bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathologic comparisons between estrogen receptor‐positive and ‐negative gastric cancers
Authors: Wu Chew‐Wun , Tsay Shyh‐Haw , Chang Tai‐Jay , Chang Hway‐May , Hsieh Mao‐Chih , Lui Wing‐Yiu , P'Eng Fang‐Ku , Chi Chin‐Wen
Published: February 2007

We report that a modified dextran‐coated charcoal (DCC) assay, including the addition of sodium molybdate and 5% DCC stripping of endogenous hormone, detected higher estrogen receptors (ERs) than those by the conventional assay. ERs in 21 gastric adenocarcinoma were determined by the modified DCC assay; 13 patients had ERs of 2.5 to 520.2 fmol/mg protein with a mean dissociation constant of 1.9 × 10×10 M. The remaining 8 patients had no detectable amount of the receptor. There were no differences between the ER‐positive and ER‐negative groups in clinico‐pathologic characteristics such as age, sex, tumor size, location, gross appearance, invasive depth, invasion of lymph vessel or vein of stomach wall, nodal involvement, peritoneal dissemination, liver metastasis, and curability. Histological analysis, using Japanese, Lauren's, or Ming's classifications, all revealed no differences between the ER‐positive and ‐negative groups. The survival rate was identical for the 2 study groups. These results suggest that the presence or absence of ERs in gastric adenocarcinoma does not correlate to either biologic or clinicopathologic characteristics of this tumor; the role of ERs in human gastric cancer remains to be elucidated. © 1992 Wiley‐Liss, Inc.
Transhiatal and transthoracic esophagectomy: A comparative study
Authors: Bolton John S. , Sardi Armando , Bowen John C. , Ellis James K.
Published: February 2007

From January 1981 to December 1990, 55 consecutive patients underwent esophageal resection by either the transhiatal (THE, 26 patients) or transthoracic (TTE, 29 patients) approach. Patient age, tumor size, and tumor stage were similar in the two groups. THE patients had a significantly worse mean preoperative American Society of Anesthesiologists (ASA) risk class assigned by the anesthesiologist. Patients who underwent THE had a significantly lower operative mortality and rate of cardiopulmonary complications, significantly shorter intensive care unit and hospital length of stay, and a significantly better postoperative survival when operative deaths are included in the analysis. Operative deaths in the TTE group were concentrated among patients > 65 years of age (4 of 9 died), in an ASA risk class ⩾III (3 of 7 died) or with moderate or severe cardiac or pulmonary impairment preoperatively (4 of 6 died). © 1992 Wiley‐Liss, Inc.
Early drain removal following modified radical mastectomy: A randomized trial
Authors: Parikh Hemen K. , Badwe Rajendra A. , Ash Cathy M. , Hamed Hisham , Freitas Ruffo , Chaudary Murid A. , Fentiman Ian S.
Published: February 2007

The dilemma of increasing costs of medical care and shrinking health budgets has stimulated attempts to implement stricter control on expenditure without affecting the quality of care. This study shows that in patients with operable breast cancer, a policy of early discharge after a mastectomy did not have deleterious effects on wound healing and was well accepted by patients. In a randomized trial, drains were removed after either 3 or 6 days postmastectomy, and in both groups of patients there was no difference between the mean volumes of seromas aspirated or the number of aspirations and return visits to the hospital. This suggests that a policy of early discharge is safe, acceptable, economical, and may improve bed utilization. © 1992 Wiley‐Liss, Inc.
P‐glycoprotein expression in hepatocellular carcinoma
Authors: Isshiki Koichi , Nakao Akimasa , Ito Masafumi , Hamaguchi Michinari , Takagi Hiroshi
Published: February 2007

In hepatocellular carcinoma cell lines, the intensity of staining with the monoclonal antibody C‐219 to the multidrug‐resistant gene (mdr1) product P‐glycoprotein and the intensity of the band at a molecular weight of 170 KDa on Western blot were associated closely with resistance to Adriamycin but not with the resistance to cis‐dichlorodiamine platinum (CDDP). In clinical specimens, noncancerous liver tissue was regularly stained with this antibody on the biliary canalicular front of the hepatocyte cell membrane. In liver cancer tissue, however, regular staining as in the noncancerous regions of the liver was observed in only 16% of the patients, irregular staining was seen in only 24%, and no staining was seen at all in 60%. Staining of P‐glycoprotein with the C‐219 antibody is technically simple and is useful for studying the role of P‐glycoprotein in drug‐resistant hepatocellular carcinoma. © 1993 Wiley‐Liss, Inc.
The significance of ureteral obstruction in lnvasive transitional cell carcinoma of the urinary bladder
Authors: Leibovitch Ilan , Ben‐Chaim Jacob , Ramon Jacob , Madjar Igael , Engelberg Izchak S. , Goldwasser Benad
Published: February 2007

Ureteral obstruction is a frequent complication of transitional cell carcinoma (TCC), known as a poor prognostic sign and indicative of advanced disease. We investigated retrospectively the medical records of 122 consecutive patients who suffered from invasive TCC of the urinary bladder during a 6‐year period. Unilateral or bilateral ureteral obstruction was found in 66 patients (54.1%). High stage (T3‐T4) and grade (III‐IV) tumors were correlated with ureteral obstruction in 89.4% and 83.3% respectively compared to 67.9% and 66.1%, respectively, among patients with normal upper tracts (P < 0.001); 10.6% of the patients with ureteral obstruction had low stage disease, and all of them proved to have involvement of the ureteral orifices on the affected side. The 5‐year survival rate of patients with and without ureteral obstruction was 32.2% and 65.9%, respectively (P < 0.001). The presence of ureteral obstruction, particularly in the absence of intravesical involvement of the ureteral orifices, signified a high stage, muscle invasive, and often metastatic tumor in more than 90% of the patients. Ureteral obstruction was an accurate criterion for poor prognostic and was associated with significantly lower, overall and stage‐specific, survival rates, despite of radical surgery. We conclude that evidence of ureteral obstruction is an important staging standard and significant prognostic indicator in transitional cell carcinoma of the urinary bladder. © 1993 Wiley‐Liss, Inc.
Choroidal metastasis from primary adenocarcinoma of the esophagus
Authors: Parikh Hemen K. , Deshpande Raman K. , Swaroop Durga V. , Desai Prafulla B.
Published: February 2007

Primary adenocarcinoma of the esophagus is uncommon and the incidence in the middle third of the esophagus is rare, accounting for about 0.7%‐1.5% of cases. Metastasis of carcinoma to the eye is a rare occurrence. We report here a case of primary adenocarcinoma of the middle third of the esophagus with choroidal metastasis. © 1993 Wiley‐Liss, Inc.
Cancerous residue in breast‐conserving surgery
Authors: Morimoto Tadaoki , Okazaki Kuniyasu , Komaki Kansei , Sasa Mitsunori , Mori Toshiaki , Tsuzuki Hideo , Kamamura Yoshitaka , Miki Hitoshi , Monden Yasumasa
Published: February 2007

Local tumor extension was studied using a continuous series of multiple blocks of mastectomy specimens to assess malignancy remaining after breast‐conserving surgery for early‐stage breast cancer. In this study, 183 cases were chosen, consisting of 6 noninvasive ductal carcinoma cases and 177 invasive ductal carcinoma cases. The histopathology in 59 (32%) of the 183 cases corresponded to that showing extensions of more than 2.6 cm from the tumor margin. These wide extensions were also seen in 17% of breast cancers with a tumor size of less than 2 cm. The incidence of wide extension was higher in younger patients with cases of noninvasive ductal carcinoma. Extension to the nipple‐areola was seen in 14% of cases with a tumor size of less than 2 cm. Breast cancers with multicentric development accounted for 3% of those with a tumor size under 2 cm. These findings suggest that if lumpectomy is performed with a margin of 2 cm for tumors with a size of 2 cm or less, a cancerous residue would be found in the surgical margin of 15–20% of the cases. The actual incidence was 23% of cases after breast‐conserving treatment in our study. On the basis of the data, breast‐conserving treatment with only local resection of the primary lesion showed cancerous residue such as intraductal cancerous extension in about 20% of cases. Therefore, it was concluded that, as part of breast‐conserving therapy of early‐stage breast cancer, radiation therapy of the whole breast should be performed after surgery with clear margins to Control local recurrence. © 1993 Wiley‐Liss, Inc.
Heterogeneity in early and advanced gastric carcinomas by flow cytometric DNA analysis
Authors: Umehara Yasuhiko , Kimura Taizou , Yoshida Masayuki , Oba Noriyuki , Harada Yukio
Published: February 2007

We investigated 230 systematically sampled fresh specimens from 12 early and 26 advanced gastric cancer patients by DNA flow cytometry for heterogeneity in DNA content. Fifty‐eight percent of the 12 early gastric cancers were uniformly diploid and 42% were uniformly aneuploid. Fifty‐four percent of advanced cancers were uniformly diploid in superficial layers and 42% were uniformly diploid in deep layers, whereas 46% were uniformly aneuploid in superficial layers, and 50% were uniformly aneuploid and 8% were heterogeneously aneuploid and diploid in deep layers. Both diploid and aneuploid samples were obtained from 15% for advanced cancers, but ploidy heterogeneity did not occur in early cancers. Heterogeneity for DNA index (more than one aneuploid DNA index) occurred in 46% of whole thickness of advanced cancers, in 19% of superficial layers of advanced cancers, and in 8% of early cancers. We concluded that DNA ploidy determination using superficial layer specimens may be reliable in early gastric cancer but must be interpreted with care in advanced cancer. © 1993 Wiley‐Liss, Inc.
Postoperative outcome following thoracotomy in the pediatric oncology patient with diminished pulmonary function
Authors: Tobias Joseph D. , Bozeman Paula M. , MacKert Paul W. , Rao Bhaskar N.
Published: February 2007

Surgical resection of pulmonary metastatic disease is often indicated in pediatric malignancies. Although several adult studies document increased postoperative morbidity in adults with diminished pulmonary function, there is little information in the pediatric population or in patients with restrictive lung disease. We reviewed the postoperative course following thoracotomy in patients with diminished pulmonary function (FVC, FEV1, or TLC less than 80% predicted). Thirty‐two thoracotomies were performed in 19 patients. The preoperative FVC (% predicted) was 68 ± 3.6 with a postoperative value of 60 ± 2.4 (P < 0.01). The preoperative FEV1 was 69 ± 4.2 with a postoperative value of 60 ± 3.8 (P < 0.01). Although there was a significant drop in pulmonary function tests (PFTs) following surgery, there was not a significantly greater loss when comparing patients with mild, moderate, and severe disease. When considering postoperative morbidity, there were 3 events (prolonged oxygen requirement, need for postoperative ventilation, or persistent air leak) following 20 surgeries in patients with mild preoperative respiratory dysfunction, 5 events (including one death) in the 7 patients with moderate dysfunction, and 3 events following 5 surgeries in patients with severe dysfunction. There was no correlation with a decrease in any specific PFT and the occurrence of postoperative morbidity. Our limited review suggests that aggressive surgical treatment of metastatic pulmonary disease is tolerated even in patients with severe decreases in pulmonary function. © 1993 Wiley‐Liss, Inc.
Distribution of adenosine deaminase binding protein in normal and malignant tissues of the gastrointestinal tract studied by monoclonal antibodies
Authors: Sakamoto Junichi , Watanabe Tadashi , Teramukai Satoshi , Akiyama Seiji , Morimoto Takesh , Takaci Hiroshi , Nakazato Hiroaki , Ueda Ryuzo , Takahashi Toshitada
Published: February 2007

A mouse monoclonal antibody V‐715 was raised against fresh colon cancer tissues. Biochemical analysis elucidated that the antigen defined was adenosine deaminase binding protein (ADBP). In colon cancer cell lines, V‐715 was positive in 8 out of 16 differentiated cancers and in 2 out of 8 poorly differentiated cancers. In frozen sections, ADBP was expressed in 17 out of 33 differentiated colon cancers, but none of 4 poorly differentiated colon cancers. In normal colon, the expression was observed in epithelium. In gastric cancers, ADBP was expressed in 10 out of 15 differentiated cancers, but weakly or only heterogenously expressed in 2 out of 8 poorly differentiated cancers. In normal gastric mucosa, ADBP was mainly detected in the foveolar epithelium, but was weakly or not expressed in the deep gastric glands. Carcinoid tumors and malignant lymphoma of the stomach did not express ADBP. These results suggest that ADBP may act as a marker of enterocytic differentiation in normal and neoplastic gastrointestinal cells, and might be exploitable in clinical and pathological diagnosis of gastrointestinal cancers. © 1993 Wiley‐Liss, Inc.
Malignant pericardial effusion from squamous cell cancer of the cervix
Authors: Nelson Beth E. , Rose Peter G.
Published: February 2007

Although rarely diagnosed in women with gynecologic cancers, pericardial metastasis and effusion are often considered preterminal events. As newer therapies result in prolongation of survival for women with advanced cervical cancer, uncommon metastatic sites may be seen with increasing frequency, and warrant increased attention by the gynecologist with oncologic expertise. Cases: Two women with squamous cell carcinoma and symptomatic pericardial effusion, one at initial presentation and the other as recurrent disease, are presented. Following pericardiocentesis, both patients received cisplatinum‐based chemotherapy. The patient with effusion at diagnosis survived four months, with recurrent effusion at death. The second patient had no return of cardiac symptoms, with twelve month survival. As demonstrated by the cumulative experience of the six reported cases of this entity, many women with pericardial involvement are candidates for aggressive radiation or chemotherapy. Duration of time from primary therapy prior to occurrence of effusion correlates with survival. © 1993 Wiley‐Liss, Inc.
Selective use of drains in thyroid surgery
Authors: Shaha Ashok R. , Jaffe Bernard M.
Published: February 2007

In the past, it was generally advised that every patient undergoing thyroid surgery have a drain placed because of the fear of post‐operative hematoma. In the past 9 year, we have performed 400 thyroidectomies. For the first 6 years, we drained the operative site in most of thyroid procedures. However, it was apparent from our experience that drains had very little effect on the prevention of post‐operative hematoma or of seroma. As a matter of fact, all four patients who required re‐exploration in our initial series had drains in place. As a result of this experience over the past 3 years, during which time we have performed 150 thyroidectomies, we have used drains selectively. The indications for draining for a large substernal goiter, and subtotal thyroidectomy for either large, multinodular goiter or for Graves' disease. Thus, among 150 recent thyroidectomies, we have drained only 35, and avoided drains in 115 patients. Though this is not a prospective study, we found no difference in the overall outcome whether drains were employed or not. Most patients who had no drains were ready for discharge within 24‐48 hours of surgery. Since it may be difficult to perform a randomized prospective trial examining the use of drains in thyroid surgery, we propose that drains should be utilized only selectively for thyroid surgery. © 1993 Wiley‐Liss, Inc.
Preoperative duplex venous imaging in the assessment of patients with venous access
Authors: Kraybill William G. , Allen Brent T.
Published: February 2007

Occult or clinically apparent central venous thrombosis frequently complicates central venous catheter placemnt in patients requiring long‐term vascular access. Thirty‐three patients, aged 12‐83 years, underwent duplex scanning of the internal jugular, axillary, and brachial veins prior to placement of long‐term venous access catheters. Twenty‐seven patients underwent duplex scanning because of a prior history of either long‐term or short‐term central venous access. Of 12 patients with a history of long‐term central venous access, without complications, 42% (5/12) had an abnormal duplex scan demonstrating thrombosis. Duplex scans on 15 patents having complications associated with central venous access demonstrated thrombosis of one or more of the central veins, 46% (7/15). Five patients who underwent duplex scanning without a history of a previous central venous catheter or other indication were found to have normal normal central veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the surgeon was directed to successful venous access in all cases. Normal findings were very helpful in confirming that the venous system was normal in selected patients. In approximately 40% of patients with a history of venous access, catheters were found to have evidence of thrombosis of one or more of the central veins. In 13 patients found to have thrombosis or obstruction by duplex scan, the surgeon was directed to a successful site for venous access in all cases. © 1993 Wiley‐Liss, Inc.
Significance of in vitro attachment of human colon cancers to extracellular matrix proteins in experimental and clinical liver metastases
Authors: Furukawa Toshiharu , Watanabe Masahiko , Kubota Tetsuro , Kase Suguru , Fujita Shin , Yamamoto Takaaki , Saikawa Yoshiro , Kuo Tsong‐Hong , Tanino Hirokazu , Kurihara Naoto , Kawano Yukio , Kawamoto Kiyoshi , Suto Akihiko , Teramoto Tatsuo , Ishibiki Kyuya , Kitajima Masaki
Published: February 2007

The attachment of 7 human colon cancer lines transplantable into nude mice, and primary tumors and liver metastases from 30 patients with colon cancer to 4 extracellular matrix proteins (EMPs)—Matrigel, laminin, fibronectin, and type IV collagen—was evaluated using the 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H (MTT) assay. Cancer cells from the 4 established tumor lines which produced experimental liver metastases in vivo showed significantly greater attachment to each EMP than those from the other 3 tumor lines which did not. Although there were no significant differences between attachment to EMPs of cancer cells from 15 clinical primary tumors with liver metastases and those without, attachment to each EMP of cells derived from liver metastases was significantly greater than that of the cells from the corresponding primary tumors in 8 cases for which liver metastases and primary tumors were examined simultaneously. Attachment to EMPs, which could be determined simply and rapidly using the MTT assay, is thus considered a significant factor in experimental and clinical liver metastases of human colon cancers. © 1993 Wiley‐Liss, Inc.
Selected benefits of thoracotomy and chemotherapy for sarcoma metastatic to the lung
Authors: Mentzer Steven J. , Antman Karen H. , Attinger Christopher , Shemin Richard , Corson Joseph M. , Sugarbaker David J.
Published: February 2007

To determine the benefit of aggressive surgical therapy, we studied 77 consecutive patients presenting to our sarcoma registry with pulmonary metastases. Detailed follow‐up was available on all patients; the median follow‐up of the 13 long‐term survivors was 72 months from the date of diagnosis of the primary tumor. Survival of these 77 patients with metastatic disease was independent of the size, location, and histology of the primary tumor. Once metastases developed, survival of patients with pulmonary metastases was not influenced by the extent of surgical resection of the primary tumor or by the use of radiation therapy. Pulmonary metastases were initially treated with thoracotomy and metastasectomy in 34 patients. The median survival after thoracotomy was 26 months. Seven patients were alive more than 4 years after their diagnosis. Pulmonary metastases were treated with chemotherapy alone in 43 patients. Although the survival was shorter (median survival 14 months) in patients treated with chemotherapy, an objective response to chemotherapy was obtained in 13 (30%) patients. Four of these patients were alive 4 years after their diagnosis. These data demonstrate that both thoracotomy and chemotherapy are associated with long‐term survival of patients with sarcoma metastatic to the lung. © 1993 Wiley‐Liss, Inc.
Prognostic factors for well‐differentiated squamous cell carcinoma in the oral cavity with emphasis on immunohistochemical evaluation
Authors: Horiuchi Keisuke , Mishima Kenji , Ohsawa Masahiko , Sugimura Masahito , Aozasa Katsuyuki
Published: February 2007

Histological and immunohistological prognostic factors for well‐differentiated oral squamous cell carcinoma (SCC) were examined in 31 patients. They included 18 males and 13 females aged 42–84 (median 63) years. The tumors were located in the tongue in 13 cases, gingiva in 7, floor of the mouth in 5, cheek mucosa in 4, and palate in 2. Advanced disease (stages III and IV) was found in 92% of patients; 22 were treated by radical surgery and nine by excisional or incisional biopsy, followed by adjuvant chemotherapy and external radiation. The 5‐year survival rate in patients with stages III and IV disease was 58% and 33%, respectively. Histologic factors evaluated were tumor cell mitotic counts, degree of lymphocyte and eosinophil infiltration around the tumor, mast cell counts, HLA‐DR expression on tumor cells, or surrounding lymphocytes. Multivariate analysis revealed that degree of eosinophilic infiltration and expression of HLA‐DR antigen on the tumor cells were significant factors for prognosis (P <0.05); i.e., heavy eosinophilic infiltration and expression of HLA‐DR antigen on tumor cells were signs of an unfavorable prognosis. The interpretation of the present findings are discussed with a review of the literature. © 1993 Wiley‐Liss, Inc.
Prognostic significance of flow cytometric analysis of DNA content in colorectal cancer: A prospective study
Authors: Tomoda Hirotsugu , Kakeji Yoshihiro , Furusawa Motonosuke
Published: February 2007

We prospectively analyzed the tumor DNA content by flow cytometry in 100 patients who underwent a curative resection for colorectal cancer between August 1989 and May 1992 in order to evaluate the prognostic significance of DNA ploidy and the DNA index (DI). Patients with aneuploid tumors were found to have a significantly shorter disease‐free survival than those with diploid tumors (P =0.014). In addition, patients who had tumors with a DI greater than 1.6 had a significantly shorter disease‐free survival than those who had tumors with a DI of less than 1.6 (P= 0.0001). After stratification by stage, this association was only seen in Dukes' stage C disease (P= 0.0065). Cox's regression analysis demonstrated that the DI (below or above 1.6) rather than DNA ploidy was an important independent predictor of disease‐free survival. These results suggest that the DI rather than DNA ploidy provides us with important prognostic information in patients undergoing curative surgery for colorectal cancer. © 1993 Wiley‐Liss, Inc.
Testicular seminoma stage I: Treatment results and long‐term follow‐up (1968–1988)
Authors: Stein Moshe Efraim , Kessel Ivan , Luberant Norman , Kuten Avraham
Published: February 2007

Sixty‐nine patients with stage I testicular seminoma were referred to the Northern Israel Oncology Center between 1968 and 1987. Sixty‐four patients were irradiated postoperatively and five patients had surveillance alone. Complete follow‐up was available for all patients, with a median follow‐up of 86 months (range 9–239 months). The last follow‐up was in December 1988. Actuarial survival was 94% to 5, 10, 15, and 20 years. Six patients relapsed following completion of irradiation. All the recurrences occurred outside the radiation field. Three of the relapsed patients could be salvaged with cisplatinum‐based chemotherapy and are alive at 4, 7, and 10 years following second‐line treatment. Acute or chronic side effects were mild and manageable. Seven patients developed second primary cancers, two within and six outside the radiation field. While surveillance policy alone in stage I testicular seminoma may be successful in terms of patient outcome, it requires prolonged observation, good compliance of patients, and intensive use of resources. Thus, until proved otherwise, infradiaphragmatic radiotherapy should further remain the optimal routine treatment in seminoma patients with stage I disease. © 1993 Wiley‐Liss, Inc.
Prognosis for patients with carcinoma in the middle third of the stomach
Authors: Anai Hideaki , Maehara Yoshihiko , Oshiro Tatsuo , Baba Hideo , Orita Hiroyuki , Okuyama Toshiro , Sugimachi Keizo
Published: February 2007

In 268 of the 1,115 patients (24.0%) with gastric cancer who underwent a curative resection in our clinics, the tumor was located in the middle third of the stomach. The clinicopathological features and prognosis of these patients were divided into two groups, according to site of the tumor: anterior wall (n = 58) vs. other sites (n = 210). Clinicopathological factors did not differ between the two groups. The survival time for patients with a tumor in the anterior group was shorter than that for patients with a tumor in other areas (P <0.05). The five‐year survival rate was 79.3% for patients with an anterior tumor and 91.9% for those with a tumor at a different site. A multivariate analysis indicated lymph node metastasis, serosal invasion, and anterior wall location to be independent prognostic factors indicative of a poor prognosis when the tumor was located in the middle third of the stomach. For such patients, close follow‐up is needed to detect possible recurrences. © 1993 Wiley‐Liss, Inc.
DNA ploidy as a major prognostic factor in resectable ampulla of vater cancers
Authors: Shyr Yi‐Ming , Su Cheng‐Hsi , Wu Li‐Hwa , Li Anna Fen‐Yau , Chiu Jen‐Hwey , Lui Wing‐Yiu
Published: February 2007

The archival paraffin‐embedded specimens from 63 ampulla of Vater cancers after pancreaticoduodenectomy between 1965 and 1991 were analyzed by flow cytometry. Of the 63 cancers, 31 (49.2%) were diploid DNA cancers and 32 (50.8%) were aneuploid. Patients with diploid DNA cancer had a median survival time of 159.0 months, and patients with aneuploid DNA cancer had 24.0 months. This difference is statistically significant (P =0.0257). The aneuploid group did have a poorer prognosis than the diploid group. The multivariate analysis demonstrated that DNA ploidy was an independent and very important prognostic factor, even stronger than the stage and lymph node status. There was a tendency toward higher values of S‐phase fraction, proliferative index, and total aneuploid DNA fraction in the shorter survival groups, but they were of no statistical significance. These data suggest that DNA ploidy appears to be the most important and the only pre‐operative predictor of prognosis in resectable ampulla of Vater cancers since endoscopic biopsy is feasible. © 1993 Wiley‐Liss, Inc.
Multiple primary gynecologic neoplasms in a young HIV‐positive patient
Authors: Rose Peter G. , Fraire Armando E.
Published: February 2007

Immune suppression from human immunodeficiency virus (HIV) infection is frequently associated with the development of certain neoplasms, including Kaposi's sarcoma and non‐Hodgkin's lymphoma. A young patient with a 5‐year history of HIV infection was found simultaneously to have invasive carcinoma of the breast, microinvasive carcinoma of the cervix, and intraepithelial neoplasia of the vulva. In view of the early nature of these neoplasms, conservative therapy was utilized; lumpectomy and adjuvant radiation therapy, conservative hysterectomy, and local therapy for the breast carcinoma, cervical carcinoma and vulvar intraepithelial neoplasia, respectively. Epithelial malignancies appear to be more common in the HIV‐positive population than previously appreciated. To our knowledge this is the first report of multiple primary gynecologic neoplasms in association with HIV infection. © 1993 Wiley‐Liss, Inc.
Extent of hepatic resection as a prognostic factor for small, solitary hepatocellular carcinomas
Authors: Torii Akihito , Nonami Toshiaki , Harada Akio , Yasui Motoshi , Nakao Akimasa , Takagi Hiroshi
Published: February 2007

The prognostic factors for solitary hepatocellular carcinomas with a maximum tumor diameter of ⩽3 cm were investigated in 59 of 231 patients who underwent curative hepatic resections at the Department of Surgery II, Nagoya University Hospital between January 1981 and December 1991. The 3‐ and 5‐year survival rates of these 59 patients were 61% and 41%, respectively. As prognostic factors, tumor maximum diameter, vascular invasion, capsule formation, cell differentiation, tumor localization, hepatic functional reserve, extent of hepatic resection, and macroscopic surgical margin were selected in this study. Of the patients with a tumor size > 1.5 cm, those who underwent major hepatic resections (hepatic lobectomy or segmentectomy) tended to have better survival than patients who received minor hepatic resections (hepatic subsegmentectomy or limited resection). Although most patients with a tumor size ⩽1.5 cm underwent minor hepatic resections, they had a good survival rate. According to Cox's multivariate analysis, the extent of hepatic resection was significantly correlated with long‐term prognosis of patients with a solitary hepatocellular carcinoma ⩽3 cm in diameter, but the macroscopic surgical margin was not. Cell differentiation, vascular invasion, capsule formation, and tumor localization were all correlated with the long survival. These results suggest that the selection of an adequate operative procedure is an important factor for the long‐term prognosis of patients with small, solitary hepatocellular carcinomas. © 1993 Wiley‐Liss, Inc.
Local control following therapeutic nodal dissection for melanoma
Authors: Monsour Paul D. , Sause William T. , Avent James M. , Noyes R. Dirk
Published: February 2007

Regional recurrence of melanoma is usually treated with surgical resection alone. Unfortunately sites of failure following surgical resection are poorly documented. Little information exists regarding local failure following surgery. In order to define local control, a retrospective analysis was performed of all patients undergoing a potentially curative lymph node dissection for metastatic melanoma. From 1978 to 1988, 48 patients underwent lymph node dissection with removal of all known disease (15 axillary, 25 groin and 8 radical neck dissections). Seven patients had stage II disease with simultaneous resection of the primary lesion and nodal dissection. The remaining 41 patients had stage I disease with dissection delayed until nodal metastasis became apparent. Of these 48 patients, 25 experienced local failure for an overall local control rate of 48%. Univariate and multivariate analysis showed only age to be a statistically significant prognostic indicator of local failure with a rate of 31% for patients >50 years of age vs. 66% for patients >50 years of age (P= 0.02). Nodal size, number of nodes involved, extracapsular extension, initial stage, location, or sex did not influence prognosis. Although not statistically significant, time to recurrence was much shorter in patients with extracapsular extension, 5 months vs. 16 months. With an overall local failure rate of 52% following a potentially curable therapeutic nodal dissection further local treatment should be considered. © 1993 Wiley‐Liss, Inc.
Head and neck synovial sarcomas
Authors: Pai Sanjay , Chinoy Roshan F. , Pradhan Sultan A. , D'cruz Anil K. , Kane Shubhada V. , Yadav Jyoti N.
Published: February 2007

Eleven cases of synovial sarcoma of the head and neck are analyzed. Patients presented with a mass either in the parapharynx, pharyngeal wall, or nape of the neck. The tumors ranged in size from 3 to 8 cm. Microscopically, the classic biphasic pattern was seen in 10 tumors. Immunohistochemistry and electron microscopy were useful in the diagnosis of the single monophasic variant of synovial sarcoma. Radical surgery was the mainstay of treatment with post‐operative radiotherapy for residual disease. Five patients were dead of disease while 6 were alive for periods varying from 9 months to 15 years. The purpose of this presentation is to accrue data on this sarcoma at a rare site, and to highlight the histopathological differential diagnosis, which includes both carcinomas and sarcomas. Treatment decisions would be affected by the histology report. © 1993 Wiley‐Liss, Inc.
Synergistic antitumor activity of mitomycin C and cisplatin against gastric cancer cells in vitro
Authors: Saikawa Yoshiro , Kubota Tetsuro , Kuo Tsong‐Hong , Kase Suguru , Furukawa Toshiharu , Tanino Hirokazu , Ishibiki Kyuya , Kitajima Masaki
Published: February 2007

The synergistic antitumor activity of mitomycin C (MMC) and cisplatin (DDP) against the gastric cancer cell lines MKN‐28 and MKN‐45 was assessed in vitro using the MTT assay. The synergism of the two agents was evaluated in terms of the interaction index (I.I.). The sequence of MMC followed by DDP showed higher antitumor activity than the reverse sequence against MKN‐28 and MKN‐45, and the intracellular concentration of platinum was significantly increased in MKN‐45 by preincubation with MMC, suggesting that MMC modulates cellular permeability to DDP or the ability of DDP to intercalate DNA. Since these two antitumor agents show different types of toxicity clinically, i.e., myelotoxicity by MMC and nephrotoxicity by DDP, this combination chemotherapy could be advantageous by providing synergistic antitumor activity without increased toxicity. © 1993 Wiley‐Liss, Inc.
Utility of the neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser for extensive pulmonary metastasectomy
Authors: Harvey James C. , Lee Kenneth , Beattie Edward J.
Published: February 2007

The neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser has been reported to have advantages in pulmonary resections including superior control of bleeding and air leak with relative sparing of pulmonary parenchyma. Extensive metastasectomies were performed in two patients with bilateral metastases who might have been excluded from surgery with other techniques. The patients were discharged within 8 days after uneventful postoperative courses. While this modality shows promise in permitting extensive metastasectomy, only long‐term follow‐up will demonstrate the ability to provide results comparable to those achieved with previous techniques. © 1993 Wiley‐Liss, Inc.
Vulvar carcinoma with 0.5 mm of invasion and associated inguinal lymph node metastasis
Authors: Hicks Michael L. , Hempling Ronald E. , Piver M. Steven
Published: February 2007

A case of vulvar carcinoma with 0.5 mm of invasion treated by radical wide local excision only, which later developed ipsilateral inguinal lymph node recurrence, is presented. This represents the least amount of invasion reported resulting in inguinal lymph node metastasis. Review of the literature of stage I vulvar carcinoma with less than 1 mm of invasion indicates that this phenomenon occurs in only 1.6% of all patients who have undergone inguinal lymphadenectomy. Although this represents the second report of ipsilateral inguinal nodal metastasis associated with less than 1 mm of invasion, we continue to perform radical wide local excision without ipsilateral inguinal lymphadenectomy until more cases demonstrate a higher incidence of lymph node involvement. © 1993 Wiley‐Liss, Inc.
The role of suprahyoid block dissection in carcinoma of the floor of the mouth
Authors: Hudson Donald Anthony , Stannard Claire E. , Binnewald Bertram , Price Bernard
Published: February 2007

The efficacy of suprahyoid block dissection combined with radiotherapy, in the management of neck nodal disease was evaluated in 15 patients with carcinoma of the floor of mouth (abutting on the mandible) between 1983 and 1989. Ten males and 5 females had a mean age of 60.3 years. Suprahyoid block dissection was performed in 10 patients as initial treatment. Nine of these presented with a submandibular mass and one patient with a T4NO lesion had a prophylactic block performed. Suprahyoid block dissection was performed in five patients who developed a submandibular mass after completion of surgery and radiotherapy. Wound sepsis occurred in three patients, but resolved with conservative treatment. Clinical assessment of the suprahyoid mass was accurate in 65% of patients. Nodal recurrence occurred in one patient. Seven patients are alive and disease free after a mean of 64.5 months. Two other patients are alive, one with lung metastases, and one with a supraclavicular mass. Six patients have died, two of whom developed local recurrence, one who developed a supraclavicular mass, one after nodal recurrence, one with lung metastases, and one of an unrelated cause. Suprahyoid block dissection combined with radiotherapy is effective treatment for nodal control of patients with carcinoma of the floor of mouth. This procedure is associated with a low morbidity. © Wiley‐Liss, Inc.
Nutritional support and prognosis in patients with head and neck cancer
Authors: Lopez Marvin J. , Robinson Pat , Madden Tim , Highbarger Toni
Published: February 2007

We retrospectively studied the relationship between nutritional status as indicated by the presence or absence of the cutaneous delayed hypersensitivity response and treatment‐related morbidity, disease recurrence, and survival at 2 years in 67 consecutive patients with head and neck carcinoma. Serial nutritional assessments were conducted throughout the course of combined initial antineoplastic treatment and nutritional support. The presence of cell‐mediated immunity at the end of treatment was associated with a 2‐year survival rate of 100%, whereas patients who were anergic at the end of treatment had a 2‐year survival rate of 48% (P < 0.01). Morbidity due to surgical therapy and tumor recurrence rates were also higher in the anergic group (P < 0.01). Prognosis in head and neck cancer is based on many factors, but vigorous nutritional support during initial treatment may have some effect on morbidity, tumor recurrence, and survival time. © Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of pancreatic ductal adenocarcinoma: Loss of diagnostic accuracy with small tumors
Authors: Graham Roger A. , Bankoff Mark , Hediger Roy , Shaker Hassan Z. , Reinhold Randolph B.
Published: February 2007

Eighty‐three patients underwent CT‐directed fine‐needle aspiration biopsies (FNAB) for pancreatic ductal adenocarcinoma. Five factors that might have influenced the diagnostic sensitivity of FNAB were analyzed: clinical history, the number of passes for each FNAB, and three radiologic criteria including tumor size, tumor location, and the presence or absence of suspected tumor necrosis by CT scan. Sixty‐three patients had a diagnosis of pancreatic carcinoma confirmed by FNAB (overall sensitivity = 76%). Tumor size was the only factor that correlated with the diagnostic sensitivity of FNAB.

Of 12 patients whose FNAB was negative but suspicious for malignancy, 10 had a repeat FNAB and 4 were positive for carcinoma. We conclude that the diagnostic sensitivity of FNAB decreases significantly with decreasing tumor size and that a repeat FNAB for suspicious biopsies should be done to increase the diagnostic yield. © Wiley‐Liss, Inc.
Malignant peripheral nerve sheath tumors of the head and neck: A clinicopathological study
Authors: Vege Durga Swaroop , Chinoy Roshan Farokh , Ganesh Balasubramaniam , Parikh Deepak Mukund
Published: February 2007

Twenty‐seven cases of malignant peripheral nerve sheath tumors involving the head and neck region over a period of 7 years were reviewed. They were graded from 1–3 based on necrosis, mitosis, cellularity, and pleomor‐phism. Mean age of occurrence was 42 years, with a range of 12–70 years. Male preponderance was noted (M:F = 3.5:1). The most common site of involvement was the neck (44.6%). The main presenting symptom was an enlarging mass. The nerve of origin could be identified in 33% of patients. Treatment consisted of wide excision. The 5‐year observed survival was 33%. Fifty‐two percent of patients developed local recurrence of disease. Fifteen percent of patients died due to advanced local disease within 18 months of treatment. Distant metastasis was seen in 18.5% of patients. Lymph node metastasis was not seen. At the end of 5 years 15% of patients remained disease free. Large tumor size (>5 cm) adversely affected the prognosis (P = < 0.1). No significant correlation was noted between the grade of tumor and survival. © Wiley‐Liss, Inc.
Osteomyocutaneous flap reconstruction for major mandibular defects
Authors: Savant Dhairyasheel N. , Kavarana Naozer M. , Bhathena Hosi M. , Salkar Shekhar , Ghosh Sudeep
Published: February 2007

Mandibular defects after composite resections for carcinoma of the buccal mucosa require immediate restitution of both form and function with an acceptable cosmetic result. The pectoralis major osteomyocutaneous flap (PM‐OMC) provides restoration of bone, soft tissue and skin with minimum morbidity. The procedure is technically simple, and in our series reconstruction using this flap has been performed by consultants, fellows and residents in training. We present a series of 116 PM‐OMC flaps with good postoperative mastication in more than 70% of cases, and satisfactory swallowing and intelligible speech in 85% patients. © Wiley‐Liss, Inc.
Tumor‐derived components were responsible for suppression of ornithine decarboxylase activity in the rat wounded skin
Authors: Abe Yoshio , Imamura Kiichi , Ogawa Yoshitaka , Tsujinaka Toshimasa , Kobayashi Mitsugu , Yano Masahiko , Kido Yoshihiro , Tanaka Takehiko , Mori Takesada
Published: February 2007

To elucidate the principal cause of delayed wound healing in a tumor‐bearing host, the effect of Yoshida sarcoma‐derived components on dermal wound healing was investigated in rats with the aid of ornithine decarboxylase (ODC) activity and in vivo bromodeoxyuridine (BrdU) labeling index. The ODC activity in the wounded skin decreased 3 and 7 days after intraperitoneal inoculation of Yoshida sarcoma cells (378.0 ± 37.3 on Day 3, 280.0 ± 140.0 on Day 7 vs. 809.3 ± 109.5 pmol/mg protein/hour on Day 0). When administered 24 hours before and immediately after wounding, the crude nuclear component of the tumor cells significantly decreased the ODC activity in the wounded skin as compared with the control (185.9 ± 159.8 vs. 5340 ± 59.1), but the non‐nuclear component was not effective. When nuclear extracts of Yoshida sarcoma cells were intraperitoneally administered immediately after wounding, the 0.15 M or 0.35 M NaCl extract significantly suppressed ODC activity in the wounded skin (233.5 ± 14.5 and 352.3 ± 63.2 pmol/mg protein/hour, respectively) in comparison to the control (445.9 ± 73.6). The BrdU labeling index of epidermal basal cells adjacent to the edge of the wound decreased up to 52% of the control by injection of the 0.15 M extract. It seems that tumor‐derived nuclear components may be responsible for delayed wound healing which is commonly observed in cancer cachexia. © Wiley‐Liss, Inc.
Perioperative allogeneic blood transfusion exacerbates surgical stress‐induced postoperative immunosuppression and has a negative effect on prognosis in patients with gastric cancer
Authors: Maeta Michio , Shimizu Norio , Oka Atsuo , Kondo Akira , Yamashiro Hiroshi , Tsujitani Syunichi , Ikegchi Masahide , Kaibara Nobuaki
Published: February 2007

The immunomodulative effect of perioperative allogeneic blood transfusion on host immunocompetence was studied in 109 patients with gastric cancer at various stages. Mitogen‐induced lymphocyte blastogenesis, lymphocyte surface markers (specific for T, B, CD4, and CD8 populations), and the activity of natural killer (NK) cells were examined before surgery and then 2 and 4 weeks after surgery. The effects on host immunocompetence of transfusion alone, in the absence of any effect of surgical stress, were studied, preoperatively, in nine patients who received preoperative transfusion. Although a tendency towards a decrease in the posttransfusion activity of NK cells was observed, there were no statistically significant differences between pre‐ and posttransfusion levels. Mitogen‐induced blastogenesis and the activity of NK cells were significantly impaired 2 weeks after surgery in transfused patients as compared to those in non‐transfused patients with gastric cancer at stage III and stage IV, and postoperative survival was significantly lower in transfused as compared to nontransfused patients. These results indicate that perioperative allogeneic blood transfusion exacerbates surgical stress‐induced postoperative immunosuppression and has a negative effect on prognosis in patients with gastric cancer. © Wiley‐Liss, Inc.
Lymphokine‐activated killer cell activity of peripheral blood, spleen, regional lymph node, and tumor infiltrating lymphocytes in gastric cancer patients
Authors: Karimine Nobuya , Nanbara Shigeru , Arinaga Shinya , Asoh Tsukasa , Ueo Hiroaki , Akiyoshi Tsuyoshi
Published: February 2007

Lymphokine‐activated killer (LAK) cell activity of peripheral blood mono‐nuclear cells (PBM), spleen cells (SPC), regional lymph node cells (LNC), and tumor‐infiltrating lymphocytes (TIL), induced by activation with in‐terleukin 2 (IL 2) for 4 days, was evaluated in patients with gastric carcinoma. TIL exhibited the lowest LAK activity and the cytotoxicity of LNC was significantly lower than that of either PBM or SPC. There was no difference between PBM and SPC. Then, there were significant correlations of LAK activity among PBM, SPC, and LNC, whereas poor correlations were observed in the cytotoxicity between TIL and PBM, SPC, or LNC. Phenotypic analysis of each cell population was performed before and after activation with IL 2. Before culture, the cells mediating natural killer (NK) activity such as CD16+, CD56+, and CD57+ cells were few in LNC and TIL. However, CD56+ and CD57+ cells in TIL were increased after culture. Then, CD4+ Leu8+ and CD8+ CD11+ cells, which identify suppressor cell function, were not elevated in LNC or TIL, as compared to that in PBM or SPC. Further, the proportions of OKIa1+ and CD25+ cells expressing T‐cell activation and IL 2 receptor were uniformly increased in all cell populations after culture. These results indicate the differential reactivity of each lymphocyte population to IL 2 and fundamental dysfunction of LNC and, especially TIL, suggesting the specific influence of the local tumor environment on the lymphocyte function in the area in patients with gastric carcinoma. © Wiley‐Liss, Inc.