bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ovarian cancer
Authors: Ozols Robert F. 
Published: February 2007

AbstractEven though cisplatin‐based combination chemotherapy results in increased clinical and surgical complete remission rates and improved median survival compared with single‐agent alkylating agent chemotherapy, the 5 year survival rates for stages III and IV ovarian cancer have only improved to 25–30%. New methods being evaluated to improve response rates, median survival, and 5 year survival rates include the use of high‐dose carboplatin, dose intensity using platinum compounds, intraperitoneal chemotherapy, concomitant intravenous and intraperitoneal chemotherapy, and the recent discovery of new active agents against epithelial ovarian cancer—Taxol, and Ifosfamide plus mesna.
Recent advances in endometrial cancer
Authors: Creasman William T. , Eddy Gary L. 
Published: February 2007

AbstractThere are well‐defined prognostic factors that identify patients with clinical stage I (confined to the uterus) endometrial adenocarcinoma and patients at high risk vs. low risk for recurrent disease and allow for treatment tailored to those specific prognostic indicators. This had led the International Federation of Gynecologists and Obstetricians (FIGO) in 1988 to revise the FIGO staging from a clinical to a surgical/histopathological evaluation. The use of these prognostic factors should lead to improved initial surgery and adjuvant therapy for patients considered at high risk for recurrence.
Clear cell adenocarcinoma of the vagina and cervix secondary to intrauterine exposure to diethylstilbestrol
Authors: Herbst Arthur L. , Andersond Diane 
Published: February 2007

AbstractIntrauterine diethylstilbestrol (DES) exposure is associated with an increased risk for the development of clear cell adenocarcinoma (CCA) of the vagina and cervix. The age of the DES‐exposed patients has varied from 7 to 34 years with the highest frequency from 14 to 22 years. The risk among the exposed is small and is on the order of 1 per 1,000. Factors that may increase the risk are maternal history of prior miscarriage, exposure to DES in early gestation, a fall season of birth, and prematurity. Pregnancy does not appear to influence adversely the tumor characteristics or prognosis of patients who have developed these malignancies. Criteria for appropriate local therapy of small clear cell adenocarcinomas of the vagina are presented. Recurrent CCA has been observed as long as 20 years after primary therapy emphasizing the importance of prolonged follow‐up.
Gestational trophoblastic tumors
Authors: Lurain John R. 
Published: February 2007

AbstractGestational trophoblastic tumor is a term applied to invasive mole, choriocarcinoma, and placental‐site trophoblastic tumor. The overall cure rate in the treatment of these gestational trophoblastic tumors now exceeds 90%. This high success rate is the result of (1) inherent sensitivity of trophoblastic tumors to chemotherapy, (2) ability to monitor therapy effectively with the use of human chorionic gonadotropin as a tumor marker, and (3) identification of prognostic factors which allows categorization of patients into high‐ and low‐risk groups for selection of treatment. Virtually all patients with nonmetastatic and low‐risk metastatic disease can be cured using single‐agent methotrexate or Actinomycin‐D chemotherapy. Intensive therapy with combination chemotherapy including etoposide, high‐dose methotrexate and Actinomycin D and, where indicated, adjuvant radiotherapy and surgery has resulted in cure rates of 80–90% in patients with high‐risk metastatic disease. The factors which are most important in determining response to treatment are: (1) clinicopathologic diagnosis of choriocarcinoma, (2) metastases to sites other than the lung or vagina, (3) number of metastases, (4) previous failed chemotherapy, and (5) WHO score ⩾8.
Current management and treatment of squamous cell carcinoma of the vulva
Authors: Malfetano John H. 
Published: February 2007

AbstractTreatment for squamous cell carcinoma of the vulva remains surgical, the standard procedure being radical vulvectomy and bilateral inguinal lymphadenectomy. There has been recent interest in refining histopathologic prognostic factors that would be highly predictive of regional lymph node metastases, recurrences, and survival. With such factors have come new innovative approaches to the management and treatment of minimally invasive carcinomas, regional nodal disease, and advanced lesions. These modifications from standard therapy could result in less morbidity, disfigurement, and hospitalization while not compromising survival.
Invasive cervical cancer in the 1990s
Authors: Piver M. Steven 
Published: February 2007

AbstractThe death rate from invasive cervical cancer has decreased by 70% since the classic work by Papanicolaou and Traut in 1941 on the use of cytologic evaluation to detect cancer of the uterine cervix in the preinvasive in situ stage—a nearly 100% curable disease. Unfortunately, the survival stage for stage of invasive cervical cancer has remained static over the nearly 5 decades since their report. However, discoveries in the decade of the 1970s of the natural spread of cervical cancer, not only to the known pelvic lymph nodes, but the increasing incidence of paraaortic lymph node metastasis with advanced stages, the higher dose of radiation required to sterilize pelvic lymph node metastasis discovered at the time of radical hysterectomy or for locally advanced cervical cancer treated solely by radiation therapy, and the use of radiation potentiators, such as hydroxyurea, should lead to the significant reduction in the annual 7,000 deaths from this disease in the decade of the 1990s.
Immunotherapy of gynecologic malignancies
Authors: Foon Kenneth A. , Fanning James 
Published: February 2007

AbstractSystemic Corynebacterium parvum and BCG have limited activity in gynecologic malignancies. Although intraperitoneal C. parvum is active, its toxicity is prohibitive. Intraperitoneal alpha‐interferon is an active second line agent for minimal residual disease following combination chemotherapy. Intraperitoneal interferon trials are ongoing. Alpha‐interferon is also active against lower genital tract condyloma acuminata. Sufficient numbers of patients have not been evaluated to determine the activity of interleukin‐2(IL‐2) in gynecologic malignancies. Radioisotope labeled monoclonal antibodies can image gynecologic malignancies and may have a future therapeutic role. The last decade has witnessed a substantial growth in immunotherapy and has demonstrated a role for biologic agents in cancer therapy. Continued improvement in biologic therapies should lead to major advances in gynecologic cancer diagnosis and therapy.
Cervical metastases from an occult primary site
Authors: Harwick Robert D. 
Published: February 2007

AbstractLess than 5% of patients with metastatic cervical carcinoma will not have a detectable primary site despite a proper work‐up. Recent aids for these diagnostic problems include fine needle aspiration and immunohistochemical panels to differentiate undifferentiated carcinoma from melanoma and/or lymphoma. CT scanning can suggest areas in the upper aerodigestive tract for biopsy and can be helpful in suggesting the pathology of the enlarged lymph nodes. EBV titers are often elevated when a nasopharyngeal carcinoma is small. Aggressive treatment of the occult primary patient with metastatic melanoma, thyroid cancer, and metastatic cancer presumed to arise from the skin of the head and neck or the mucous membranes of the upper aerodigestive tract is indicated as long‐term survival is often achieved.
Elective treatment of the neck in cancer of the oral tongue
Authors: Silver Carl E. , Moisa Idel I. 
Published: February 2007

AbstractManagement of the clinically negative neck in patients with carcinoma of the oral tongue remains a complex and controversial subject. While statistical proof of the value of elective neck dissection in tongue cancer remains elusive, the high incidence of occult cervical metastases, even with small primary tumors, and the poor salvage rates and increased incidence of extracapsular spread in cases that have developed palpable adenopathy, provide a logical basis for treatment of the neck in a preclinical stage.
Diagnosis and pitfalls in the treatment of parotid tumors
Authors: Spiro Ronald H. 
Published: February 2007

AbstractAny swelling near the ear is best considered a parotid neoplasm until proved otherwise. The diagnosis is primarily based on the clinical examination. Imaging studies are best reserved for patients who present with palate or tonsil swellings, which must be distinguished from parapharyngeal or minor salivary gland tumors. Almost all benign, and most malignant parotid tumors can be resected with preservation of the facial nerve. Aspiration biopsy can add useful information, but is not essential for treatment planning as the extent of the surgical procedure is primarily determined by the extent of the tumor. Survival rates in patients with malignant tumors are most significantly influenced by tumor stage. Results seem to have improved in recent years, possibly because we are treating a larger proportion with favorable lesions. Another factor may relate to the enhancement of locoregional control now achieved with postoperative radiotherapy, particularly in patients with Stage III or IV tumors.
Mandibulotomy and mandibulectomy in difficult tumors of the base of the tongue and oropharynx
Authors: Shaha Ashok R. 
Published: February 2007

AbstractWide exposure of the tumors of the base of the tongue and oropharynx can be easily obtained via mandibulotomy, which provides equally good exposure for tumors of the posterior oral cavity and oropharynx. Segmental mandibulectomy can be avoided in patients where the tumor does not invade the mandible or is not in close proximity of the mandible. Preoperative work‐up may include evaluation by means of the fiberoptic telescope to determine the extent of the tumor, examination under anesthesia, panoramic X‐ray of the mandible, CT scan and MRI, as well as dental evaluation. Tracheostomy provides airway during the operation and tracheobronchial access for clearance of pulmonary secretions postoperatively. The technique for median labiomandibuloglossotomy is described, as well as the mandibular swing approach and mandibulectomy. Cosmetic deformity after segmental mandibulectomy is minimal but mandible reconstruction should nonetheless be considered based on the extent of the tumor, tumor control, and the need for postoperative radiation therapy.
Evaluation of thyroid nodules
Authors: Dorsch Thomas R. 
Published: February 2007

AbstractThe first consideration in evaluating the thyroid nodule is whether it is functioning and causing hyperthyroidism. Autonomous nodules should be treated with either surgery or 1–31, with surgery favored due to the possibility, although small, of malignancy. Thyroid scans are no longer recommended during the initial evaluation of the thyroid nodule. Ultrasound is useful in determining the size of the nodule and whether it is multinodular thyroid disease, but it cannot detect thyroid cancer. Fine needle aspiration biopsy is currently the procedure of choice for evaluating all thyroid nodules. For accuracy of the cytological analysis, it is important that adequate tissue samples be obtained. False negative findings are of most concern to the clinician and occur in 2–10% of reported fine needle aspiration biopsy series. Nodules thought to be benign will need continued follow‐up.
Modern methodologies of differentiating thyroid masses
Authors: Mafee Mahmood F. , Capek Vlastimil , Blend Michael , Renigers Sigrida A. , Friedman Michael , Belmont Heraldo 
Published: February 2007

AbstractThe rational treatment of thyroid diseases requires an understanding of the thyroid function and an accurate evaluation of its functional (endocrine), as well as it morphological alteration. There are several different imaging techniques which are available and are in use in the evaluation of thyroid diseases. In this article we present a protocol for the use of diagnostic imaging to evaluate a focal thyroid mass, a diffusely enlarged gland, regional, and distant metastatic disease. The current diagnostic applications of radionuclide scanning, ultrasound, computed tomography, and magnetic resonance imaging (MRI) will be discussed.
Papillary carcinoma of the thyroid
Authors: Cady Blake 
Published: February 2007

AbstractThe clinical behavior and mortality rate of papillary carcinoma of the thyroid varies widely, and clinically insignificant microscopic foci of the disease are frequently found. Dietary iodine and radiation to the head and neck in childhood play a role in etiology. Needle aspiration cytology provides a highly accurate diagnosis. Ultrasound, radioactive iodine, and technetium scans are not specific and should only be used to complete diagnostic studies when aspiration cytology is negative for papillary carcinoma. The most important aspect of prognosis of an individual patient with papillary carcinoma of the thyroid is the age at which the disease is diagnosed, with an excellent prognosis, even in advanced primary disease or extensive lymph node involvement, in children and young adults. A multifactorial clinical risk group definition (AMES) is easy to use and reliably separates patients into low risk and high risk. Since 90% of patients with this disease rarely have metastases or late complications from the cancer, total or subtotal thyroidectomy is necessary in only 10% of cases for later use of postoperative radioactive iodine. More conservative surgical procedures are advised in low‐risk patients. Papillary carcinoma incidentally found during operation for other conditions such as Graves disease or thyroiditis and reported first on the permanent pathology reports are always clinically insignificant and completely cured by removal; total thyroidectomy should be completely avoided. Postoperatively, thyroid hormone supplementation may be unnecessary after relatively conservative surgery in selected low‐risk patients. Thyroid hormone must be maintained permanently after total or subtotal thyroidectomy.
Incidence of thyroid cancer in Japan
Authors: Koike Akihiko , Naruse Takayoshi 
Published: February 2007

AbstractThe incidence of thyroid cancer was analyzed based on data provided by cancer registration in Japan and also based on data for 11, 104 cases of thyroid cancer registered at the Japanese Committee for Registration of Malignant Neoplasm of Thyroid (JCR‐MNT) from 1977 through 1986Incidence rates for men and women gradually increased over the study period from 1959 through 1985. The age‐adjusted rates for 1985 showed 1.1 per 100,000 for men and 3.1 per 100,000 for women. The higher rates were observed in Hiroshima and Nagasaki cities. Male to female ratio was 1:6 in papillary and follicular carcinomas and 1:2 in medullary and anaplastic carcinomas. Papillary, follicular, and medullary carcinomas are more common in the fifth and sixth decades of life while anaplastic carcinoma is more common in the elderly. The age‐specific rates by histological classification showed no change over the study period of 1977 through 1986. The increased incidence could be attributed to improvements in diagnostic procedures.
Evaluation of a patient prior to second‐look surgery
Authors: Wanebo H. J. , Vezeridis M. P. , Llaneras M. R. 
Published: February 2007

AbstractThe evaluation of a patient with a suspected colorectal malignancy is well defined; however, the preoperative work‐up of a patient who is a candidate for second‐look surgery is controversial and based less on scientific evidence than on empiric or anecdotal grounds. The preoperative assessment of these patients can be divided into two phases. Phase I consists of a thorough history, physical examination, and routine laboratory tests as the most logical and traditional starting point. Phase II consists of specific tests aimed at evaluating the extent of the recurrence and the resectability of the tumor. Of the various modalities available, the enhanced computerized tomogram is currently the method most likely to provide significant information prior to carcinoembryonic antigen (CEA) directed second‐look surgery. The results of the preoperative evaluation together with a thorough understanding of the natural history of the disease will offer a clear perspective as to the most likely outcome.
CEA in tumors of other than colorectal origin
Authors: Chevinsky Aaron H. 
Published: February 2007

AbstractCarcinoembryonic antigen has been demonstrated to be a valuable clinical aid in the management of patients with colorectal carcinoma. Its elevation in the serum prior to evidence of clinical recurrence in up to 80% of patients highlights its utility. CEA has also been found to be elevated in the serum of patients with other epithelial malignancies, but these have not been as well studied as has colorectal carcinomaIn patients with breast cancer CEA elevations may be found in 40–73% of patients presenting with disease in stages I‐IV. In addition, 80% of patients will have a CEA elevation 3–10 months prior to clinical symptoms of recurrenceSeventy‐seven percent of patients with bronchogenic lung cancer will have an elevated preoperative value. However, cigarette smoking also causes an increase in the CEA assay level and, thus, differentiation between benign and malignant conditions is more difficult. In small cell carcinoma of the lung, CEA assay levels above 10 ng/ml correlate highly with metastatic disease, while values less than 2.5 ng/ml correlate with localized diseasePancreatic and gastric malignancies demonstrate CEA level elevations in just over 50% of cases. But these, however, have not been clinically usefulEpithelial neoplasms of the female reproductive tract (cervix, uterus, and ovary) also produce CEA in 47–75% of cases and may correlate with stage of disease at diagnosis and level of cellular differentiationCEA assay levels are elevated in a variety of tumors and correlate with tumor stage, degree of differentiation, and effectiveness of therapy; they may also be the earliest marker of recurrence.
Radiotherapy and brachytherapy for recurrent colorectal cancer
Authors: Nag Subir 
Published: February 2007

AbstractRadical surgical excision of locoregional recurrence of colorectal carcinoma usually produces the best survival and should be attempted whenever possible. However, recurrences are often unresectable; hence palliative local therapy may be indicated. There are several options for the radiation therapy of local, unresectable, recurrent, or metastatic colorectal cancer. Whole pelvis irradiation of 4,000–5,000 cGy followed by a coned‐down boost of 1,000–1,500 cGy generally provides good symptomatic palliation in 80–90% of patients, but long‐term control or cure is rarely achieved. External beam irradiation of 2,000–3,000 cGy to the whole liver with or without concurrent chemotherapy may be used for palliation of metastatic disease to the liver. A combination of intraoperative radiation therapy applied directly to the tumor bed and external beam irradiation may improve local control and survival rates. Multiple options are available for the intraoperative use of brachytherapy which can deliver high radiation doses to the residual tumor, or tumor bed, sparing normal tissue.
Immunotherapy of cancer with lymphokines and lymphokine‐activated killer cells
Authors: Yarbro John W. 
Published: February 2007

AbstractOur expanding knowledge of the immune system has provided a basis of rationality for immunotherapy. Some non‐specific immunotherapy has achieved the status of standard treatment: interferon in hairy cell leukemia and chronic myelogenous leukemia, BCG in bladder cancer, and levamisole in colon cancer adjuvant therapy. Tumor infiltrating lymphocytes, moreover, offer a level of specificity heretofore unknown. Combined with the newly available synthetic cytokines that regulate the normal immune system there is the potential for a major breakthrough in biotherapeutics. Problems remain. We have yet to identify tumor antigens with the precision necessary for effective immunotherapy. Indeed, we have no assurance that tumors will regularly synthesize new antigens. In the broad spectrum of immune deficiency syndromes, we have yet to see an increase in the common epithelial tumors that account for the great bulk of human cancer. This suggests that we still have a great deal more to learn.
Immunotherapy for malignant melanoma: A review and update
Authors: C. Mcgee J. Michael 
Published: February 2007

AbstractSeveral different approaches to the application of specific active immunotherapy for the adjuvant therapy of melanoma have developed independently. Specific active immunotherapy refers to autologous or allogenic inoculation or transplantation of tumor cells or cell products into patients with cancer. Several different types of tumor vaccines have been studied and have been combined with different immunotherapeutic modalities. This report will include a review of several of those different techniques and will also review the observed 5‐year survival rates for a melanoma tumor homogenate (concentrated) vaccine, developed by L.J. Humphrey and colleagues.
Immunotherapy of renal cell cancer
Authors: Crusinberry Richard , Williams Richard D. 
Published: February 2007

AbstractImmunotherapy of metastatic renal adenocarcinoma (RCC) is currently an alternative to cytotoxic chemotherapy. Bacillus Calmette‐Guérin has been associated with a 22% response rate in small series, but no large‐scale clinical trials have been completed. Transfer factor, in combination with other immunotherapeutic and chemotherapeutic compounds, has a reported 13% incidence of response. Tumor vaccines have caused clinical response in only 5% of patients while monoclonal antibodies have produced partial remission in one of nine patients. Immune RNA has been associated with a 14% overall incidence of response. Tumor necrosis factor has not as yet been studied in any large‐scale clinical investigations but preliminary studies are not promising. Leukocyte‐derived and recombinant interferons alone have produced responses in 10–20% of patients with tolerable toxicity. Combinations of interferons or with cytotoxic chemotherapy have produced slightly improved responses with short duration and substantial toxicity. Adoptive immunotherapy using Interleukin‐2 alone, or with IL‐2 plus lymphocyte‐activated killer cells, or tumor infiltrating lymphocytes or interferons have produced clinical responses in 10–30% of patients treated. Combinations of specific forms of immune therapy may hold promise for better rates of clinical response in the future.
Immune responsiveness of patients with malignant melanoma and carcinoma of the breast
Authors: Humphrey Loren , Ms Om Singla 
Published: February 2007

AbstractLymphocyte blastogenesis (LB) with PHA, CON‐A, PWM, VII (homologous tumor extract) plus T/B ratio for pre‐IT, post‐IT (2 months), and 3, 6, 9, 12, 18, and 24 months prior to each VII booster are reported. Pre‐IT and post‐IT LB‐PHA were similar for Stage I (ST I) or Stage II (ST II) breast cancer (BC) patients who expired or survived. The pre‐booster results were similar except that prior to death, stimulation with PHA decreased. Melanoma (MM) patients LB‐PHA pre‐IT showed less stimulation for ST I patients than for ST II patients (survivors and expired). LB‐CON‐A and LB‐PWM showed similar results with slight variations. When compared to survivors, LB‐VII for BC patients who expired showed no stimulation. MM patients showed different results in LB‐VII. T/B ratios for BC patients during the first 3 months showed 72% normal (N), 14% below N, and 14% above N for survivors and 40% normal (N), 60% below N, and 0 above N for expired. MM T/B ratio were not remarkable. LB anamnestic response to immune stimulation evaluated in 16 of the 62 BC and 10 of 81 MM patients showed increased peak levels over trough for survivors and a decrease for expired. The significance of data as in vitro correlates of clinical response is discussed.