Biomedical subjects

J A Stryker

Publications and source records attributed to J A Stryker.

At least 37 records · Page 2Linked to original sources

PubMed1983

Patterns of failure following surgery alone for colorectal carcinoma.

Two hundred fifty-one patients with colorectal carcinoma were studied following complete primary resection to determine patterns of failure. Seventy-two patients (29%) subsequently developed failures: Local failure (LF) occurred as the only failure in 49% of the failure group and as some component in 81%; distant metastases (DM) occurred in 19% and 47%, respectively. The groups at highest risk for local failure were those with extension of tumor through the bowel wall whether the nodes were involved or not. Furthermore, those with gross extension of disease through the wall developed a significantly higher incidence of distant metastases compared to those with microscopic extension through the wall (P less than 0.005). The absolute 5-year survival rate for those with tumor through the wall vs within the wall was 40% and 79%, respectively. Adjuvant therapy was discussed in view of the ability to identify subgroups of patients at highest risk for local vs distant failures.

Adenocarcinoma↗

PubMed1983

Treatment outcome of recurrent cervical cancer.

A total of 85 patients with recurrent cervical cancer were reviewed: 17 patients with recurrences were treated by radical surgery, 18 by radiotherapy, 29 by chemotherapy, and 21 cases received no further treatment. Survival was presented according to the site of recurrence and the mode of therapy. All patients were followed for a minimum of 24 months after recurrence. Of the total group, 14% are living without evidence of disease, 29% died of metastatic disease with no involvement in the pelvis, and 45% died of pelvic cancer. Overall, 22% were living more than 2 years, and only 2% lived over 5 years after recurrence. The NED (no evidence of disease) rate for radical surgery group was 47 and 44% for the radiotherapy group. There were no significant differences in median survival between the chemotherapy group and the no-treatment group (6.8 versus 4.8 months). New chemotherapy agents and adjuvant systemic therapy are discussed.

Adult↗

PubMed1983

Colestipol hydrochloride prophylaxis of diarrhea during pelvic radiotherapy.

Thirty-three patients were randomized prior to pelvic radiotherapy to receive the bile acid-sequestering resin colestipol hydrochloride, 5 grams qid, during the entire time of their therapy or diphenoxylate hydrochloride and atropine sulfate 2.5-20 mg per day (control) if they experienced diarrhea. The colestipol patients also took diphenoxylate if they had diarrhea. The patients in the colestipol group often experienced nausea, vomiting, and abdominal cramps and 8 were forced to discontinue the drug. There was no difference in the weekly stool frequency between the colestipol and the control patients but the colestipol patients who took at least 50% of the prescribed dose required fewer diphenoxylate tablets than the controls. The data suggest that colestipol hydrochloride is not of value in preventing radiation-induced diarrhea because of the side effects associated with the drug, but the theory on which the use of bile acid-sequestering agents is based may be correct.

Adult↗

PubMed1982

Colorectal carcinoma: evaluation of histologic grade and factors influencing prognosis.

We analyzed 246 patients with adenocarcinoma of colorectum treated with "curative" surgery alone. In reviewing these cases it is apparent that patients with poorly differentiated tumor (Grade 3) have an increased likelihood of deep invasion of tumor through the bowel wall and lymph node metastases compared to well (Grade 1) or moderately differentiated tumor (Grade 2). Poor differentiation of the tumor, deep penetration through the bowel wall and lymph node metastases appear to represent unfavorable prognostic indices in patients operated upon. Age, sex, size of primary tumor, and large bowel site of tumor origin were unrelated to the prognosis. Compared to Grade 1 and 2 tumors, patients with Grade 3 lesions had more local recurrences and/or distant metastases. These findings suggest that histologic grading is an important adjunct to the clinical evaluation and treatment planning of patients with colorectal carcinoma.

Adenocarcinoma↗

PubMed1982

Evaluation of adjuvant postoperative radiotherapy for lung cancer.

One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

Adenocarcinoma↗

PubMed1982

Analysis of residual disease following preoperative radiotherapy versus initial surgery in endometrial carcinoma.

A clinicopathologic study of residual disease following pre-operative radiotherapy (RT) in 67 patients and initial surgery in 40 patients with early invasive endometrial carcinoma is presented. In 10%, extrauterine spread was found at operation. In 10% of patients, the histologic type, and in 19% the grade of tumor, differed between the curettage and hysterectomy specimens. Pre-op RT altered the depth of myometrial invasion and frequency of vascular invasion, but there was no evidence that irradiation itself affected the histologic type or grade of tumor. The patients with residual tumor after pre-op RT had significantly more cancer-related deaths than those without residual disease. The high risk factors were deep myometrial invasion and residual disease outside the uterus. Vascular invasion did not affect the prognosis in this series. The importance of surgical-pathologic staging by initial surgery is discussed.

Adenocarcinoma↗

PubMed1982

Carcinoma of the lung: evaluation of histological grade and factors influencing prognosis.

The results in 96 patients with lung cancer who underwent lobectomy or pneumonectomy were analyzed. In reviewing the case histories of these patients, it became apparent that those with poorly differentiated tumor (grade 3) have an increased likelihood of positive lymph node metastases compared with those with well-differentiated (grade 1) or moderately differentiated (grade 2) tumor. Poor differentiation of the tumor, vascular invasion, and lymph node metastases appear to represent poor prognostic indices in patients undergoing operation. Compared with patients with grade 1 and grade 2 tumors, patients with a grade 3 adenocarcinoma had more local recurrences, while those with grade 3 squamous cell carcinoma had more distant metastases. The findings suggest that histological grading is an important adjunct to the clinical evaluation of and planning of treatment for patients with lung cancer.

Adenocarcinoma↗

PubMed1982

Histopathologic subclassification of diffuse histiocytic lymphoma and response to therapy.

In 55 patients with diffuse histiocytic lymphoma (Stages I-IV), the disease was subclassified as large cleaved-cell (17 patients), large noncleaved-cell (12 patients), mixed follicular-center cell (14 patients), blastic (6 patients), and pleomorphic pyroninophilic (6 patients). Two-year survival rates for these subclasses were 47%, 42%, 64%, 17%, and 33%, respectively, suggesting that histopathologic subclass is an important prognostic factor in diffuse histiocytic lymphoma. The mean tumor dose that produced local control in 22 patients who were treated with radiation therapy alone was 4,834 rad (48.34 Gy), whereas the mean tumor dose for local control when chemotherapy was used in combination with radiation therapy (16 patients) was 3,679 rad (36.79 Gy). This suggests that when chemotherapy is used with radiation therapy, a lower tumor dose will be sufficient to achieve local control than when radiation therapy is used alone. In addition, 43% of the patients who presented with an intra-abdominal primary lymphoma experienced local failure following treatment. It is recommended that patients who present with an abdominal primary tumor be treated aggressively with combined modality therapy whenever feasible.

Abdominal Neoplasms↗

PubMed1982

14C-lactose breath tests during pelvic radiotherapy: the effect of the amount of small bowel irradiated.

Thirty patients who were undergoing pelvic radiotherapy had 14C-lactose breath tests performed in the first and fifth weeks of treatment. In Group I (21 patients), a significant portion of the small intestine was irradiated, and in Group II (9 patients), only a small portion of the small intestine was irradiated. In Group I, the average reductions in the excretion of ingested 14C between the first- and fifth-week tests were 41.5% at 1/2 hour postingestion (p less than 0.05), and 21.8% at 1 hour postingestion (p less than 0.05). In Group II, the percentage reductions were 11.8% and 3.7% at 1/2 and 1 hour, respectively (p greater than 0.05). The data suggest that lactose malabsorption is a factor in the etiology of the nausea, vomiting, and diarrhea experienced by patients who are undergoing pelvic radiotherapy, and that the amount of bowel included in the treatment volume significantly influences the degree of malabsorption.

Breath Tests↗

PubMed1982

Prophylaxis of radiation dermatitis with a topical cortisone cream.

Nineteen cancer patients receiving radiation therapy to the head, neck, chest wall, or abdomen were evaluated in a double-blind study to determine the effectiveness of 0.2% hydrocortisone valerate vs. placebo in reducing acute radiation dermatitis. Patients applied hydrocortisone valerate to one-half of the irradiate area and the placebo to the other half beginning two weeks after the initiation of radiotherapy and continuing until three weeks after completion. Left and right sides were scored each week with respect to erythema, dry desquamation, moist desquamation, ulceration, and the duration and intensity of symptoms such as soreness, burning, and itching. No statistically significant difference was found between the 0.2% hydrocortisone valerate and the placebo in the acute skin response or the symptoms of radiation dermatitis. The patients were evaluated three months following radiotherapy for evidence of skin atrophy. There were no differences found between hydrocortisone valerate and the placebo with respect to the late effects of radiation therapy.

Administration, Topical↗

PubMed1982

Taste acuity, plasma zinc levels, and weight loss during radiotherapy: a study of relationships.

Thirty-five patients who were to undergo radiotherapy and 13 normal subjects were evaluated with taste questionnaires, taste acuity tests, and plasma zinc analyses. The studies were repeated on the patients in the fifth week of radiotherapy. The mean taste thresholds for NaCl (salt), sucrose (sweet), HCl (sour), and urea (bitter) were elevated and the plasma zinc levels were lower (77.2 +/- 11.8 vs. 94.6 +/- 30.1 g/100 ml, p = 0.055) for the patients than for the controls. However, there was not a significant correlation between the taste thresholds and plasma zinc levels at any time. The mean weight loss experienced by the 14 patients who reported subjective taste alteration in the fifth week was 3.1 kg versus 0.1 kg (p = 0.005) for those who did not report taste alteration. The data suggest that alterations in taste acuity, but not plasma zinc levels, are associated with weight loss during radiotherapy.

Adult↗

PubMed1982