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Biomedical subjects

G Crile

Publications and source records attributed to G Crile.

At least 19 recordsLinked to original sources
PubMed1985

The advantages of subtotal thyroidectomy and suppression of TSH in the primary treatment of papillary carcinoma of the thyroid.

Patients between the ages of 6 and 45 years with distant metastases from papillary carcinoma of the thyroid can be treated as effectively by subtotal thyroidectomy and suppressive doses of thyroid hormone as by total thyroidectomy followed by treatment with iodine 131 (131I). Moreover, distant metastases can be treated by either 131I or suppression as effectively after they are apparent on x-ray as they can be when treated in a subclinical stage. Therefore, in patients younger than 45 years old it is rarely necessary to perform a total thyroidectomy or to do frequent postoperative scans. In patients older than 44 or younger than 7 who have distant metastases or extensive involvement of both lobes, total or almost total thyroidectomy is justified if it can be done with minimal morbidity. In patients of this age group whose tumors fail to respond to suppressive doses of thyroid, 131I should be used. In view of the importance of diagnostic related groups (DRG) to the economy of hospitals, we note that the cost of total thyroidectomy, ablation by 131I, and intermittent body scans is at least three times that of less radical procedures which, in conjunction with suppression by thyroid feeding, give the same survival with less morbidity.

Adolescent↗
PubMed1985

Results of conservative operations for breast cancer.

The results of conservative operations for breast cancer in 1,593 patients treated at the Cleveland Clinic between 1957 through 1975 are reported. During this period, we individualized our treatment of breast cancer depending on tumor size, location in the breast, and clinical stage of the disease. The following three principal operations were performed: modified radical mastectomy in 592 patients (37%), simple (total) mastectomy in 442 patients (28%), and partial (segmental) mastectomy in 291 patients (18%). Survival results at 5, 10, and 15 years are reported. Factors important in long-term survival included stage of the disease, number of lymph node metastases, delay in therapy, size of the tumor, histologic type, and estrogen receptor status; type of operation was not a significant factor. In this series, partial (segmental) mastectomy without radiation therapy provided five- to 15-year survival rates equal to modified radical mastectomy and simple (total) mastectomy.

Adenocarcinoma, Mucinous↗
PubMed1985

Factors influencing the survival of patients with follicular carcinoma of the thyroid gland.

Between 1948 and 1977, 84 patients with follicular carcinoma of the thyroid gland were treated at the Cleveland Clinic. The crude survival rate was 73 per cent at five years and 43 per cent at ten years. The most important prognostic factor was the age of the patient--86 per cent of those less then 40 years old appeared to be cured of carcinoma compared with only 26 per cent of those more than 60 years old. The survival of women was a little better than that of men. Patients with large tumors did not do as well as those with small or medium sized ones. Those with highly invasive carcinoma did poorly as did those with oxyphilic tumors. Neither the extent of the operation nor the use of either external radiation or 131I appeared to affect prognosis. Both involvement of lymph nodes and local recurrences had grave prognostic significance. Those who had neither distant metastases nor a history of recurrence after a previous operation when they were first seen by us had good prognoses, 90 per cent of them apparently having been cured.

Adenocarcinoma↗
PubMed1984

Partial mastectomy without radiation therapy.

Partial mastectomy without radiation therapy has been used at The Cleveland Clinic as a treatment option for selected patients with breast cancer since 1957. Our experience with 322 patients has been reviewed; survival results are equal to or better than the other operative procedures we have employed for the treatment of breast cancer. These results, we believe, relate more to the selection of patients with small tumors and at a more favorable stage of the disease than to the benefit of the operative procedure itself.

Axilla↗
PubMed1984

Breast cancer. A personal perspective.

The history of the evolution of thought about the treatment of breast cancer is reviewed. First the surgery was too radical, then radiation was overused; soon perhaps adjunctive chemotherapy will be overused. We should continue to search for new methods such as combinations of heat and radiation that might maintain or increase the immunologic resistance of the host.

Animals↗
PubMed1983

Treatment of breast cancer: past, present, and future.

We have gone through a period when radical surgery for breast cancer was accepted without question. Next there was a period in which radiation was used almost routinely after operations. Now chemotherapy is in high vogue. We are still in a period of transition, with a momentum toward simpler, often breast-saving, operations, usually with axillary dissection and often with added radiation. When mastectomy is performed, reconstruction of the breast is an option for those who want it. Today we can safely say that no woman need live without a breast unless she prefers to do so. The final choice of treatment now rests with the patient.

Breast Neoplasms↗