. Pancreatic carcinoma has a more dedifferentiated histopathologic nature, showing a more aggressive growth and fares worse than Am, DCBD, and Du.
The role of intraluminal radiotherapy and concurrent 5‐fluorouracil infusion in the management of carcinoma esophagus: A pilot study
Authors: Dinshaw Ketayun A. , Sharma Vinay , Pendse Anil M. , Telang Champat S. , Vege Shanti Swaroop , Malliat Mohandas K. , Deshpande Raman , Desai Prafulla B.
Published: February 2007

Fifty patients with carcinoma of the esophagus were entered in a randomized pilot study to test the efficacy of intraluminal radiotherapy (ILRT) and concurrent 5‐fluorouracil (5‐FU) infusion. The median age was 65 years, with 80% having middle third lesions; in 62%, the lesions were longer than 5 cm. After external beam therapy of 50 Gy in 5 weeks, patients were randomized to receive chemotherapy. Significant improvement in dysphagia was recorded in 76% patients with complete response in 47 cases ranging from 6 to 27 months. The overall survival at 2 years was 15% with ILRT alone versus 22% with ILRT plus 5‐FU infusion.
Effects of splenectomy on pulmonary metastasis and growth of SC42 carcinoma transplanted into mouse liver
Authors: Imai Shiro , Nio Yoshinori , Shiraishi Takahiro , Tsubono Michihiko , Morimoto Hideki , Tseng Chen‐Chiu , Kawabata Kazuya , Masai Yoshikazu , Tobe Takayoshi
Published: February 2007

The carcinoma SC42 was transplanted into the liver of its syngeneic mice DS, and the immunological integrity of the spleen and the effects of splenectomy on the growth and pulmonary metastasis of the liver tumor were assessed. On day 7 after liver tumor transplantation, the natural killer (NK) activity of the splenocytes was significantly elevated; it subsequently decreased at a later stage of the tumor. The response of the splenocytes to PHA and Con‐A decreased significantly from the early stage of the tumor. However, the mixed lymphocyte‐tumor cell reaction increased significantly from day 14 to day 28. The survival rate of the mice, which had undergone simultaneous splenectomy and liver tumor transplantation, was significantly lower than that of sham‐operated control mice. The number of pulmonary metastases in splenectomized mice was significantly greater than in the control mice. There was, however, no difference between the two groups in the weight of the liver tumor. By contrast, splenectomies performed 14 days before or 14 days after tumor transplantation had no significant influence on the survival of the mice. Splenectomies performed on day 0 and on day 3 after tumor transplantation significantly increased the number of pulmonary metastases, Furthermore, the intravenous injection of anti‐asialo GM1 antisera on day 0 and day 3 significantly increased the number of pulmonary metastases, but injection of anti‐Thy 1,2 antisera had no effect. These results suggest that splenic NK cells may play an important role in the suppression of pulmonary metastasis at early stages of the liver tumor.