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Biomedical subjects

A Sadeghi

Publications and source records attributed to A Sadeghi.

At least 37 records · Page 2Linked to original sources
PubMed1988

Prevalence of dysplasia and cancer of the cervix in a nationwide, planned parenthood population.

Two and three-tenths percent of cervical smears disclosed abnormalities from among 1,045,059 submitted for processing and examination by the Cancer Screening Service. The smears came from 198 Planned Parenthood Family Planning Clinics in 23 States during a 3-year period. Mild to moderate dysplasia was most frequent in women 25 to 29 years of age (prevalence rate, 25.7/1000), severe dysplasia and carcinoma in situ in women 35 to 39 years of age (prevalence rate, 4.6/1000), and invasive carcinoma in women older than 50 years of age (prevalence rate, 0.47/1000). All lesions also were encountered in younger women. Mild dysplasia was found in girls as young as 10 years of age, severe dysplasia in girls as young as 15 years, and invasive carcinoma in women as young as 20 years. The large number of young women with abnormalities suggests that availability of screening programs for sexually active women is important.

Age Factors↗
PubMed1988

Combined modality treatment for resected advanced non-small cell lung cancer: local control and local recurrence.

The purpose of this study was to compare the effect of post-operative thoracic radiation with or without systemic chemotherapy on survival and recurrence patterns in patients subjected to thoracotomy with curative intent, but subsequently found to have residual tumor in the resected margin or metastasis in the highest paratracheal lymph node. All patients were treated with postoperative mediastinal irradiation and randomized to receive or not receive combination chemotherapy (cytoxan, adriamycin, and platinum) for 6 months beginning concurrently with radiation. Of the 172 patients randomized, 164 were eligible for analysis. The mean time since randomization for the eligible patients is 4.2 years. Radiation therapy was administered to all patients by split course regimen [20 Gy in 5 fractions over 5 days]. Two such courses were given with a 3-week interval. The initial recurrence rates for both in-field recurrence and distant relapse were reduced in the combined postoperative radiation therapy and chemotherapy group, although only the latter difference achieved statistical significance (p = 0.01). Also, local recurrence overall (not restricted to initial recurrences) is examined as a function of histology, extent of residual disease after resection, and T and N status. The treatment effect achieves statistical significance only for patients with macroscopic residual (p = .023) or T3 tumor (p = .010). The combined therapy group of patients have a significantly longer recurrence-free survival [p = 0.006 by the two-sided Mantel-Haenszel logrank test] which fails, however, to translate to a significant difference in overall survival (p = 0.146). Median survival of the entire group is 14.5 months with 34% alive 2 years after resection. Most of the initial recurrences (82%) have been systemic, with brain being the most common site. Distant failure, therefore, remains an important problem even in the favorable prognosis subset of patients with advanced NSCLC, but combined modality approaches can produce improved recurrence-free survival.

Adenocarcinoma↗
PubMed1987

Salivary gland tumors of the palate: the UCLA experience.

A retrospective review of 38 patients with salivary gland tumors of the palate treated between 1961 and 1984 is presented. The majority of tumors were identified at an early stage. Most (23 of 38 cases) originated over the hard palate. The most common histological type was adenoid cystic carcinoma (22 cases). Twenty-five patients were treated with surgery alone, of whom, three had wide local excision. Thirteen patients received postoperative radiation therapy in addition to surgery. The local control was comparable for surgery alone and combined therapy (88% and 85%, respectively) although the combined therapy group was biased by more advanced disease, inadequate margins, and/or poorly differentiated histologies. Mucoepidermoid lesions had an excellent prognosis with local control of 100%. In contrast, there was a 23% recurrence rate for adenoid cystic carcinoma. Regional neck node metastasis was noted in 2% of the patients. This experience indicates that radical resection of palate salivary gland malignancy with adequate margins results in excellent local control. Adjuvant radiation therapy is recommended in cases where there is a question of adequate margins and in advanced lesions of high grade tumors.

Adenocarcinoma↗
PubMed1986

The role of radiation therapy in squamous cell carcinoma of the upper aerodigestive tract with positive surgical margins.

One hundred four patients with squamous cell carcinoma of the upper aerodigestive tract and with histologically positive surgical margins were evaluated for this historically controlled study to determine the efficacy of postoperative radiation therapy. Positive margins were defined as the presence of one or more of the following: carcinoma in situ, tumor within 0.5 cm from the surgical margins, microscopic disease, or dysplasia. Patients received either surgery alone (44 cases) or surgery plus postoperative radiation therapy (60 cases) and were followed for a minimum of 2 years. Treatment strategies, stage by stage, were similar for all patients. Surgery varied from simple excision in T1 to composite resection and/or laryngopharyngectomy with radical neck dissection in advanced cases. Radiation therapy was given postoperatively with doses ranging from 4,500 to 7,500 cGy. The overall 2-year survival rate with no evidence of disease (NED) was consistently higher in the surgery plus radiation therapy group. Furthermore, when the subgroup of patients who had dysplasia at the surgical margins was excluded from the analysis, the 2-year NED survival rate difference became statistically significant (p = 0.05). This outcome favored combined therapy (36 of 58 patients) over surgery alone (13 of 32 patients). This favorable result was obtained despite the high percentage of T3-T4 stages (79 vs. 21%) and clinically positive lymph nodes (83 vs. 17%) in patients who had received postoperative radiation therapy. The significance of dysplasia at the surgical margins and the impact of radiation therapy on the tumor and nodal control in this group of patients needs further clarification.

California↗
PubMed1986

Value of radiation therapy in addition to surgery for cancer of the head and neck.

This historically controlled study evaluates radiation therapy in 119 patients--with squamous cell carcinomas of the head and neck--who underwent surgery alone (SA) or surgery plus radiation (S + R). The primary tumor control and nodal control, in patients with negative surgical margins who had surgery alone (SA), were 63% in the oral cavity, 60% in the oropharynx, and 67% in the hypopharynx. The same rates for S + R group and negative surgical margins were 100%, 73%, and 100%. Combining the patients with negative and positive surgical margins, control of the tumor and nodal control were the same in the oral cavity for both treatment groups (41% for SA and 44% for S + R) and increased with the addition of radiation in the oropharynx (30% for SA to 65% for S + R) and hypopharynx (33% for SA to 86% for S + R), in spite of higher percentages of T3 and T4 tumor and positive lymph nodes in the S + R group. The lower control rate in patients who had surgery alone could be due (in part) to inadequate surgery at the primary site (42% local excision) and lack of neck dissection (35% for SA vs. 77% for S + R). Postoperative radiation therapy to the primary site and neck is shown to effectively reduce local recurrence in patients with oral cavity and oropharynx cancer, regardless of surgical margins.

Carcinoma, Squamous Cell↗
PubMed1986

Major salivary gland tumors: treatment results and prognostic factors.

A retrospective review of 133 patients with major salivary gland carcinomas treated between 1955 and 1981 is presented. The majority of cases (104) originated in the parotid gland. The most common histological type was mucoepidermoid carcinoma (39 cases). Tumor-free interval was longest for patients with acinic cell and mucoepidermoid carcinomas. In contrast, adenoid cystic carcinoma was poorly controlled, regardless of the form of treatment. Initial control of primary major salivary gland tumors was inversely related to the presence of disease at the surgical margins. In cases with microscopic or gross disease at the surgical margins, postoperative radiation therapy controlled the tumor locally in 18 of 26 patients (69%). Postoperative radiation therapy was generally used only in cases with high-grade histologies, advanced stages, or positive surgical margins. Of the patients treated with surgery alone, 53% achieved local control, as compared to 75% of the group which received postoperative radiation therapy. Although the difference was not statistically significant, we would have expected the combined therapy group to have a lower control rate due to more advanced disease. There was a low salvage rate (22%) and a high incidence of distant metastasis (60%) in recurrent cases. The data indicates that complete surgical resection results in the best local control, with or without adjuvant radiation. When the surgical margin is inadequate and re-excision not possible, adjuvant radiation therapy appears to have a role to optimize local control and survival.

Adolescent↗
PubMed1983

Epidemiologic study of oral cancer in Fars Province, Iran.

From January 1962 to December 1978, 381 consecutive cases of oral cancer in Fars Province were analyzed and studied. The incidence of oral cancer was found to be 1.13/100 000. The male/female ratio was 5:1, the median age of oral cancer was 55 years. 97% of the oral cancer was squamous cell carcinoma. The most commonly affected oral site was the lower lip, next was the tongue. Tobacco smoking and opium addiction were more common among the affected compared with the control group. Dental sepsis and poor oral hygiene were common in both groups. Malnutrition, anemia and liver dysfunction were common in the examined sample and are thought to be possible causative factors especially in those with no smoking habits. The role of general dental practitioners was limited, they suspected and referred only 13 advanced cases.

Adolescent↗
PubMed1979

Opium: a potential urinary bladder carcinogen in man.

Evidence is presented that opium addition is a risk factor for cancer of the bladder. A case-control study of 99 bladder cancer patients admitted to Nemazee Hospital in Shiraz, Iran was evaluated. Cancer patients and controls, matched by age and sex, were analyzed as to their opium and/or cigarette smoking habits. A high correlation between opium addiction and bladder cancer has been observed. This evidence significantly exceeded the one observed in relation to cigarette smoking only. The sex ratio for this cancer site, from hospitalized cases in Southern Iran, is estimated to be about nine male cases per one female case. This high male to female ratio was attributed to the greater addiction of males to opium. It was concluded that opium and, more likely, its pyrolysis derived fractions may represent potential bladder carcinogens in man.

Adult↗
PubMed1978

Cancer of the bladder in Southern Iran.

The sex ratio for cancer of the bladder from hospitalized cases in Southern Iran is estimated to be about nine male per female cases. Differential case ascertainment may account for some of the discrepancy; however, no other major cancer site has a sex ratio of this nature, utilizing the same data. Since industrial carcinogens and other predisposing factors, such as schistosomiasis, are rare, the role of other possible etiologic factors, such as opium addiction, which is predominantly male, were considered and discussed.

Adolescent↗
PubMed1977

Cancer of the esophagus in southern Iran.

The minimal yearly incidence of cancer of the esophagus in Fars Province in Southern Iran, based on hospital records in the capital city, is five to 10 times as high as the yearly incidence in Connecticut for the age group 15-44. Since these represent only a portion of cases among residents of the Province, the true rate is probably considerably higher. An unusual proportion of these cases (32% overall) presented with primary tumor in the upper third of the esophagus. The location of the tumor was related strongly to age, but not to sex after taking age into account. The proportion of esophageal cancer cases who were female was significantly greater than that of other GI tract cancers combined. It appears that the risk in males and females in this area is at least nearly equal, and risk could conceivably be higher in females (similar to the appearance of the disease in Northern Iran).

Adenocarcinoma↗
PubMedDate not supplied

The role of positron emission tomography in occult primary head and neck cancers.

PURPOSE: To evaluate the utility of positron emission tomography (PET) fluorodeoxyglucose (FDG) imaging in the workup of unknown primary head and neck tumors. METHODS: Fourteen patients with squamous cell carcinoma of cervical lymph node metastasis of unknown primary origin (clinical stage N2-N3) were studied prospectively. The patients underwent conventional workup, including physical examination, computed tomography, and random biopsies of the potentially suspected sites. If no primary site was found, 8 to 13 mCi of FDG was given intravenously, and whole-body scans with standardized uptake values were obtained. The results of FDG-PET imaging were compared with clinical, CT, and histopathologic findings. To eliminate bias, PET scans were reviewed by nuclear medicine physicians who had no previous knowledge of the other findings. RESULTS: PET identified the location of primary tumor in three patients: lung hilum, base of tongue, and pyriform sinus. These lesions were pathologically confirmed. All these primary sites were not visualized on CT or physical examination, except for a pyriform sinus lesion, which was seen on CT, but initial biopsy result was negative. In one patient, the initial PET did not identify a primary tumor, but a nasopharyngeal carcinoma was identified in post-radiation therapy follow-up PET. In the remaining nine patients, a primary lesion was never found. All cervical lymph nodes detected by CT were identified by PET. DISCUSSION: A previously unknown primary tumor can be identified with FDG-PET in about 21% of the patients in our prospective series. PET can be of value in guiding endoscopic biopsies for histologic diagnosis and treatment options.

Aged↗
PubMedDate not supplied

Human papillomavirus infection. Frequency and association with cervical neoplasia in a young population.

One million, six hundred thirty-two thousand, eight hundred forty-seven women from two independent populations in the United States received cytologic screening during a two-year period. Condylomatous lesions (human papillomavirus [HPV] infections) were the most frequent cytologic abnormality in women in both the Planned Parenthood and private sector groups (prevalence rates of 18.6 to 19.0 in women between ages 15 to 19). The prevalence rates of mild-to-moderate dysplasia were also similar in both populations, with the highest frequencies being between ages 25 to 29. Severe dysplasia and carcinoma in situ were most frequent between ages 35 to 39. In both populations, women with condylomatous changes coexisting with dysplastic changes were about ten years younger, grade-for-grade of severity of the lesion, than women without evidence of HPV infection. Since HPV infection is believed to represent the soil from which neoplasm develops, both the frequency of condyloma and the occurrence of dysplasia and cancer in young women suggest that women should begin regular screening programs while in their teens or after they become sexually active.

Adolescent↗