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Biomedical subjects

M H Shiu

Publications and source records attributed to M H Shiu.

At least 55 records · Page 3Linked to original sources
PubMed1983

Sensitivity of xenografts of human pancreatic adenocarcinoma in nude mice to heat and heat combined with chemotherapy.

The sensitivity of two human pancreatic adenocarcinomas (Capan-1 and Capan-2) to heat and heat combined with chemotherapy was studied using xenografts of the tumors in the foot of athymic nude mice. Heat was applied by immersion of the tumor in a water bath at 43.5 degrees for 1 hr. A single i.p. dose of mitomycin C, cisplatin, 5-fluorouracil, or 0.9% NaCl solution was given at 1 hr prior to treatment. Heat treatment alone significantly suppressed tumor growth (p less than 0.001), with 35% of the tumors showing complete regression. Combined treatment using heat plus chemotherapy yielded significantly greater suppression of tumor growth (p less than 0.05) with mitomycin for both tumors and with cisplatin or 5-fluorouracil for Capan-1. Combined treatment also gave higher rates of complete tumor regression: 55 and 64%, respectively, for Capan-1 and Capan-2 as compared with 18 and 47% for the respective tumors treated by heat alone. These observations suggest that human pancreatic carcinomas are sufficiently sensitive to heat combined with chemotherapeutic treatment to warrant a clinical trial of these modalities.

Adenocarcinoma↗
PubMed1982

Myosarcomas of the stomach: natural history, prognostic factors and management.

A retrospective study was made of 41 patients treated for gastric myosarcoma to identify prognostic factors that influence results. The adjusted five- and ten-year survival rates were 56% and 43% respectively, with no significant difference between leiomyosarcoma and malignant leiomyoblastoma. A histopathologic grade of malignancy could be assigned to each tumor according to the degree of hypercellularity, nuclear abnormality, mitotic rate and other characteristics. High histopathologic grade, large tumor size (greater than 5 cm diameter) and invasion of adjacent organs adversely affected prognosis. Five-year survival after curative treatment was: 100% (9/9) for small tumors, of which six were treated by wedge gastric resection; 67% (8/12) for large tumors, mostly after subtotal gastrectomy; and 0% for tumors that invaded adjacent organs, despite extended resections. It is concluded that the management of gastric myosarcomas can be planned according to these prognostic factors and that multimodal therapy of tumors with adverse factors warrants consideration.

Adult↗
PubMed1982

Sarcoma of the buttock: a trend toward limb-saving resection.

A retrospective comparison was made between soft tissue sarcomas of the buttock treated during two consecutive periods at one institution: (1) 1966-1978, during which almost all tumors were treated by radical buttectomy with limb preservation, often in conjunction with radiation therapy, and (2) 1934-1966, as previously reported by Wanebo et al, in which treatment by hemipelvectomy was frequently offered. Desmoid tumors were excluded. The five-year survival rates after curative treatment were almost identical, 40% vs 39%, respectively. Distant metastases were the main cause of death. Very high local recurrence rates were recorded after therapy: 45% vs 39% for the respective periods. Local recurrences seemed prone to occur with large, deeply fixed sarcomas, particularly when inadequate or no radiation therapy had been utilized. These observations point to the need for innovative methods to prevent local tumor recurrence and a trial of adjuvant chemotherapy if long-term cure with limb preservation is to be achieved.

Adolescent↗
PubMed1982

Management of primary gastric lymphoma.

A retrospective study of 51 patients treated for primary gastric lymphoma was made to evaluate the influence of clinicopathologic features and the method of treatment on survival. The lymphocytic type of tumor showed a higher survival rate than the histiocytic type. Tumors that involved only the gastric wall resulted in a five-year survival rate of 62%, as compared with 50% for tumors that involved also the adjacent gastric lymph nodes, and 25% for those involving the distant gastric lymph nodes. Treatment by subtotal, total, or extended forms of gastric resection without postoperative radiation gave a five-year survival rate of 33%. Resection followed by radiation yielded a higher survival rate of 67%. The best results were obtained in 13 patients who received higher doses of radiation: 11 (85%) survived five or more years. One-third of the patients developed manifestations of systemic malignant lymphoma after curative therapy. These observations suggest a planned multimodal therapeutic program for this disease.

Adult↗
PubMed1982

Resection of pancreas without production of fistula.

A method of management of the pancreatic stump after partial pancreatic resection is described which successfully prevented the development of postoperative pancreatic fistulas in 25 patients. After pancreaticoduodenectomy, performed upon ten of the patients, the pancreatic remnant was managed by ligation of the pancreatic duct, using an absorbable polyglycolic acid suture plus anastomotic invagination of the entire pancreatic stump into the jejunum. After distal subtotal pancreatectomy, performed upon 15 of the patients management of the pancreatic stump consisted of ductal ligation and provision of gentle occlusive coverage of the cut surface, using mattress sutures and an omental plug. Successful prevention of pancreatic fistulas in these patients probably depended upon ligation of the pancreatic ducts which precluded release of pancreatic enzymes into the jejunum and the juxtapancreatic region in the early postoperative period of healing.

Duodenum↗
PubMed1981

Adjuvant chemotherapy of soft-part sarcomas with ALOMAD (S4).

Sixty-four adult patients with soft-tissue sarcomas received adjuvant chemotherapy with a six-drug combination regimen after surgery. Seventy percent remain free of disease with a median follow-up of 50 months. Only seven patients have died of their disease, all within the first 24 months after surgery. Most patients experienced severe nausea and vomiting secondary to the actinomycin D and dacarbazine parts of the protocol, and three patients experienced frank Adriamycin cardiomyopathy. Toxicity from this combination was otherwise mild. The 58% recurrence rate of 12 patients who discontinued therapy early because of nausea was significantly greater than the 23% rate for those who completed or relapsed on therapy (P = 0.01). Adjuvant chemotherapy should be considered after surgery for patients with soft-part sarcomas, especially those with high-grade tumors that have a considerable risk of recurrence.

Adolescent↗
PubMed1981

Management by en bloc multiple organ resection of carcinoma of the stomach invading adjacent organs.

During the period of 1949 to 1971, 72 patients at this cancer center underwent en bloc multiple organ resection with curative intent for adenocarcinoma of the stomach that had invaded adjacent organs and structures. The over-all five year survival rate was 7 per cent and the operative mortality, 37.5 per cent. Patients with advanced stage tumors did poorly, although relief of symptoms and some prolongation of survival time were evident. Those patients with early staged tumors limited to the stomach and adjacent perigastric lymph nodes had a remarkable salvage rate of 31 per cent for a corresponding operative mortality of 25 per cent. Most of the postoperative complications and deaths occurred in the earlier period of the study and are preventable with present day surgical management; few deaths occurred during the last five years of the study. In the absence of detectable distant metastases, aggressive resection of these tumors is warranted in carefully selected patients with reasonable prospects of cure and palliation.

Abdominal Neoplasms↗
PubMed1980

Malignant soft-tissue tumors of the anterior abdominal wall.

A clinicopathologic study was made of 32 soft-tissue sarcomas of the anterior abdominal wall (ten desmoid tumors and 22 fully malignant sarcomas). Direct invasion of the costal margin or the iliac crest was observed in both types, whereas transperitoneal invasion and metastasis developed characteristically with fully malignant sarcomas. Wide monobloc resection of the abdominal wall, including, where necessary, resection of adjacent bony parts and reconstruction with a prosthetic mesh, satisfactorily controlled local disease in nine of ten patients with desmoid tumor, and in three of four patients with primary operable, fully malignant sarcoma. Adjunctive therapy with radiation and chemotherapy may improve the outcome in patients with recurrent or high-grade sarcomas, but adequate monobloc resection of the primary tumor remains the most important therapeutic objective.

Abdominal Muscles↗
PubMed1980

Selection of operative procedure for adenocarcinoma of the midstomach. Twenty years' experience with implications for future treatment strategy.

Pathoanatomic studies of the regional spread of adenocarcinoma of the middle one-third of the stomach suggested the need for extensive gastric and lymphatic resection. To seek evidence of improved results, a retrospective study was made of 213 patients curatively treated by three commonly used procedures: 1) radical high subtotal gastrectomy (SG, n = 39), 2) radical total gastrectomy (TG, n = 48), and 3) extended total gastrectomy (ETG, n = 126). The overall five-year survival rates were SG:10%, TG:16%, and ETG:19%. Advanced stage tumors (N2, N3, or M1) were highly lethal, irrespective of the type of resection. However, patients with early stage tumors (T1-4, N0 or N1) showed higher survival rates after more extensive resections (ETG:42% and TG: six of eight patients, versus SG:17%). The highest survival rate (93%) was observed in a subset of patients with early stage tumors electively treated by ETG; this was achieved despite the presence of metastasis to the juxtagastric (N1) lymph nodes or direct invasion of an adjacent organ in most of these patients. These observations confirm the merit of extensive resection for carcinoma of the midstomach.

Adenocarcinoma↗
PubMed1980

Treatment of regionally advanced epidermoid carcinoma of the extremity and trunk.

A retrospective study was made of 106 locally and regionally advanced epidermoid carcinomas of the trunk and extremity treated from 1949 to 1970. Forty-six of the tumors had a known cause, of which radiation exposure was the most common. In addition to axillary and inguinal nodal metastases, these cancers also manifested intransit, epitrochlear and popliteal lymphatic metastatic disease. Surgical treatment consisted of wide monobloc resection for the majority of the primary neoplasms, amputation being necessary for tumors fixed to skeletal or neurovascular structures. Clinically enlarged regional lymph nodes were subjected to biopsy, but elective regional node dissection did not offer therapeutic benefit. Patients with biopsy proved nodal metastases were treated by either radical nodal dissection or high exarticulation, with similar results. Actuarial five year survival rates after definitive surgical treatment were 71 per cent for patients with regional node-negative and 57 per cent for those with regional node-positive tumors. Local and regional recurrences of tumors were frequent in patients who had deep seated tumors of the trunk and postsacral region, or bulky nodal disease, despite pathologically negative resection margins. Uncontrolled recurrent tumor with sepsis and compromise of vital organ function was the most common cause of death. Radiation therapy achieved partial regression of the tumor in eight patients and complete regression in one of 15 patients. A critical analysis is made of the various clinicopathologic factors which affect prognosis, and the possible means of improving the results of treatment are discussed.

Adult↗
PubMed1980

Intraperitoneal hyperthermic treatment of implanted peritoneal cancer in rats.

The feasibility and efficacy of treating peritoneal cancer implants by applying heat to the peritoneal surfaces were studied in inbred Buffalo A rats given i.p. injections of Morris hepatoma 5123TC tumor cells. Heat was delivered to the peritoneum by contact with a heated physiological salt solution (Normosol-R) in the peritoneal cavity. A treatment temperature of 43.3 +/- 0.3 degrees was maintained for 30 min by an immersed stainless steel coil through which hot liquid circulated. Rats implanted with 0.5 to 1.0 x 10(8) tumor cells were treated at 1 to 4 hr (Group I), 4 to 5 days (Group II), and 22 to 24 days (Group III) after tumor implantation to simulate treatment for the clinical conditions of surgically spilled cancer cells, established microscopic cancer implants, and macroscopic cancer implants, respectively. A statistically significant improvement in survival was observed in Groups I and II compared with sham-treated control animals; 58% of the heat-treated animals were cured. Only a slight but statistically insignificant improvement was noted in Group III. These observations indicate that i.p. surface heat treatment of peritoneal implanted cancer is feasible and effective.

Animals↗
PubMed1979

Surgical treatment of tendosynovial sarcoma.

Tendosynovial sarcoma is notorious for its high rates of local recurrence and metastases after surgical treatment. A retrospective study was made of 109 cases of monobloc wide soft part resection and amputation for primary tumors, and 29 patients who underwent resection of pulmonary metastases. Actuarial five-year survival rates after soft part resection was 70% for untreated, and 61% for previously treated, locally recurrent neoplasms. Corresponding rates after amputation were 47% and 64%. Local tumor recurrence developed in 18% of the primary soft part resections and 4% of the amputations, usually when some basic surgical principle had been violated. 35% five-year survival was achieved with judicious resection of solitary and multiple lung metastases in most cases without chemotherapy. Local control of a tendosynovial sarcoma can be achieved with properly executed surgical procedures which adhere to established tenets of cancer surgery. Resection of pulmonary metastases merits an important position in the management of these patients.

Amputation, Surgical↗
PubMed1977

Limb-preserving vascular surgery for malignant tumors of the lower extremity.

Monobloc soft-part resections have been carried out with excision of segments of the illac and femoral vessels in seven patients with cancer in the lower extremity. Amputation would have been necessary otherwise. Ischemic loss of the extremity did not occur. In four of the earlier patients, vascular reconstruction was not performed, and postoperative lymphedema was a major complication. In the recently treated three patients, complete reconstitution of the circulation by simultaneous arterial and venous grafting permitted smooth postoperative recovery and absence of notable edema. Creation of a distal arteriovenous fistula appears essential to maintain venous patency. Six of the seven patients are alive at six months, 1, 3, 4, 7, and 18 years, respectively. One patient died of pulmonary metastases at three years after operation. Two patients developed local recurrences requiring limb disarticulation, both in the earlier group in which excision and grafting of both artery and vein was not done. It is concluded that excision and simultaneous reconstruction of major blood vessels can extend the scope of soft-part resections for cancer of the extremities, offering opportunities for preservation of limbs that would otherwise require amputation for control of disease.

Adult↗
PubMed1977

Tendosynovial sarcoma: a clinicopathological study of 136 cases.

A series of 136 cases of tendosynovial sarcomas were studied from the histologic point of view. All of the primary, recurrent and metastatic tumors were reclassified according to histologic type, anatomic site and size; age and sex of patients and modality of surgical treatment. The overall 5-year survival rate was 40%. Among the factors which most favorably influenced the prognosis were: small size (74%, 5-year survival), "exposed" primary site (53%, 5-year survival), and histologic type (biphasic form: 55%, 5-year survival and epithelioid sarcoma: 58%, 5-year survival). Children and elderly patients had also better than the average prognosis. Sixty percent of the sarcomas recurred after wide local excision. Twelve percent of the tumors metastasized to regional lymph nodes and 10% to bones. Almost all of the 24 patients who were autopsied died because of cardio-pulmonary insufficiency due to massive pleuropulmonary metastasis. It is hoped that better understanding of the natural history of these tumors will lead to optimal local and systemic therapy and better survival.

Age Factors↗