[Problems of organ-preserving treatment of breast cancer (lecture)].
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Biomedical subjects
Publications and source records attributed to I V Kuz'min.
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Two hundred-thirty patients were operated on for peripheral lung cancer TIN0M0 in 1960-1990. Pheumonectory was performed in 3 cases, lobectomy-123, segmentectomy-40, wedge-like resection-57 and removal of tumor-in 7 cases. Limited resection in 20 patients was not followed by radiation therapy, Radiation treatment was given to 15 patients preoperatively, 53-postoperatively and 16 patients-pre-and postoperatively, Five-year survival after combined treatment was recorded in 70.5%, while without this treatment-68.7%. Local recurrences following limited intervention were usually detected 3-5 years later, regional and distant metastases developing within the first 24 months. A reverse correlation was established between extent of surgery and local recurrence incidence. Reoperation such as lobectomy or pneumonectomy is feasible in cases of timely diagnosis. The highest 5-year survival rates were registered for segmentectomies carried out in combination with postoperative radiotherapy (77.2%). Prognosis proved best in cases of adenocarcinoma and tumor arising in the cicatrix. Paliative surgery appeared preferable for primary tumor 1.5 cm in diameter and less. Even in small-size malignancy, removal of tumor is not radical enough, Wedge-like resection is admissible in small-size subpleural lesions only. Preoperative radiotherapy results proved inferior to those of other procedures of combined treatment. Pronounced radiation-induced pneumonitis involving re-hospitalization for symptomatic treatment occurred in 7 (5.5%) cases of lobectomy combined with radiotherapy and in 2 (1.9%) cases of limited resection.
The study group included 2161 patients operated on in 1968-1990. Tumors stage I were morphologically confirmed in 910 cases (T1S-3, T1-375 and T2-532). 827 patients survived 5 years (90.9%); 551 patients-10 years (60.3%). Primary multiple neoplasms (PMN) of different localization were detected in 96 (10.6%) patients with stage I tumors. Thirteen patients (13.5%) died of progression of a second tumor; 17 (17%)-of other causes. Average 5-year survival was 65%, 10 years-53%. These indices in 96 patients with PMNs were 73 and 53%, respectively. Relative risk of PMN in lung cancer was found to be in direct correlation with survival time and to depend, to a large degree, on tumor extension. When PMNs are detected early and treated radically, new primary tumors emergence does not significantly in lung cancer stage I. Preliminary results showed chemotherapy (neoadjuvant one included) to lower the risk of PMN in lung cancer stage I. The most plausible causes of enhanced survival of patients with PMNs are discussed.
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This study was undertaken for the purpose of determining the primary structure of the 3' end gene of RNA polymerase of foot-and-mouth disease virus A22 550. Reported are isolation and purification of the virus, isolation of RNA, synthesis of cDNA, experience obtained from cloning as well as analysis of hybridisation and isolation of plasmid DNA. Nucleotide sequences, characterised by specific clones, were tested for potential needle structures. Also described are homology comparisons among FMD virus types A12, A10, O1, and C1.
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Complete nucleotide sequence of gene RNA polymerase for the foot-and-mouth disease virus subtype A22 has been determined.
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An analysis of short- and long-term results of the combined treatment of tumors of the trachea and adjacent organs with the involvement of the trachea in 100 patients suggests that this method holds promise. In 41 patients the irradiation phase preceded operation, in the rest of 59 patients it followed operation. Radiotherapy was performed daily, 5 fractions every week at a single focal dose of 2-3 Gy. The summary focal dose was 36-48 Gy, for some of the patients 70-80 Gy. Adjuvant radiotherapy did not prevent the performance of complex reconstructive plastic operations with circular, distal or window resection of the trachea. Postoperative complications occurred in 16%, lethal outcome in 4%. Five-year survival following the combined treatment of tracheal tumors was observed in 57%.
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Late results of surgical treatment for lung cancer in stage TINOMO have been studied. A 5-year survival was 83.3%, 10-year survival--67%. Primary multiplicity of malignant tumors was revealed in 16% of observations. Peripheral cancer has more frequently arisen against the background of scars, central- on the background of proliferation and metaplasia of bronchial epithelium. Roentgenological methods for recognizing small size tumors proved to be effective in peripheral cancer, repeat cytological assays of the sputum--in central one. Lobectomy is considered to be the operation of choice in this stage of cancer. The diagnosis of cancer established in stage T1N0M0 should be considered as being timely, but it requires further improvement in the organization of active recognition of such patients.
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