Biomedical subjects
Publications and source records attributed to M I Davydov.
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According to the data on the treatment of 964 patients with cardioesophageal cancer, the local recurrence incidence fell dramatically (from 19.7 to 4.8%) in patients who had gone extensive surgery. The results of treatment of 1,209 cases operated on for tumor in the proximal part of the stomach are discussed. Extensive excision of lymph nodes without postoperative complications was found to assure better end results. Excision of lymph nodes should be regarded as an indispensable component of extensive surgery given for stomach cancer.
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The specific features of the development and natural history of nonclostridial anaerobic infection (NACI) were studied in 125 cancer patients with various site tumors. It was shown that after surgery for malignant abdominal and genital tumors, NCAI might develop in the late postoperative period despite antibacterial antianaerobic prevention and even long-term antianaerobic therapy. NCAI treated with antianaerobic therapy was found to run long with aggravations and remissions in patients undergone surgery and drug therapy for genital cancer. Radiation therapy is a risk factor for NCAI in patients with malignant genital neoplasms. The risk factors for NCAI in skin cancer patients are tumor ulceration, second infection, and resolution. The most severe problem is likely anaerobic bacteremia in cancer patients. Anaerobic bacteremia appears to be more common than we thought and this issue requires further in-depth study.
Whether the DNA index (DNAI) of tumor cells and serum carcinoembryonic antigen (CEA) may be used to make prognosis in 78 patients with epidermoid lung cancer at the stage of T1-3 N(o) Mo was studied. There was a direct correlation between tumor ploidy and CEA levels. The two-year relapse- free survival among the operated-on patients at the stage T1-2 N(o) Mo was not shown to be associated with DNAI. At the same time in the T1-3 M1-2 Mo patients radically operated on, the two-year survival correlates with DNAI: it is significantly (p < 0,05) higher in patients with diploid tumors (DNAI = 1.0) than in those with aneuploid cancer (DNAI > 1.05). The patients with low preoperative CEA levels ( < 10 micrograms/l) have a more favourable prognosis after radical surgical treatment.
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Some prognostic signs of surgical treatment of carcinoma of the lung are analysed. The stability and paramount importance of the integral clinical factor "extension of the tumor" is shown. The ultrastructural features of adenocarcinoma and squamous-cell carcinoma of the lungs influencing the disease prognosis were revealed. It is shown that electron microscopy allows differentiation of the tumor cells to be profoundly and precisely assessed. The results of the study unable a differentiated approach to the problems of postoperative therapy.
The authors describe 694 patients who underwent operation in 1985-1993 for carcinoma of the proximal part of the stomach with various degree of involvement of the adjacent parts of the stomach and esophagus. The tumors differed in histological structure. The main principles of classification of the groups of regional lymph nodes, taking into account the localization of the tumor in the stomach, are shown. These Principles are applied by Japanese surgeons in performing lymph node dissection and were modified in the Clinic od Thoracic Oncology of the Scientific Research Institute, Oncological Center, Russian Academy of medical Sciences. The localization and incidence of metastases in disseminated carcinoma of the proximal stomach with involvement of the esophagus were studied. The sequence of the stages of intraabdominal lymph node dissection in proximal gastric resection and gastrectomy is discussed. The tendency towards improvement on the indices of 3-year survival after expanded operations is noted. Expanded operations with scrupulous morphologic examination of the removed lymph nodes is very important for more precise determination of the stage and individual prognostication of the choice of the postoperative methods of treatment. In palliative interventions the operation is cytoreductive in essence and may create to a certain measure better conditions for chemotherapy.
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Biochemical characteristics of blood serum were studied in 310 patients with lung cancer (stage I-IV), 188 cases of non-malignant pathology od the lung and 35 healthy subjects. Mean levels of total sialic acids, lipid-bound sialic acids, neuron-specific enolase and lactate depydrogenase in blood serum of cancer patients were significantly higher than those in control groups. Mean neuron-specific enolase concentrations in small cell carcinoma of the lung were significantly higher than those in squamous cell and glandular carcinoma and carcinoid. Significant differences were observed for blood serum levels in cases of lung cancer disseminated to the liver and bones, as compared with those without distant metastases. Gamma-glutamyl transferase proced the most sensitive and specific when used for diagnosis of hepatic metastases, while alkaline phospohase--for bone metastases.
Clinical and morphological criteria for the extent of resection of the adjacent organs (structures) involved in the metastatic process were defined by analyzing 598 extensive, combined, and extensive-combined operations for giant-cell carcinoma of the lung. Morphological studies of the serial sections of resected intrathoracic structures showed that the true margins of the process extent do not always correspond to those determined on revision or palpation. It was indicated that for radical intervention, the pericardium should be resected at least at 2 cm from the visible invasion edges when a tumor is extended into it. When the process is extended into the diaphragm and chest, resection should be made at least at 2 cm of the tumor edges. In endobronchial carcinoma, the bronchus should be dissected at a distance of at least 1 cm from the tumor edges, but in peribronchial and mixed forms, it should be done at least at 2 cm. Intraoperative morphological studies are demonstrated to be of high diagnostic value in identifying the local and regional extent of lung cancer.
The article deals with the experience in the treatment of more than 1,000 patients with cardioesophageal carcinoma in 1965-1989. The authors note increase of surgical activity and widening of indications for operative treatment at the cost of patients of the old age groups and those with locally-extending forms of the neoplastic process. In distinguishing the term cardioesophageal carcinoma the authors insist on the community of the surgical tactics and operative methods in carcinoma of the cardia extending to the esophagus and in esophageal carcinoma spreading to the stomach. Improvement of the results of tre treatment the authors attribute to the perfection of the methods of lymphodissection and formation of esophageal anastomoses. The authors claim that the development of effective methods of combined treatment underlies the prospects of improving the late-term results. Experience in preoperative hypoxyradiotherapy, adjuvant postoperative chemotherapy, and preoperative regional intraarterial polychemotherapy is analysed.
163 operated on patients were divided into 2 groups: the 1st group--those surviving 5 years without recurrence (44.2%) and the 2nd group--those dying earlier from the tumour progression (55.8%). Central carcinoma was in 104, peripheral one in 59 cases. The number of dark cells (DC) and the degree of desmosome development revealed ultrastructurally have the greatest practical importance as the favourable course in the 1st group was associated with the absence or low number of DC (7%) and the high number of desmosomes (89%). These indices were found in the 2nd group in 86 and 41%, respectively. Both indices are of independent importance and are not associated with the spread of the carcinoma. The level of DC is of greater importance. Prognosis of the squamous cell carcinoma is the worse the higher is DC number in the tumour and the lower the desmosome number.
The homeostatic features of trace elements were studied in 48 patients with cardio-esophageal and esophageal carcinoma in development of incompetence of the anastomosis sutures (17), peritonitis (19), and intestinal fistulas (12). The level of the trace elements was determined in the red cells, blood plasma, and urine by emission plasma spectrometry. With the development of surgical complications after operation on the stomach and esophagus, the metabolism of trace elements was sharply disturbed, catabolic processes prevailed and were manifested by the escape of essential trace elements from the cells and their excretion in the urine. The changes of trace elements metabolism were more profound in peritonitis and intestinal fistulas. Complex intensive therapy including artificial feeding corrected partly the metabolic disorders.