bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors of adult metastatic renal carcinoma: A multivariate analysis
Authors: De Forges Anne , Rey Annie , Klink May , Ghosn Marwane , Kramar Andrew , Droz Jean‐Pierre 
Published: February 2007

AbstractIn order to define the prognostic factors for metastatic renal carcinoma, we reviewed 134 patients who were treated from 1971 through 1986. Survival rates were 72,45, and 25% at 6, 12, and 18 months, respectively. Seventeen variables were tested using the logrank test. Improved survival was correlated with normal performance status, and an absence of fever, weight loss, hepatic metastasis, and lung metastasis (or, if lung metastasis was present, < 2 cm in diameter and limited to one site), a disease‐free interval, sedimentation rate < 100, and renal surgery. Four variables retained significant value in the multivariate analysis: hepatic metastasis, lung metastasis, disease‐free interval, and a variable combining the sedimentation rate and the weight loss (SWRL). Predictive survival rates based on these variables were calculated from the Cox model. Six subgroups of patients were identified. The estimation of survival is clinically of value for future phase II trials of chemotherapy in patients with adult metastatic renal carcinoma.
Principles of biotherapy and its application to the treatment of disseminated renal cancer
Authors: O'Connor T. E. , West W. H. , Marshall G. D. , Orr D. W. , Lewis M. , Oldham R. K. 
Published: February 2007

AbstractMonoclonal antibody technology permits the preparation of tumor‐specific immunoglobulin reagents that can be used directly in tumor therapy or that can be coupled to various chemotherapeutic drugs or toxins to aid in their delivery to the tumor site and thus enhance their therapeutic effectiveness. Additionally, recombinant DNA technology has facilitated the economic production of rare lymphokines (e.g., interleukin 2, interferon and interferon γ) or cytokines (tumor necrosis factor, lymphotoxin) that can either modulate the host immune response or kill tumor cells, respectively. These developments collectively have led to the development of a fourth modality for treatment of human cancers—biotherapy—as an addition to surgery, radiation, and chemotherapy modalities. This paper presents the rationale and emerging practice of the biotherapy of cancer and documents early clinical results, including the treatment of metastatic renal carcinoma at the Biological Therapy Institute.
Hormone receptors in renal cancer: An overview
Authors: Jakse Gerhard , Müller‐Holzner Elisabeth 
Published: February 2007

AbstractThe current literature concerning hormone receptors in renal cell cancer is reviewed. Our own results of histochemical determination of estrogen receptors by means of monoclonal antibodies are presented. Based on the studies that have been reviewed and the differing results of the receptor assays, we conclude that there is a very limited basis to apply hormone therapy in renal cell cancer. However, the new immunohisto‐chemical methods should be used to resolve the question about the hormone dependency of renal carcinoma.
Deoxyribonucleic acid content in metastatic renal cell carcinoma: Clinical implications
Authors: Ljungberg Börje , Roos Göran , Stenling Roger 
Published: February 2007

AbstractTumor DNA content was analysed in 26 patients with metastatic renal cell carcinoma. The primary tumors were homogenously diploid in ten patients (38%). In 16 patients (62%) an aneuploid DNA content was found in at least one of eight tumor samples analyzed. Patients with diploid tumors survived significantly longer (P < 0.001) than patients with aneuploid primary tumors (median 32.5 and 6 months, respectively). The DNA content of the metastases seems to give additional prognostic information. The results indicate that DNA content is a useful prognostic predictor in renal cell carcinoma. Patients with homogenously diploid tumors might be treated aggressively with nephrectomy and excision of apparent metastases, particularly solitary, since these patients seem to have a chance for prolonged survival time. Aneuploidy in metastases, solitary and multiple, indicates that nephrectomy is not meaningful.
Immunotherapy of metastatic renal cancer
Authors: Rauschmeier H. A. 
Published: February 2007

AbstractVarious reports in the literature suggested active specific immunotherapy to be highly efficient in metastatic renal cell cancer (RCC). Thirty five patients with tumor stage III or IV, according to Robson, were treated with autologous or homologous cell vaccine after radical nephrectomy had been performed. In stage III tumors immunotherapy was administered as prophylaxis or after an interval, when metastases occurred. Clinical results during a 3‐year follow‐up period revealed no statistically significant differences in comparison to an age‐matched control group. There was no advantage in employing autologous instead of homologous therapy. Three‐year survival rate in stage IV tumors with autologous vaccination was 11% vs. 6% in tumors with homologous therapy. Two complete and two partial tumor remissions occurred.
Interferon therapy for metastatic renal cell carcinoma
Authors: Swanson David A. , Quesada Jorge R. 
Published: February 2007

AbstractWe have used multiple interferon protocols to treat 274 patients who had metastatic renal cell carcinoma. Leukocyte (alpha) interferon in 50 patients produced 3 complete responses (CR) and 10 partial responses (PR), a 26% response rate that was nearly matched among the next 89 patients treated with recombinant alpha interferon (2 CR, 17 PR, 21%). Other types and combinations of interferon, even when coupled with cytotoxic chemotherapy or other biologic agents, did not produce better results. Interferon has definite activity against renal cell carcinoma, but clinical experience has not yet defined the optimal type dose, and treatment schedule.
Laser treatment of urologic cancers
Authors: Smith Joseph A. 
Published: February 2007

AbstractIn urologic surgery, laser energy has been used to treat various cancers of the genitourinary system. Excellent functional and cosmetic results have been obtained with squamous cell carcinoma of the penis. In selected patients, the need for partial penectomy may be avoided. Demonstrated practical advantages and decreased patient morbidity form the basis for laser treatment of superficial bladder cancer. Therapeutic advantages over electrocautery resection are theoretical. Nd:YAG laser treatment can provide reasonable local control rates for tumors that invade the bladder muscle, but this treatment should be reserved for patients who are poor candidates for radical surgery. For kidney cancer, lasers may facilitate tumor removal in solitary kidneys and extend the margin of resection.
Management of endobronchial tumors: A comparative study
Authors: McCaughan James S. , Hawley Philip C. , Walker John 
Published: February 2007

AbstractBetween September 1982 and July 1987 we treated 102 patients with endobronchial or endotracheal disease with one or a combination of the following modalities: CO2 laser, Nd:YAG laser, and photodynamic therapy (PDT). Many patients had multiple treatments and treatment sites. In all, 259 Nd:YAG treatments were performed on 154 sites in 80 patients, 118 PDT treatments were performed on 87 sites in 45 patients, and nine CO2 treatments were performed on nine sites in nine patients. Of the 71 patients who died, 19 lived longer than 6 months, and seven lived longer than 1 year. A total of 11 patients have survived for more than 1 year, including four who are still alive 18, 22, 33, and 54 months after treatment. Five patients achieved a status of “no evidence of disease,” and at autopsy. Two others had no evidence of disease to the treated site. All seven of these patients wcrc treated with PDT only. There were no intraoperative deaths or cases of intraoperative bleeding or smoke with PDT. Eight patients died from pulmonary hemorrhage 2 to 9 weeks after treatment. Four had been treated with Nd:YAG therapy alone and four with PDT alone. Evaluation of the survival rate in this study must consider that this therapy involves severely ill paticnts with a high potential for intraoperative or perioperative fatality. Some patients who were near death before treatment have enjoyed quality survival for over 1 year.
Lasers in cutaneous disease
Authors: Aronoff B. L. 
Published: February 2007

AbstractOne of the first clinical uses of the laser was in dermatology. It was used to help in diagnosing not only the presence of disease but the extent. It was used in various large naevi and very soon in port wine stains and other vascular anomalies. Skin cancer soon was treated with the laser, and soon tumors in patients with various platelet defects could be resected successfully with a minimal risk. The advent of photodynamic therapy now allows successful treatment of many lesions.
Imaging techniques in breast cancer
Authors: Dershaw D. David , Osborne Michael 
Published: February 2007

AbstractIn the diagnosis of clinically inapparent breast cancer, mammography remains the most effective imaging modality, which is due in large part to its ability to detect microcalcifications. Of the ancillary modalities, sonography is the most useful because it readily differentiates cysts from other breast lesions. Internal mammary and axillary node imaging have been tried with varying levels of success, but false‐positive and false‐negative rates remain high with available techniques. Pulmonary metastases are best evaluated by chest X‐ray with specificity increased by other imaging techniques. Liver and bone metastases may be screened for with isotope scans with computerized tomography, sonography, and magnetic resonance imaging, increasing the specificity of abnormal scans. CT and MRI are the most effective tools for evaluating CNS disease.
The present state of screening for breast cancer
Authors: Tabár László , Dean Peter B. 
Published: February 2007

AbstractThe results to date are convincing enough to justify recommending large scale mammography screening. The International Union Against Cancer (UICC) Workshop on screening for breast cancer in 1986 concluded that “In countries where breast cancer is common and where the necessary resources are available, screening using mammography alone or mammography plus physical examination is applicable as public health policy.” The Swedish government has recommended screening with mammography for all women aged 40–74. This recommendation repeatedly emphasizes the necessity of high‐quality examinations interpreted by well‐trained radiologists. Screening with mammography is bringing breast cancer patients to therapy at a far earlier stage in the development of the disease. This calls for a re‐evaluation of therapeutic methods.
Breast conservation versus mastectomy: Psychological considerations
Authors: Maguire Peter 
Published: February 2007

AbstractFrom the available evidence it is clear that mastectomy is associated with a substantial psychological and psychiatric morbidity. To date there is no convincing evidence that counseling can prevent this morbidity, but monitoring of women's psychological adjustment can lead to early detection and effective treatment of their problem. The use of immediate or delayed implantation or reconstruction appears to reduce the psychiatric morbidity in those women who are particularly concerned about their appearance at the time of surgery. Psychiatric morbidity is further increased when adjuvant chemotherapy is used and when treatment results in persistent arm pain and swelling. A shorter course of adjuvant chemotherapy and reduction of surgery within the axilla could reduce psychiatric morbidity. The role of radiotherapy is still unclear, but in some studies a link has been found between the amount of radiotherapy given, adverse effects, and psychiatric morbidity. In women undergoing breast conservation the reduction in body image problems is offset by greater anxiety about recurrence and depression caused by radiotherapy. Exploring and allowing choice when a patient has a strong preference for breast conservation or mastectomy appears to reduce morbidity. But attention still needs to be paid to the early recognition and treatment of psychological problems in patients with breast cancer, and guidelines are provided.
The role of tumor markers in the early detection of cancer
Authors: Humphrey Peter A. 
Published: February 2007

AbstractTumor markers include a broad range of substances expressed at different levels and in different biochemical forms. Bence‐Jones protein, carcino‐embryonic antigen and alpha‐fetoprotein are recognized as some of the earlier utilized markers.Recent technologic advances have led to the development of a variety of serum tumor markers, tumor markers in body fluids, tissue tumor markers, and genetic tumor markers, such as protooncogenes.
Early detection of prostate cancer
Authors: Huben Robert P. 
Published: February 2007

AbstractProstate cancer is the second most common malignancy in American males and the third leading cause of cancer deaths in this population. There are no symptoms that are unique to early prostate cancer, and nearly one‐half of patients will have metastatic disease at diagnosis. Because of its tremendous impact upon the health and well‐being of the American male population, and the importance of early diagnosis in curability, there is keen interest in the development of effective screening procedures that are highly sensitive, specific, and cost‐effective. Rectal examination serves as the historical control. The serum tumor markers of prostate cancer, prostatic acid phosphatase (PAP), and prostate‐specific antigen (PSA), are sensitive but relatively nonspecific in the diagnosis of prostate cancer. The use of transrectal ultrasound as a screening tool is highly controversial but suffers from a similar lack of specificity. As yet, no diagnostic tests, alone or in combination, have proven to be of practical value in screening for prostate cancer. Fundamental but unanswered questions about the natural history and the high incidence of “latent” disease also obscure the issue of early diagnosis of prostate cancer and its impact on survival.
Testicular cancer
Authors: Garnick Marc B. 
Published: February 2007

AbstractThe management of testis cancer is continually changing. Since the introduction of curative chemotherapy for metastatic disease, the entire approach to early disease (stage I and stage II) is undergoing reevaluation. Individuals with favorable prognostic features can be offered, under detailed clinical protocols, orchiectomy followed by meticulous surveillance. Likewise, individuals with retroperitoneal disease may be offered retroperitoneal lymph node dissection initially or, alternatively, chemotherapy initially. The prognosis for individuals with metastatic disease is extremely favorable, with the majority of patients being cured with 9–12 weeks of combination chemotherapy. Major efforts are still underway to identify appropriate second‐line or “salvage” regimens for individuals who are not cured with first‐line chemotherapy. Likewise, the use of new modalities, such as bone marrow transplantation, and new drugs must be evaluated in appropriately designed, prospective studies. Such studies will continue to increase the cure rate of individuals with metastatic disease and enhance the prognosis for such high‐risk populations of patients. This paper reviews basic aspects relating to histology, clinical staging, and approach to management for all stages of germ cell cancer of the testis.
The value of regional lymph node dissection in genitourinary cancer
Authors: Skinner Donald G. 
Published: February 2007

AbstractRegional lymph node dissection in the management of genitourinary (GU) neoplasms is controversial but is based on a 17 year clinical experience and the achievement of survival figures as good or better than those achieved by any other modality of therapy. Lymphadenectomy has proved to be effective in curing patients with metastatic testicular cancer, renal cell carcinoma and transitional cell carcinoma. Its efficacy in prostate cancer is much less certain and remains largely a staging procedure.
Treatment of localized prostatic cancer
Authors: Smith Joseph A. 
Published: February 2007

AbstractDiscovery of a localized prostatic cancer frequently creates a therapeutic dilemma. A significant number of patients do well for an extended period of time without treatment, while others suffer rapid tumor progression and death from prostatic cancer. Without treatment nearly one third of patients with stage B prostatic cancer can be expected to develop distant metastatic disease or death from prostatic cancer within 10 years. In patients who otherwise have a reasonable life expectancy of 10 years or more, aggressive therapy is justified. Long‐term disease‐free survival has been reported after both radical prostatectomy and external irradiation. The fact that nearly 50% of patients treated with external irradiation for stage B prostatic cancer have positive postirradiation biopsies is of concern, but the impact of this finding on overall survival is yet to be determined. The only randomized prospective study comparing radical prostatectomy with external irradiation showed a statistically significant decrease in the time to evidence of disease progression in the radical prostatectomy group. Nevertheless, as evidenced by the National Institutes of Health Consensus Development Panel, further randomized prospective trials are needed to determine the relative value of radical prostatectomy versus external irradiation for localized prostatic cancer. For the forseeable future, definitive scientific data on which to base treatment recommendations will not be available. Therefore, patients should be well informed of the various treatment options available, and the wishes of the patient are paramount. The clinician's roles are to interpret the data, present it in a meaningful manner to patients, be guided in discussions by patient preferences, and make recommendations. In this manner, the most appropriate form of therapy can be selected that provides the greatest chance of prolonged disease‐free survival with morbidity that is acceptable for an individual patient.
Diagnosis and management of superficial bladder cancer
Authors: Soloway Mark S. 
Published: February 2007

AbstractSuperficial transitional cell carcinoma is defined as a transitional cell urothelial tumor that is confined to the mucosa, stages Ta or CIS, or with invasion of the lamina propria, T1. The initial treatment is transurethral resection with an attempt to remove all tumor. This should provide an accurate histologie grade and stage, and from this information a prognosis can be determined. The important predictive factors that correlate with a new occurrence or true recurrence and the development of a subsequent tumor with muscle invasion are a high tumor grade, lamina propria invasion, a positive cytology following resection, multifocal tumors, dysplasia or carcinoma in situ from mucosal biopsies of normal appearing urothelium, and a prior history of bladder cancer. Based on these factors, the recurrence rate varies from 30 to 80% and progression with a muscle invasive tumor up to 30%. Intravesical chemotherapy or “immunotherapy” following tumor resection has been shown to diminish the likelihood of a recurrence. Thiotepa has been used for the longest period of time. It is relatively inexpensive, safe if myelosuppression is closely monitored, and effective. Mitomycin C was more effective than Thiotepa in randomized trials, but is significantly more expensive. This has retarded its use as a first‐line agent. It has been shown to eradicate persistent tumor in 30 to 40% of patients who have failed Thiotepa. Mitomycin C is also highly effective when used for prophylaxis. Intravesical bacillus Calmette‐Guerin (BCG) has recetly been demonstrated to be an effective intravesical therapeutic agent. It is effective both for treatment and prophylaxis. BCG is relatively safe and inexpensive. The most important factor in the treatment and monitoring of patients with superficial bladder cancer is rigorous follow‐up after the initial transurethral resection. This consists of regular endoscopy and cytology. The urologist must be ready to intervene with cystectomy once it is apparent that the tumor is no longer remaining superficial or has become resistant to intravesical therapeutic agents, particularly with a high‐grade tumor.
Neoadjuvant chemotherapy for invasive bladder cancer
Authors: Herr Harry W. 
Published: February 2007

AbstractNeoadjuvant chemotherapy is being integrated increasingly into the primary therapy for locally advanced bladder cancer. The rationale is due to the favorable responses observed in patients with metastatic bladder cancer, the high systemic relapse rate after apparent local control with either surgery or radiotherapy, the potential for using the bladder lesion as a indicator for selecting patients responsive to chemotherapy, and the ultimate possibility of bladder preservation. While neoadjuvant chemotherapy can induce significant clinical and pathologic tumor regression, such experiences have exposed multiple variables involving bladder tumor heterogeneity, patient selection, and investigator evaluation that raise serious questions regarding the overall efficacy of neoadjuvant therapy.
Treatment alternatives for invasive bladder cancer
Authors: Wajsman Zev , Klimberg Ira W. 
Published: February 2007

AbstractRadical cystectomy remains the gold standard in the treatment of patients with muscle invasive bladder cancer. However, the specter of high failure rates coupled with morbid treatment methods has caused urologists, oncologists, and radiotherapists to explore modifications in, and alternatives to, the traditional treatments for invasive bladder cancer.The identification of the active methotrexate‐platinum‐based combination chemotherapy regimens heralds a new era in our ability to treat advanced disease effectively. Patients with less extensive muscle invasive tumors may be efficiaciously treated using conservative surgical excision, either alone or in combination with adjunctive treatments. In addition, definitive radiation therapy, given via the interstitial route or in combination with radiosensitizers, may result in long‐term survival and preservation of bladder function.Progress has been made on multiple fronts in our ability to improve overall survival rates while allowing for the preservation of bladder function. The ability of these new mixed multimodality treatment initiatives to produce viable statistics equal to that of radical exenteration is an important landmark on the route towards an ideal treatment for invasive bladder cancer.
Salvage surgery for renal cell carcinoma
Authors: Pontes J. Edson , Huben R. , Novick A. , Montie J. 
Published: February 2007

AbstractComplete surgical excision of solitary metastatic lesions in renal cell carcinoma has been reported to be associated with improved survival.An analysis of 65 outpatients undergoing excision of metastatic renal cell carcinoma is reviewed. In our series there was no significant difference among patients with solitary versus those with multiple metastasis. The overall 5‐year survival was considerably lower than previously reported. We recommend that only patients with good performance status, who are participating in protocols with biological response modifiers, could potentially benefit from surgical removal of metastatic lesions.