bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soft‐tissue sarcoma: Initial characteristics and prognostic factors in patients with and without metastatic disease
Authors: Torosian Michael H. , Friedrich Mdclaudia , Godbold James , Hajdu Steven I. , Brennan Murray F. 
Published: February 2007

AbstractFive hundred and sixty‐five patients with soft‐tissue sarcoma were admitted to Memorial Sloan‐Kettering Cancer Center from July 1, 1982 to July 1, 1985. Clinical and pathologic factors were analyzed to identify initial characteristics and to determine factors associated with prognosis and the development of metastasis. In decreasing order of frequency, the most common sites of primary tumor were the extremity (51.1%), retroperito‐neum/viscera (28.8%), trunk (15.9%), head and neck (3.7%) and breast (0.4%). The most common histologie types were liposarcoma (21.4%), malignant fibrous histiocytoma (20.2%), leiomyosarcoma (20.0%), fibrosarcoma (11.0%), and tendosynovial sarcoma (9.6%). One hundred and twenty‐eight patients (22.7%) had metastases in a median follow‐up period of 19 months. Metastasis was more common in patients with retroperito‐neal and visceral sarcomas than in patients with extremity sarcomas. Patients with leiomyosarcomas were more likely to develop metastases than those with other histologie types. Fibrosarcoma and liposarcomas were the least likely to develop metastases in this time frame. Tumors greater than 5 cm in diameter occurred more frequently in patients with metastases. Actuarial survival was related to the site of primary tumor and the histologie type and grade of malignancy. Multivariate analysis indicated that patients with low‐grade sarcomas, extremity sarcomas, and fibrosarcomas and patients without metastatic disease demonstrated significantly improved survival. In patients with metastases, disease‐free interval (< 365 or >365 days) was significantly related to overall survival. Thus the development of metastatic disease and prognosis in patients with soft‐tissue sarcoma is significantly associated with specific clinical and pathologic factors, including site of primary tumor, histologie type, histologie grade, and disease‐free interval.
Patterns of metastatic spread following resection of extremity soft‐tissue sarcomas and strategies for treatment
Authors: Huth James F. , Eilber Frederick R. 
Published: February 2007

AbstractThis study examines recurrence patterns in 255 patients with soft‐tissue sarcoma treated with preoperative chemotherapy and radiation, followed by limb‐sparing surgery. Eighty‐five patients developed metastatic disease: 13 had isolated local recurrence, 43 had isolated pulmonary metastases, 11 had metastases to lung and elsewhere, and 18 had metastases to multiple sites. Of the patients with isolated pulmonary metastases, 19/43 had resection of the metastases, and 9 are disease free. All 13 patients with local recurrences had resection of the recurrence, and 9 remain disease‐free. Patients with multiple sites of recurrence had a 2‐year survival of less than 10%. Resection of metastases is beneficial to a small number of patients who develop metastatic disease.
Incidence of metastases to lymph nodes from soft‐tissue sarcomas
Authors: Ariel Irving M. 
Published: February 2007

AbstractLymph node metastases occur in an appreciable number of soft‐tissue sarcomas. The histologic subtype plays a most important role. Synovial sarcoma, malignant fibrous histiocytoma, rhabdomyosarcoma, and an‐giosarcoma manifest relatively frequently such metastases, whereas fibrosarcoma, liposarcoma, and malignant schwannoma do so very infrequently. With the use of the newer radiologic techniques, it is expected that this feature will be more clearly defined and taken into account in planning the treatment. For histologic subtypes known frequently to manifest metastases to the regional lymph nodes, the latter should be considered for inclusion in the surgical and/or radiation treatment plan, particularly for primary tumors situated close to a nodal basin; and careful follow‐up of these nodes should be practiced.
Soft‐tissue sarcoma: Mayo clinic experience
Authors: Sim Franklin H. , Pritchard Douglas J. , Reiman Herbert M. , Edmonson John H. , Schray Mark F. 
Published: February 2007

AbstractSoft‐tissue tumors encompass a wide variety of lesions and continue to pose a difficult treatment problem. The outlook, however, is improving, and there have been recent advances in pretreatment assessment, clinico‐pathologic correlation, and adjuvant treatment programs. We retrospectively reviewed our experience in a large series of soft‐tissue tumors treated at the Mayo Clinic as well as recent experience using chemotherapy and radiation treatment.
Chemotherapy of advanced soft‐tissue sarcomas
Authors: Antman Karen H. , Elias Anthony D. 
Published: February 2007

AbstractThe most active single agents in soft‐tissue sarcomas are doxorubicin (Adriamycin) and ifosfamide, with response rates of 20‐35%. Dacarba‐zine (DTIC) has a response rate of 16%. A randomized trial of 5 g/m2 of ifosfamide versus 1.5 g/m2 of cyclophosphamide noted a higher response rate for ifosfamide with less myelosuppression. Both randomized studies of doxorubicin with or without DTIC documented an increased response rate for the combination. In contrast, three randomized trials of doxorub‐icin‐based regimens with and without cyclophosphamide have failed to detect an advantage for the addition of cyclophosphamide. Thus, the most active combination for soft‐tissue sarcomas is doxorubicin and DTIC. The role of the addition of ifosfamide is currently under evaluation.
Adjuvant Chemotherapy for Soft‐Tissue Sarcoma: A Critical Appraisal
Authors: Elias Anthony D. , Antman Karen H. 
Published: February 2007

AbstractAdjuvant chemotherapy, established in the treatment of osteogenic sarcoma, Ewing's sarcoma, and rhabdomyosarcoma, currently remains controversial in adult soft‐tissue sarcoma. Because the survival of the control arms in randomized studies is significantly better than historical controls, only randomized studies with nontreatment control arms will be analyzed here. None of the 11 reported adjuvant studies showed a significant survival advantage for chemotherapy overall. Although subset analyses are less reliable, the National Cancer Institute reported a significant prolonged survival and disease‐free survival for the subset of chemotherapy‐treated extremity primaries. The M.D. Anderson and Italian studies observed a significant disease‐free survival advantage; however, survival was not significantly different in the former and survival statistics were not provided in the latter study. In the subset of central body lesions none of the studies revealed a significant survival advantage for chemotherapy. Adjuvant chemotherapy should be considered investigational for adult soft‐tissue sarcomas.
Concepts in Limb‐Sparing Treatment of Adult Soft Tissue Sarcomas
Authors: Lawrence Walter 
Published: February 2007

AbstractPretreatment assessment of patients with soft tissue sarcomas of the extremities requires careful attention to a biopsy approach that will establish the precise diagnosis and will not compromise the subsequent definitive operative procedure. Also, staging procedures are required to evaluate the status of both local and distant sites. Limb‐sparing surgery for high grade extremity soft tissue sarcomas is a feasible and appropriate approach in approximately 90% of patients with such lesions. Wide gross surgical margins around the sarcoma are the optimal operative approach. Circumstantial evidence is convincing that local treatment failure can be reduced by adjuvant regional radiation treatment when surgical margins are narrow, and end results appear to be equal to those obtained by more extensive surgical resection alone. Adjuvant radiation following operation with optimal gross surgical margins has not been established as adding benefit. Although some groups treating soft tissue sarcomas do use intraarterial chemotherapy in conjunction with these other modalities, there is, as yet, no convincing evidence that this aspect of the multimodality treatment adds to local and/or systemic disease control. The efficacy of adjuvant systemic chemotherapy for high grade soft tissue sarcomas remains to be established within the context of prospective clinical trials.
Selective combination of modalities in soft tissue sarcomas: Limb salvage and survival
Authors: Karakousis C. P. , Emrich L. J. , Rao U. , Khalil M. 
Published: February 2007

AbstractOne hundred fifty‐two consecutive patients with soft tissue sarcomas were operated in the period 1977 through 1985. Eighty‐seven patients with minimum resection margin of 2 cm or greater had no further local therapy, whereas 65 patients with minimum margin less than 2 cm had adjuvant postoperative radiation. Of 121 patients with extremity sarcomas, only 5 (4%) were managed with amputation. The overall 5‐year survival rate is 58%, and for patients with extremity tumors, 67%. The 5‐year local recurrence rate in extremity sarcomas was 10% for patients with minimum surgical margins 2 cm or greater and no further local therapy, and 6% for those with lesser surgical margins and adjuvant postoperative radiation. With selective combination of modalities limb salvage can now be practiced in 96% of the patients with acceptable local control and survival rates.
Surgical management of soft tissue sarcomas, with an analysis of 313 cases
Authors: Guo‐Hui Li , Jin‐Qing Li , Yong‐Hui Cai , Min Huang 
Published: February 2007

AbstractFrom 1964 to 1978, 313 patients, 192 males and 121 females, with soft tissue sarcoma underwent surgery in our hospital. All patients have been followed up for over 5 years. One hundred ninety patients (60.7%) had recurrence of the tumor after previous surgery. The tumor was located in the head in 55 cases, in the trunk in 136, and in the extremities in 122 cases. Regional lymph node metastases occurred in 23 patients (7.4%). Fibrosarcoma, neurofibrosarcoma, and rhabdomyosarcoma were the types mosts commonly encountered in this series. The 5‐year survival rate, according to the extent of surgical resection for 117 patients with local resection, was 47.9%; for 75 patients with wide local resection, 62.7%; for 43 patients with amputation, 18.6%; and for 78 patients with local resection combined with irradiation, 48.7%. For the whole series, the 5‐and 10‐year survival rates were 47.6% and 35.8%, respectively. The 5‐year survival rates of stages I, II, III, and IV (TNM classification) were 60%, 46.9%, 40%, and 22.2%, respectively.
Is interferon with or without vinblastine the “treatment of choice” in metastatic renal cell carcinoma? the norwegian radium hospital's experience 1983–1986
Authors: Fosså Sophie D. 
Published: February 2007

AbstractFifty‐seven of 66 patients with metastatic renal cell carcinoma (RCC) were evaluable for response after treatment with Interferon (IFN) — Alfa 2a (Roferon A, Roche) with or without Vinblastine (VB). Three different dose schedules were used in 3 subsequent trials: protocol 1: (18 evaluable patients): IFN 36 × 106 U tiw ± VB 0.1‐0.15 mg/kg/2–3 week; protocol 2: (13 patients): IFN 18 × 106 U tiw ± VB 0.1 mg/kg/3 week; protocol 3: (26 patients): IFN 18 × 106 U tiw ± VB 0.1 mg/kg/3 week. Twelve of the 57 patients obtained an objective response (CR:1; PR: 11). Regarding the main indicator lesions responses were seen in lung metastases (10), lymph node metastases (1), and bone metastases (1). The median response duration was 243 days. No significant impact of the IFN/VB treatment on survival could be demonstrated. Flulike symptoms represented the main toxicity. Four patients developed mental confusion, and in 2 patients with visual disturbances retinal exudation was observed. In more than half of the patients, the drug(s) had to be reduced, delayed, or finally discontinued due to toxicity. It is concluded that IFN with or without VB yields a 15–20% response rate in metastatic RCC. Due to the considerable toxicity of the treatment and the lack of proof of survival improvement, the clinical usefulness of IFN therapy in RCC remains questionable. However, on the background of the present therapeutic nihilism in metastatic RCC, additional clinical trials using IFN in RCC are justified.
Effect of alpha‐ and gamma‐Interferon and tumor necrosis factor on colony formation of two human renal tumor xenografts in vitro
Authors: Beniers A. J. M. C. , Peelen W. P. , Hendriks B. Th. , Schalken J. A. , Debruyne F. M. J. 
Published: February 2007

AbstractThe in vitro antitumor activity of alpha‐ and gamma‐interferon as well as tumor necrosis factor was tested on two human renal cell carcinoma xenografts—RC‐43 and NC‐65. A dose‐dependent inhibition of colony formation in soft agar was found for both tumor lines. NC‐65, however, showed no sensitivity for gamma‐interferon. Combination drug tests showed a synergistic effect on colony formation of both tumor lines. The strongest inhibition was shown by the combination of alpha‐interferon and tumor necrosis factor. We conclude that both interferons as well as tumor necrosis factor show direct in vitro cytostatic effects against renal tumor direct in vitro cytostatic effects against renal tumor cells.
Interferon therapy of metastatic renal cell cancer
Authors: Muss Hyman B. 
Published: February 2007

AbstractThere is no curative therapy for metastatic or recurrent renal cell carcinoma (RCC). Almost three‐quarters of such patients die of their malignancy in 1 year and less than 5% of such patients are alive at 3 years. Few patients respond to hormonal therapy or chemotherapy, and when responses occur, they are usually brief and partial with little impact on survival. Interferon therapy in metastatic RCC has been associated with response rates of approximately 15–20%, and tumor regression has been demonstrated in patients treated with both partially purified and, more recently, recombinant interferon. Analysis of published trials shows no clear dose‐response relationship; however, the highest therapeutic index appears associated with a daily dosage of 5–10 million units. The time to response is variable and may occasionally be prolonged; however, some patients have durations of response exceeding 12 months. Although ne‐phrectomy may be associated with higher response rates, review of available data indicates that nephrectomy has frequently been an eligibility criteria, and indeed there are adequate descriptions of responses in patients that have not undergone this procedure. Patients with pulmonary metastases have the highest response rate. Recently, laboratory and clinical investigations of interferons and several chemotherapeutic agents, notably vinblastine, suggest synergy, but further data is needed to confirm these findings. The role of interferon therapy in improving survival is unknown. There is little doubt, however, that symptomatic patients who respond to interferon therapy may show improvement in their quality of life and prolongation of survival.
Adverse reactions in long‐term interferon treatment
Authors: Levens W. J. , Fischer N. , Ingehag W. , Rubben H. 
Published: February 2007

AbstractAdverse reactions in interferon treatment were studied in long‐term treatment schedules. Thirteen patients with metastatic renal cell carcinoma treated with 107 units interferon‐2b s.c. daily for 6 months showed serious side effects. The general condition worsened in 10 patients. The average weight loss was 7 kg per patient. The remissions achieved (1 complete, 2 partial) were seen after 2–3 months of treatment. In 11 patients treated in an adjunctive setting (107 units interferon‐2b s.c. 3 times weekly) side effects were less severe. Generally the treatment was tolerated well. In one patient the general condition worsened, weight loss was mild and restricted to the first treatment month.
A phase I‐II study of high‐dose recombinant human interleukin‐2 in disseminated renal‐cell carcinoma
Authors: Javadpour N. , Lalehzarian M. 
Published: February 2007

AbstractNatural interleukin‐2 is a lymphokine with an immunoregulatory function. The recombinant interleukin‐2 (rIL‐2) is cloned from a human lympho‐blastoid T‐cell line for this trial. The gene is expressed in Å‐coli, allowing production of large quantities of rIL‐2. This study is an open label phase I‐II trial designed to evaluate the toxicity and efficacy of a rIL‐2 in disseminated renal cell carcinoma. After surgical resection of the primary tumor, 3 × 106 units/m2day rIL‐2 is administered by 2‐hr IV infusions daily for 5 days every other week for a total of eight cycles. At the conclusion of eight cycles of therapy, the patients were re‐evaluated for response. Patients with complete and partial responses were eligible to receive an additional eight cycles every other week. Patients demonstrating progressive disease during this study were withdrawn. The toxicities of the high‐dose rIL‐2 included transient hypotension, pyrexia, malaise, and skin rashes. The transient hypotension responded to fluid replacement, and the other toxicities also responded to symptomatic treatment. The early results in ten patients indicate two partial and one complete response. We have concluded that administration of high‐dose interleukin‐2 has acceptable toxicities with encouraging response and deserves a phase III study.
Histopathologic risk factors for breast cancer in women with benign breast disease
Authors: Page David L. , Dupont William D. 
Published: February 2007

AbstractMammary epithelial hyperplasia indicates an increased likelihood of carcinoma development as it does in other organs. Prospective studies have demonstrated that in the premammography era about 70% of women undergoing surgical biopsy had no increased risk of cancer and have little if any hyperplastic alteration. About 25% of women have well‐developed hyperplastic changes and have a risk elevation, controlled for age, of 1.5–2 times that of the general population. Less than 5% of women have atypical hyperplasia demonstrating some histologic features of carcinoma in situ, which indicates a risk elevation of 4–5 times. This is about one half the risk associated with microscopic carcinoma in situ. Therapeutic implications of these premalignant lesions rest predominantly in their indication for the heightened intensity of subsequent breast cancer surveillance and screening.
Mass screening to reduce mortality from breast cancer
Authors: Strax Philip 
Published: February 2007

AbstractIt is generally agreed that the best and possibly the only means to reduce mortality in breast cancer is to detect the disease in its early, most curable stage. This usually means detection when nodes are negative and often when the lesion is nonpalpable. The best method with which to achieve this goal is periodic examination including clinical study and mammography when the woman is apparently well, as is done in mass screening. This applies today to all women over 40 yr old. A baseline examination at age 35 yr is helpful. Radiation risk is today considered to be minimal, if any, and probably is not even measurable. Cost is important. The dedication of the screening institution is most important in this regard. The chief stumbling block is a lack of motivation on the part of subjects to accept or even demand the examination. This needs to be stimulated through contacts with women directly and with their physicians.
Breast cancer detection epoch
Authors: Byrd Benjamin F. , Hartmann William H. 
Published: February 2007

AbstractThe Action and Planning Committee on Breast Cancer Control was formed in 1970 by the American Cancer Society, based on their earlier successful experience with early‐detection programs for uterine cancer. The original intention was to support 12 centers for 2 years, but with the passage of the Conquest of Cancer Act in 1971, and the consequent availability of more funds for cancer programs, the American Cancer Society and the National Cancer Institute decided jointly to expand the program to 27 Breast Cancer Detection Demonstration Project Centers, with 280,000 women participating, who would be examined annually for 5 years. Data from the examinations, which included history, physical examination, mammo‐gram, and thermogram, were subjected to a continuing computer analysis. The thermogram was deleted after the second year. Although patients were randomly selected, there was an almost identical number of subjects in two age groups—35–49 years and 50–75 years. The results of the study are presented, and the importance of the program's efforts at breast self‐examination education as contained in the program's original protocol, is discussed.
Surgical treatment of primary breast cancer
Authors: Wickerham D. Lawrence , Fisher B. 
Published: February 2007

AbstractThe background to the Halstedian era of breast cancer treatment is sketched, and the development of the changes in surgical treatment are outlined, with a review of the most important findings from the several clinical trials conducted to evaluate the alternative operative procedures. Included is a short description of operative techniques; also pathological examination of the operation specimen, and the use of radiation therapy when performing a segmental mastectomy are briefly described. This review is based almost entirely on observations from clinical trials conducted by the National Surgical Adjuvant Breast and Bowel Project.
Primary surgical treatment of breast cancer
Authors: Urban Jerome A. 
Published: February 2007

AbstractAn unexpected rise in breast cancer mortality has been reported for 1984 and 1985 in white women below 50 years of age in the United States. During the preceding 10 years, there had been a progressive drop of approximately 1% in breast cancer mortality for each successive year. This recent increase in mortality occurred despite the increased use of adjuvant chemotherapy; it is most likely a direct result of the current tendency to downgrade the need for adequate primary therapy. Several recent prospective randomized studies that evaluated the relative efficacy of mastectomies of varying extent have shown a direct relationship between local control and long‐term survival. They also demonstrated that specific operative procedures were most effective for the appropriate clinicopathological stage of disease. Stage I cancers can be treated effectively by modified mastectomy, but radical mastectomy is superior for control of stage II and stage in disease. Inner‐quadrant cancers are most effectively managed by extended radical mastectomy, which includes excision of the internal mammary nodes. Excellent surgical technique was employed in all studies, which included observed follow‐up of 10–20 years. Optimal local control and long‐term survival were achieved by the appropriate operative procedure.
Primary radiation therapy for stage I and II breast cancer
Authors: Fisher Scot , Brady Luther W. 
Published: February 2007

AbstractIn 1987 there were estimated to be approximately 130,000 new cases of breast cancer diagnosed in the United States. Presently, about 20–30,000 of these cases are treated with primary radiotherapy, although many more of the 90,000 stage I and II breast cancer cases are eligible for this form of treatment. Appropriate selection must be employed, including the size and site of the primary tumor, the size of the breast, the potential for multifocal disease, and the age of the patient. When proper selection is used, primary radiotherapy for stage I and II disease yields equivalent overall survival and NED survival when compared to traditional mastectomy. The benefit is preservation of the breast with good to excellent cosmesis in the vast majority of patients.
Adjuvant chemotherapy for breast cancer
Authors: Bonadonna Gianni , Valagussa Pinuccia 
Published: February 2007

AbstractThe development of the use of chemotherapy in the treatment of breast cancer is discussed. Its contribution in the primary management of this disease lies not only in the limited but consistent reduction in mortality, but it has helped to elucidate the biological complexity of breast cancer. Also, it has stimulated basic scientists and research physicians to integrate their efforts, which is expected to result in further clinical progress.