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Biomedical subjects

A Kułakowski

Publications and source records attributed to A Kułakowski.

At least 19 recordsLinked to original sources
PubMed1991

Retroperitoneal lymph node dissection in the treatment of patients with non-seminoma testicular tumours.

Twelve years of experience in performing retroperitoneal lymph node dissection (RPLND) in patients with testicular non-seminomas is presented. One hundred and fifty-two procedures were performed during the years 1977-1989. Seventy-four patients had RPLND prior to chemotherapy and 78 were operated on after the initial chemotherapy. The disparity between the initial staging and intra-operative findings was 35% in the first group and 16% in the second. The mortality rate in both groups was similar (20.3% and 20.5%, respectively). Forty-one of 78 patients operated on after the initial chemotherapy had vital or only partially damaged neoplastic tissue found in the specimen. The diagnostic and therapeutic significance of RPLND is discussed and the importance of the pathological findings in planning postoperative chemotherapy, and in prognosis is stressed.

Adolescent↗
PubMed1991

Preoperative concurrent chemotherapy and radiotherapy for local-regional and advanced squamous cell carcinoma of the thoracic oesophagus: preliminary results of a pilot study.

Preliminary experience based on the results of a pilot study on preoperative concurrent continuous i.v. infusion chemotherapy and radiotherapy for squamous cell carcinoma of the oesophagus in eight consecutive patients is presented. Chemotherapy consisted of 5-fluorouracil and cisplatin. Radiotherapy (Co-60) was delivered to a total dose of 3000 cGy. Clinical tolerance was good in four of eight patients, but poor in the remaining four, including three septic deaths. Oesophagectomy was performed in five patients with no postoperative deaths. Postoperative complications (Horner syndrome, hydrothorax, abdominal wound dehiscence) were observed in three cases. The response was categorized as complete (CR), partial (PR) or stable disease (SD), based on a comparison of the initial and immediate preoperative imaging studies and on the presence of tumour degeneration and/or necrosis in pathological examination of operative specimens. CR was observed in 1/8 patients, PR in 4/8 and SD in 3/8. Concurrent preoperative chemo- and radiotherapy may be effective as a neo-adjuvant or remission-inducing modality in the combined treatment of oesophageal carcinoma, however, it may also lead to fatal complications.

Aged↗
PubMed1991

Breast cancer in elderly women: characteristics of the disease.

The records of 325 women aged over 70 years, with breast cancer were reviewed to identify the characteristics of the disease in elderly women and to determine the eventual effect of age on its management. Over 50% of patients were in the advanced stage (stage III or IV). The percentage of inoperable cases increased with greater delay between the onset of first symptoms and the first medical consultation (Chi-square (chi 2) = 42.8 P less than 0.001), but the delay time did not influence relative survival rates. Axillary lymph node status, stage of the disease and recurrences were the major factors influencing survival. Postoperative complications were analysed. Other, co-existing diseases were found in a significant number of patients (145, 44.6%); they did not influence long term results but increased postoperative mortality and morbidity. We conclude that breast cancer in elderly women can be treated by appropriate surgical therapy if the patient's overall performance status is good. Advanced age alone is not a contra-indication to the relevant therapy, corresponding with the stage of the disease.

Age Factors↗
PubMed1987

Reconstruction of full-thickness cheek defects after cancer surgery.

The value of various surgical techniques used to reconstruct full-thickness cheek defects is discussed. Small defects can be repaired with the use of local cervical skin flaps with a random vascular pattern. Axial pattern temporal flap is another choice, either alone or combined with a cervical flap. Whenever local tissues are not suitable (i.e. after irradiation or neck dissection) a transfer of distant myocutaneous island flap based on a pedicle of axial muscle vessels is a valuable alternative. Split skin graft may form a good intra-oral lining of such island flap.

Aged↗
PubMed1984

Distribution of lymph node metastases in the malignant melanoma of the trunk.

Of 1217 patients with malignant melanoma treated at the Institute of Oncology in Warsaw during the period from 1947 to 1982 there were 135 patients (11.1%) with malignant melanoma of the trunk. A retrospective analysis of this group of patients has been carried out in order to study the routes of lymphatic dissemination of melanoma. 14 patients were excluded from this study due to the lack of sufficient information. In the group of 121 patients considered, lymph node metastases were found in 82 patients (67.7%). In 12 patients (9.9%), blood-borne metastases were found as the first sign of dissemination. In 26 patients the primary melanoma was located in the midline skin along the spine at the back, on the white line and its extension at the front, and in a 6-cm-wide horizontal strip of skin at the level of the iliac crest. Among this group in 9 individuals simultaneous metastases to two different lymph regions were found; in 7 patients the first metastases occurred in distant lymph nodes without metastases to the nearest ones. In the remaining 56 patients the primary melanoma was located on the skin of the trunk elsewhere. In 49 of these patients (87.5%) metastases were found in the regional lymph nodes, while in 7 they were found in distant lymph nodes. 21/121 (17.3%) have survived longer than 5 years without symptoms of disease.

Abdomen↗