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Biomedical subjects

G H Lytle

Publications and source records attributed to G H Lytle.

10 recordsLinked to original sources

Five-year survival in breast cancer treated with adjuvant immunotherapy.

In this follow-up report of the treatment of primary breast cancer with adjuvant immunotherapy, a total of 95 patients were studied: 46 patients with stage I breast cancer and 49 patients with stage II breast cancer. All patients underwent standard surgical treatment and received immunotherapy as adjuvant treatment. Patients received a primary series of eight doses (1 mL of tumor-associated antigen preparation given as 0.2 mL intradermally and 0.8 mL subcutaneously) given over 8 weeks, and then booster injections every 3 months for at least 2 years. The 5-year survival with adjuvant immunotherapy was 83% for those with negative axillary nodes and 53% for those with positive nodes; this compares favorably with national 5-year survival statistics from two other studies (node-negative, 72% and 83%; node-positive, 51% and 59%). Based on these data, the addition of immunotherapy to other adjuvant therapies in randomized prospective trials seems both reasonable and justified.

Actuarial Analysis↗

Medical student abuse: a review of the literature and experience on one campus.

Medical students, when questioned, report a fairly significant rate of abuse during their education. A review of the literature shows the reported frequency of such abuse, as well as the several forms it may take. A review of one campus's experience shows a similar prevalence, as well as the effect of educational seminars on the perception of such abuse.

Education, Medical↗

Laparoscopic cholecystectomy: an initial community experience.

The initial 950 consecutive laparoscopic cholecystectomies performed in one city at four hospitals by 30 general surgeons are reported, covering a period from April 4, 1990 to April 3, 1991. There were two operative deaths (0.2%), three common bile duct lacerations (0.3%), two subhepatic abscesses, two bowel perforations, and three bile leaks, two requiring laparotomy. Seven episodes of bleeding occurred, of which five required laparotomy, but none involved a major vessel. Sixty-five procedures were converted to open (6.7%). The mean operative time was 85.4 min. Intraoperative cholangiography was adequately completed in 49.8% and not attempted in 30.3%. Thirteen patients (2.7%) were found to have common duct stones. The pathologic diagnoses were chronic cholecystitis in 784 patients (82.5%), acute cholecystitis in 145 (15.3%), and cancer of the gallbladder in one (0.1%). Hospital stays ranged from 4 h to 31 days (mean 49.5 h). This procedure can be learned and performed safely in a community setting.

Age Factors↗

Melanoma tumor vaccine: five-year follow-up.

For many years, various melanoma vaccines have been employed. This is a unique melanoma vaccine in that it is a subcellular tumor homogenate and no adjuvants have been added. This vaccine has been given to 129 stage I and 61 stage II melanoma patients. All were followed at least 5 years and had 87.5% and 63.9% 5-year survival rates, respectively. Sixty-four stage I males and 65 stage I females had 84% and 90% 5-year survival rates, respectively. We saw no difference between those with or without lymph node dissection. Thirty-six stage II males and 25 stage II females had 66.7% and 60% 5-year survival rates, respectively. Of stage II patients, 23 had only one positive node, 22 had two to four positive nodes, and 9 had five or more positive nodes with 69%, 63%, and 55% 5-year survival rates, respectively. Large published series were used as historical controls [6,27,28], and significant differences were noted when compared to our stage II patients (P = 0.001)--those with two to four positive nodes (P = 0.03), and those with five or more positive nodes (P = 0.04). We conclude that there is a significant increase in survival for these stage II patients, at high risk of recurrence, receiving a tumor homogenate vaccine. This vaccine warrants further analysis, development, and use in a phase III randomized clinical trial.

Adult↗

Postmastectomy locally recurrent breast cancer.

With the popularity of breast-conserving treatment plans, the natural history of "breast recurrence" in the ipsilateral breast must be distinguished from local recurrence following modified radical mastectomy. Hence, this study considers those patients who develop skin or chest wall recurrence after modified radical mastectomy, whether as a primary procedure or for patients with "breast recurrence" after partial mastectomy. The incidence of postmastectomy locally recurrent breast cancer following modified radical mastectomy (MRM) and adjuvant immunotherapy (IT) is compared to historical controls. The risk factors and treatment of local recurrence in this program as well as in a larger group of patients who recurred after modified radical mastectomy are reported.

Breast Neoplasms↗

Screening for colorectal carcinoma.

Colorectal carcinoma will occur in some 147,000 Americans this year. This disease accounts for 15% of all cancers and 12% of all cancer deaths. Screening for colorectal carcinoma may allow the disease process to be found earlier and, in some situations such as when polyps are found and removed, may even prevent the disease. The two main modalities of screening are fecal occult blood tests and sigmoidoscopy. By general screening of asymptomatic patients as well as by selective screening of those at high risk, there is hope that the incidence and mortality of this cancer will diminish. Absolute confirmation of this benefit is still lacking, making the evaluation of the cost-effectiveness of this screening somewhat questionable. Current educational efforts are designed to increase compliance and to help solve some of these unanswered questions.

Colonoscopy↗

Immunotherapy of breast cancer: a review of the development of cell-specific therapy.

A brief history of immunotherapy for breast cancer is presented, with emphasis on how theories developed as the field of immunology became more sophisticated. Non-specific therapies, such as Bacillus Calmette-Guérin, levamisole, interferon, interleukin, and others are reviewed. A form of cell-specific immunotherapy is then presented, and some current results are summarized. Problems and proposals for the future development of immunotherapy for breast cancer are then presented.

Breast Neoplasms↗