bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoadjuvant chemotherapy in marginally resectable stage III M0 non‐small cell lung cancer: Long‐term follow‐up in 41 patients
Authors: Skarin Arthur , Jochelson Maxine , Sheldon Thomas , Malcolm Arnold , Oliynyk Peter , Overholt Richard , Hunt Myla , Frei Emil
Published: February 2007

Forty‐one patients with marginally resectable stage III M0 non‐small cell lung cancer (NSCLC) were entered into a study evaluating neoadjuvant cyclophosphamide, adriamycin, and cisplatin chemotherapy (CAP) followed by radiotherapy and subsequent resection. Postoperative radiotherapy and additional CAP were also administered. The objective disease regression rate prior to surgery was 72% (2 complete, 12 partial, and 7 minimal responses). Thoracotomy was carried out in 37 patients (90%), with resection of all gross disease in 36 patients (97%). Relapse occurred in 22 (61%) of the resected patients, involving chest only (four patients), chest and extra thoracic (nine patients), and extra thoracic only (nine patients). Subsequent CNS relapse developed in 9 (25%) of 36 postop patients in association with other sites of relapse (five patients) or as a solitary location (four patients). Only one of seven patients receiving prophylactic cranial irradiation (PCI) developed CNS relapse compared with 7 (26%) of 27 patients not receiving PCI. The median long‐term follow‐up for 14 living patients is 53 + months, with a range of 38 + to 71 + months. Median survival for all patients is 32 months, with 1‐year survival being 75%. The survival curve shows a plateau of 31% from 3 to 5 + years. Using a log rank test, no prognostic subgroups could be identified that significantly affected response rate, disease‐free survival, or overall survival. While neoadjuvant CAP followed by radiotherapy appears to improve survival, more effective chemotherapy along with randomized studies are needed to determine the role of initial chemotherapy in marginally resectable NSCLC.
Lung resection for metastatic sarcomas: Total survival from primary treatment
Authors: Pastorino Ugo , Valente Maurizio , Gasparini Marco , Azzarelli Alberto , Santoro Armando , Alloisio Marco , Ongari Mauro , Tavecchio Luca , Ravasi Gianni
Published: February 2007

The results of surgical management of 63 cases of pulmonary metastases from bone and soft tissue sarcomas, admitted at the Istituto Nazionale Tumori of Milan, between 1970 and 1987, are reviewed in this paper. To estimate the relative impact of metastasectomy on the overall performance of treatment, survival curves were calculated from the time of first thoracotomy, as well as from the initial treatment of primary sarcoma. In the present series, total actuarial survival at 10 years was 37% for osteosarcoma, 27% for soft tissue sarcomas, and 24% for the other bone sarcomas, with a median survival of 48, 56, and 36 months, respectively. Five‐year survival from the first pulmonary resection was influenced by the number of metastases and the length of the first disease‐free interval only in osteosarcoma, while in soft tissue sarcomas a major untoward factor was represented by local recurrence at the site of the primary tumor. These data support the concept of pulmonary metastasectomy as effective salvage therapy for radically treated sarcomas; this management can rescue a significant proportion of all relapsed patients.
Study of cell kinetics in anaplastic thyroid carcinoma transplanted to nude mice
Authors: Yoshida Akira , Fukazawa Masakatu , Ushio Hiroki , Aiyoshi Yuji , Soeda Shugo , Ito Kunihiko
Published: February 2007

The cell kinetics of the transplantable human anaplastic thyroid carcinoma were studied in athymic nude mice using bromodeoxyuridine (BrdU) pulse labeling. In order to estimate the cell cycle time in this study, the percent labeled mitosis curve was prepared with immunoperoxidase staining using monoclonal antibody to BrdU instead of 3[H]thymidine autoradiography. This technique was considered to be very useful because it can be done for a short term and can still be changed to the autoradiographic method.

Comparing the results in this study with already reported data on various xenografts of human carcinomas in nude mice, the tumor doubling time (117.5 hr) and the cell cycle time (23.5 hr) were rather short, but the growth fraction (54%) and the cell loss factor (68%) were nearly equivalent to the median value.

These findings suggest that the very rapid growth rate of this tumor was mainly due to the shortness of the cell cycle time.
Positivity to glial fibrillary acidic protein in bone, cartilage, and chordoma
Authors: Kasantikul Vira , Shuangshoti Samruay
Published: February 2007

Twenty vertebral bones, 11 costal, 11 epiglottic, six tracheal, and five bronchial cartilages and seven chordomas were evaluated by the application of peroxidase‐antiperoxidase (PAP) indirect immunohistochemical method for localization of glial fibrillary acidic protein (GFAP). Positive immunostaining for GFAP was observed in osteocytes of normal bone (13/20), chondrocytes of normal epiglottis (5/11), costal cartilage (3/11), trachea (2/6), and bronchus (4/5). Four of seven chordomas had neoplastic cells that exhibited cytoplasmic positivity to GFAP. These findings suggested that osteocytes, chondrocytes, and chordoma cells have cytoskeletal intermediate filaments that are antigenically identical to or similar to or associated with GFAP.
Implantable catheter system for long‐term intravenous chemotherapy
Authors: Hall Per , Cedermark Björn , Swedenborg Jesper
Published: February 2007

Fifty‐three implantable catheter systems (Port‐A‐Cath) were placed subcutaneously in 48 patients with malignant tumours. This device consists of a stainless steel chamber covered by a silicone membrane connected to a silicone catheter placed in a central vein. All systems were used for administration of chemotherapy. The mean function time was 187 days (range 0‐867). Complications necessitating reoperation occurred in six patients. In three cases, the catheter occluded from thromboses. In two patients, wound dehiscence occurred, and in one a wound infection developed. In one case, the catheter was disconnected from the port. Four patients who had had the port removed later received new ports. One patient had the second port removed and was given a third catheter system. It is concluded that subcutaneously implantable injection ports constitute a safe and convenient access for long‐term intravenous chemotherapy. The complication rate is low, and it should be possible to avoid most recorded complications in the future.
Massive intraoperative atelectasis secondary to untreated mediastinal Hodgkin's disease: Report of the hazard and review of the literature
Authors: Merrick Hollis W. , Martin John T. , Woldenberg Lee S. , Driscoll Peter L.
Published: February 2007

Mediastinal adenopathy in Hodgkin's disease has been known to cause relative airway compromise, particularly in the more vulnerable left mainstem bronchus. This has been infrequently reported to occur during general anesthesia and to cause respiratory embarrassment, representing a significant hazard. The possibility of its occurrence should be recognized. Preoperative evaluation of the airway by chest films and tomography, followed by radiation therapy in those patients at risk, is recommended to minimize the chances of respiratory complications during general anesthesia.
Clinical and experimental studies on a midgut carcinoid tumor
Authors: Åhlund L. , Kindblom L. G. , Nilsson O. , Skolnik G. , Tylén U. , Dahlström A. , Ahlman H.
Published: February 2007

This study reports on a patient with a midgut carcinoid discovered due to the occurrence of a subcutaneous metastasis that caused symptoms. The histopathologic diagnosis of a carcinoid was confirmed by light and electron microscopic and immunocytochemical examination of the metastasis. The primary ileal tumors were only localized after the determination of serotonin in platelet‐poor plasma/whole blood sampled at selective mesenteric vein catheterization. Tumor cells from lymph node metastases were studied in vitro, in intraocular heterotransplants, and in cell culture.
CEA and CA 19‐9 in benign pulmonary or mediastinal cystic lesions
Authors: Uyama Tadashi , Monden Yasumasa , Sumitomo Masayuki , Miura Kazumasa , Kimura Suguru
Published: February 2007

Serum carbohydrate antigen (CA) 19‐9 was present at high levels in pulmonary sequestration, mediastinal bronchogenic cysts, and mediastinal mature teratomas. The fluid in the cysts of the lesions contained a high level of CA 19‐9. After operation, the titer of serum CA 19‐9 returned to normal ranges. Histological studies showed that mucosal epithelium stained positively for CA 19‐9. We speculate that CA 19‐9 concentrated in the cystic lesion might flow into the peripheral blood. Carcinoembryonic antigen (CEA) was also present at high levels in the cyst fluid. CEA was positively stained in the epithelial cells using a polyclonal antibody but not a monoclonal antibody. The CEA detected at high concentration in the fluid was considered to be immunologically cross‐reacting CEA.
Infiltrating lobular carcinoma of the breast treated with segmental and modified radical mastectomy
Authors: Martin Michael A. , Welling Richard E. , Strobel Stephen L.
Published: February 2007

Conservative treatment of infiltrating lobular carcinoma (ILC) has previously been examined only in terms of general breast carcinoma studies. However, this lesion has been shown to differ from the more common infiltrating ductal carcinoma (IDC) in estrogen receptor (ER) status, metastatic patterns, and bilaterality. Therefore, it is necessary for the physician to consider these distinctions when planning both pre‐ and post‐operative treatment. To determine the effectiveness of both segmental and modified radical mastectomies, the medical records of 26 patients with ILC were reviewed, and follow‐up information was obtained. In addition to surgical treatment, hormonal manipulation and/or radiotherapy were used when appropriate. We found the results of a conservative approach in the treatment of this disease to be comparable to the more radical procedures with respect to overall survival and disease‐free intervals. The single factor that most affected a patient's prognosis was involvement of the axillary nodes.
Pre‐ and postoperative sequential study on the immunosuppressive activity of serum and cell‐free skin bleb fluid of patients with lung cancer and esophageal cancer
Authors: Zhou Qinghua , Yang Zhenhua , Zhang Huaibin , Yang Junjie , Xiao Yuankang
Published: February 2007

Serial changes of immunosuppressive activity of serum and cell‐free skin bleb fluid that can suppress the activity of acid a‐naphthyl acetate esterase (ANAE) of lymphocytes and phagocytosis of macrophages were detected by immunoregulatory tests in vitro in 50 lung cancer and 42 esophageal cancer patients. In comparing these tests with those of 53 cases of non‐cancerous thoracic lesion and 69 normal adults, the immunosuppressive activity of serum and skin bleb fluid from cancer patients is significantly higher than that of noncancerous thoracic lesions and normal individuals (P < .01). The activity is related to the stages of cancer, the size of primary tumor, the presence of lymph node metastasis, and tumor resectability, but not to histological classification, sex, and age. The immunosuppressive activity of serum and skin bleb fluid decreased gradually after the removal of the tumor and was eliminated on the 30th postoperative day.

These results suggest that serum and skin bleb fluid from cancer patients may contain immunosuppressive factors that can suppress the immune responsive functions of lymphocytes and macrophages in vitro in a manner similar to that seen in vivo. Therefore, complete surgical removal of cancer is likely the most effective immunotherapy.
Effects of combined modality therapy of head and neck carcinoma on shoulder and head mobility
Authors: Nowak Peggyann , Parzuchowski Jeanne , Jacobs John R.
Published: February 2007

One hundred twenty‐six patients were evaluated prospectively for head and shoulder mobility following combined treatment of their advanced head and neck carcinoma. In the absence of a pectoral myocutaneous flap reconstruction, the sacrifice of the spinal accessory nerve does not appear to be deleterious to overall head and shoulder mobility with the exception of shoulder elevation. The addition of the pectoral myocutaneous flap reconstruction negated the shoulder elevation difference between the modified neck dissection and the classical neck dissection. The administration of postoperative radiation therapy appears to decrease the range of motion of both the head and the shoulder by up to 20%. We conclude that head and shoulder mobility following combined modality treatment for patients with head and neck carcinoma appears to be a multifaceted problem involving more than the presence or absence of the accesory nerve and psychosocial considerations. The multifaceted etiology of this problem should be taken into consideration when developing physical and occupational programs directed specifically at this problem.
Partial nephrectomy in mice with milliwatt carbon dioxide laser and its influence on experimental metastasis
Authors: Ammirati Mario , Rao Leela N. , Satya Murthy M. , Buchmann Tamara , Goldschmidt Robert A. , Scanlon Edward F.
Published: February 2007

We have developed a surgical model to perform partial nephrectomy in mice using the milliwatt CO2 laser and have used this model for studying the influence of the sequel of surgery on experimental tumor metastasis. Strain A mice were subjected to partial nephrectomy using the milliwatt CO2 laser. The surgical procedure was time efficient, the blood loss was minimal, and the postoperative mortality was 6%. Immediately after surgery, the wound consisted of a superficial layer of charring and a deeper layer of thermal damage (coagulative necrosis). The wound healing was completed within 30 days and was accompanied by fibroblast infiltration and tubular regeneration but minimal inflammatory response. Seventy surgical mice were injected I.V. with TA3Ha murine mammary adeno‐carcinoma cells at different intervals (immediately to 30 days) after surgery. Among 38 mice inoculated with tumor cells immediately or up to 3 days after surgery, 18 (47%) showed histologically confirmed tumors at the site of surgical trauma. None of the 38 unoperated kidneys showed any evidence of tumor. This difference is statistically significant at a P value of <0.001. As the interval between surgery and tumor inoculation was increased to 7, 15, and 30 days, the frequency of tumor formation at the site of surgery decreased to 20% (2/10), 14% (2/14), and 0% (0/8), respectively. The results demonstrate that a) partial nephrectomy in mice is feasible with minimal mortality or apparent morbidity, b) the laser‐induced surgical trauma favors implantation and growth of tumors, c) the frequency of tumor formation is related to the stage of wound healing, and d) the tumors are anatomically related to the healing wound but do not invade into the parenchymal tissue.
The use of a hand‐held gamma detector improves the safety of isolated limb perfusion
Authors: Sardi Armando , Minton John Peter , Mojzisik Cathy , Nieroda Carol A. , Ferrara Peter J. , Hinkle George H. , Thurston Marlin O. , Martin Edward W.
Published: February 2007

We used two hand‐held gamma‐detecting probes (GDP) (Neoprobe™ 1000 system) capable of detecting small gamma emissions to monitor leakage in patients undergoing hyperthermic isolated limb perfusion (HILP) who received 800 μCi Technetium 99m pentetate through the perfusate. The percentage of gamma‐ray leakage was calculated by a simultaneous reading of two probes at 1‐minute intervals (one over the precordial area and one over the thigh) and this was compared to results of simultaneous blood sampling from the perfusate and systemic circulation at 15‐minute intervals for gamma well counting (GWC). The percentage of leakage recorded by the GDPs was essentially identical to that detected by the GWC (7.3% and 8.2%, respectively at the conclusion of the perfusion). The GDP gives an immediate and accurate indication of the percentage of leakage during HILP, making it a safer procedure.
Urinary polyamine levels in cancer patients treated with D,L‐α‐Difluoromethylornithine, an inhibitor of polyamine biosynthesis
Authors: Horn Yoav , Spigel Lina , Marton Laurence J.
Published: February 2007

The polyamine biosynthesis inhibitor D,L‐α‐Difluoromethylornithine hydrochloride monohydrate (DFMO) has cytostatic and cytotoxic effects against various human tumor cell lines in vitro. We measured levels of the polyamines putrescine and spermidine in the urine of cancer patients undergoing “conventional” chemotherapy in a two‐arm randomized phase I–II study with and without additional DFMO administered orally at a dose of 1.7 g/sq.m. t.i.d. The study group included 38 patients with carcinoma of the breast, stomach, prostate, or female genital organs or metastatic carcinoma of unknown origin. A control group of 32 patients with similar malignancies received “conventional” chemotherapy without DFMO. Polyamine levels were determined periodically in the urine of all patients. In DFMO‐treated patients, a significant decrease in putrescine and spermidine levels was observed after 3 weeks of DFMO therapy (the first time point evaluated) that usually persisted throughout the course of treatment. Significant differences in polyamine levels between DFMO‐treated and control patients were observed for patients in remission. Less significant differences were noted, however, for patients with static or progressive disease between DFMO‐treated and control groups. DFMO activity appears to be reflected by a long‐term decrease in urinary polyamine levels.
Proximal colostomy: Still an effective emergency measure in obstructing carcinoma of the large bowel
Authors: Gutman Mordechai , Kaplan Ofer , Skornick Yehuda , Greif Franklin , Kahn Perry , Rozin Ron R.
Published: February 2007

Large bowel obstruction constitutes an emergency abdominal condition and necessitates prompt surgical treatment. The optimal approach is still controversial as to whether to perform a diverting colostomy only or a tumor resection with or without primary anastomosis. Seventy‐one elderly and high‐risk patients were treated by proximal diverting colostomy through a right upper abdominal incision. The operative mortality was 8.5%, with an additional morbidity of 20.5%. Stomal complications appeared in 6.1% of the survivors. Seventy‐five percent of surviving patients underwent successful resection and closure of colostomy within 3 months without additional mortality. Others were not operated because of metastatic disease or severe concomitant disease. We conclude that although primary resection should be attempted in good risk patients, for those patients who are elderly and at high risk, a simple life‐saving procedure, such as fecal diversion, could alleviate obstructions with relatively low morbidity and mortality and improve the patient's prospects for subsequent definitive surgery.
Spontaneous gastroduodenal perforation in cancer patients receiving cytotoxic therapy
Authors: Ricci John L. , Turnbull Alan D. M.
Published: February 2007

Spontaneous gastroduodenal perforation (SGDP) occurs in cancer patients receiving cytotoxic drugs, corticosteroids, or radiation therapy as primary or adjuvant treatment for their tumors. A retrospective review identified 12 patients from 1974 to 1987 at the Memorial Sloan‐Kettering Cancer Center who underwent surgery for SGDP while receiving anticancer therapy.

There were five gastric and seven duodenal perforations. Vague abdominal pain was the most common symptom. Exploration was delayed in six patients because of an absence of physical findings. All patients received a Graham omental patch. The in‐hospital operative mortality was 33%, with all major complications occurring in those that died. There were no prognostic indicators identified that would preoperatively predict outcome. Aggressive surgical intervention is advised in all patients who have a reasonable chance of worthwhile palliation if not cure.
Chronic radiation enteritis: A community hospital experience
Authors: Fenner Michael N. , Sheehan Patricia , Nanavati Parashar J. , Ross Donald S.
Published: February 2007

A retrospective study was undertaken to evaluate the operative management of patients with chronic radiation enteropathy. Thirty‐eight affected patients from 1974 to 1986 were reviewed. Patients with recurrent cancer responsible for symptoms were excluded. Seventy‐one percent of patients presented with bowel obstruction. Twenty‐one patients were treated with bowel resection, while 17 were treated with a bypass procedure or diverting ostomy alone. Overall morbidity was 45%, and postoperative mortality was 16%. Patients in the bypass group were significantly older than those in the resection group (70.3 vs. 55.5 years, P = .024), suggesting that age may have been a determinant of the procedure performed. In our study there was no difference in outcome based on preexisting vascular disease, tumor site, type of procedure performed, or radiation dose. We conclude that resection is the procedure of choice in cases of chronic radiation enteritis requiring surgery except in cases with dense adhesions when enteroenterostomal bypass is a viable alternative.
Right colon cancer: Long‐term results after curative surgery and prognostic significance of duration of symptoms
Authors: Fegiz G. , Barillari P. , Ramacciato G. , De Angelis R. , Gozzo P. , Indinnimeo M. , Valabrega S.
Published: February 2007

Between 1976 and 1986, a consecutive series of 195 patients with right colon cancer were admitted at the First Department of Surgery of the University of Rome. Patients were divided into five groups according to the absence of intestinal symptoms (group 1) and the duration of the symptomatic phase (groups 2‐5). Analysis of the preoperative investigation showed that colonoscopy was able to identify 33 (26.2%) of tumors misdiagnosed by double contrast X‐ray barium enema. We did not notice any correlation among symptom duration and tumor stage, tumor differentiation, operability rate, and survival. Patients admitted in the asymptomatic phase presented tumors of less advanced stage and, thus, had the best survival rate (71.4%). In this group, patients promptly treated had a better survival rate (87.5%) than those treated after 2 months (50%).

Our study suggests that only neoplasms diagnosed in asymptomatic patients and treated promptly are related to a good survival rate. We, therefore, emphasize the importance of education of patients and family physicians about right colon cancer and the necessity to investigate all patients with a suspected right colon cancer by means of colonoscopy.
Use of transrectal ultrasound in detection of prostatic carcinoma: A preliminary report
Authors: Drago Joseph R. , Nesbitt John A. , Badalament Robert A.
Published: February 2007

Three hundred twenty patients who were asymptomatic males aged 55‐70 years, were evaluated with transrectal ultrasound in both the axial and sagittal projections to evaluate the efficacy of transrectal ultrasound in detecting early prostatic carcinoma. Thirteen patients had palpable nodules that were positive for prostatic carcinoma, and ten patients had normal rectal examinations but ultrasound abnormalities, which were confirmed with prostate biopsy positive for prostatic carcinoma. This preliminary report points to certain advantages of this screening procedure, but conclusions as to its efficacy must await the results of more extensive trials.
Metastatic tumors of the penis
Authors: Perez‐Mesa Carlos , Oxenhandler Ronald
Published: February 2007

Six patients with metastases to the penis are described. The main characteristics of the primary tumors are described, along with the treatments, the features of the metastasis, and the response to treatment. Although in one patient a survival of 5 years was obtained, metastasis to the penis is generally associated with a dismal prognosis. A brief commentary is made concerning mechanisms of metastases formation.
MTT assay with reference to the clinical effect of chemotherapy
Authors: Suto Akihiko , Kubota Tetsuro , Shimoyama Yutaka , Ishibiki Kyuya , Abe Osahiko
Published: February 2007

Tumor cells from 40 patients were tested by MTT assay. Five thousand to sixteen thousand tumor cells were plated into 96‐well microplates with various concentrations of anticancer agents. After incubation for 48 h, the absorbance of each well was detected with an EIA reader and the effects of the agents were evaluated as positive when the inhibition rate was equal to or more than 50%. Normal cells were also processed under the same conditions, and the absorbance for normal cells was lower than that of tumor cells with statistical significance (P < .05). The efficacy rates of MMC, 5‐FU, ADM, and CDDP were 16.7, 8.3, 13.9, and 5.6%, respectively. The overall accuracy of this assay for clinical effects was 83.3%, with one false‐positive and five true‐negative cases. This MTT assay was also assumed to be useful for in vitro chemosensitivity testing of fresh surgical specimens.
Management of nodal metastases from head and neck melanoma
Authors: Belli F. , Santinami M. , Rovini D. , Vaglini M. , Nava M.
Published: February 2007

Ninety‐three patients with nodal metastases from melanoma (stage II) located in the head and neck underwent surgery at the National Cancer Institute of Milan. Different surgical techniques were employed, ranging from radical to conservative treatment. Analysis of the data shows no significant difference from an oncological standpoint between radical and conservative surgery when a radical dissection is performed. Elective nodal dissections for malignant melanoma of the head and neck region, like those at other sites of lymphatic drainage such as the groin and axilla, did not prove beneficial. We do recommend parotidectomy in cases where the primary tumor arises in the superior area of the head. The number of nodes involved and the type of disease spread constitute the major prognostic factors, as in the case of melanomas located in other sites. Our data further indicate that the incidence of distant and local recurrence is not influenced by the type of dissection performed.
New intraoperative brachytherapy techniques for positive or close surgical margins
Authors: Nori D. , Harrison L. , Fass D. , Peretz T. , Donath D. , Fuks Z. , Bains M. , Hilaris B. S.
Published: February 2007

Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the paravertebral spaces, or critical abdominal structures often present technical difficulties for standard brachytherapy procedures using 1‐125 or Ir‐192 implants. These techniques allow for a high‐dose delivery to the tumor bed with minimal normal tissue toxicity. A relatively simple and accurate method is described using 1‐125 seeds in Vicryl® suture threaded through Gelfoam®. These permanent implant procedures with radioactive 1‐125 seeds effectively treat small residual tumors or suspicious margins where standard brachytherapy techniques may be unsatisfactory and technically difficult to perform.
Metastatic sweat gland carcinoma: Response to 5‐fluorouracil infusion
Authors: Swanson John D. , Pazdur Richard , Sykes Elizabeth
Published: February 2007

A 78‐year‐old white male presented with metastatic sweat gland carcinoma involving regional lymph nodes, pleura, pericardium, and chest wall. A complete response of three months duration was achieved by using a 96‐hour infusion of 5‐fluorouracil. This is the first report of a complete response to systemic chemotherapy in metastatic sweat gland carcinoma.
Non‐neurogenic soft tissue tumours of the axilla: Prospective review of 16 cases
Authors: Bell R. S. , Ready J. , Hudson A. , O'sullivan B. , Mahoney J. , Richards R. , Davis A. , Fornasier V. L.
Published: February 2007

Sixteen consecutive patients entered in a prospective study of non‐neurogenic soft tissue tumours had lesions in the axilla. Delayed diagnosis and inappropriate biopsy prior to referral to a surgical oncologist were frequent findings. Sarcoma and fibromatosis were diagnosed in 14 cases, and the approaches used for these two diseases were fundamentally different. The functional outcome with limb salvage surgery in these patients is presented.
Pre‐neoplastic changes in rat urothelium following portacaval anastomosis
Authors: Mori Katsutaka , Yamaguchi Yasuo
Published: February 2007

The development of pre‐neoplastic and neoplastic changes has been documented in the urinary tract of the rat after portacaval shunting (PCS) and has been attributed variously to circulating carcinogens, the development of bladder stones, or deficiency of vitamin A. Therefore, an investigation of the pathogenesis of bladder tumors after PCS was undertaken in 120 PCS and 120 sham‐operated male Sprague Dawley rats. Ten rats from each group were sacrificed at monthly intervals for 1 year after surgery. The incidence of calculus formation in the bladder increased from 20% at 2 months to 80% at 12 months after PCS. Hyperplastic mucosal changes occurred 3 months after surgery. After 5 months, distinct papillomas developed, and after 7 months, increasingly severe papillary changes and squamous metaplasia were evident. Interestingly, these urothelial changes were seen both in animals with and without bladder stones. Significantly decreased serum vitamin A levels were observed at 6 months (54.0 ± 8.8 IU/dl, n = 10) (P, 01), and 12 months (41.0 ± 7.9 IU/d1, n = 10) (P < .01), compared to those in sham‐operated controls of 126.0 ± 12.5 IU/dl (n = 10) and 122.7 ± 19.2 IU/dl (n = 10). In addition, PCS resulted in a significantly increased activity of urothelial ornithine decarboxylase (ODC), a marker of neoplastic changes, at 6 months (3.1 ± 0.4 nmoles CO2 in 60 min/mg protein, n = 5) (P < .05) and 12 months (8.1 ± 0.6 nmoles CO2 in 60 min/mg protein, n = 5) (P < .05), when compared to ODC activity in controls (0.9 ± 0.2 nmoles CO2 in 60 min/mg protein, n = 5). These data suggest that the development of urinary bladder tumor after PCS in the rat may be due to vitamin A deficiency rather than to bladder calculi or urinary carcinogens.
Late recurrence of stage I malignant melanoma
Authors: Gutman Mordechai , Klausner Joseph M. , Inbar Moshe , Rozin Ron R.
Published: February 2007

Although the introduction of well‐established risk factors has made the clinical course and prognosis of malignant melanoma disease much more predictable, in a considerable number of patients the disease's course is still not as expected. One group to which this applies are stage I melanoma patients who develop metastatic disease after 10 years or more of a disease‐free interval. In our series of 94 such patients, 6 developed late relapse of their disease. The subsequent survival of these patients did not relate to any of the primary tumors' characteristics, but to the pattern of the late recurrence. Four patients with visceral metastases were dead within 1 to 5 years following relapse, one patient with lymph node involvement is alive with metastases, and another patient with skin metastases has no signs of disease following surgery and immunotherapy. Our conclusion is that malignant melanoma patients should be placed under close follow‐up for the rest of their lives.
Blood transfusion and the prognosis of patients with gastric cancer
Authors: Sugezawa Akira , Kaibara Nobuaki , Sumi Kenichi , Ohta Michio , Kimura Osamu , Nishidoi Hideaki , Koga Shigemasa
Published: February 2007

A retrospective analysis was undertaken of the association between blood transfusion and long‐term results for 218 patients with stage III gastric cancer who were curatively treated by partial gastrectomy. One hundred and fifty‐two patients received blood transfusion within the perioperative period. The postoperative 5‐year survival rates were 49.3% for the transfused patients and 62.1% for the non‐transfused patients (P < 0.05). Furthermore, the postoperative survival of patients who had been transfused preoperatively was significantly lower than that of the non‐transfused patients. The preoperatively transfused group of patients were found to have tumors that were larger than those of the non‐transfused group. On the basis of the above data, it appears that the prognosis of patients with advanced gastric cancer is poorer when such patients receive preoperative blood transfusion than when patients do not receive transfusions, and that this adverse effect in the transfused patients is probably attributable to the larger size of their tumors, even though the stage of advancement of gastric cancer is the same in both groups of patients.
Intraoperative pancreatic biopsy—a diagnostic dilemma
Authors: Witz M. , Shkolnik Z. , Dinbar A.
Published: February 2007

The intraoperative diagnostic dilemma of pancreatic cancer vs. chronic pancreatitis often remains unresolved. In the literature, diagnosis based on intraoperative pancreatic biopsy is a matter of controversy. Our study comprised 70 patients with a suspected space occupying pancreatic process who were operated on with the primary goal of arriving at a speedy and precise diagnosis, according to which the appropriate surgery for the specific patient would be performed. Frozen section showed that 44 patients had malignancy of the pancreas; in three patients, there was a false‐negative result. In four patients, the histological picture was consistent with chronic pancreatitis. In the remaining 19 patients, biopsy was not performed and the diagnosis was made on the basis of intraoperative inspection and palpation of pancreas. On reviewing the patients, we found that the surgical risk involved in biopsy is quite low and that a high price was paid for diagnosis by inspection and palpation alone. The risk vs. benefit aspect of intraoperative pancreatic biopsy is discussed.
Granular cell lesions in head and neck: A clinicopathological study
Authors: Fliss Dan M. , Puterman Marco , Zirkin Howard , Leiberman Alberto
Published: February 2007

Twenty‐five cases of granular cell lesions in the region of the head and neck are presented. The adult form (18 cases) was more frequent in women, and the most frequent sites were the tongue, the skin, and subcutaneous tissues, followed by the lip and buccal mucosa. One lesion occurred in the larynx. The congenital forms (7 cases) all occurred in female infants and involved the mucosa overlying either the anterior ridge of the maxilla or the mandible. Immunohistochemical studies revealed positive staining for S100 protein in all the granular cell tumors of the adult but in none of the congenital granular cell epulides. Embryonic antigen was present in the cells of all the congenital cases and in three‐quarters of the adult cases. The significance of the histological and immunohistochemical findings is discussed. We conclude that the congenital and adult lesions are similar morphologically but are not necessarily of similar histogenesis. The findings with respect to S100 protein favor a neural (Schwann cell) origin of the adult granular cell tumor, but not the congenital form.
Results of surgical treatment in 6,123 cases of carcinoma of the esophagus and gastric cardia
Authors: Shao Lingfang , Gao Zongren , Yang Naipu , Wei Gongquan , Wang Yuandong , Cheng Chaopeng
Published: February 2007

Six thousand one hundred twenty‐three cases of carcinoma of the esophagus and gastric cardia were treated surgically from 1965 to 1985. Overall resectability was 89.9%. Postoperative mortality was 3%, and incidence of postoperative complication, 10.3%. Follow‐up rate was 91.3%, with 5 year survival of 36.8% (esophageal nearly twice that of gastric cardia), and 10 year survival of 17.2%. Factors affecting long‐term survival were clinicopathologic staging and preoperative irradiation. Early discovery and timely treatment are the key to high resectability and improved longterm survival. More efficacious combined therapies are needed for the predominant late cases. We propose more radical resection because of the multifocal tendency of esophageal and extensive submucosal infiltration of cardia carcinoma. Continuing refinements of surgical technique helped to reduce postoperative leakage and structure.
Species differences in substrate specificity of pyrimidine nucleoside phosphorylase
Authors: Maehara Yoshihiko , Sakaguchi Yoshihisa , Kusumoto Tetsuya , Kusumoto Hiroki , Sugimachi Keizo
Published: February 2007

To compare the activity of pyrimidine nucleoside phosphorylase (PNP), an enzyme involved in the metabolism of 5‐fluorouracil (5‐FU), we used uridine (Urd), deoxyuridine (dUrd), and thymidine (dThd) as substrates and human, rat, and mouse neoplastic and normal tissues. As PNP activity was higher in the tumor tissues than in the normal ones in all species examined, the level of PNP activity is expected to be one critical factor linked to the effectiveness of 5‐FU. In rats and mice, the ratio of the activities of Urd, dUrd, and dThd was about 10:7:1, whereas in humans, the ratio was 1:30:20. The main enzyme of PNP is Urd phosphorylase in rodents and dThd phosphorylase in humans. Therefore, when examining the metabolism of 5‐FU and its analogues for potential clinical application, human tissues should be used.
Histopathologic evaluation of survival time in patients with colorectal carcinoma
Authors: Adachi Yosuke , Mori Masaki , Kuroiwa Shigekazu , Sugimachi Keizo , Enjoji Munetomo
Published: February 2007

A histopathologic study was done on tissues from 117 patients with colorectal carcinoma, and we compared data on 57 patients who died of a recurrence within 2 years (group I) with 60 others who survived for over 10 years (group II). All patients were surgically treated and followed for over 10 years. Particular attention was directed to the very advancing margin of the tumor, and we examined invading modes of sprouting tumor cells, reactive fibrosis, and inflammatory infiltration around the tumor, in addition to the other clinicopathologic features. In group II, extensive sprouting of individual tumor cells occurred less often, and intense reactive fibrosis and marked inflammatory infiltration around the tumor were more frequent than in group I in which conspicuous lymphatic and vascular permeations were often present. We propose that the invading mode of sprouting tumor cells and the presence or absence of reactive fibrosis and inflammatory infiltration at the advancing margin of the colorectal tumor are of prognostic value.
Hypercalcemia related to the poor prognosis of patients with squamous cell carcinoma of the esophagus
Authors: Kuwano Hiroyuki , Baba Hideo , Matsuda Hiroyuki , Ohno Shinji , Mori Masaki , Kanematsu Takashi , Sugimachi Keizo
Published: February 2007

A review of 208 cases of surgically treated squamous cell carcinoma of the esophagus revealed 16 (7.7%) with hypercalcemia. There was no evidence of bone metastases in 13 (6.3%) of the patients with hypercalcemia. Pathogenesis of this hypercalcemia without bone metastases was suggested to be multifactorial. Anastomotic leakage and malnutrition because of fasting were the most possible causes of mild hypercalcemia, and moderate to severe hypercalcemia was thought to be due to subclinical and clinical recurrence of the tumor, probably with PTH‐like hormonal activity. Overall survival rates in the groups with and without hypercalcemia were 18.2 and 61.7% at the 12th postoperative month and 9.1 and 37.8% at the 24th month, respectively. Thus hypercalcemia is a significant prognostic factor linked to an unfavorable clinical course even in patients with no evidence of bone metastases.
Cisplatin, bleomycin, and methotrexate (PBM) chemotherapy in locally advanced and metastatic head and neck cancer
Authors: Uziely B. , Peretz T. , Sulkes A. , Feigin E. , Isacson R. , Biran S.
Published: February 2007

Twenty‐two patients with locally advanced or metastatic head and neck tumors received a total of 84 courses of a combination of cisplatin, bleomycin, and Methotrexate (PBM) for a median of four courses per patient (range, 1‐7). Among these 22 patients there were four patients (18%) who achieved complete remission (CR) and 13 patients (60%) who had a partial remission (PR). The overall remission rate (CR + PR) thus reached 78%; five patients (22%) progressed while on therapy. The mean duration of objective response (CR + PR) was 8 months; CR lasted a median of 18 months (range, 2‐48). Survival was not influenced by tumor histology or by previous surgery. The presence of locoregional disease did adversely affect survival from the onset of chemotherapy (P = 0.1). The rate of survival was also affected by primary tumor site; patients with nasopharyngeal primaries survived longer than all other patients (22 vs. 11 months, P = 0.06). Toxicity to chemotherapy consisted mainly of nausea and vomiting and stomatitis. Three patients developed fever while leukopenic. One patient experienced irreversible renal damage, and another suffered from bleomycin‐induced pulmonary fibrosis. The high response rate obtained in our group of patients did not have a substantial impact on overall survival. Aggressive, multimodality approaches should be considered in the treatment of these patients when possible.
Observations on Indian node‐negative breast cancer patients: A multivariate analysis
Authors: Vyas J. J. , Desai P. B. , Sampat M. B. , Shinde S. R. , Rao D. N. , Sarkar Sudeep , Badwe Rajan , Tiwari J. , Koppikar A.
Published: February 2007

The modern treatment of breast cancer has evolved over the past 100 years based on clinical observations. Therapeutic principles, from the choice of surgical procedure to the management of disseminated disease, have also changed. The axillary tumour burden, that is, the number of histologically positive nodes (N+) plays an important role as a prognostic factor. However, in histologically Negative nodes (N−), it is necessary to discriminate individuals at high risk despite negative nodes. This presentation analyses retrospectively the prognostic factors for long‐term failures in N− patients. These prognostic factors need to be studied in detail, and controlled clinical trials should be carried out to detect high risk N− patients and consider them for adjuvant chemotherapy.
Declining trend in cervical cancer incidence in Bombay, India (1964‐1985)
Authors: Yeole B. B. , Jayant K. , Jussawalla D. J.
Published: February 2007

Population‐based incidence rates for cervical cancer in Bombay showed a decline over the past two decades. The observed rates fitted to a log linear regression model showed a good fit. In an attempt to explain the observed decline, cohort‐specific age incidence curves were drawn, cumulative incidence rates over common age ranges estimated, and the log linear model fitted separately for each of the religious groups that showed diverse age‐adjusted rates for cervical cancer. It was found that the decline could be explained as a cohort effect, indicating that it was due to an upward shift in age at marriage in the younger cohorts. Furthermore, a significant decline was observed in Hindus in whom the mean age at marriage has increased from 12 years in 1921‐1931 to about 17 years in the 1960s, but not in the Christians who even in 1911 had a mean age at marriage of 17 years. It appears that, in India, cervical cancer rates will continue to decline until 1995 after which it will stabilise unless there is a change in other risk factors.
Treatment of radiation side effects with oral pilocarpine
Authors: Schuller David E. , Stevens Philip , Clausen Kathryn P. , Olsen John , Gahbauer Reinhard , Martin Melanie
Published: February 2007

Radiation therapy is commonly utilized either alone or in combination with surgery in the treatment of malignancies arising in the upper aerodigestive tract. Frequent post‐treatment sequelae include xerostomia, dysgeusia, and dysphagia. Numerous commercial products designed to decrease these symptoms have not been uniformly successful. This pilot study was designed to evaluate prospectively oral pilocarpine as a means of stimulating minor and major salivary gland flow to eradicate these radiation‐induced symptoms. The results of this pilot study support the hypothesis that the salivary glands are capable of responding to oral pilocarpine, and this therapeutic approach warrants further study.
Flow cytometric DNA content analysis in primary lung cancer: Comparison of results from fresh and paraffin‐embedded specimens
Authors: Isobe Hiroshi , Miyamoto Hiroshi , Inoue Kazuaki , Shimizu Mikio , Endo Takashi , Mizuno Shigetaka , Kawakami Yoshikazu
Published: February 2007

Tumor DNA content was determined by flow cytometry in 24 surgically resected specimens from patients with primary lung cancer to compare results from fresh and paraffin‐embedded specimens. We found a good correlation in DNA indices between fresh and paraffin‐embedded specimens (r =.978), although one tumor with DNA near‐diploidy was mistaken as DNA diploid in paraffin‐embedded specimens. In the measurements of paraffin‐embedded specimens, eight of 24 tumors were DNA multiploid and showed DNA content heterogeneity. These results indicate that DNA content analysis of paraffin‐embedded specimens is helpful because it makes it easy to analyze multiple specimens from different parts of the tumor.
In situ demonstration of immunological heterogeneity in vascular endothelial cells of renal cell carcinoma
Authors: Kinjo Tsutomu , Takashi Munehisa , Miyake Koji , Nagura Hiroshi
Published: February 2007

Phenotypic characteristics of endothelial cells of blood vessels in renal cell carcinoma were studied immunohistochemically. Vascular endothelial cells in different compartments expressed surface antigens heterogenously. Sinusoidal capillary endothelial cells adjacent to carcinoma cells shared antigens with a monocyte/macrophage subset (OKM5 +, HLA‐DR +, interleukin‐1 +), but were only faintly positive or absent for factor VIII/von Willebrand factor antigen. Endothelial cells of larger vessels in fibrous septa were OKM5‐, HLA‐DR +, interleukin‐1 +, factor VIII/von Willebrand factor antigen+. Renal cell carcinoma cells expressed HLA‐DR and HLA‐ABC antigens. These findings suggest that renal cell carcinoma cells are surrounded by blood vessels containing effector cells for immune responses, and that they have a high‐potency response to immunopotentiators.
Absence of effect of supplemental oral calcium on ornithine decarboxylase (ODC) activity in colonic mucosae of healthy individuals with a family history of colorectal cancer
Authors: Love Richard R. , Verma Ajit K. , Surawicz Tanya S. , Morrissey John F.
Published: February 2007

Tissue activity levels of ornithine decarboxylase (ODC) have been suggested to be a marker of colonic epithelial cell proliferation and risk for colorectal cancer. Supplemental dietary calcium has been hypothesized and reported to suppress colonic epithelial‐cell proliferation. We measured sigmoid and rectal mucosal ODC activity levels in 45 healthy, disease‐free subjects with strong family histories of colorectal cancer before and after 2 months, during which daily dietary supplementation with calcium carbonate (to provide 600 mg calcium base) was taken. Although the mean ODC activity levels decreased in both sigmoid and rectal specimens, these changes were small in relation to the standard deviation and were not statistically significant. These data suggest that the magnitude of dietary calcium intake does not significantly influence sigmoid‐rectal mucosal ODC activity levels and that ODC measurements may not be a useful intermediate endpoint for interventions designed to interrupt the colon carcinogenic sequence.