bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of the cancer patient: Preoperative assessment and perioperative medical management
Authors: Ewer Michael S. , Ali M. K. 
Published: February 2007

AbstractCancer patients undergoing surgery often present with unusual and challenging problems. Their age and the fact that they are often chronically ill place them at increased surgical risk. In many instances the need for surgical intervention is crucial to the extent that risk‐assessment becomes an academic issue, especially for those patients whose only reasonable chance for either cure or palliation of unbearable disease is surgery. However, the internist's role in these situations often has preoperative, intraoperative, and postoperative ramifications. Preoperatively, the internist assesses operative risk and intervenes, when possible, to reduce the likelihood of surgical complications. Patients who clearly cannot survive surgery may be identified and channeled to other treatment modalities. Intraoperatively, the internist may be called upon to help with the management of acute organ failure, cardiac arrest, or vascular collapse. Following surgery, the internist may help by managing cardiopulmonary problems and treating infectious complications. The critical care internist is therefore an important member of the perioperative team and often provides valuable expertise, which can help to identify and treat problems expediently.
Tumor recurrence and options for further treatment after resection of liver metastases in patients with colorectal cancer
Authors: Hohenberger Peter , Schlag Peter , Schwarz Volker , Herfarth Christian 
Published: February 2007

AbstractThe aim of this study was to evaluate the pattern of recurrence and its impact on therapy in patients undergoing liver resection for colorectal metastases. Within 7 years 105 patients were operated on; 75 patients were followed up for at least 2 years postoperatively with a median follow‐up of 30 months (range 24–93 months). The median time interval when patients were free of tumor recurrence was only 9 months. The initial recurrence site was the liver in 47% and the other sites were ex‐trahepatic in 39%. Seventy‐one percent of the patients developed disseminated metastases as the disease progressed. The median survival time after diagnosis of tumor recurrence was 14 months and was significantly affected by the type of treatment used for the recurrence. Surgical resection was followed by a 23‐month median survival, while systemic and intra‐arterial chemotherapy led to a 14‐ and 15‐month median survival time, respectively. Untreated patients had a median survival of only 4 months. It is concluded that liver resection for colorectal secondaries leads to a very limited number of disease‐free survivors after 5 years. As a few patients may profit from a surgical treatment even in cases of recurrence, surgery should not be regarded as useless.
Phyllodes tumor of the breast: A clinicopathologic study of 34 cases
Authors: Kario Kazuomi , Maeda Sakan , Mizuno Yoshifuml , Makino Yoshihiko , Tankawa Hidemitsu , Kitazawa Souhei 
Published: February 2007

AbstractThirty‐four cases of phyllodes tumor of the breast were studied to evaluate the clinical and pathological features, which correlate with local recurrence. Histologically, local recurrence correlated with the finding of more than ten mitotic figures per ten high‐power fields, marked cellularity, prominent nuclear pleomorphism, and stromal overgrowth. Older patients and patients with larger tumors had a higher probability of local recurrence. Stromal overgrowth correlated with the other histological parameters, with rapid tumor growth, a tumor diameter of over 10 cm, and with local recurrence. It was thus considered to be a histological indicator of the malignant potential of phyllodes tumor of the breast.
Selective management of patients with neutropenic enterocolitis using peritoneal lavage
Authors: Sauter Edward R. , Vauthey Jean Nicolas , Bolton John S. , Sardi Armando 
Published: February 2007

AbstractNeutropenic enterocolitis is a symptom complex of fever, abdominal pain, distention, nausea, vomiting, diarrhea, and bloody stools occurring in a patient with a low neutrophil count and is most often seen in patients with acute leukemia after a course of chemotherapy. In most cases, neutropenic enterocolitis is a self‐limited condition, but complications of transmural intestinal necrosis and bowel perforation may occur in a small number of patients. Surgical management should be reserved for those patients with bowel wall necrosis or perforation; however, early identification of these patients is difficult. We report our experience with the use of diagnostic peritoneal lavage in three patients with the symptoms and signs of neutropenic enterocolitis. In each case, Gram's stain of lavage fluid revealed no evidence of polymicrobial contamination of the peritoneal cavity. All three patients were managed medically, with resolution of their abdominal symptoms. Peritoneal lavage is helpful in excluding bowel perforation and avoiding unnecessary surgical intervention in patients with neutropenic enterocolitis.
Distinguishing malignant mesothelioma from pulmonary adenocarcinoma: An immunohistochemical approach using a panel of monoclonal antibodies
Authors: Tuttle Steven E. , Lucas Joel C. , Bucci Donna M. , Schlom Jeffery , Primus James 
Published: February 2007

AbstractA panel of six monoclonal antibodies (MAbs) was employed to evaluate antigen expression in pulmonary adenocarcinomas and mesotheliomas. Monoclonal anti‐human milk fat globulin (HMFG‐2), anti‐carcinoembryonic antigen (NP‐2), antiepithelial membrane antigen (EMA), anticytokeratin (PKK‐ l), anti‐tumor‐associated antigen 72 (B72.3), and anti‐human myelomonocytic antigen (Leu M‐1) antibodies were used to localize their respective antigens in formalin‐fixed, paraffin‐embedded tumors by using the avidin‐biotin‐complex immunoperoxidase technique. In all, 28 mesotheliomas obtained from Ohio State University Anatomic Pathology files and from a Southwest Oncology Group (SWOG) protocol were compared to 22 pulmonary adenocarcinomas by using this MAb panel. None of the mesotheliomas demonstrated positive staining with MAbs NP‐2 (anti‐CEA) or Leu M‐1. However, 95% (21/22) of adeno‐ carcinomas stained with one of these two antibodies. Although neither of these two MAbs stained all adenocarcinomas, each antibody demonstrated positive immunostaining in more than 90% of the adenocarcinomas studied. Therefore, MABs NP‐2 and Leu M‐1 are, individually, quite useful for distinguishing mesothelioma from adenocarcinoma. However, in our study, no single MAb could be used to distinguish these two tumor types in every case. MAb B72.3 stained 91% (20/21) adenocarcinomas but also stained 7% (2/28) of mesotheliomas. MAb HMFG‐2 reacted positively with 95% of adenocarcinomas, but also stained 39% of the mesotheliomas, usually in a membranous pattern. MAbs EMA and PKK‐1 were not found useful in distinguishing mesothelioma from adenocarci‐noma. We conclude that MAbs Leu M‐1 and NP‐2 were both useful in distinguishing mesothelioma from pulmonary adenocarcinoma in that positive staining was demonstrated in adenocarcinomas and not mesothe‐liomas.
Utility of surgical margins in the radiotherapeutic management of soft tissue sarcomas
Authors: Avizonis Vilija N. , Sause William T. , Menlove Ronald L. 
Published: February 2007

AbstractSeventy‐four adult patients with localized soft tissue sarcomas were treated with radiation therapy following surgery between 1965 and 1988. Fiftythree were treated after the first excision of their tumor with 6 (11.3%) local recurrences. Twenty‐one received radiation after excision of recurrent disease with 11 (52.4%) local failures (P <.0005). Metastatic disease occurred in 14 (26.4%) of the primary tumors and 8 (38.1%) with multiple previous excisions (P <.48). Of those patients treated for primary sarcoma, there were no local failures with pathologically wide margins or if a single margin was microscopically positive. Local failure occurred in 4 of 26 (15.4%) if the tumor was merely enucleated and in 2 of 11 (18.2%) who had grossly positive surgical margins (P not significant). Local failure was also more common in truncal locations (33.3%) as compared with extremity locations (8.7%, P=.1359). Additional factors analyzed which adversely affected prognosis included tumor grade, stage, and inadequate radiation dose.
Acral with melanoma: A review of 185 patients identification of prognostic variables
Authors: Slingluff Craig L. , Vollmer Robin , Seigler Hilliard F. 
Published: February 2007

AbstractOne hundred eight‐five patients with acral melanoma treated since 1972 were reviewed. These included 53 subungual lesions, 123 plantar lesions, and 9 palmar lesions. Eighty percent presented with stage I disease. Mean age was 57 years. Males outnumbered females 1.1:1. Seventeen percent (17%) were blacks. Actuarial 10‐year survival was 58% for stage I patients and 35% for stage II patients. Univariate Cox regression analyses identified 5 prognostic variables affecting survival: stage at diagnosis (P< 0.00l), race (P< 0.00l), ulceration (P=0.012), Clark's level (P=0.014), and thickness of the primary lesion (P=0.013). Factors unrelated to survival included sex of the patient, site (volar vs. subungual), histology, and treatment with amputation. Multivariate analysis for patients with stage I lesions identified race (P=0.00l) and ulceration (P=0.018) as significant variables, with thickness approaching significance (P=0.094). In an additional series of 71 patients with melanomas arising from extremity sites near the junction of glabrous and non‐glabrous skin, survival was significantly poorer for those arising from glabrous skin (P=0.024), and reflects a higher incidence of metastatic disease at diagnosis. Specific active immunotherapy was the principal adjuvant used for these patients, and survival was comparable to that reported with regional perfusion therapy. Acral melanoma a) has a strong racial predilection, b) carries a grave prognosis, and c) arises from glabrous skin. It is a clinical entity distinct from other extremity melanomas. Surgical management with either wide excision or amputation is appropriate for the primary lesion.
Long‐term experience with a totally implanted catheter system in cancer patients
Authors: Freytes Cesar O. , Reid Patricia , Smith Kirby L. 
Published: February 2007

AbstractLong‐term experience with totally implanted catheter systems (TICS) is limited. We retrospectively evaluated the performance and long‐term complications of TICS for intravenous infusion in cancer patients; 134 systems were implanted in 128 patients. The median duration of implantation was 144 weeks with 49 systems implanted for more than one year. Complications related to surgical factors included malposition of reservoir (2%), skin perforation or wound dehiscence (1.5%) and pneumothorax (< 1%). Complications not related to surgical factors included: drug extravasation (1.5%), mechanical malfunction (1.5%), vein thrombosis (< 1%), clotting of the reservoir or catheter (2%), skin infection (1.5%), and sepsis (< 1%). The total complication rate was 13%. Most complications resolved spontaneously or with medical treatment and only 6 patients (4.6%) required re‐implantation of a second system. We conclude that with long‐term usage of TICS, the complication rate remains low, making it a safe and viable alternative for patients requiring long‐term intravenous therapy.
Effect of prostaglandin E in multiple experimental models: V. Effect on tumor/host interaction
Authors: Waymack J. Paul , Chance William T. 
Published: February 2007

AbstractProstaglandin E (PGE) has long been incriminated as a cause of the immunosuppression seen in cancer patients and for the increased rates of tumor growth due to the impairment of the immunologic response to the tumor. We have investigated the effect of PGE on tumor‐host interaction by utilizing a parenterally administered long‐acting PGE derivative, 16,16‐dimethyl‐prostaglandin E (dPGE). Administration of dPGE was found to decrease the rate of tumor growth but at a cost of decreasing tumor‐free body mass. The dPGE did not alter resting metabolic rates but did alter some parts of brain dopamine metabolism and significantly decreased the serum level of multiple amino acids. In conclusion, elevated PGE levels may significantly alter metabolism in tumor patients.
Toxicity comparison of neoadjuvant versus adjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (M‐VAC) in radical cystectomy patients
Authors: Bahnson Robert R. , Ernstoff Marc S. , Miller Ralph J. , O'Donnell Walter F. 
Published: February 2007

AbstractA reduction in the toxicity of M‐VAC chemotherapy has been postulated for patients who receive these drugs prior to radical cystectomy for muscle invasive bladder carcinoma: A review of the toxicity and patient dropout rates from a group of 9 patients who received neoadjuvant M‐VAC was little different from 9 patients who were treated with M‐VAC after radical cystectomy. This similarity suggests that preoperative M‐VAC should not be favored on the basis of reduced patient morbidity.
Small cell carcinoma of the pancreas and biliary tract
Authors: Motojima Koichi , Furui Junichiro , Terada Masazumi , Shiogama Toshiaki , Kohara Norihiro , Tsunoda Tsukasa , Tsuchiya Ryoichi 
Published: February 2007

AbstractFour cases of anaplastic carcinoma of the pancreas or biliary tract were studied clinicopathologically and immunohistochemically. All four cases were intermediate cell type and contained a minimum amount of microscopic foci of differentiated glandular adenocarcinoma. Argyrophilic tumor cells were not seen in any of the four tumors. Immunohistochemically, no tumor was positive for hormonal products, but all tumors were positive for epithelial markers.These findings suggest that the anaplastic carcinoma are not derived from argyrophilic cells, but rather from adenocarcinomas which have the potential for anaplastic metaplasia. The long‐term survival of one patient emphasized the importance of chemotherapy in the treatment of small cell carcinoma of the pancreas and biliary tract.
Neoadjuvant cis‐DDP in esophageal cancers: An experience at a regional cancer centre, India
Authors: Murthy S. Krishna , Prabhakaran P. S. , Chandrashekar M. , Deshpande Raman , Doval D. C. , Copinath K. S. 
Published: February 2007

AbstractWe are analysing the results of 80 patients who underwent surgery during 1983‐84 for esophageal cancer. Forty patients who received pre‐operative single agent Cis‐DDP were grouped under “A” and 40 patients who went for surgery directly were grouped under “B.” Twenty‐two patients (55%) of Group A showed tumor necrosis. Both groups underwent resection and hand‐sewn anastamosis of the esophagus. There were 10 post‐operative deaths among 80 resected cases, 9 of them being from anastomatic leak. Cis‐DDP has induced negligible side effects. A comparatively high survival rate during early years in patients who responded to Cis‐DDP suggests that neoadjuvant chemotherapy might be of value.
Carcinoma of the pancreas: A retrospective review
Authors: Harris Gary J. , Gaskill Harold V. , Cruz Anatolio B. 
Published: February 2007

AbstractEighty‐five patients with adenocarcinoma of the pancreas were reviewed in order to evaluate the efficacy of our methods of diagnosis and treatment. The most useful diagnostic test was percutaneous transhepatic cholangiography (PTC) with a diagnostic rate of 96%. Pancreaticoduodenectomy (Whipple procedure) and total pancreatic resection were performed in 13 and 2 patients, respectively. The remaining 50 patients underwent various palliative drainage procedures. Twenty patients did not undergo operation for various reasons. The primary tumor was found in the head of the pancreas in 50 patients (59%), the body in 6 patients (7%), and in the tail in 8 patients (9%). Postoperative complications, including sepsis, bleeding, intra‐abdominal abscesses, and anastomotic leaks, occurred in 37% of the patients. There were one operative and 9 postoperative deaths. The average survival for those patients undergoing surgical intervention was 6 months. There were no 5‐year survivors.
Symptomatic pericardial effusion in breast cancer patients: The role of fluid cytology
Authors: Edoute Yehouda , Kuten Abraham , Ben‐Haim Shlomo A. , Moscovitz Marian , Malberger Ehud 
Published: February 2007

AbstractClinical and cytologic findings in 21 breast cancer patients with symptomatic pericardial effusion are presented. The etiology of the pericardial effusion was definitely malignant, by cytology/histology in 13 patients (62%), and suspected malignant by cytology in 2 patients (9%). One patient (5%) with definitely nonmalignant pericardial effusion by cytology was found to be histologically positive at autopsy. In 5 patients (24%) there was no histological/cytological evidence of malignancy; radiation pericarditis could be the etiology in 4 of these 5 patients. The median time from the diagnosis of breast cancer to the development of symptomatic pericardial effusion was 60 months (range: 1–219 months). Ten patients developed cardiac tamponade; they were treated by either pericardiocentesis or pericardiectomy. The mean survival of patients with negative cytology/histology was 12 months; patients with suspicious cytology had a mean survival of 9 months; patients with malignant effusion, treated by pericardiectomy, had a mean survival of 22.3 months, while patients with malignant pericardial effusion, who were not subjected to surgery, had a mean survival of 4.7 months, only. It is concluded that the etiology of symptomatic pericardial effusion in breast cancer patients is not always malignant, which emphasizes the role of fluid cytology in establishing definite diagnosis.The survival probability is a function of the extent of extracardiac disease; among patients with malignant pericardial effusion those selected for pericardiectomy have a longer than average survival.
Multiple endocrine neoplasia type IIb: A clinicopathological report
Authors: Van Zyl Jacobus Alwyn , Muller Anna Gertruida Smuts , Rossouw Daniel Johannes , Van Velden Dirk Johannes Jacobus 
Published: February 2007

AbstractThe clinicopathological findings in a 12‐year‐old boy with multiple endocrine neoplasia type IIb (MEN‐IIb) are presented. He demonstrated the characteristics of a Marfanoid habitus and had mucosal neuromas of the lips, tongue, eyelids, and cornea. The enlarged right thyroid lobe showed an increased thallium‐201 chloride uptake, and the serum calcitonin level was markedly raised. A total thyroidectomy was performed. Histopathological examination showed an infiltrating medullary carcinoma of the thyroid (MCT) and metastatic spread to supraclavicular lymph nodes. Special stains, immunocytochemistry, and electron microscopy revealed mucin‐containing follicular structures lined by calcitonin‐positive and thyroglobulin‐negative tumour cells. Ultrastructurally the mucosal neuromas consisted of proliferating perineurial and Schwann cells. The serum calcitonin level fell below 300 pmol/L, and his stools returned to normal postoperatively. Because the incidence of MCT in MEN‐IIb is virtually 100%, a total thyroidectomy in high risk patients—even before clinical evidence of malignant tumours—may be the only hope of cure.
Renal oncocytoma: Long‐term follow‐up and flow cytometric DNA analysis
Authors: Jow William W. , Zeid Mohamed Y. , Cowan Daniel , Malin Barry , Deberry John L. 
Published: February 2007

AbstractWe report a retrospective study on the clinicopathologic features and flow cytometric DNA analysis of ten renal oncocytomas compared with a control group of ten randomly selected renal cell carcinomas. Among the oncocytoma patients, no recurrences or metastases were noted over an average follow‐up of 6.7 years (range = 6 months to 16 years). Reproducible, high‐quality DNA histograms were obtained on the paraffin‐embedded specimens by using our modified flow cytometric procedure. One aneuploid (10%) and two hyperdiploid tumors (20%) were found in the oncocytoma group. There was no correlation between these abnormal DNA histographic patterns and survival or tumor stages. On the contrary, a good correlation was found between tumor grades and DNA ploidy in the controls.We conclude that renal oncocytoma is a clinically benign tumor, yet it may exhibit varying degrees of flow cytometric DNA abnormalities, which have no predictive value on survival and probably reflect the characteristics of oncocytes rather than its malignant potential.
Primary undifferentiated small cell carcinoma of the esophagus: Clinicopathological and flow cytometric evaluation of eight cases
Authors: Isolauri Jouko , Mattila Jorma , Kallioniemi Olli‐Pekka 
Published: February 2007

AbstractWe present a clinicopathological and flow cytometric evaluation of eight primary small cell carcinomas of the esophagus representing 1.5% of all esophageal malignancies diagnosed during a 22‐year period (1965–1987) in the Tampere University Central Hospital. The mean age of the patients (four male and four female) was 67 years (range 55–75 years). Five cases had distant metastases at the time of diagnosis. Three patients were treated by esophageal resection, one by laser vaporisation, and four by chemotherapy. The median survival time was 4 months (range 9 days to 8 months). A complete local response to chemotherapy in serial esophagogramms was detected in one patient. All four patients given chemotherapy survived longer than those treated with esophageal resection only. Four (67%) of the six carcinomas analyzed by DNA flow cytometry contained DNA‐aneuploid stemlines. The median S‐phase fraction of these small cell carcinomas was high (16.3%), reflecting rapid cell proliferation rate, which may be related to their responsiveness to chemotherapy.
Lugol stain for intraoperative determination of the proximal surgical margin of the esophagus
Authors: Sugimachi Keizo , Tsutsui Shinichi , Kitamura Kaoru , Morita Masaru , Mori Masaki , Kuwano Hiroyuki 
Published: February 2007

AbstractAn adequate proximal surgical margin is difficult to determine particularly in cases of esophageal carcinoma with surrounding intraepithelial invasion. We report here readily facilitated intraoperative approaches for detection of the exact margin of carcinomatous invasion of the esophagus.The resected specimen of the esophagus is incised longitudinally and placed in a 1% Lugol bath for 2–3 minutes. The normal squamous epithelium includes glycogen that interacts with the iodine of Lugol's solution and the normal epithelium of the esophagus becomes a uniform greenish‐brown. A squamous cell carcinoma does not include glycogen, hence is not stained with this solution and a clear identification is feasible. Thus, a carcinomatous infiltration not recognizable in routine examinations becomes macroscopically visible when Lugol's solution is used.
Primary soft tissue tumours of the pelvis causing referred pain in the leg
Authors: Ball Adrian B. S. , Serpell Jonathan W. , Fisher Cyril , Thomas J. Meirion 
Published: February 2007

AbstractReferred pain in the leg is occasionally due to a pelvic soft tissue tumour. Among 11 patients who presented this way, one had a lymphoma, one had a benign schwannoma, and nine had soft tissue sarcomas. Most patients had undergone a variety of procedures, including laminectomy, before the correct diagnosis was established. In five cases, an accurate diagnosis was obtained by needle biopsy. The lymphoma responded to chemotherapy, and the benign schwannoma was excised. Of the nine patients with soft tissue sarcoma, six underwent marginal/intracapsular excision, three receiving supplementary radiotherapy, and two were treated by nonsurgical means. Hindquarter amputation was technically impossible or inappropriate in these cases. All those with high‐grade tumours have died or have metastases. Of four patients with low‐grade tumours, three have exhibited only slow disease progression. Careful judgment and a precise histopathological diagnosis are required in planning treatment for patients with pelvic soft tissue tumours causing referred pain in the leg.