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K Keminger

Publications and source records attributed to K Keminger.

At least 19 recordsLinked to original sources
PubMed1991

[Risk factors in recurrent nerve paralysis: a statistical analysis of 7566 cases of struma surgery].

Between 1979-1988, 7566 operations for benign diseases of the thyroid gland were performed. The frequency of the paresis of the recurrent nerve examined between the third and fifth postoperative day was 5.2% for patients and 3.2% for resected lobes. The incidence was correlated to performed operative procedure (enucleation, subtotal resection, lobectomy) to size (weight of specimen) and to the expansion of the goiter (substernal, intrathoracic, retrotracheal) as well as to sex. These factors influence the risk of injury with high statistic significance. The side of resection and the ligature of the thyroid inferior artery also influenced the rate of recurrent nerve pareses. Age of patient and morphology of the thyroid disease did not cause an increasing risk of nerve injury.

Adenoma↗
PubMed1990

[Chemotherapy of highly malignant thyroid tumors].

In a prospective phase II study 15 patients suffering from anaplastic thyroid carcinoma or thyroid sarcoma were treated by surgery and chemotherapy. Chemotherapy varied according to age of the patient and histological subtype of the tumour. The following regimen was used: 100 mg/m2 BSA CDDP, 20 mg/m2 mitoxantrone and 1.5 mg/m2 vincristine. 10 patients responded to chemotherapy, 4 of whom had a complete response. Responders showed a longer mean and median survival time (20.8 months versus 4.5 ms, 15.5 ms vs. 3.8 ms, respectively) than non-responders. In the group responding to chemotherapy no evidence of metachronous metastases was found. Local recurrence was absent only in the patients showing a complete response. Anaplastic carcinomas with areas of differentiated thyroid carcinoma and small cell carcinomas (after exclusion of malignant lymphoma of the thyroid) showed a higher response rate to chemotherapy than spindle or giant cell carcinoma or thyroid sarcoma.

Aged↗
PubMed1990

[Prognostic factors in highly malignant thyroid tumors].

Patients diagnosed as suffering from highly malignant thyroid tumours die within a few months due to rapid tumour progression. Survival depends on some valuable prognostic factors, namely tumour size, lymph node involvement, metastatic status, fast tumour growth and preoperative N. recurrens paresis. Life expectation and life quality are dependent on the feasibility of radical surgical treatment. It is necessary to remove the whole tumour to improve the survival rate and to reduce the incidence of local recurrence. Some highly malignant thyroid tumours show a high chemosensitivity.

Adult↗
PubMed1989

["Secondary surgery" in the oncologic concept of malignant struma].

Between 1978-1987 a reoperation had to be performed on 115 patients with carcinoma of the thyroid gland due to oncologically inadequate initial surgery. In papillary carcinomas, the high percentage of T1-tumors (43.1%) were the reason for lack of prae- or intraop. diagnostic evaluation, with the follicular carcinomas the high percentage of borderline frozen section. With invasive carcinomas, residues of the tumor were found either in the remaining thyroid tissue or in the lymph nodes (20.8%) while no further tumor has been found in encapsulated carcinomas. The rate of recurrent nerve paralysis document right after reportation was 18%, and its frequency depended on the time interval between initial surgery and reoperation. With encapsulated carcinomas of the type T1 we would suggest not to consider a reoperation, because we do not expect intrathyreoidal metastasation nor tumor involved lymph nodes and the risk of causing a recurrent nerve paralysis by a reoperation is not justifiable.

Adenocarcinoma↗
PubMed1987

[Distant metastases of malignant thyroid cancer. A retrospective study of 892 cases].

In 892 patients with thyroid carcinoma, distant metastases developed in 151 cases, and these were classified according to conventional pathohistological types and--in particular--to the incidence of surgically treatable solitary sites. The aim of the present study was also to investigate whether the histological diagnosis is of value in predicting the pattern of metastatic spread. Distant metastases of anaplastic carcinoma and sarcoma were found most frequently in the lungs (70 out of 81 patients, this is 86%), with 4 cases being solitary tumors. Metastatic spread into the skeleton, however, occurred rarely (14 out of 81 patients, 17.3%), when compared with differentiated carcinoma (64.8%). Moreover, with the exception of 1 case, metastatic growth was not solitary but involved more areas in bone. On the other hand, the well differentiated carcinoma displayed a greater predilection for the metastatic spread to the skeleton: 35 cases of bone involvement were identified in 54 patients with distant metastases (64.8%), and out of these cases, 10 metastases were solitary. Metastatic spread into the lungs occurred less often (30 of the 54 patients, 55.5%) and always displayed a diffuse pattern or involved multiple sites. In some cases, solitary metastases of different histological types were also identified in other organs. Our findings suggest that the pathohistological classification appears to be of use in guiding the clinical approach to a curative extirpation of distant solitary metastases in selected patients.

Humans↗
PubMed1986

[The cold adenoma as a surgical indication in an endemic area: over- or underestimated?].

The retrospective analysis of 7016 operations of the thyroid (1978-1985) showed an increase of operations of cold nodules from 23% to 52%. The rate of malignancy of cold nodules decreased from 7.2% to 6.3%. But, the intensive operative management of cold nodules resulted in an increase of operations of low stage tumors. Therefore radical operation of thyroid tumors was possible in 68.3% of cases. An elevated rate of malignancy is observed, if a cold nodule is associated with the following criteria: solitary, solid, male patients, younger than 30 and older than 60 years.

Austria↗
PubMed1984

[Changes in thyroid gland surgery caused by nuclear medicine. Report of experiences on 32,743 thyroid operations].

At the time of Th. Kocher surgery was the predominant therapy of thyroid diseases. Because of interdisciplinary cooperation, i.e. nuclear medicine, radiology and endocrinology the indication for surgical therapy has narrowed. However, this cooperation proved to be profitable to the treatment of thyroid carcinoma. Radionuclear diagnosis made elective operative procedures possible. On the other hand, extended surgery as radical neck dissection or resection of trachea and oesophagus can be performed. Successful treatment of thyroid carcinoma, in former times more or less by chance, is nowadays possible to a very high percentage.

Adenocarcinoma↗
PubMed1983

[Medullary thyroid cancer].

This paper attempts to review current opinions on medullary thyroid carcinoma. Histologically described for the first time in 1951 belongs to the endocrine-secreting group of tumours (APUD). It can be sporadic as well as hereditary. The histological classification nowadays is increasingly performed immunohistologically via calcitonin. Clinically the tumour ranges from the very small, but hormonally highly active form, to the aggressive, mostly undifferentiated form. According to this the therapy must be radical. Our study group recommends thyroidectomy and functional neck dissection, followed by radio-chemotherapy. A close interdisciplinary follow up of the patients is necessary. Our surgical department treated 1048 thyroid malignancies between 1949 and 1982. 26 patients (2.4%) were diagnosed to have medullary thyroid carcinoma. Follow up time was between 1 month and 17 years. The recurrence--free interval was 4.5 years. The 5 and 10 year survival rate was 52% and 26%, respectively.

Adult↗
PubMed1983

[Experiences with recurrent malignant goiter].

At the Surgical Department of the Kaiserin Elisabeth Spital, Vienna, 30,301 thyroid operations have been performed from 1949 to 1981. Out of this number thyroid carcinomas were 1051 cases, 112 of them developed in recurrent goiter. Recurrencies of benign goiter were 2,743 (9.1%) cases. Overall frequency of thyroid carcinoma was 3.5% and they had a recurrency rate of 8.3% where reoperation was necessary. The percentage of thyroid carcinoma developing in operated benign goiter was 6.9%.

Female↗
PubMed1983

[Life expectancy in thyroid cancer in youth. Report on experiences with 28 cases].

28 cases of juvenile struma maligna are reported. One case, followed for 31 years, finally died as the only one out of this number. Since her 21st year of life multiple pulmonary metastases were known. This patient did well till her day of death and refused all therapy. She died because of general metastatic spread. No change of tumour's histology was observed. In case of thyroid carcinoma, pulmonary and bone metastases are frequent, whereas cerebral metastases are rare. Out of an autopsy material of 83 thyroid carcinomas, according to Walther, 77 patients showed pulmonary and bone metastases, but only 7 cerebral ones. It is pointed out that the thyroid carcinoma of the youth has a chronic course of the disease in spite of pulmonary metastases. This is a peculiar nature of this malignancy contrary to other carcinomas occurring in the young.

Adolescent↗
PubMed1981

[Mortality rate in surgery of goitre. Report on 27711 thyroid operations in the years 1949 to 1978].

This is a report on 27 711 thyroidectomies (partial and total) performed in the years 1949 to 1978 at the Empress-Elisabeth-Hospital Vienna. The patients treated comprise cases of simple goitre, recurrences, hyperthyroid and malignant goitres. Typical intra- and postoperative complications, such as air embolism, bleeding, damage to the recurrent nerves, thyrotoxic crisis, hypocalcaemia, disease of the thymus gland and postoperative malignant hyperthermia are discussed. Due to better preoperative medication and surgical technique respectively the frequency of intraoperative complications as well as thyrotoxic crises and recurrent nerve damage went down, thromboembolic complications however, increased corresponding to the increase of the mean age of patients undergoing surgery of their goitre nowadays.

Adult↗
PubMed1980

[Papillary carcinoma of the thyroid gland (author's transl)].

Records were examined of 174 patients with papillary thyroid carcinoma operated on at the 1st Department of Surgery of the University Hospital in Vienna between 1948 and 1976. The overall mortality rates amount to 20 +/- 8% after 5 years, rising to 70 +/- 21% after 20 years. Clear relationships are demonstrated between lymph node metastases, distant metastases, extrathyroid tumours and higher mortality rates. An older age correlates in the extrathyroid tumour group only with a higher risk of death. In our material reclassified by the criteria of the WHO classification (1974) between 1965 and 1976 the incidence of papillary carcinoma is 25% of all thyroid carcinomas. The incidence of this tumour subgroup varies in the literature between 25 and 90% and is influenced by regional differences in the use of childhood radiation on the one hand and iodine uptake on the other hand, different methods of thyroid examination and the subjectivity of the pathologist.

Adult↗