Adenocarcinoma of small intestine (25 year review--Roswell Park).
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Biomedical subjects
Publications and source records attributed to D F Temple.
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In 361 patients with recurrent malignant melanoma, the clinical stage was the strongest determinant of subsequent survival (P less than 0.01). In Stage IV, the number of initial, distinct lesions was important. Patients presenting with a single metastatic nodule had median survival ten months, whereas those with two or more metastatic nodules had median survival 6.9 months (P less than 0.05). The length of disease-free interval from excision of the primary to recurrence correlated consistently with subsequent survival in patients with regional lymph node metastases. Those with disease-free interval less than one year had median survival 15.8 months with 16% surviving at five years, while those with interval one year or longer had median survival 23.7 months with 30% surviving at five years (P less than 0.05). In Stage IV, the correlation of survival with disease-free interval became significant only with 24 months as the demarcation point of length of disease-free interval. Age and sex affected the disease-free interval, but not survival after recurrence.
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A case report is presented in which carcinoma of the cecum in the early stage manifests as acute appendicitis. The experience in the world literature has been reviewed. The carcinoma of the cecum is often missed during the initial appendectomy.
Two patients were recently treated for incarcerated obturator hernias. Although the entity is unusual, the consequences of strangulation obstruction magnify its importance. Awareness of the natural history of the disease and the pathognomonic Howship-Romberg sign should reduce the incidence of gangrenous bowel and its resultant complications. The pitfalls encountered in the care of two patients and a review of the literature form the basis for this report.