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At least 235 records · Page 13Linked to original sources
PubMed1988

The effect of inadvertent tumor contamination of wounds during the surgical resection of musculoskeletal neoplasms.

The effect of inadvertent tumor violation with visually evident wound contamination during the surgical resection of musculoskeletal neoplasms is unknown. In an attempt to assess the significance of wound contamination by tumor tissue, the incidence of local recurrence in 28 cases of known wound contamination was determined. The influence of immediate lavage, re-excision, subsequent surgical margin, and the use of adjuvant chemotherapy and/or radiation therapy upon local recurrence was assessed. Achieving a wide surgical margin by immediate re-excision after contamination gave a significantly lower incidence of recurrence than those with lesser final margins (P less than 0.01). The use of postoperative adjuvant chemotherapy or irradiation resulted in a lower recurrence rate, but the difference between those with and without adjuvant treatment had statistically less significance than the surgical margin on the incidence of local recurrence (P less than 0.2). The risk of local recurrence after contamination was not influenced by the histologic grade of the tumor.

Adult↗
PubMed2004

Transfusion of leukoreduced red blood cells may decrease postoperative infections: two meta-analyses of randomized controlled trials.

PURPOSE: To evaluate the efficacy and effectiveness of red blood cell leukoreduction in reducing postoperative infection, mortality and cancer recurrence, two meta-analyses of randomized controlled trials (RCTs) were conducted. METHODS: A systematic search of the scientific literature was conducted. The pooled relative risk ratio (RR) of developing an adverse postoperative outcome with either leukoreduced or non-leukoreduced blood was calculated using a random effects model. To better estimate the efficacy of leukoreduction, a second analysis of transfused patients only was conducted. RESULTS: Ten RCTs met inclusion criteria and eight provided separate data for patients randomized and transfused. The mean percentage of patients randomized but not transfused was 34%. For postoperative infection, the overall pooled RR was 0.76 [(95% confidence interval (CI): 0.54-1.08] for the "all patients randomized" analysis. For the "only patients transfused" analysis, the pooled RR became clinically and statistically significant (RR = 0.60 (95% CI: 0.38-0.93). For mortality, the pooled RR for the "all patients randomized" analysis was 0.71 (95% CI: 0.45-1.13) and 0.61 (95% CI: 0.36-1.04) for the "only patients transfused" analysis. When analyzing either all patients randomized or all patients transfused, there was no statistically significant difference in cancer recurrence rates (one study only). CONCLUSION: We demonstrated that patients who were transfused leukoreduced red blood cells might benefit from a decrease in postoperative infections. A decrease in mortality may have been realized if more patients had been enrolled in the various randomized trials. Including all patients randomized, regardless of whether or not they were actually transfused diluted the observed clinical benefit of leukoreduction.

Blood Transfusion↗
PubMed2003

[Follow-up of a cohort of 2604 colorectal adenomas treated in 1991 and 1992. Search for parameters related to adenomatous recurrence].

AIM: To evaluate the recurrence of colorectal neoplasia after endoscopic resection of adenomas. METHODS: The establishment of a register of colorectal cancers and pre-cancerous lesions for Loire-Atlantique (a French administrative division) led to the recording of files for all subjects with colorectal adenomas. The files for the cohort followed up for the years 1991 and 1992 were re-examined at the end of 1998 to determine the risk factors for recurrence. Data from control colonoscopies were recorded. RESULTS: The files of 2 208 (84.9%) of the 2 604 subjects included in the study were examined in 1998. One thousand and four hundred fifty- two subjects had at least one control colonoscopy after a mean period of 28 months: 743 (28.5%) had colorectal neoplasia recurrence, including 18 with a cancer and 50 (2%) with high-grade dysplasia adenomas. The parameters related to recurrence risk were: polyp size, number and topographic distribution of adenomas, pedunculated type, histopathological classification, especially the degree of dysplasia. CONCLUSION: Recurrence of neoplasic lesions (cancer, high grade dysplasia adenomas) may be observed after adenoma resection.

Adenoma↗
PubMed1998

[Local recurrences and mortality after mastectomy--a retrospective analysis].

It is the aim of the study to reveal the underlying causes of local recurrences and lethality in post-mastectomy patients. A retrospective analysis is done in a series of 293 patients presenting mammary gland carcinoma, operated in the period October 1994 through June 1996. The causes of local recurrences and lethality are linked to the stage of disease (TNM-system), pathohistological patterns of the neoplasm, malignancy degree, as well as inadequate surgical and therapeutic approach against the background of concomitant affections and age factor. The analysis is done using data-base elaborated by the author in computerized program "Paradox 5 for Windows". As shown by the results, in patients with high-degree neoplastic malignancy, inaccurate assessment by the TNM system preoperatively and in 2b and following stages, the rate of local relapses and lethality augment. 1. A more accurate elucidation of the preoperative stage of the disease using instrumental methods is absolutely necessary, since it contributes to reduce the risk of missing single stages in the complex management of this contingent of patients. 2. After obtaining a definitive pathohistological result and malignancy degree assessment, a revision of the complex management protocol worked out in advance is indispensable.

Adult↗
PubMedDate not supplied

Development of mantle cell lymphoma in a patient with adrenocortical carcinoma and an 18-year survival after complete removal of the primary cancer and resection of local recurrences.

The case of a patient with a non-functional and poorly-differentiated adrenocortical carcinoma, who had an unexpected long-term survival after a right adrenalectomy and subsequent removal of 2 local recurrences, is reported. However, fifteen years after the complete resection of the primary neoplasm, the patient first developed an autoimmune thrombocytopenic purpura and later a mantle cell lymphoma located in the mediastinal lymph nodes. This case confirms the possible growth of a second tumour in patients with adrenocortical carcinomas, especially if presenting a long survival after resection of the primary malignancy, and emphasises the need for the close follow-up of these patients.

Adrenal Cortex Neoplasms↗
PubMed1978

A twenty-year analysis of the results of sleeve resection for primary bronchogenic carcinoma.

Ninety-six patients with primary bronchogenic carcinoma were treated by lobectomy with sleeve resection of the bronchus, over a 20 year period (1958 through 1977). In 80 resections undertaken prior to 1973, a 5 year survival rate of 34 percent was realized, with an operative mortality rate of 7.5 percent. Survival at 10 and 15 years has been assessed. A review of factors influencing survival has been undertaken and the biologic behavior of these pulmonary neoplasms, modified by sleeve resection, has been outlined. Of interest is the high rate of local recurrence accounting for death within 5 years postoperatively and the late incidence in the survivors of second malignancies and other diseases of surgical interest. Sleeve resection represents a surgical alternative in selected cases of bronchogenic carcinoma in which wider resection may be hazardous, and the indications should be extended to include some lesions commonly managed by pneumonectomy.

Adult↗