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A I Neugut

Publications and source records attributed to A I Neugut.

At least 109 records · Page 6Linked to original sources
PubMed1992

A comparison of the clinical characteristics of second primary and single primary sarcoma: a population based study.

The clinical characteristics of 240 patients with sarcoma as a second metachronous primary neoplasm (SPN) were compared with those of 8,815 patients with sarcoma as a single tumor. The data were obtained from patients registered during the period 1973-1986 in the Surveillance, Epidemiology and End Results (SEER) Program in the United States. Seventy-four of the 240 SPN patients had postirradiation sarcoma (PIS) while the other 153 patients developed the sarcoma as a second tumor in an area which was not exposed to prior radiotherapy (non-PIS). The stage of disease at diagnosis was more advanced in patients with PIS than in those with single sarcomas but the difference did not reach statistical significance. Overall, in comparable clinical stage localized and regional disease there was no statistically significant difference in survival between PIS and non-PIS sarcoma patients after adjusting for age. The survival of patients with localized or regionally advanced sarcoma as a second tumor was significantly worse than of those with single sarcomas with the same stage. There was no difference in survival between first or second sarcomas with metastatic disease.

Adolescent↗
PubMed1992

Clinical, demographic, and follow-up characteristics of patients with two primary metachronous tumors, one of them being in the colon.

The clinical characteristics of 152 patients diagnosed with two primary metachronous tumors--one or both of them in the colon--were studied. Nineteen patients had both primary tumors in the colon (Group I), 59 had the first primary tumor in the colon and the second tumor elsewhere (Group II), and 74 had the second primary tumor in the colon and the first primary tumor elsewhere (Group III). The group in which the second primary tumor was in the colon included significantly more female patients than did the other two groups, with a younger median age at diagnosis of first tumor. The median time interval between the two primary tumors was 44, 57, and 62 months in Groups I, II, and III, respectively. The number of clinic visits during the year before diagnosis of the second primary was similar in all groups, but only 60 percent of the patients kept their follow-up appointment. In most instances, the diagnosis was made after the patients' symptoms, although only a small percentage of the second primary tumors (15-30 percent) were diagnosed during routine follow-up. The second primary tumor occurred in the field of radiotherapy of the first primary tumor in 27 of 35 patients who received radiotherapy. To increase the number of patients diagnosed in an earlier stage of disease, they should be urged to keep their follow-up appointment, and physicians following patients with single tumors should be aware of the increased likelihood of a second tumor. To increase the cure rate of those tumors, efforts toward early diagnosis are warranted. This includes physical examination and mammography to detect breast cancer in women, annual occult blood tests and rectal examination, and sigmoidoscopy or colonoscopy at three-year intervals to detect colon cancer early.

Aged↗
PubMed1992

Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of colon cancer patients. A controlled, prospective study.

Individuals with a family history of colorectal cancer are believed to be at an increased risk of developing colorectal neoplasia. To estimate this risk and the potential yield of screening colonoscopy in this population, we recruited and prospectively colonoscoped 181 asymptomatic first-degree relatives (FDR) of colorectal cancer patients and 83 asymptomatic controls (without a family history of colorectal cancer). The mean ages for the FDR and control groups were 48.2 +/- 12.5 and 54.8 +/- 11.0, respectively. Adenomatous polyps were detected in 14.4 percent of FDRs and 8.4 percent of controls. Although 92 percent of our FDRs had only one FDR afflicted with colon cancer, those subjects with two or more afflicted FDRs had an even higher risk of developing colonic adenomas (23.8 percent) than those with only one afflicted FDR (13.1 percent). A greater proportion of adenomas was found to be beyond the reach of flexible sigmoidoscopy in the FDR group than in the controls (48 percent vs. 25 percent, respectively). Logistic regression analysis revealed that age, male sex, and FDR status were independent risk factors for the presence of colonic adenomatous polyps (RR = 2.32, 2.86, and 3.49, respectively; P less than 0.001). Those at greatest risk for harboring an asymptomatic colonic adenoma are male FDRs over the age of 50 (40 percent vs. 20 percent for age-matched male controls). Based on probability curves, males with one FDR afflicted with colon cancer appear to have an increased risk of developing a colonic adenoma beginning at 40 years of age. Our results document, for the first time, an increased prevalence of colonoscopically detectable adenomas in asymptomatic first-degree relatives of colon cancer patients, as compared with asymptomatic controls, and support the use of colonoscopy as a routine screening tool in this high-risk group.

Adenoma↗
PubMed1991

The association of breast cancer and colorectal cancer in men. An analysis of surveillance, epidemiology, and end results program data.

There is a known increased risk for the co-occurrence of both breast cancer and colorectal cancer in the same women, presumably as a result of either shared reproductive hormonal or environmental risk factors. Using data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, the authors investigated whether there is a similar relationship between breast cancer, colorectal cancer, and prostate cancer in men. The observed-expected ratio was not significantly elevated for either colorectal cancer after breast cancer or for breast cancer after colorectal cancer in men. There was an increased incidence of prostate cancer after colorectal cancer, but this relationship was not present in the opposite direction and is believed to result from detection bias. There was an increased incidence of breast and colorectal cancer in women. These results suggest that the observed breast and colorectal cancer relationship in women may be a result of shared reproductive hormonal factors.

Breast Neoplasms↗
PubMed1991

Cholecystectomy as a risk factor for colorectal adenomatous polyps and carcinoma.

Multiple studies have suggested a possible relationship between prior cholecystectomy and the occurrence of subsequent colorectal carcinoma. This relationship has been particularly noticed among female patients and for right-sided lesions of the colon. In the current study, the authors undertook a case-control study among patients who underwent colonoscopy in three private practices in New York City between April 1986 and March 1988. Over this period, 302 adenomatous polyp cases, 106 colon cancer cases, and 507 controls were interviewed regarding their prior history of cholecystectomy. Overall, no significant association was observed between cholecystectomy and either colorectal adenomatous polyps or cancer. Cholecystectomy does not appear to be a significant risk factor for colorectal neoplasia.

Adult↗
PubMed1991

Epidemiologic analysis of warfare. A historical review.

Although warfare is thought to be responsible for high and increasing levels of morbidity and mortality in the modern era, little comparative epidemiologic research is available on the subject. Most research on past wars has been carried out for purposes of military planning. The present report provides an overview of the direct health impacts of various wars on military and civilian populations during the last 200 years. Risk factors for injury and death are analyzed. Changes in weaponry, military strategy, and medical services are found to modify the health effects of warfare.

History, 17th Century↗
PubMed1991

A comparison of the clinical characteristics of first and second primary head and neck cancers. A population-based study.

The clinical characteristics of 183 patients with second primary neoplasms in the head and neck region were compared with those of 20,598 patients with one primary tumor in the same region registered during the period 1973 to 1984 in the Surveillance, Epidemiology and End-Results Program. Second primary head and neck tumors were more likely to be diagnosed in a localized stage (47%) than if diagnosed as a single primary tumor (43%), but this difference was not significant. The tumor grade distribution was comparable in both groups. Using Cox proportional hazards modeling with age, sex, race, and stage as covariates, the median survival of patients with first and second head and neck cancer was identical (50 months). The survival of patients with localized second head and neck cancer was shorter than that of patients with single localized tumors (55 versus 102 months, P less than 0.026). Survival for regional tumors was similar (18 versus 21 months, not significant). The 84 second head and neck cancers in which the first head and neck cancer received radiation therapy (RT) had a median survival of 20 months; the 98 cases without prior RT had a median survival of 35 months. The high incidence of localized second cancers was probably due to the more intense surveillance. The worse survival in this group may be a result of prior RT or biologic characteristics of the tumor.

Carcinoma, Squamous Cell↗
PubMed1991

Obesity and colorectal adenomatous polyps.

Obesity has been investigated as a risk factor for various malignancies, including colon cancer. A case-control study was conducted on patients in three colonoscopy practices in New York City to determine possible risk factors for colorectal adenomatous polyps, a known precursor lesion for most cases of colorectal cancer. Among 301 case subjects with incidence adenomatous polyps (174 men and 127 women) and 506 control subjects (223 men and 283 women), an increased risk was observed with increasing body mass index in women (odds ratio 2.1, 95% confidence interval 1.1-4.0; for highest versus lowest quartile, linear trend P = .02). A nonsignificant trend was observed for men. The increased risk seen in women is consistent with prior observations regarding reproductive hormonal and dietary risk factors for colorectal cancer.

Adenoma↗
PubMed1991

Colorectal cancer: differences between community and geographically distant patients seen at an urban medical center.

Many studies in clinical oncology rely on hospital-derived patients. Hospitals vary in the proportions of patients from the local catchment area vs. those from more distant places, of whom a larger proportion are presumably referrals. To study the differences between these two types of patients, we analyzed 1,245 colorectal cancer patients seen at a large urban medical center over a seven-year period. Three hundred ninety-eight patients were from the local community (32 percent), 489 were from the extended community (39.3 percent), and 358 from more distant communities (28.8 percent). The patients from the local community tended to be older and from minority ethnic groups. In addition, the local community patients were more likely to have advanced disease at the time of presentation. The grade of the tumor and its site distribution within the large bowel were similar for the three groups. After adjusting for age, sex, race, and stage of disease, the survival was somewhat better for the distant community patients as compared with the local and extended communities (P less than 0.02). Overall, in our patient population, the distant patients tended to have more favorable socioeconomic factors and less advanced disease, and these differences may account, in large part, for a better prognosis for these patients. Particularly in large cooperative trials, studies may need to take into account the respective proportions of local community and geographically distant patients in analyzing and generalizing treatment outcomes.

Catchment Area, Health↗
PubMed1990

The clinical behavior of radiation-induced thyroid cancer in patients with prior Hodgkin's disease.

Second primary neoplasms are occurring with increasing frequency. Despite growing literature on the incidence and etiology of this phenomenon, very little has been documented about the clinical aspects and biological behavior of these tumors. As our experience has hinted at a worse prognosis for second primaries, we thought it of interest to study this phenomenon for one type of tumor. We reviewed 32 cases of thyroid cancer arising as a second neoplasm in patients with Hodgkin's disease and compared various clinical characteristics to reported series of de novo (non-radiation-induced) thyroid cancer. Thyroid cancer, as a second primary, occurred more frequently in males with a more malignant histology and was diagnosed at a more advanced stage. The survival appears to be worse. The behavior of radiation-induced thyroid cancer in a host with prior malignant neoplasia appears to be more aggressive than that of both de novo (non-radiation-induced) thyroid cancer and radiation-induced thyroid cancer in a host with no prior malignancy. The selected nature of the cases precludes any firm conclusions. This type of information should be collected prospectively for all secondary malignancies as it may have an impact on the clinical management of these patients.

Adenocarcinoma↗
PubMed1989

Leiomyosarcomas of the extremities.

Leiomyosarcomas are uncommon malignant neoplasms that rarely arise in the extremities. We report on the clinical characteristics of 17 cases seen at the Memorial Sloan-Kettering Cancer Center over a 32 year period. Most neoplasms occurred in the lower extremities, and most of the tumors recurred after surgery alone, with several late recurrences. The overall prognosis was grim, with a median survival of 24 months. More aggressive multidisciplinary approaches to this disease are warranted.

Adult↗
PubMed1989

Serum cholesterol and primary brain tumours: a case-control study.

The association between serum cholesterol level and primary brain tumours in adults was studied in a case-control study. Some 150 cases were compared with 649 hospital-based controls. An association between elevated serum cholesterol level and primary brain tumours was found. This relationship was concentrated in meningioma cases and may represent a marker for an elevated socioeconomic status.

Aged↗
PubMed1989

Clinical aspects of multiple primary neoplasms.

We review the medical literature for the clinical characteristics of patients developing multiple primary neoplasms (MPN). Also, preliminary results of our study at Memorial Sloan Kettering Cancer Center are reported. Although there have been very few specific reports on this topic, it was possible to find some data, suggesting a worse prognosis for patients with MPN. Several factors may be responsible for this, and further studies are in progress. Meanwhile, it is of great importance to decrease the incidence of cancer by prevention, such as reducing smoking and alcohol consumption. This may reduce the incidence of first primary neoplasms and MPN. Optimal treatment for the first primary neoplasm should be given, but the possible risk of MPN should be taken into consideration, and, if there are two alternatives for the treatment of the first tumor, the one that is less carcinogenic and that will allow appropriate therapy for a second primary neoplasm (MPN2) should be chosen. On follow-up of cancer patients, a low threshold of suspicion for a second primary neoplasm is recommended to detect them early for possible curative treatment. Because of the poor prognosis, more aggressive treatment regimens for MPN are warranted.

Breast Neoplasms↗