bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical considerations in the surgical treatment of colon and rectal cancer
Authors: Fengler Scott A. , Pearl Russell K. 
Published: February 2007

AbstractSurgery is the primary mode of therapy for colorectal cancer. Advances beyond exteriorization began to appear at the end of the nineteenth century. The antibiotic era brought on more advances. Dogma abounds with respect to the technical aspects of surgery for colon and rectal cancer and few randomized, prospective trials have been done to evaluate the importance of these techniques. Firmly established are the techniques of resection of lymphatic drainage of tumors, en bloc resection of invaded structures, and obtaining at least 2 cm margins of rectal cancers. Radical lymph node dissection, luminal ligation, oophorec‐tomy, and the “No‐Touch Technique” are discussed. Despite the paucity of irrefutable scientific data to support many of the described surgical techniques, differences in outcome between surgeons suggest that technique is important. There is great need for randomized, prospective trials to evaluate the multitude of techniques described for the surgical treatment of colorectal cancer. © 1994 Wiley‐Liss, Inc.
Perineal reconstruction with continent colostomy after the miles operation
Authors: Santoro Emanuele , Santoro Roberto , Santoro Eugenio 
Published: February 2007

AbstractSince the beginning of the century, different surgical procedures have been employed to create new anal sphincters for a continent perineal colostomy after abdominal perineal anorectal resection for cancer.After a detailed review of all the currently employed surgical procedures, the authors present their experience with 15 cases treated by transposition of the gracilis muscles to the perineum.More than 50% of the operated patients had good functional results with complete continence for solid stools and sufficient control of the stimulus. Poor results are related to surgical complications or unexpected postsurgical diseases and cancer recurrence or metastases. This surgical procedure seems to be an interesting possibility for selected patients in the case of a permanent abdominal incontinent colostomy after the Miles operation. © 1994 Wiley‐Liss, Inc.
Optimal follow‐up in colorectal cancer patients: What tests and how often?
Authors: Kronborg Ole 
Published: February 2007

AbstractPatients' benefit from follow‐up examinations after curative surgery for colorectal cancer is unproven in spite of numerous different programs' having been designed for that purpose. Unfortunately, no final results from prospective randomized studies have been published yet and no ideal marker for recurrent cancer is available to identify patients in whom new curative treatment may be possible. So far, screening for metachronous neoplasia with intervals of several years may influence survival, whereas benefit from detecting recurrent colorectal cancer may be claimed only by using historical or other inappropriate controls. The tradition of follow‐up is expensive and prospective evidence for any cost benefit is needed to justify continuous use of our limited resources in this area of patient care. © 1994 Wiley‐Liss, Inc.
Etiology, biology, and epidemiology of ovarian cancer
Authors: Baker Trudy R. , Piver M. Steven 
Published: February 2007

AbstractEpithelial ovarian cancer kills more women per year than all other gynecologic cancers combined. Pregnancy, oral contraceptive use, and tubal ligation decrease the risk of the disease, whereas risk is increased for women whose family history is consistent with one of the familial ovarian cancer syndromes. Several theories have been postulated concerning the etiology of ovarian cancer, including the incessant ovulation theory and that based on the model of hypergonadotropic hypogonadism. Chromosomal abnormalities and allele losses have been described in ovarian cancers. Involvement of oncogenes and tumor suppressor genes has been investigated as well. Genetic linkage studies are ongoing in families whose history is consistent with one of the familial ovarian cancer syndromes. © 1994 Wiley‐Liss, Inc.
Histopathology of ovarian cancer
Authors: Gore Hazel 
Published: February 2007

AbstractOvarian tumors which form a complex group due to the variety of tissues composing the ovary are classified according to world health organization criteria with minor variations. The histopathology of the most common ovarian carcinomas, common epithelial tumors and germ cell tumors is discussed in detail. © 1994 Wiley‐Liss, inc.
Surgical management of ovarian cancer
Authors: Farias‐Eisner Robin , Kim Young B. , Berek Jonathan S. 
Published: February 2007

AbstractAlthough several surgical approaches to the diagnosis and management of epithelial ovarian cancer are now standard, surprisingly few prospective data exist to support many of these procedures. However, retrospective data have accumulated over the past decade, much of it very recent, which allow clinicians to make informed decisions regarding most of the commonly performed procedures. This review is an attempt to critically evaluate the best available data regarding the following procedures: primary surgical staging, primary cytoreductive surgery, second look laparotomy and secondary cytoreductive surgery, and palliative surgery for relief of bowel obstruction. We conclude that there is evidence to support the continued use of primary surgical staging and primary cytoreductive surgery. However, data in support of second look laparotomy and secondary cytoreductive surgery are lacking, and we recommend that these procedures not be performed on a routine basis. Finally, we conclude that palliative surgery is hazardous at best and results in questionable benefits for most patients. © 1994 Wiley‐Liss, Inc.
Second‐look laparotomy
Authors: Moore James L , Barter James F. 
Published: February 2007

AbstractThe second‐look laparotomy has become an important means of assessing therapy response in ovarian cancer patients. This procedure enables the gynecologic oncologist to diligently search for small volume persistent disease, which often escapes detection by less invasive means. Subsequent treatment, if required, may then be tailored to the initial biologic response to therapy. However, many patients with negative findings at second look will develop recurrent disease, dampening enthusiasm for the operation. Although controversial, this procedure remains the gold standard for the detection of disease status following chemotherapy for ovarian cancer. © 1994 Wiley‐Liss, Inc.
Chemotherapy of ovarian germ cell tumors and sex cord stromal tumors
Authors: Gershenson David M. 
Published: February 2007

AbstractMalignant ovarian germ cell tumors (ogct) and sex cord stromal tumors (scst) are much less common than epithelial ovarian cancer, each accounting for less than 5% of all ovarian malignancies. The combination of vincristine, dactinomycin, and cyclophosphamide (vac) became the standard chemotherapy for patients with ogct in the 1970s; it produced excellent sustained remission rates in patients with stage i disease but less than 50% sustained remission rates in those with metastatic tumor. With the introduction of cisplatin for the treatment of testicular cancer in the late 1970s, platinum‐based regimens replaced the vac regimen by the mid‐1980s. Currently, the most popular regimen for all patients with ogct is the combination of bleomycin, etoposide, and cisplatin (bep). The bep regimen appears to be superior to vac, with sustained remission rates of more than 75% in patients with metastatic tumor. For patients with metastatic pure dysgerminoma, chemotherapy appears to have supplanted radiotherapy as standard treatment with the advantage of preserving fertility in most patients. For patients with scst, no standard therapy exists. Surgery alone is currently acceptable treatment for all patients with scst except those with metastatic disease, sarcomas, or sertoli‐leydig cell tumors with poor differentiation or heterologous elements. Currently, platinum‐based combination chemotherapy is favored for these latter patients but activity with such regimens is only modest. © 1994 Wiley‐Liss, inc.
Role of radiation in the management of adult patients with sarcoma of soft tissue
Authors: Suit Herman D. , Spiro Ira 
Published: February 2007

AbstractRadiation in moderate dose levels, viz. 60‐65 Gy at 2 Gy/fraction, administered in combination with conservative surgery, yields local control frequencies at least comparable to those achieved by radical resectional surgery alone. The clinical interest in this management strategy is the reduction in the scope of the resection and a consequent gain in cosmetic and functional status. This combined approach is favored for sarcomas so situated that resection with wide margin, ≧ 2 cm at the most narrow, cannot be realized unless there is a clinically important loss in function. Where radical surgery is planned, there must be great care in assessment of the probability of achieving good margins. The patient is ill served if there is radical surgery and then, because of close margins, postoperative radiation is required. There appears to be clinical gain for the patient with a large sarcoma by administering the radiation preoperatively. Advantages include smaller treatment volume and higher local control rates. The management of the surgical wound in the irradiated patient is discussed. Also, brief consideration is given to current use of brachytherapy, high linear energy transfer (LET) radiation, and combination of radiation and chemotherapy. © 1994 Wiley‐Liss, Inc.
Chemotherapeutic approaches to soft tissue sarcomas
Authors: Edmonson John H. 
Published: February 2007

AbstractConventional chemotherapy for adult type soft tissue sarcomas is not very effective. Rarely are patients with advanced soft tissue sarcomas curable by systemic chemotherapy. Thus, the benefits from chemotherapy have been equivocal even when treatment is given postoperatively to patients whose primary sarcomas have been excised. Current research is directed toward the achievement of a high percentage of complete tumor regressions in patients with advanced metastatic disease in hope that this can be translated into truly effective adjuvant therapy. Several recent new approaches to systemic treatment for soft tissue sarcomas are assessed including prospects for possible enhancement of chemotherapy by agents which stimulate cellular immunity. Some unexpectedly favorable responses to chemotherapy + granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) in an ongoing study are discussed. © 1994 Wiley‐Liss, Inc.
Gynecological sarcomas
Authors: Disaia Philip J. , Pecorelli Sergio 
Published: February 2007

AbstractSarcomas of the uterus, ovary and lower genital tract are fortunately rare, since the prognosis is quite often poor. The most frequent are sarcomas of the uterine corpus, and these account for only 4% of all uterine tumors. Ovarian sarcomas are less frequent, and the prognosis is even poorer when compared to the uterus. Sarcoma of the lower genital tract (vagina and vulva) in adults in often published as a case report, given their very infrequent occurrence. © 1994 Wiley‐Liss, Inc.
Laparoscopic approaches to abdominal malignancy
Authors: Greene Frederick L. , Brown Pamela A. 
Published: February 2007

AbstractThe use of laparoscopy for diagnosis and staging of intra‐abdominal malignancies is not an exclusive procedure. It is another modality in the armamentarium of caring for the patient. The selection of the appropriate patients is discussed in detail and must include a determination of the long‐range plans for intervention. The technical issues include problems of previous abdominal surgery, adhesions, ability to tolerate general endotracheal anesthesia, and ability to properly position the patient for an adequate examination. The endoscopic surgeon must be able to differentiate between the benign and malignant process during endoscopic examination and must be skilled in obtaining appropriate biopsies. In the staging of lymphoma, laparoscopy has virtually replaced the open celiotomy technique. Laparoscopic removal of appropriate lymph nodes is essential. The role of laparoscopy in a second‐look operation is discussed as well as contraindications and complications of the procedure. © 1994 Wiley‐Liss, Inc.
Apneumic laparoscopy in surgical oncology
Authors: Schneider James J. , Smith R. Stephen , Organ Claude H. 
Published: February 2007

AbstractMinimally invasive techniques now play an important role in virtually every aspect of general surgery. While it is unlikely that celiotomy for malignant disease will fall into obscurity as rapidly as open cholecystectomy, greater use of videoscopic techniques in surgical oncology are inevitable and will undoubtably improve patient care. Techniques of isopneumic laparoscopy have already proven useful in trauma, chole‐cystectomy, bowel resection, herniorrhaphy, and a variety of other procedures. Further advances in this technique are dependent on the development of “user friendly” abdominal wall retraction systems. © 1994 Wiley‐Liss, Inc.
Laparoscopy for construction of feeding enteral tubes and diverting stomas
Authors: Duncan Titus D. , Mason Edward M. 
Published: February 2007

AbstractLaparoscopy has now assumed a new and important role in the treatment of malignant diseases. An important part of this role is the establishment of feeding enterostomies and stomas. This function is vital in both those patients who may not be candidates for curative therapy and those being staged for definitive therapy. © 1994 Wiley‐Liss, Inc.
Minimally invasive surgery for pulmonary and esophageal tumors
Authors: McKenna Robert J. 
Published: February 2007

AbstractThe development of endoscopic video capabilities has opened a new era in thoracic operations. This paper discusses video‐assisted thoracic surgery (VATS) as part of the armamentarium of the thoracic surgeon. VATS is the procedure of choice for a solitary pulmonary nodule. It is also a useful staging procedure in selected patients with pulmonary and esophageal tumors. The role of VATS in the definitive resection of certain lung cancers is discussed and there is a call for randomized controlled studies to determine if there is an advantage for the utilization of VATS. The use of VATS for resection of esophageal tumors is discussed. It is currently under development and investigation. © 1994 Wiley‐Liss, Inc.
The role of laparoscopy in the management of gynecologic malignancy
Authors: Nezhat Camran , Nezhat Farr , Teng Nelson N. H. , Edraki Babak , Nezhat Ceana H. , Burrell Matthew O. , Benigno Benedict B. , Ramirez Carlos E. 
Published: February 2007

AbstractWith the advent of minimally invasive laparoscopic techniques, most gynecologic procedures for benign conditions can be performed in an outpatient setting. However, the role of such techniques in gynecologic oncology is not well defined. By reviewing the literature and presenting some new data, we attempt to elucidate the applications of operative videolaparoscopy in gynecologic oncology. Advanced laparoscopic techniques are utilized for the management of cervical cancer as well as the staging and treatment of endometrial and ovarian cancers. Such techniques are used in performing radical hysterectomy for early stage cervical cancer, pelvic and paraaortic lymphadenectomy, and second look laparoscopy following chemotherapy for ovarian cancer. Even though preliminary data are encouraging, large prospective controlled studies with long‐term follow‐up are necessary to better define the role and limitations of laparoscopy in the treatment of gynecologic malignancies. © 1994 Wiley‐Liss, Inc.
Natural history of clinically localized prostate cancer
Authors: Barry Michael J. 
Published: February 2007

AbstractThe natural history of clinically localized prostate cancer is controversial. However, the data that is available suggests outcomes are good for men with well and moderately differentiated disease, but relatively poor for men with poorly differentiated cancer. For example, in one synthesis of individual‐patient level data from six series, ten‐year prostate cancer‐specific mortality for men with well, moderate, and poorly differentiated disease was estimated at 13%, 13%, and 66%, respectively. Tumor grade is the dominant predictor of prognosis. Few studies report on risks of morbidity due to local cancer progression; the data available suggest this risk is relatively low. Cancer‐specific mortality figures overestimate the impact of disease among older men with competing causes of mortality. Given the available data on prognosis of men with localized prostate cancer not treated for cure, clinical trials designed to measure the effectiveness of aggressive therapy will need to be large. © 1995 Wiley‐Liss, Inc.
Anatomy of the prostate and distribution of early prostate cancer
Authors: Greene Damian R. , Fitzpatrick John M. , Scardino Peter T. 
Published: February 2007

AbstractMany of the difficulties in understanding diseases of the prostate have arisen through poor understanding of the anatomy of the prostate. The recent description of histologically separate zones in the prostate has been an important advance, allowing evaluation of separate cancers arising in the transition and peripheral zones of the prostate. While the majority of cancers sampled at transurethral resection of the prostate (TURP) are of transition zone origin, most of these prostates contain separate cancers in the peripheral zone. The peripheral zone cancers have a higher grade‐to‐volume ratio and are more frequently associated with histological features of progression (extracapsular extension, seminal vesicle invasion) than transition zone cancers. Furthermore, peripheral zone cancers are frequently associated with prostatic intraepithelial neoplasia, in contrast to transition zone cancers. These findings suggest a greater biological activity for cancers arising in the peripheral zone. The majority of cancers detected by digital rectal examination are of peripheral zone origin. While associated transition zone cancers are less frequently present than in TURP sampled prostates, a similarly high association of peripheral zone cancers with histological indicators of biological activity is seen. DNA ploidy analysis of separate foci in radical prostatectomy specimens confirms a significantly higher rate of non‐diploidy in cancers of peripheral zone origin, some of very small volume, which further suggests a greater biological activity compared to transition zone cancers. © 1995 Wiley‐Liss, Inc.
Incidental carcinoma of the prostate
Authors: Van Andel George , Vleeming Ruud , Kurth Karlheinz , De Reijke Theo M. 
Published: February 2007

AbstractTransrectal ultrasonography (TRUS), digital rectal examination (DRE), and quantification of serum prostate‐specific antigen (PSA) are accepted and evaluated methods for detecting prostate cancer. Positive predictive values (PPV) of DRE and TRUS are low, and only slightly enhanced when used in combination with PSA. PSA lacks sufficient sensitivity and specifity to be used alone as a screening test for prostate cancer. The parameters PSA‐density and PSA‐velocity make PSA a better tumor marker, but they are not reliable on an individual basis. Age‐specific reference ranges have the potential to make PSA a more sensitive tumor marker for men less than 60 years of age and a more specific one for men beyond 60 years. With currently available diagnostic methods approximately 10% of patients undergoing transurethral or open resection of the prostate for presumed benign prostatic hyperplasia will have carcinoma detected in the histologie material. In 392 patients successively treated in our clinic for presumed BPH and thoroughly investigated to exclude prostatic carcinoma (DRE, TRUS, biopsy when PSA > 4 ng/ml or PSA‐D > 0.15), the tumor was found incidentally in 4%. Another finding in this study was the detection of prostatic carcinoma by random biopsy in patients without a palpable or visible tumor by imaging and without PSA increase ( > 4 ng/ml). Biopsies were performed because of a hypoe‐choic zone in the opposite lobe which turned out to be negative. Such tumors cannot be properly classified in the current TNM system. Treatment options for patients with incidental prostatic carcinoma are age‐ and stage‐dependent. Patients less than 60 years old may be treated with a curative approach, irrespective of the T category (Tla or Tib); patients with a life expectancy longer than 10 years and a pTlb incidental carcinoma likewise should be offered a curative therapy. © 1995 Wiley‐Liss, Inc.
Oestrogens reconsidered
Authors: Smith Philip H. 
Published: February 2007

AbstractOestrogen therapy or orchidectomy reigned supreme for the treatment of metastatic prostatic cancer for almost 40 years. In the last 15 years many alternative agents have been tested alone and more recently in combination. This contribution evaluates the results of some of these newer therapies considering relief of symptoms, toxicity, quality of life, survival, and benefit to the community. The results are compared with those of oestrogen therapy and with the way in which such treatment might be amended in light of more modern knowledge. © 1995 Wiley‐Liss, Inc.
Hormone refractory disease
Authors: Mahler Charles , Denis Louis J. 
Published: February 2007

AbstractHormone refractory disease is observed in less than 20% of newly diagnosed cases of advanced prostatic cancer. In the majority of cases, hormone refractory disease appears after a median time of 18 months of endocrine manipulation and is attributed to the selection and/or cloning of pre‐existing or de novo appearing hormone‐independent or resistant cell lines. There are no generally accepted rules for second‐line management. The varying sets of criteria used by different study groups make comparisons of widely different regimens very difficult. Actually, it seems reasonable to consider length of survival as the only objective response criterion. This implies, however, that there should be an unanimous definition about the moment of primary treatment failure. Indeed, the detection of hormonal escape is a gradual event and the relative length of survival time depends on the chosen moment of therapy administration. To date, monitoring of prostate specific antigen (PSA) has become the best and primary tool to document progression of disease. Earlier diagnosis based on a rise in PSA levels in patients that are still asymptomatic with a good performance status, might provide the opportunity to treat patients that could profit from therapy and give a fair chance to the investigated drug to show efficacity and tolerability. In this paper we will discuss the rationale of the current available second‐line therapeutic options in relapsed pro‐static cancer. © 1995 Wiley‐Liss, Inc.
Clinical use of tumor markers in pancreatic carcinoma
Authors: Chung Maureen A. , Chang Helena R. 
Published: February 2007

AbstractThere is no ideal tumor marker for pancreatic carcinoma. Most of the tumor‐associated antigens in this disease are cell surface mutins, such as CA19‐9, TAG‐72, CA242, CA50, CA195, and CA494. CA19‐9 is the most promising marker. It is used for clinical and pathological diagnosis, prognosis, and response to chemotherapy. The other mucin antigens are currently being investigated for clinical practice. CA242 shows promise as a marker of tumor load and CA494 may play a role in immunotherapy. Oncofetal antigens such as CEA are not specific for pancreatic carcinoma and have a limited use in this disease. Malignancies associated with the endocrine pancreas secrete hormonal products which can be used as tumor markers. Fluid aspirated from pancreatic cysts can also be evaluated. Tumor antigens in aspirated fluid from pancreatic cysts should be interpreted with caution since multi‐locu‐lated cysts do not have a uniform expression of these markers. © 1995 Wiley‐Liss, Inc.