bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of cyclins by adhesion: Elements in the anchorage‐signalling pathway
Authors: Carstens Carsten P. , Krämer Alwin , Fahl William E.
Published: February 2007

Loss of adhesion leads to cell cycle arrest at the G1/S boundary in normal, adhesion‐dependent, mesenchymal cells. This arrest is accompanied by the inability to produce cyclin A. Using deletional and mutational analysis of the cyclin A promoter, we have identified a CCAAT element that mediates the adhesion‐dependent transcriptional activation of cyclin A. Specific binding of a novel 40/115 kDa heteromeric protein complex, which we have named CBP/cycA, to this CCAAT element was detectable only in cycling cells, not in cells arrested in G0 or at the anchorage checkpoint at the G1/S boundary. However, during the G0 and G1 phases of the cell cycle, CBP/cycA appeared to be present but sequestered by a retinoblastoma (Rb) family member. Activity of Rb family members is generally thought to be controlled by the cyclin D‐cdk4/cdk6 and cyclin E‐cdk2 kinases. We have found that cyclin E‐cdk2 complexes from cells G1‐arrested by adhesion deprivation, though present at normal levels, are catalytically inactive. These results suggest that control of cell cycle progression by adhesion is mediated by a pathway involving cyclin E‐cdk2, Rb, and CBP/cycA, ultimately controlling transcriptional activation of cyclin A at the G1/S boundary. © 1995 Wiley‐Liss, Inc.
Role of the low‐affinity nerve growth factor receptor and the high‐affinity trk nerve growth factor receptor in human prostate carcinogenesis
Authors: Djakiew Daniel , Delsite Robert , Dalai Rakhi , Pflug Beth
Published: February 2007

Nerve growth factor (NGF) interacts with a low‐affinity NGF receptor (LNGFR) and a high‐affinity Trk receptor in the paracrine regulation of human prostate growth. Both the LNGFR and the Trk receptor localize to the epithelia of the normal prostate. During malignant progression of the prostate, expression of the LNGFR is progressively lost from the epithelia, whereas Trk expression is retained in the epithelia of the adenomatous foci. Human prostatic stromal cell secretory protein (hPS) containing NGF stimulates autophosphorylation of the Trk receptor in a time‐ and concentration‐dependent manner. This effect appears to be broadly based, because three distinct human prostate tumor cell lines (TSU‐pr1, DU‐145, and PC‐3) were shown to undergo Trk autophosphorylation in response to treatment with hPS. These observations are of potential significance, because the LNGFR is thought to participate in the inhibition of prostate growth via apoptotic mechanisms, whereas the Trk receptor is thought to participate in the stimulation of prostate growth via initiation of a phosphorylation cascade. Therefore, loss of the LNGFR may eliminate an inhibitor of prostate growth as well as reducing competition for the NGF ligand, thereby enhancing a growth stimulus to the prostate tissues mediated via the Trk receptor. In this manner, an alteration in the balance of growth regulation between the inhibitory effect of the LNGFR and the stimulatory effect of the Trk receptor may play a causal role in prostate carcinogenesis. © 1995 Wiley‐Liss, Inc.
Modulation of epithelial differentiation by the E6 and E7 oncoproteins of human papillomaviruses
Authors: Monini Paolo , Laimins Laimonis A.
Published: February 2007

Human papillomaviruses (HPVs) infect squamous epithelial cells of the genital tract and induce a variety of hyperproliferative lesions, including carcinomas. The vegetative viral life cycle is linked closely to epithelial differentiation, with virion production occurring only in highly differentiated suprabasal cells. We have used organotypic cultures to study the effects of HPV gene products on epithelial differentiation. Although E6 and E7 gene products immortalize normal human keratinocytes efficiently in culture, additional cellular mutations are required to induce a complete loss of differentiation capability. These results are consistent with a multistep process in the development of HPV‐associated anogenital malignancies in vivo. © 1995 Wiley‐Liss, Inc.
Analysis of the multistep nature of human carcinogenesis utilizing human fibroblasts
Authors: Justin McCormick J. , Maher Veronica M.
Published: February 2007

We have developed a human fibroblast cell lineage in which, by sequential clonal selection, we have been able to isolate cells that exhibit more and more of the characteristics of tumor‐derived cells. The ultimate cells in the lineage form rapidly proliferating sarcomas in athymic mice. Analysis indicates that various “activated” oncogenes, such as ras, sis and myc, can play a causal role in the transformation of human fibroblasts. The evidence suggests that some of the steps in the transformation process that we have not yet been able to associate with a specific gene involve loss of expression of suppressor genes. © 1995 Wiley‐Liss, Inc.
Mini review: Molecular mechanisms of immortalization of human mammary epithelial cells
Authors: Wazer David E. , Band Vimla
Published: February 2007

Normal human mammary epithelial cells (MECs) exhibit a finite life span both in vivo and in vitro. A critical event in oncogenic transformation is the ability of cells to multiply indefinitely, a phenomenon referred to as immortalization. Using human papillomavirus (HPV) oncogenes, we have recently identified multiple MEC subtypes that show distinct susceptibilities to immortalization by the HPV16 E6 and E7 oncogenes. Because HPV16 E6 and E7 inactivate two well‐known tumor suppressor proteins, p53 and Rb, respectively, these results suggest a cell‐type‐specific predominance of the tumor suppressor pathways. Indeed, E6‐ and E7‐immortalized cells exhibit dramatic reduction in the levels of p53 and Rb proteins, respectively, resulting in abrogation of p53‐ and Rb‐dependent functions, such as the cell cycle arrest response to DNA damage. Moreover, the E6‐susceptible MECs could also be immortalized by mutant p53 alone and by exposure to γ‐irradiation. Interestingly, the loss of p53 function was an early event in γ‐irradiation‐induced immortalization, further supporting the essential role of p53 in regulating the growth of these cells. Availability of these in vitro models should facilitate elucidation of the molecular mechanisms of early mammary tumorigenesis. © 1995 Wiley‐Liss, Inc.
Immunochemosurgery for gastric cancer
Authors: Kim Jin‐Pok
Published: February 2007

The effects of immunochemosurgery on 73 patients with stage III gastric cancer who were treated with radical subtotal gastrectomy followed by immunochemotherapy for 18 months during the 5‐year period between 1975 and 1980 were compared to the effects of therapy on 64 patients with stage III gastric cancer treated with radical subtotal gastrectomy atone during the period between 1970 and 1980.

For immunotherapy, picibanil (streptococcus pyogenes preparation) was intramuscularly given weekly, and for chemotherapy, either MFC (mito‐mycin‐C, 5‐FU, and cytosine arabinoside) regimen I.V. ten times followed by oral 5‐FU or FME (5‐FU and methyl‐CCNU) regimen was given. The percentage of survivors who received postoperative immunochemotherapy compared to mat of survivors who received surgery alone differed by approximately 15%. This difference was rather constant with more than 5 years of follow‐up. The 5‐year survival rate in the immunochemosurgery group was 38.1%, whereas that in the surgery alone group was 24.8%, which was statistically significant (p < 0.01).

Various immune parameter studies such as 1‐chloro‐2,4‐dinitrobenzene (DNCB) test, T lymphocyte count and percent, PHA‐ and concanavalin‐A‐stimulated lymphoblastogenesis, and antibody dependent cellular cyto‐toxicity (ADCC) activity showed more favorable data in the immunoche‐mosurgery group than in the surgery alone group.

The effects of early postoperative immunochemotherapy (immunotherapy from the fourth to fifth postoperative day, and chemotherapy from me eighth to tenth postoperative day) after radical gastrectomy seems to be superior to that of surgery alone for stage III gastric cancer. For stage J and II gastric cancer, radical gastrectomy and postoperative immunotherapy for 3 months would be the best treatment.
A surgical oncology perspective on AIDS
Authors: Pollock Raphael E. , Ames Frederick C. , Ota David M. , Mansell Peter
Published: February 2007

During the summer of 1981 reports of unusual opportunistic infections among male homosexuals first began to appear in the literature and by December 1983, 3000 cases has been reported to the Center for Disease Control in Atlanta, Georgia. Homosexual and bisexual men comprise 71% of the reported cases, while 17% are known intravenous drug users, and the remaining 12% made up of persons with other risk factors.

Approximately 80% of AIDS patients with Kaposi's sarcoma have identifiable gastrointestinal lesions. Specific risk factors for Kaposi's sarcoma in AIDS patients have not been exclusively identified, but it is thought that repeated sexual involvement with multiple partners exposes the victim to the immunosuppressive effect of cytomegalovinis and allo‐genic sperm, which may in turn impair lymphoid cells. The immunologi‐cal abnormalities associated with AIDS have included striking changes in T‐cell ratios, with more profound changes in the Kaposi‐AIDS groups. Increases in IgG, decreased antibody production by B‐cells to challenge antigen, decreased B‐cell proliferative responses to B‐cell mitogens, abnormalities in macrophage function, and increased serum thymosin levels have been found. Various opportunistic infections afflict the patient with AIDS, Antimicrobial therapy, various interferons, interleukin‐2, and im‐munomoduiation with thymosin have all been used without much success. The distribution and transmission of AIDS parallels hepatitis B virus infection which is transmitted sexually and parenterally. On the whole the same precautions as for hepatitis B should be taken for AIDS, Health care personnel treating patients with AIDS should also wear masks and eye protection against the splatter of body fluids and secretions.

The management of the AIDS patient is based on treating the associated Kaposi's sarcoma, lymphomas and some opportunistic infections as determined by histology of biopsy specimens.

Surgical and medical interface is necessary for the most effective treatment of this disease which can present with a wide variety of gastrointestinal manifestations which may require surgical intervention.
Esophageal carcinoma cases surviving for more than ten years in Japan
Authors: Mori Shozo , Nakayama Mdand Komei
Published: February 2007

The early results of surgical treatment of esophageal cancer were unfavorable, but have steadily improved. At present, more than 1,000 surgical procedures for carcinoma of the esophagus are performed annually in Japan, with an operative mortality of around 6%; long‐term results are steadily improving. In a survey of the 256 institutional members of the Japanese Society for Esophageal Diseases, 387 patients were found to have survived for 10 years or more. The main factors affecting prognosis are the size of the lesion, degree of invasion, extent of metastasis, and stage. Mild problems of regurgitation or heartburn in 25.5% of cases point to a need for improved operative procedures; the fact that 31.2% have died due to malignant disease, including recurrence, emphasizes the need for follow‐up.
Acquired immunodeficiency syndrome
Authors: Rolston Kenneth V. I. , Bodey Gerald P.
Published: February 2007

The acquired immunodeficiency syndrome (AIDS) was recognized as a distinct clinical entity in 1981 and was characterized by unexplained opportunistic infections and an aggressive form of Kaposi's sarcoma. High risk groups for contracting AIDS include homosexual men, parenteral drug users, hemophiliacs, recipients of blood and blood products, and heterosexual contacts of such individuals. Immunologic abnormalities associated with AIDS include lymphopenia, functional T‐cell deficits, B‐lymphocyte defects, and various serologic abnormalities. The causative virus has been identified as the human T‐lymphotropic virus/lymphade‐nopathy associated virus (HTLV‐in/LAV). AIDS represents the severe end of the clinical spectrum of infection with HTLV‐in/LAV. Other manifestations are asymptomatic carriage, generalized lymphadenopathy, and a set of non‐specific symptoms, termed the AIDS‐related‐complex (ARC). Although seen predominantly in the United States, AIDS has a world‐wide occurrence. No known therapy for AIDS exists. Research efforts are being directed at antiviral therapy, immunorestoration and the development of a vaccine.
Evaluation of the second‐look laparotomy in the management of carcinoma of the ovary
Authors: Yakushiji Michiaki , Kato Toshi
Published: February 2007

One hundred and thirty four patients had a second‐look laparotomy in the course of management of cancer of the ovary. Patients were stratified according to four indications: (1) resection of the residual tumor following chemotherapy or radiation therapy, (2) evaluation of the disease with intent to stop chemotherapy and assess signs of recurrence or persistence, (3) restaging, and (4) surgical indication. The first group consisted of 35 patients. In 20 of 35 patients in this group, complete removal of the residual tumor (residual ≦m 2 cm) was possible, and the survival curves indicated that removal of the residual tumor during the second‐look laparotomy improved the survival rate. The second group consisted of 77 patients. No evidence of disease was found in 44 of the 77 patients in this group. Four patients with negative second‐look laparotomy developed recurrences, and three patients died from the disease. The third group consisted of seven patients. In one of seven patients in this group, the stage was modified after second‐look laparotomy.
Imaging of a pediatric abdominal mass
Authors: Seidel F. Glen
Published: February 2007

The approach to the child with an abdominal mass will be aided by careful consideration of the radiographic imaging modalities available at an institution. The relative advantages, disadvantages, costs, and radiation of each modality are presented. The recommended workup of a pediatric abdominal mass, as well as the most common masses and their differential diagnosis, are outlined.
Malignant lymphomas in children and adolescents
Authors: Brecher Martin L.
Published: February 2007

Malignant lymphomas constitute the third most common group of childhood cancers in the United States. Hodgkin's disease (HD) exhibits a bimodal age peak, with the first peak occurring in the 15–34‐year age group. Nodular sclerosis is the most common histologic subtype of HD seen in children. The disease tends to be primarily supradiaphragmatic at presentation. Accurate staging is essential for determination of appropriate therapy. Staging laparotomy with splenectomy is indicated for those patients with clinically localized disease whose therapy may be altered by pathologic staging. Radiation therapy is curative in the great majority of patients with localized disease. Multimodality therapy has been employed with increasing success in patients with advanced disease. The late sequelae of therapy must be considered in the design of optimum therapeutic regimens. More than 90% of non‐Hodgkin's lymphoma (NHL) in childhood can be grouped into one of three histologic subtypes: lymphoblastic, undifferentiated, and diffuse large cell type. Lymphoblastic lymphomas most commonly present with mediastinal involvement. The majority of nonlymphoblastic lymphomas arise within the abdomen. Because of the tendency of NHL for extralymphatic dissemination, systemic therapy is always required. Treatment is determined by stage and histology. Significant improvements in survival rates have resulted from the development of effective combination chemotherapy programs. Cure rates in excess of 90% can be expected in children with localized disease. The outlook for children with advanced disease of undifferentiated histology remains poor. The presence of central nervous system involvement at diagnosis is a particularly ominous sign.
Testicular tumors in infants and children
Authors: Green Daniel M.
Published: February 2007

Primary malignant tumors of the testis are uncommon in infants and children. Tumors of germ cell origin are identified most frequently. The clinical presentation is usually due to the presence of an enlarging scrotal mass. Determinations of the serum alpha fetoprotein (AFP) and beta subunit of human chorionic gonadotropin (beta‐hCG) levels are helpful for diagnosis and management. All suspected testicular tumors should be surgically evaluated through a high inguinal incision. Postoperative chemotherapy is recommended for some patients with yolk sac tumor and all patients with embryonal rhabdomyosarcoma. Prolonged relapse‐free survival is possible for most infants and children with malignant testicular tumors.
Monoclonal antibodies in studying immunological phenotypes of neoplastic diseases
Authors: Kadagidze Zaira G. , Baryshnikov Anatoly Ju.
Published: February 2007

Six hybridoma clones were obtained secreting monoclonal antibodies (Mab) against differentiating antigens of human hemopoietic cells. ICO‐1 Mab detect la‐like (Dr) antigens. Mab react with IMymphocytes and monocytes without detecting antigens on granulocytes and T‐cells. Antigen expression was enhanced following cell activation in a blast cell transformation test and mixed lymphocyte culture (MLC). ICO‐1 Mab blocked MLC. The molecular weights of the antigen were 29 and 34 kilodaltons. Comparative studies of ICO‐1 Mab with other Mab against la‐like antigens revealed their identical reactivity. ICO‐11 Mab detect the antigen on 4% of Wood lymphocytes, 75% thymocytes, monoMasts, and CFU‐GM. These Mab block NK‐cell activity of blood mononuclear cells. ICO‐GM‐1 Mab detect the antigen on myelomonocytic cells and their precursors, but not CFU‐GM. These Mab block binding of the C3Bi complement component to CR3 receptor and NK‐cell activity. ICO‐G2 Mab detect the antigen expressed at final stages of granulocyte differentiation. ICO‐10 Mab detect the antigen on early thymocytes and ICO‐02 on undifferentiated blast cells. Mab were shown to be applicable for human leukemia and lymphoma immune diagnosis.
Tumours of the small intestine
Authors: Ellis Harold
Published: February 2007

Tumours of the small intestine are a relatively unusual group of benign and malignant tumours of both epithelial and supporting tissue origin. Their pathology, associated syndromes, clinical features, diagnosis, and management are discussed.
Clinical experience in breast cancer—20 years after radical mastectomy
Authors: Yu Hongtiao
Published: February 2007

From 1958 to 1982, 1,035 radical mastectomies have been performed in our institute in cases of breast cancer. A total of 804 cases have been followed up for 5 years or more after the operation, the follow‐up rate being 100%. Routine radical operations were performed in 695 cases, whereas the other 109 cases were treated with simple mastectomy, modified radical mastectomy, and extended radical mastectomy. The 5‐, 10‐, 15‐, and 20‐year survival rates of these 804 cases were 71.8%, 58.2%, 48.8%, and 41.8%, respectively. According to the tumor‐node‐metastases (TNM) classification, the 5‐, 10‐, 15‐, and 20‐year survival rates for stage I were 85.4%, 77.0%, 58.3%, and 75.0%; for stage II, 72.8%, 57.4%, 53.5%, and 58.8%; and for stage III, 55.3%, 44.7%, 36.5%, and 8.0%, respectively.
Chemotherapy for gestational trophoblastic tumors
Authors: Takamizawa H. , Sekiya S. , Kobayashi O. , Matsui H.
Published: February 2007

Virtually 100% of patients with nonmetastatic and low‐risk metastatic trophoblastic tumors are now curable by only conventional chemotherapeutic agents such as methotrexate, actinomycin D, or their combination with or without other agents. However, approximately 30% of high‐risk patients with metastatic trophoblastic tumors are resistant to conventional chemotherapy. All of the high‐risk patients resistant to chemotherapy are those with metastatic choriocarcinoma. Thus, the efficacy of multidrug chemotherapy and combination chemotherapy of cisplatin or VP16‐213 with other agents is now being examined.
Extracolonic manifestations of familial polyposis coli
Authors: Jagelman David G.
Published: February 2007

The original concept of familial polyposis coli (FPC) as only a genetically determined premalignant disease of the colon changed in the 1950's, with the description of Gardner's syndrome. The extracolonic manifestations of osteoma and epidermoid cyst have since been shown to be only a small part of the spectrum of both benign and malignant extracolonic manifestations of the disease. The modern concept of this condition is that FPC is a genetically determined generalized growth disorder that gives rise to tumors in various parts of the body.
Surgical alternatives in the treatment of polyposis coli
Authors: Welling David R. , Beart Robert W.
Published: February 2007

The history of familial polyposis coli and its various surgical treatment alternatives are presented. Each form of treatment has advantages and disadvantages. The menu of alternatives allows the surgeon the freedom to choose the best option for each patient.
Surveillance in relatives of patients with adenomatous polyposis
Authors: Berk T. , Cohen Z. , McLeod R. S. , Cullen J. B.
Published: February 2007

Registry ascertainment of kindreds with adenomatous polyposis (AP) reduces the incidence of colorectal carcinoma by medical monitoring for offspring and siblings of affected patients. Due to its pleiomorphic genotype and a 50% risk for AP in each patient's progeny, early screening is mandatory. Flexible sigmoidoscopy, averaging from puberty to age 48, annually or every two years, is one diagnostic technique that does not result in excess patient discomfort or cost. Timely examination is facilitated when eye anomalies, osteomas, or epidermoid cysts are present in childhood as potential clinical markers for AP. Denial, misperceptions, and fear may impede surveillance in the absence of education by the registry health care team.
Activities of the leeds castle polyposis group
Authors: Northover John M. A.
Published: February 2007

In June 1985 an international meeting took place at Leeds Castle, England, to discuss some of the problems facing those caring for polyposis patients and conducting research in the field. From this grew the Leeds Castle Polyposis Group, comprising workers from 19 centers around the world; they agreed to cooperate initially in the collation of retrospective data with the hope that this would lead to prospective studies including comparative therapy trials. So far four retrospective pro formas have circulated. The data from these and plans for further projects will be discussed at the next meeting of the group in Washington in April 1987.
Anatomical considerations relevant to fecal continence
Authors: Peña Alberto
Published: February 2007

A brief description is given of the anatomical operative findings considered relevant to fecal incontinence. The posterior sagittal approach and the importance of the electrical muscle stimulator in effecting meticulous repair are stressed. New viewpoints are presented with regard to the functions of the anatomical structures and their roles in fecal continence.
Role of chemotherapy in the treatment of colorectal carcinoma
Authors: Kemeny Nancy
Published: February 2007

Large bowel cancer afflicts more patients in the United States than any other malignancy excluding skin cancer. Fifty percent of patients who undergo resection of colorectal carcinoma have positive lymph nodes, and approximately 18% have liver metastases at initial presentation. To improve survival, more effective treatment than surgical resection of the primary must be developed. The most active single agent in the treatment of colorectal carcinoma is 5‐fluorouracil (5‐FU). To increase the response rate obtained with this agent, work has been done on the modulation of 5‐FU by other agents, using drugs that are synergistic with 5‐FU and manipulating the method of 5‐FU administration. Combination chemotherapy has improved response rates in some situations, though generally it has not been shown to improve survival. Studies using direct hepatic infusion clearly demonstrate an increase in response rates, but again, it is too early to say whether this type of treatment increases survival. Early adjuvant chemotherapy trials used inadequate doses of chemotherapy for short periods of time and demonstrated no added efficacy to surgery alone. Later studies with more aggressive therapy suggested some benefit to treating patients with rectal carcinoma; however, there is still little evidence that adjuvant chemotherapy improves survival in patients with colon carcinoma. To compare and understand the various chemotherapy trials, more stringent reporting of baseline laboratory values, performance status, and estimation of tumor involvement are needed.
Recombinant alpha‐lnterferon and vinblastine in metastatic renal cell carcinoma: Efficacy of low doses
Authors: Getto Gian Luigi , Franceschi Tiziano , Turrina Gianni , Chiarion‐Sileni Vanna , Capelli Maria Carla , Bellini Anna , Paccagnella Adriano , Bassetto Maria Antonietta , Molino Anna Maria , De Sandre Giorgio
Published: February 2007

Twenty‐six patients with metastatic renal cell carcinoma (RCC) were treated in a phase I‐II trial with recombinant interferon alpha‐2b (α‐IFN) and vinblastine (VBL) in combination. Patients received IFN at a starting dose of 3 × 106 IU/m2 subcutaneously three times a week and VBL 0.1 mg/kg intravenously every 3 weeks, with dose modification for toxicity. All patients were evaluable for toxicity; 18 patients were evaluable for efficacy. An objective response rate of 44% was observed (eight of 18 patients, with one complete response and seven partial responses). The median duration of response was 5 months. The actuarial survival of responding patients was significantly longer than that of nonresponding patients. In general, the toxicity was tolerable; the subjective toxicity and fever were similar to that reported for the same doses of IFN alone. Only a mild neurotoxicity, usually mixed polyneuropathy, occurred with increased frequency. Alpha‐IFN and VBL administered at low doses in combination demonstrated the highest response rate so far reported in RCC without significant toxicity.
Alpha and gamma interferon in the treatment of advanced renal cell carcinoma
Authors: Geboers A. D. H. , De Mulder P. H. M. , Debruyne F. M. J. , Strijk S. P. , Damsma O.
Published: February 2007

Thirty‐two patients with proven progressive metastatic renal cell carcinoma were treated with the combination of 0.1 mg/m2 (2 × 106 IU/m2) r‐interferon (r‐IFN)‐gamma and 6 μg/m2 (2 × 106 IU/m2) r‐IFN‐alpha. In case of progressive disease (PD) or stable disease (SD), after 8 weeks, the dose of r‐IFN‐alpha was escalated by 6 μg/m2 every 2 weeks until the maximum tolerable dose was reached, while r‐IFN‐gamma was maintained at the low dose. The rationale for this study is provided by the dose‐related efficacy of IFN‐alpha as a monotherapy, the potent immuno‐stimulatory activity of IFN‐gamma, and the alleged synergistic effect of the combination. Fourteen patients are evaluable for 8 weeks of low‐dose combination treatment (7×SD, 5×PD, 2× early progression), while so far 6 of 24 patients (25%) who started dose escalation of IFN‐alpha have reached a partial response. These data indicate better efficacy with higher doses of IFN‐alpha. Because of the infrequent administration and the relative low doses, compared to other trials, the treatment regimen was well tolerated. Although preliminary results are promising, definite efficacy remains to be proven.
Prognostic factors in breast cancer
Authors: Saez Ruben A. , McGuire William L. , Clark Gary M.
Published: February 2007

There are several independent but interrelated prognostic factors predictive of recurrence and survival in breast cancer. These include axillary nodal status, histopathology, steroid receptors, proliferative rate, ploidy, and oncogene amplification. Axillary nodal status has been the traditional mainstay predictor for recurrence and survival in primary breast cancer. In addition, the presence of the estrogen and progesterone receptors has correlated with longer disease‐free interval and overall survival in stage I and II breast cancer. Thymidine‐labeling index and percent S‐phase as measured by flow cytometry are indices of cell proliferation that correlate with relapse rate in pre‐ and postmenopausal women with breast cancer. Estrogen and progesterone receptor‐negative tumors are more commonly aneuploid, and have higher percent S‐phase, factors that predict for recurrence in Stage I breast cancer.
Clinical management of minimal breast cancer
Authors: Veronesi Umberto
Published: February 2007

Minimal breast cancer includes three different entities: lobular carcinoma in situ, noninfiltrating intraductal carcinoma, and invasive carcinoma less than 0.5 cm. The common feature is their small dimensions and the fact that they are often clinically occult. For lobular carcinoma in situ the risk of developing an invasive carcinoma varies from seven to nine times compared with the general population and a careful follow‐up of the patients with frequent mammograms is therefore suggested. Intraductal noninfiltrating carcinoma should be locally treated as an invasive carcinoma of small size, and therefore an extensive mammary resection like the quadrantectomy, plus radiotherapy is the recommended form of treatment, while the axillary dissection may be avoided. Finally, small invasive carcinomas should be treated with conservative procedures, including a total axillary dissection.
Routine breast screening for cancer
Authors: Letton A. Hamblin , Mason Edward M.
Published: February 2007

Breast screening for cancer has increased the survival for women over age 50 as well as those younger than 50 years old. The 13‐year average follow‐up period disproves the claim that the survival gain is due to lead‐time bias. The information brought forth in this presentation proves that higher‐risk women must be screened in order to reduce the constant death rate from breast cancer.
Early detection of gynecologic malignancies
Authors: Weed John C. , Marine Clifford S.
Published: February 2007

Gynecological malignancies constitute 14% of cancers in women. Failure to control disease is most frequently related to delays in diagnosis, which may be corrected through renewed efforts at patient and physician education as well as the use of diagnostic techniques currently available.
Screening for lung cancer
Authors: McGee J. Michael C.
Published: February 2007

Lung cancer incidence is increasing. Survivability has increased over the last few years particularly in certain subsets and has also been shown to increase with early detection. Chest X‐ray and sputum cytology have been the mainstays of screening programs. Although survival is increased, overall mortality rates seem unchanged except in certain subsets. Whether the addition of serum markers or use of monoclonal antibodies, automated cytological, and computer‐aided techniques will show decrease in mortality remains to be documented. We recommend yearly chest X‐rays, sputum cytology in high‐risk patients, i.e., age greater than 65, greater than 20 year history smoking, other significant carcinogenic exposure. Serum markers, monoclonal antibodies, and advanced, automated cytology methods are yet to be tested and therefore should be considered in clinical trials only.
Cost‐benefit impact on cancer screening
Authors: Humphrey L. J.
Published: February 2007

Prevention and early detection of cancer programs can double the survival rate in the next 5 years. For many programs it will cost more dollars than savings realized. Only through education can government, insurance carriers, and individuals realize that the value of these far exceeds cost when compared to cost of so many lifestyle things of temporary value.
New concepts in the treatment of genitourinary cancer in childhood
Authors: Walker R. Dixon
Published: February 2007

The treatment of Wilms' tumor is based on initial surgical removal followed by clinical and histologic staging. Chemotherapy provides the major adjunctive therapy in virtually all Wilms' tumors, radiotherapy being used in some situations. Exceptions to this are the treatment of bilateral Wilms' tumors and large intracaval extension. Bilateral Wilms' tumor is treated with initial biopsy and staging, adjunctive chemotherapy, and/or radiation therapy and bilateral partial nephrectomy after there is maximum resolution of tumor. Similarly, extensive caval extension of tumor may be treated preoperatively with chemotherapy and radiotherapy followed by resection. Nephroblastomatosis, a precursor of Wilms' tumor, is a common associated finding at exploration. It requires alteration in management and may change the prognosis. Sarcomas of the kidney and congenital mesoblastic nephroma represent the spectrum of severity of solid renal masses in children. Neuroblastoma is the most common solid tumor in children, and its prognosis is largely dependent on the age of the patient and the stage of disease. Chemotherapy and radiotherapy as adjunctive treatments have been disappointing. Immunotherapy holds some promise for the future. Testicular tumors are unusual in children. Those that occur in infancy are most often benign teratomas that require orchiectomy alone. Malignant germ cell tumors in children are most often yolk sac tumors and respond to surgery and chemotherapy. Lymph node dissection is indicated only in paratesticular rhabdomyasarcoma. Other genitourinary rhabdo‐myasarcomas occur in the bladder, prostate, vagina, and uterus. After maximum decrease in tumor volume with chemotherapy and radiotherapy, surgical exploration and resection of remaining tumor probably represent the best form of treatment. Organ‐sparing procedures should be carefully selected in that they may worsen the prognosis.
Role of planned preoperative irradiation in the management of clinical stage B2‐C (T3) bladder carcinoma in the 1980s
Authors: Parsons James T. , Million Rodney R.
Published: February 2007

In recent years the role of planned preoperative irradiation in the management of clinical stage B2‐C (T3) bladder cancer has been questioned by a number of investigators. Much of the confusion regarding the efficacy of combined therapy results from studies that compare the results of treatment of pathological stage B2‐C patients treated by cystectomy alone versus clinical stage B2‐C patients treated by preoperative irradiation plus cystectomy. Such comparisons are biased because of 1) the exclusion of a large number of pathological stage D patients from cystectomy‐alone series and their inclusion in preoperative irradiation plus cystectomy series and 2) the inclusion in the cystectomy‐alone series of patients whose clinical stages were ≦T2. The purpose of this paper is to compare the results of treatment in patients with clinical stage B2‐C bladder carcinoma following radical cystectomy alone versus preoperative irradiation plus cystectomy. This article reviews the rationale for administering preoperative irradiation, the effect of preoperative irradiation on the pathological specimen (including down‐staging, the effect on regional lymph nodes, and radioresponsiveness according to tumor configuration, i.e., papillary vs. solid), the impact of preoperative irradiation on pelvic recurrence and 5‐year survival, and the effect of preoperative irradiation on operative and postoperative complications.

This paper cites all known literature on the subject in the English language. Data comparing 5‐year survival results of radical cystectomy alone versus preoperative irradiation plus cystectomy are analyzed in three different ways: a) retrospective comparisons of historical results, b) comparison of contemporaneous “modern‐day” (1960–1980) series comprising 1185 patients who received either radical cystectomy alone or preoperative irradiation plus cystectomy, and c) review of the results of six randomized trials. Preoperative results are also analyzed according to dose level (2,000 cGy versus 4,000 cGy vs. 4,500–5,000 cGy).

The data presented indicate that the addition of preoperative irradiation to cystectomy for clinical stage B2‐C (T3) bladder cancer adds approximately 15–20 percentage points to the 5‐year survival, leading to a survival figure that is approximately half again that achieved by cystectomy alone.
Role of computerized tomography imaging in staging oesophageal carcinoma
Authors: Sharma O. P. , Subnani S.
Published: February 2007

One hundred eight patients with oesophageal malignancy proven on oesophagography and oesophagoscopy underwent computed tomography (CT). In 48 patients the CT findings were correlated with findings at surgery. Results indicated that CT findings correlated closely with surgical findings in local extension, regional adenopathy, size of tumour mass, and distant metastasis. Blurring and distortion of the tissue interfaces is a reliable indicator of disease only if the patient has not received any prior radiotherapy. CT is a fairly accurate method for assessing the spread of oesophageal carcinoma. Its use can prevent unnecessary surgery in patients with inoperable tumours.
Preoperative hyperthermochemoradiotherapy for patients with esophageal carcinoma or rectal carcinoma
Authors: Ueo Hiroaki , Sugimachi Keizo
Published: February 2007

Hyperthermia is effective for the treatment of carcinoma when applied concomitantly with chemotherapy and irradiation. However, it is difficult to heat deep portions of the body, such as the esophagus and the rectum. We therefore devised an electrode for radio frequency, and we have been successfully using this electrode in the treatment of both esophageal and rectal carcinoma

The 5 yr survival rates of patients with esophageal carcinoma, given either preoperative hyperthermochemoradiotherapy or chemoradiotherapy, were 43.2 and 14.7%, respectively. On the other hand, 11 patients with rectal carcinoma underwent radical surgery after preoperative hyperthermochemoradiotherapy. In the histologic studies of in the resected specimens, patients classified as marked, moderate, mild, and no effectiveness were seen in six, three, two, and zero cases, respectively. Since there were no severe side effects in patients given hyperthermia, this treatment deserves serious consideration when treating patients with malignant lesions in the esophagus or rectum.
Estrogen enhances cytotoxicity of hyperthermia on cultured transformed cells
Authors: Ueo Hiroaki , Matsuoka Hideo , Sugimachi Keizo
Published: February 2007

The synergistic cytotoxicity of the combined treatment of hyperthermia and estradiol was demonstrated. This effect was measured for both clonogenic efficiency and membrane function, whose function was expressed as the initial rate of thymidine (dThd) incorporation. V‐79 cells in a suspension culture were simultaneously treated with 10−9‐10−4 mg/ml estradiol at temperatures of 41–43°C in a water bath. The survival rate of the V‐79 cells decreased as the temperature increased. However, there was little decrease from treatment by estradiol alone. The survival rate for combined treatment by both heat and estradiol was lower than that of the separate treatment by either hyperthermia or estradiol alone, and the results were statistically significant. The values for Vmax (maximum reaction velocity) of hyperthermia decreased as the temperature increased, although the Vmax value of estradiol treatment alone changed little. The I/Vmax value for the combined treatment of heat and estradiol increased in comparison with that of heat treatment alone. However, the Km (Michaelis constant) value showed little correlation with the survival rate. Based on these results, we propose that estradiol enhances cell membrane damage by hyperthermia.
Growth of cells superinoculated onto irradiated and nonirradiated confluent monolayers
Authors: Matsuoka Hideo , Ueo Hiroaki , Sugimachi Keizo
Published: February 2007

We prepared confluent monolayers of normal BALB/c 3T3 cells and compared differences in the growth of four types of cells superinoculated onto these nonirradiated and irradiated monolayers. The test cells were normal BALB/c 3T3 A31 cells, a squamous cell carcinoma from a human esophageal cancer (KSE‐1), human fetal fibroblasts, and V‐79 cells from Chinese hamster lung fibroblasts. Cell growth was checked by counting the cell number, determining [3H]thymidine incorporation and assessing colony formation. We found that on nonirradiated monolayers, colony formation of human fetal fibroblasts and normal BALB/c 3T3 cells was completely inhibited. On irradiated cells, test cells did exhibit some growth. KSE‐1 cells, which had a low clonogenic efficiency on plastic surfaces, formed colonies on both irradiated and nonirradiated cells. On these monolayers, the clonogenic efficiency of V‐79 cells was also higher than that on plastic surfaces. We conclude that the nonirradiated monolayer of BALB/c 3T3 cells completely inhibits the growth of superinoculated normal BALB/c 3T3 and human fetal fibroblasts, while on the other hand, they facilitate the growth of neoplastic KSE‐1 and V‐79 cells by providing a surface for cell adherence and growth, without affecting the presence of normal cells in co‐cultures.
Endocrine neoplasms (non‐gastrin) of the pancreas
Authors: Gower William R. , Fabri Peter J.
Published: February 2007

Although neoplasms that produce gut regulatory peptides and amines can be found throughout the gastroenteropancreatic axis (excluding carci‐noids), the vast majority of these lesions are found within the pancreas. Recognition of the various clinical syndromes produced by the secretions of these tumors, the development of sensitive and specific radioimmu‐noassays for the elaborated peptides, and development of more effective localization techniques have contributed to earlier diagnosis and marked improvement in patient care. Treatment is directed toward medical management to correct the metabolic disturbances produced by the excessive amounts of gut regulatory peptides, followed by localization and extirpation of tumor. In the presence of unresectable tumor or metastases, palliative treatment directed at reducing peptide secretion or preventing its effects by surgery, chemotherapy, hormonal therapy, and hepatic‐artery embolization can produce long‐term remission of symptoms. Because the majority of these tumors are malignant, the ultimate goal in successful patient management is the early detection and surgical excision of the islet cell tumor before metastases occur.
Anesthetic management of laser airway surgery
Authors: Spiess Bruce D. , Ivankovich Anthony D.
Published: February 2007

This brief review of the anesthesiologist's role in the team effort necessary for the safe treatment of airway tumors by laser beam is provided to acquaint the referring physician or medical oncologist with some of the anesthesiologist's operating room concerns and how they are met. The necessity of bringing the patient to a level of maximum physiologic reserve prior to treatment becomes obvious with information gained by scanning this review. The referring physician or medical oncologist aids the patient and the anesthesiologist and surgeon by performing a thorough preoperative cardiopulmonary evaluation and therapeutic intervention, as indicated by patient need. The review includes a description of the actions of the carbon dioxide (CO2) and neodynium‐yttrium aluminum garnet (YAG) lasers, “laser safety” for patients and personnel, monitoring, guarding the airway, ignition dangers, and comments on the use of jet and high frequency jet ventilation (HFJV).
Treatment of breast cancer by radical surgery: A personal experience of 653 patients with minimal follow‐up of 10 years
Authors: Caceres Eduardo , Gamboa Mabel
Published: February 2007

From June 1952 through December 1976, 695 radical operations were performed on 653 women suffering from invasive cancer of the breast. All operations were performed by a single surgeon (E.G.); the same principles in the selection of the patient techniques of surgery and overall treatment were practiced. Postoperative radiation therapy was used only in the beginning of the study, and 56 (15.9%) of the group with axillary metastases received such therapy. No patient with negative axillary lymph node received radiation therapy. No postoperative adjuvant chemotherapy or immunotherapy was administered. Complete follow‐up data were obtained in 94.7% of all patients.

In accord with the UICC clinical classification, 96 were classified as stage I (14.7%), 445 as stage II (68.1%), and 111 as stage III (17.%); 1 (0.1%) was not classified.

From the 653 patients, 651 (two postoperative deaths) were observed for an average of 141.9 months. The longest period of follow‐up evaluation for any patient was more than 35 years and the minimum, 10 years. Survival was calculated for the entire study group and for patients classified by nodal status and stage of disease. The 10‐year overall survival rate for 651 patients is 60.4%; for those with positive nodes 46.4%, and for those with negative nodes, 76.7%.

The overall survival, according to clinical stage, was as follows: the 5‐year survival for patients in stage I was 89.5%, and the 10‐year survival was 83.1%. In the stage II group, the 5‐year survival was 76.1% and the 10‐year survival, 58.5%. The patients in stage III had only a 62.1% 5‐year survival and a 47.7% 10‐year survival.
Gastric lymphomas: Chemotherapy as a primary treatment
Authors: Solidoro Andres , Payet Carlos , Sanchez‐Lihon Juvenal , Montalbetti Juan A.
Published: February 2007

Twenty‐one of 65 patients with gastric lymphoma have been treated with combination chemotherapy; 17 patients had chemotherapy as primary treatment, and 4 had it for residual disease after incomplete surgical resection. Three of these patients were in stage III and 18 were in stage IV of the disease, according to the TNM Staging Classification. CHOP‐Bleo or CHOP combination was given to 17 patients, and the COPP‐Bleo regimen to three; the last one was treated with COP.

Sixteen of the 18 stage IV patients entered into complete remission after 6 to 10 courses of CHOP or COPP‐Bleo; there was one partial response and one failure. Six complete responders had a surgical restaging performed and none of them had gross evidence of residual disease; all of them had partial gastrectomy and in five cases there was no microscopical evidence of disease; in one of the resected stomachs, a focus of residual disease was discovered involving the submucosa but without compromise of the serosa. Fourteen (77.7%) of these patients are alive with no evidence of disease 1–10 (X = 3.8 years); one patient died with recurrent disease at 30 months; another patient died of other causes after 3 years; one patient is alive with disease at 18+ months. All the remaining 16 stage IV patients who were not given chemotherapy have died, median survival time being 5 months.

Seventeen stage I–II patients were treated by surgery alone and 12 of them (70%) are alive and free of disease at 5 years; five patients died of causes not related to lymphoma. Six (42.8%) of the 14 stage III patients were alive at 5 years; 12 patients of this group underwent gastric resections and only 3 of them have been treated with combination chemotherapy: one of them lived for 9 years and another one for more than 4 years; seven patients were not given any type of complementary treatment, and only 1 is alive and free of disease at 5 years. All three patients who were given chemotherapy after surgical resection are alive and free of recurrence 14–28 months after the operation.