bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biology of metastasis: Clinical implications
Authors: Liu Brian C.‐S. , Weiss Robert E. , Gordon Jeffrey N. , Droller Michael J. 
Published: February 2007

AbstractBladder tumor has a spectrum of neoplastic activity. Some behave in a benign fashion, and others are highly aggressive and lead rapidly to metastatic disease and death. The processes of metastasis can be described as a sequence of interrelated steps. The processes involve 1) tumor cell adhesion to basement membranes, 2) the degradation of basement membranes, and 3) the migration of tumor cells through the destroyed stroma into blood and lymphatic vessels. Each of these processes involves the expression of molecular factors unique to tumor cells. With better understanding of the molecular basis of these factors, novel prognostic and potential therapeutic agents can be generated and applied to the clinical arena.
Cutaneous malignant melanoma: Epidemiological considerations
Authors: Franceschi Silvia , Cristofolini Mario 
Published: February 2007

AbstractLarge geographic and ethnic variations in incidence and mortality rates of cutaneous malignant melanoma (CMM) suggest inverse correlations with the degree of skin pigmentation and latitude. Increases in CMM incidence and mortality rates have occurred in virtually all white populations, more markedly in those that permanently (immigrants) or temporarily (tourists/vacationers) reside in very sunny areas outside their primitive living environment. The interpretation of data from case‐control studies is, however, hampered by the difficulties in quantifying retrospectively, but reliably, CMM risk correlates (e.g., host factors, sun exposure, clothing habits, sunburns) in various periods during the life span. There is, thus, a need for large prospective studies on the development of CMM and naevi, ideally in different contexts as concerns host factors, sun exposure, and other life‐style habits within and across different populations.
Surgical management of primary melanoma
Authors: Holmström Hans 
Published: February 2007

AbstractThe outline of the surgical treatment of a primary cutaneous malignant melanoma may be divided into the problems of biopsy, definitive excision and reconstruction of the defect. An excisional, in contrast to an incisional, biopsy provides the full scope of prognostic parameters and should be used whenever possible. General anesthesia is not necessary, and frozen‐section examination is inaccurate. An immediate excision biopsy should therefore be performed under local anesthesia as an outpatient procedure. Whenever possible, a margin of 10 mm should be used, as this would mean an adequate and definitive treatment in melanomas up to 1 mm, and possibly 2 mm, in Breslow thickness. In melanomas more than 1‐2 mm in thickness a 3‐cm free margin instead of a 5‐cm free margin is recommended. Many patients, especially those with trunk lesions with a 3‐cm free margin may not need a complicated repair, such as a skin graft or a flap. The excision in depth is recommended to be carried perpendicular to the skin and inclusion of underlying fascia is optional, as no study has proved it to be beneficial. The defect after the excision should whenever possible be closed directly. If this is not possible the defect is covered with either a skin graft or a flap and the latter is recommended from both a cosmetic and a functional point of view. If a skin graft has been used, the secondary defect may be reconstructed with a skin expansion technique.
Hyperthermic antiblastic perfusion in the treatment of local recurrence or “In‐transit” metastases of limb melanoma
Authors: Cavaliere Renato , Filippo Franco Di , Giannarelli Diana , Carlini Sandro , Anzà Michele , Cavaliere Francesco , Graziano Franco , Perri Pasquale 
Published: February 2007

AbstractOn the basis of personal experience and a review of the literature, the authors have evaluated the results obtained with hyperthermic antiblastic perfusion (HAP) for the treatment of stage II, III and IIIAB limb melanoma.The evaluation showed that today HAP may be considered a safe and effective treatment, with a major complication rate ranging between 1% and 4%.In terms of tumor response, locoregional control and survival, this treatment has provided better results than other regional chemotherapeutic modalities and undoubtedly better results than those obtained with conventional, even radical, surgery.The multiparametric analysis showed that, of the treatment‐related prognostic factors, the minimum tumor temperature influenced the percentage of complete response (CR) to the greatest extent (P< 0.03), with a positive trend also with regard to the dosage of the antiblastic drug employed (P<0.08). In turn, the complete response rate was a determinant as far as locoregional control (75.3%;P< 0.0009) and disease‐free (51.4%;P< 0.009) and overall survival (63.2%);P< 0.009) rates were concerned. Of the tumor‐related prognostic factors, the number of lesions (P< 0.0014), sex (P<0.04), and the number of disease recurrences (P<0.01) appear to influence overall survival.
Surgical management of distant melanoma metastases
Authors: Lejeune Ferdy J. , Liénard Danielle , Sales Francois , Badr‐El‐Din Heiman 
Published: February 2007

AbstractDisseminated melanoma remains a tumour that is poorly responsive to chemotherapy and radiotherapy. However, this review demonstrates that surgical removal of visceral metastases such as at the, lung or digestive sites, as well as the brain, yields consistent median survivals, often longer than 12 months, and long‐term survivors. Such surgery is followed by little complication cost and low perioperative mortality. Our experience tends to confirm that complete debulking offers longer survivors as compared to partial. Also, one site of metastases, whatever its anatomical location, when operated on, gives a better chance for survival than when there are multiple sites.
Evolving role of surgery after induction chemotherapy and primary site radiation in head and neck cancer
Authors: Norris Charles M. , Busse Paul M. , Clark John R. 
Published: February 2007

AbstractChemotherapy, as preliminary treatment before surgery and/or radiation for advanced squamous cell carcinoma of the head and neck, is no longer novel. In prospective trials to date, however, multiple agent induction chemotherapy has yet to demonstrate the initial presumptive promise of improved rates of cure. As an alternate goal, there has emerged a renewed attentiveness toward limiting treatment morbidity, several strategies for which may be considered. Extirpative, often radical, surgery on the primary site of disease usually represents the most significant threat to life quality. Various ways of limiting surgical morbidity will be considered by way of introduction. The trends of head and neck cancer treatment over the decades, leading into the era of induction chemotherapy and refined radiation techniques, will be described. At the combined Dana‐Farber/New England Deaconess Head and Neck Oncology Clinic, an experience with over 300 patients receiving induction chemotherapy for advanced head and neck cancer has been analyzed with an emphasis on the postulate of lessening the extent of surgery in appropriately selected patients. In a comparison between trials initiated in 1980 and 1987, improved complete response rates from 26 to 57% were documented. Survival rates were identical, but the use of planned primary site ablative surgery was decreased from 47 to 14%. While some increase in local failure has been noted in patients treated by primary site radiation alone, surgical salvage appeared to be more effective. The implication of these trends for patterns of failure and surgical salvage and data concerning the need for neck dissection in this group of patients will be briefly summarized. Other trials addressing organ‐preservation strategies will also be referenced and the dichotomy between survival‐based studies and morbidity‐limiting studies illustrated. Independent trends in radiation technique as a potential substitute for traditional surgical practice will be reviewed.
Influence of multimodality therapy on the management of pancreas carcinoma
Authors: Jessup J. Milburn , Posner Marshall , Huberman Mark 
Published: February 2007

AbstractCarcinoma of the pancreas has an especially grim prognosis. Only 1‐3% of patients survive for 5 years. Radical pancreaticoduodenectomy, especially for minimal disease, is currently the only chance for cure. While radiation therapy does not improve overall survival, it may improve local control following radical resection and decrease pain in locally advanced cancers. Although chemotherapy has led to significant improvements in survival in patients with locally advanced disease, the overall effect is small. When surgery, radiotherapy, and chemotherapy are administered to localized carcinomas in randomized, prospective trials, survival is significantly lengthened. Similar trials in locally advanced, unresectable pancreatic cancer also confirm the concept of synergistic interaction between therapies. Thus, pancreas carcinoma is one neoplasm where multimodality therapy has had a demonstrable, although small effect.
Impact of combined modality therapy on the treatment of adenocarcinoma of the colon
Authors: Posner Marshall R. , Bleday Ronald , Huberman Mark , Jessup John M. , Busse Paul , Steele Glenn 
Published: February 2007

AbstractAn emphasis on careful surgical staging of adenocarcinoma of the colon has improved the predictive value of tumor staging systems. As a result of improved staging and carefully conducted randomized clinical trials, adjuvant therapy of locally advanced colon cancer, based on 5‐fluorouracil chemotherapy, has been proven to substantially reduce recurrence rates and significantly increase overall survival for selected patients. Improved treatments and schedules are currently being studied in randomized trials and may increase the efficacy of this adjuvant therapy. Radiation therapy has not as yet been integrated into the adjuvant treatment of colon carcinoma. The application of a combined approach of surgery and chemotherapy in selected patients with liver metastases may also improve cure rates and long‐term survival. The developing understanding of molecular determinants for the biological behavior of these cancers will increase the opportunities to identify, on the one hand, those patients who will benefit from specific therapies, and, on the other hand, new therapeutic strategies and treatments.
Conservative management of rectal carcinoma: The efficacy of a multimodality approach
Authors: Jessup J. M. , Bleday R. , Busse P. , Steele G. 
Published: February 2007

AbstractThe goals of the conservative management of adenocarcinoma of the distal rectum are to preserve rectal sphincter function and achieve excellent local tumor control. Multimodality therapy for more advanced disease suggests that these goals will be met by conservative surgery combined with radiation therapy and chemotherapy. Over 100 patients with T0‐3 N0‐1 lesions have been treated in prospective single institution trials with either local excision or anterior resection with coloanal anastomosis, usually combined with chemotherapy and radiotherapy. The typical criteria for local excision have been for lesions to be 4.0 cm or less, mobile, and not poorly differentiated or mucinous. Patients with larger or more advanced lesions may undergo anterior resection with coloanal anastomosis. Following resection, radiotherapy is delivered to the pelvis and tumor bed often with concomitant chemotherapy. The overall rate of local failure in the trials in which local excision is performed with postoperative chemoradiotherapy is 3% for TI lesions, 5% for T2 lesions, and 30% for T3 lesions with a median follow‐up of at least 25 months. Local failure in patients with a coloanal anastomosis is 9% overall. Salvage was successful in about half of the patients who failed locally. Importantly, nearly all patients remained continent. These institutional studies show that sphincter preservation can be used in patients who are objectively selected for this procedure. However, before this multimodality approach may be considered standard therapy the rate of local control must be confirmed in a large, Phase II, multicenter, prospective trial such as that now underway in many of the cooperative groups.
Effect of combined modality therapy on the surgical management of locally advanced rectal carcinoma
Authors: Busse Paul M. , Jessup J. Milburn , Cady Blake , Bothe Albert , McDermoll William V. , Stone Michael D. , Steele Glenn 
Published: February 2007

AbstractThe treatment of locally advanced rectal carcinoma is one of the more complicated problems in the management of colorectal carcinoma. More than any other site successful treatment requires a multimodality approach as surgery alone is frequently insufficient to completely eradicate all disease. This review focuses primarily on the management of patients who present without prior treatment and discusses the role of preoperative radiation therapy as well as intraoperative radiation therapy. Although much less gratifying, patients who present after failing previous therapy may also benefit from an aggressive multimodality approach.
Laparoscopy/thoracoscopy for staging: I. Staging endoscopy in surgical oncology
Authors: Forse R. Armour , Babineau Timothy , Bleday Ronald , Steele Glenn 
Published: February 2007

AbstractThe application of laparoscopy to the staging of solid abdominal tumors is reviewed. The current evidence support the use of laparoscopy particularly in hepatic tumors. There is evidence that the hospital length of stay for a patient with a nonresectable hepatic tumor can be reduced from 5.6 ± 0.4 days with a laparotomy to 1.5 ± 0.3 days with a laparoscopy. Where the palliative and bypass issues are not limiting, cases of pancreatic and gastric carcinoma also appear to benefit in having a staging laparoscopy before a formal laparotomy for resection. Current instrumentation does produce limits, but with future prospects of laparoscopic ultrasound, and tumor staining, staging laparoscopy will become an important diagnostic tool in surgical oncology.
Recent developments in the epidemiology of lung cancer
Authors: Kabat Geoffrey C. 
Published: February 2007

AbstractLung cancer is currently the leading cause of cancer death in the United States and also the most common tumor worldwide. Changes in the distribution of histologic types over the past two decades in the United States, as well as high rates of lung cancer in certain subpopulations, require explanation. While cigarette smoking and specific occupational exposures are firmly established as important risk factors for lung cancer, recent work provides evidence that other factors may play a role either as independent risk factors or as modifiers of the effect of smoking. This paper reviews the epidemiology of lung cancer, with an emphasis on developments in the past decade.
Choice of procedure for surgical treatment of non‐small cell lung cancer
Authors: Harvey James C. , Pisch Julianna , Rubin Eva , Beattie Edward J. 
Published: February 2007

AbstractAsymptomatic coin lesions without specific patterns of benign calcifications can and should have a diagnosis established. Surgical diagnosis can be accomplished with very low morbidity. Accurate staging of lung cancer requires tissue confirmation of mediastinal node status either by thorough sampling or by complete node dissection. Complete resection with lobectomy is the preferred treatment providing better results than lesser resections. Segmental or wedge resections and internal radiotherapy are appropriate for patients unable to tolerate lobectomy. Video assisted thoracoscopy may prove useful in wedge excision for patients with poor pulmonary reserve.
Resection for second and third primary lung cancer
Authors: Faber L. Penfield 
Published: February 2007

AbstractThe continued increasing incidence of bronchogenic carcinoma increases the likelihood that a patient may develop a second or third primary tumor. We have carried out a second thoractomy for 114 patients who met our criteria of having a new primary lung cancer. These criteria were a different histologic cell type, a tumor‐free interval of 24 mo, the second primary in the contralateral lung, or the new tumor in a separate and distinct ipsilateral lobe if the tumor was on the same side. There were 18 patients who had a thoracotomy for a third primary lung cancer and they met the same criteria. There were 73 segmental resections in the 132 thoracotomies, and a conservative resection is important to minimize postoperative complications. Operative mortality for the second resection group of patients was 8.8% (10/114). There was one operative death in the 18 patients undergoing a third resection. The cumulative survival rate following a second resection in 114 patients with metachronous tumors was 33% at 5 yr and 20% at 10 yr. Early detection of a second and third primary lung cancer and surgical resection offers the greatest chance for long‐term survival in this group of patients.
Primary tumors of the thoracic skeleton
Authors: Bloom Norman D. 
Published: February 2007

AbstractFrom 1975 to 1990, eighty‐nine primary tumors of the thoracic skeleton; ribs, sternum, scapula, clavicle, and thoracic spine, were treated. Forty‐four tumors (49%) were benign lesions. Forty‐five tumors were malignant and were proportionately distributed amongst the five sites. The most common malignancies were Ewing's sarcomas, chondrosarcomas, plasmacytomas, osteogenic sarcomas, and lymphomas.All patients with Ewing's sarcomas were treated with combination chemotherapy, surgical resection, and radiation therapy for those with residual disease after surgery. Only one patient has died of disease. Patients with primary chondrosarcomas were treated by surgery alone and all are free of disease or have died without disease. Patients with solitary plasmacytomas or primary lymphomas of bone were treated with radiation therapy initially. Half the patients developed systemic disease. The patients with osteogenic sarcomas included several with radiation induced lesions and Paget's osteosarcoma and all but one died of disease.
Superior results with complete resection of Askin's tumor
Authors: Harvey James C. , Bergland Richard , Pisch Julianna , Krishnamachari Venkatesan T. , Reich Herbert , Malamud Stephen , Beattie Edward J. 
Published: February 2007

AbstractA malignant small round cell tumor of the thoracopulmonary region arising in childhood has been described by Askin and colleagues. Subsequent descriptions have emphasized refinements (or disagreements) regarding pathology and emphasized the usual poor outcome. Complete excision has not been uniformly attempted in previous series. Our purpose is to describe superior results possible in a multidisciplinary setting emphasizing complete surgical excision.
Pleuroperitoneal shunt for malignant pleural effusions: A one‐year experience
Authors: Reich Herbert , Beattie Edward J. , Harvey James C. 
Published: February 2007

AbstractMalignant pleural effusions are often debilitating conditions for the patient with advanced cancer. Traditionally, treatment has been repeated thoracentesis or tube thoracostomy with installation of sclerosing agents. This, however, required the patient to be hospitalized and subjected to the pain and inconveniences of the chest tubes. The drainage also had to be low enough for sclerotherapy to be effective. In 1982, the pleurovenous shunt was modified and the pleuroperitoneal shunt became a feasible alternative to sclerotherapy. We started using the Denver pleuroperitoneal shunt in July 1991. Seventeen shunts were inserted into 13 patients over a 1‐year period ending June 30, 1992. All patients were relieved of their dyspnea. The average length of patency was 2.5 months, and fewer than 25% of the shunts clotted. Our favorable experience with the shunt has lead us to recommend the Denver pleuroperitoneal shunt for the treatment of recurrent malignant effusions.
Evolution of surgery in the treatment of hepatocellular carcinoma from the 1950s to the 1990s
Authors: Tang Zhao‐You , Yu Ye‐Qin , Zhou Xin‐Da 
Published: February 2007

AbstractIn the 1950s, hepatic lobectomy for huge hepatocellular carcinoma (HCC) has benefited 5–10% of HCC patients; in the 1970s, limited resection for small HCC and reresection for recurrence have benefited another 5–10% HCC patients. Cytoreduction and sequential resection for unresectable HCC might be of benefit to a further 5–10% HCC patients in the 1990s. Analysis of 1,642 patients with pathologically proven HCC in 1959‐1991 demonstrated that the series 5‐year survival has increased from 3.0% (n = 136) in the 1960s, to 12.2% (n = 440) in the 1970s, to 40.2% (n = 1,066) in the 1980s, which was correlated to the increasing number of limited resections for small HCC, re‐resections for subclinical recurrence, and cytoreductions and sequential resections for portions of unresectable HCC. With the advances in early detection, multimodality treatment, and changing concepts in surgical oncology, the role of surgery in the treatment of HCC has increased.
Experience with resection of segment VIII of liver for hepatocellular carcinoma
Authors: Yu Ye‐Qin , Zhou Xin‐Da , Tang Zhao‐You , Xu Dong‐Bo , Feng Xue‐Sheng 
Published: February 2007

AbstractHepatic segment VIII is located at the dome of the right liver lobe, next to the intrahepatic inferior vena cava (IVC) and is situated between the right and the middle hepatic veins. Its close relation to the IVC inferior medially makes liver cancer resection in this particular segment extremely difficult and hazardous.A personal series of 32 cases of segment VIII resection for hepatocellular carcinoma performed during the period January 1970–May 1992 is being presented. Most resections could be performed with occlusion of the porta hepatis only but some cases required total hepatic vascular exclusion.Since segment VIII is surrounded by major vessels, the extent of resection is limited in this region. Furthermore, tumor cells are easily disseminated along the vascular route. The long‐term results are far from ideal. One‐, 3‐, and 5‐year survival rates were 93.33%, 57.14%, and 28.5%, respectively. However, eight patients in this series have survived 180, 168, 104, 78, 53, 43, 43, and 36 months, respectively, and some of them have returned to work. Therefore, despite the technical difficulties involved in segment VIII resection, it is still worthwhile adopting an aggressive operative approach to this group of patients.
Cryosurgery of liver cancer
Authors: Onik Gary M. , Atkinson Donald , Zemel Reubin , Weaver M. Lance 
Published: February 2007

AbstractCryosurgery, the in situ destruction of tissue using subzero temperatures, has been used to treat hepatic metastases. Because it is a focal treatment, cryosurgery can be used in patients with unresectable lesions due to location (next to major blood vessels) or multiplicity. In this study, 57 patients with unresectable hepatic metastases were treated with cryosurgery (with at least a 6‐month follow‐up). The number of lesions treated ranged from 1–16 with a mean of 4.6. Forty‐three patients (73%) had bilobar disease, while 25 patients (42%) were treated with a combination of resection and cryosurgery. The disease‐free survival rate (patients with normal computed tomography [CT] scans and carcinoembryonic antigen [CEA] levels) was 27% with a mean follow‐up of 21 months. This is comparable to other hepatic cryosurgery studies that have found survival rates of 25–37.5%. Although the results are still short‐term, this study indicates that hepatic cryosurgery offers the hope of long‐term survival in patients with unresectable hepatic metastases.