The surgical margin in soft tissue sarcoma.
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Adult↗
Biomedical subjects
P N Miceli
Publications and source records attributed to P N Miceli.
The surgical margin in soft-tissue sarcoma.
In a retrospective review of 231 patients who were referred to Princess Margaret Hospital because of a soft-tissue sarcoma in an extremity, 100 patients were identified who had no metastases when they were first seen and who had been treated by local resection and adjuvant radiation therapy. Complete data were collected for each patient for the following variables: age; sex; location of the tumor and its size, grade, depth, and compartmental status; chemotherapy; and dose of radiation. The surgical margins were characterized as positive or negative for histological evidence of disease on the basis of an independent review of the pathological and operative reports by a surgeon and a radiation oncologist who were experienced in the management of sarcoma. Cox multivariate analysis was used to determine which of these variables contributed to local recurrence and evidence of systemic disease. Adequacy of the margin of resection was the only variable that was associated with local relapse (p = 0.0004). The size of the tumor (p = 0.0008) was the major determinant of the risk of systemic disease.
Adolescent↗
Breast cancer. Experiences with conservation therapy.
A series of 1,504 patients with clinically node-negative carcinoma of the breast treated by breast conservation has been followed for 26 years. The majority did not have an axillary dissection. A relative survival of 84% at 5 years and 72% at 10 years compares favorably with reported survival rates for radical surgery. Postoperative irradiation does not influence survival but breast irradiation reduces relapse in the breast. Irradiation of the regional nodes is unnecessary. Lumpectomy alone in clinically node-negative patients produces a survival rate equivalent to more radical treatment. Younger patients had larger tumors, an increased risk of breast relapse, and reduced survival. Local or distant relapse was not a function of estrogen receptor (ER) or progesterone receptor (PR) status.
Adult↗
Amyloid angiopathy in Alzheimer's disease.
Thirty cases of Alzheimer's disease and 30 age-matched controls were studied to determine the incidence of cerebral amyloid angiopathy and its relationship to age, neuritic plaque formation, and amyloid plaque content. Cerebral amyloid angiopathy (CAA) was present in 86% of AD cases and 40% of age-matched controls. Its frequent occurrence in AD is not merely a reflection of the advancing age of this group: it was seen only in the presence of neuritic plaques, regardless of age, and represents an integral component of AD. Neuritic plaques however, did occur in the absence of CAA in 17% of all cases. The amount of vascular and plaque amyloid tended to be of comparable severity in many cases, but significant discrepancies were observed, with preferential deposition of amyloid in either plaque or vessel. Our results suggest that neuritic plaque formation and amyloid deposition are linked genetically or etiologically, but independently expressed, without a cause-and-effect relationship.
Adult↗
Clinical correlations of carcinoembryonic antigen in post-operative patients with epithelial ovarian cancer.
Plasma CEA as a tumor marker was studied in 681 postoperative patients with invasive epithelial cancer of the ovary. The sensitivity of a single CEA value was low in correlating with tumor burden, relapse status or in predicting subsequent relapse. The false negative rate was high. Serial samples were helpful in predicting relapse in a small number of patients where the value was persistently high. CEA showed greater sensitivity and prognostic value in patients with the mucinous tumor subtype, than other histologies. A clinically useful role for CEA is likely to be restricted to small subsets of patients, such as those with mucinous tumors where CEA may have a complementary role with other markers. A change in assay method during the course of the study resulted in a weakening of the value of CEA as a tumor marker.
Analysis of Variance↗