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PubMedDate not supplied

[Salvage surgery after unsuccessful radiotherapy of cancer of the larynx].

The problem of the surgical management of irradiation failures in laryngeal carcinoma is taken into consideration. A series of 60 consecutive laryngectomies performed at the E.N.T. Department of the Regional Hospital of Varese from 1982-1987 is presented. All patients had previously undergone curative radiotherapy for squamous cell carcinoma of the larynx with subsequent local recurrence. The postoperative course is examined in relation to the observed 11 cases of complications (18.3%) taking them into consideration individually. A statistical analysis is also presented for the incidence of complications in relation to the most significant parameters. No significant difference was found in regard to timer elapsed since termination of radiotherapy (more or less than 6 months), irradiation field extension (limited to the larynx or extended to the neck nodes), type of surgical salvage (including neck dissection or not) and pre-operative hemoglobin and blood proteins values. In those patients who had previously undergone irradiation, total laryngectomy is quite a safe procedure in terms of potential local-regional complications. The choice of primary radiotherapy should not be influenced by the fear of such complications arising if salvage surgery is required after local recurrence.

Adult↗
PubMed1979

Effect of preoperative administration of oxytetracycline and neomycin on the development of local tumour recurrences in cases of cancer coli-recti.

In the available literature some evidence has been shown, implying that antibiotic prophylaxis in connection with colorectal surgery might increase the frequency of local recurrences of the carcinoma. 134 patients undergoing elective curative surgery of the large bowel have been followed for 20-52 months. 66 patients had been pretreated with Enterobiotic; 68 patients were controls. In our study, we found no difference between the pretreated and non-pretreated group concerning the frequency of anastomotic suture line recurrences or other types of local recurrences in the operation field.

Adenocarcinoma↗
PubMed1989

Local recurrence after anterior resection.

Local recurrence after anterior resection is due to both pathological and surgical factors. The pathological factors include level of tumour, pathological stage, histological grade and the occurrence of perforation. Particularly important is the extent of local spread, which can be identified clinically by digital palpation and by endoluminal ultrasound. Extensive local spread identified preoperatively is related to local recurrence after surgical treatment. Surgical reports of the incidence of local recurrence from less than 5-30%. There is strong evidence of a surgeon-related variable. Mesorectal excision may be associated with a low rate of local recurrence. Pathological involvement of the lateral margin of excision is related to local recurrence. Implantation by viable tumour cells is likely to be related to anastomotic recurrence.

Anastomosis, Surgical↗
PubMed1975

Is a 'second look operation' justified in suspected recurrences after abdominal cancer surgery?

Seventy-three patients have been submitted to 74 further laparotomies for suspected recurrent malignant abdominal disease over a period of 13 months. The original tumour was situated in the large bowel in 42, oesophagus or stomach in 24, ovary in 3, small intestine in 2 and pancreas and retroperitoneum in 1 instance each. There were 10 examples of benign lesions, 16 of further primary cancer and 24 of resectable local recurrences or metastases. Seventeen patients underwent some palliative procedure, and only 7 were beyond any surgical help.

Abdominal Neoplasms↗
PubMed1976

Differences in potentiation of melanoma growth by absorbable and nonabsorbable suture.

This study demonstrates that various suture materials have different influences on tumor take and growth. When used in an area containing 10(5) or greater tumor cells, all suture types studied potentiated tumor growth. At subclinical tumor cell doses- that is, 1,000 or fewer cells that do not normally grow to a clinically detectable tumor- silk and steel increased tumor occurrence. In comparison, monofilament nylon, polyglycolic acid, and chromic suture did not potentiate tumor growth. This phenomenon of increased tumor growth associated with certain suture types appears to be related to the physical characteristics of the suture involved, although the interaction of the chemical breakdown products of the suture material with the local tumor cells is under investigation. The type of suture material used may play a significant role in the subsequent development of local recurrence of cancer.

Animals↗
PubMed1989

Potential impact of improvements in radiation therapy on quality of life and survival.

The NCI goal for the U.S. is to reduce the cancer mortality rate to one-half by the year 2000. Part of this improvement will be due to use of state of art treatment on a population wide basis and in addition, major improvements in efficacy of treatment. More effective radiation therapy will result in fewer local failures, increased survival, reduced treatment associated morbidity, and less frequent complications of treatment. The latter two aspects are very important to quality of life. If radiation combined with other modalities (e.g., sensitizers) were to become of greatly enhanced efficacy, then the number of patients requiring cystectomy, abdominal perineal resection, pneumonectomy, amputation, etc., would come down. The beneficial consequence would be fewer patients subjected to permanent ileostomy, colostomy, etc. The increase in survival if local failure were eliminated was estimated to be the decrease in local failure less the same loss in the new local controls due to DM as obtained in the local control patients after conventional treatment. For all sites, patients experience higher survival rates if they do not have local failure. For those sites where loss due to metastasis is not high, more effective local therapy would result in numerically impressive gains in survival.

Humans↗
PubMed1992

Etiology and prognosis of local recurrence in malignant melanoma of the skin.

All patients with stage I and stage II malignant melanoma of the skin were analyzed for stage; time of local, regional, or systemic recurrence, or two or more of these events; presence or absence of ulceration of the primary tumor; thickness of the primary tumor; level of invasion according to Clark; and margins of resection. Local recurrence had a significant negative impact on the long-term survival of patients. Our data revealed that local recurrence had the same poor prognostic effect as regional or systemic recurrence, or both. Factors significant in predicting local recurrence included the primary tumor characteristics of ulceration of the primary tumor and thickness of the primary tumor. Margins of resection and level of invasion were not noted significant in predicting local recurrence.

Florida↗
PubMed1991

A review of the role of established tumour markers.

Increasing numbers of commercial assays for the established tumour markers are available which are capable of excellent analytical performance. Whilst all these assays are useful as research tools, their clinical value is more limited and should be appreciated before any decision is taken to offer a tumour marker assay service. 1. Calcitonin (medullary carcinoma of thyroid), alphafetoprotein (hepatoma) and human chorionic gonadotrophin (choriocarcinoma) are the only tumour markers that can be used for screening for malignancy in high risk populations. 2. Hormones, paraproteins, alphafetoprotein, human chorionic gonadotrophin and prostate specific antigen are valuable in establishing the diagnosis of certain tumour types. 3. Alphafetoprotein and human chorionic gonadotrophin concentrations at the time of diagnosis are of value in predicting prognosis in specific tumour types. 4. Although their sensitivity for a particular tumour type may be poor, most tumour markers can be used for monitoring the therapy and follow-up of selected marker positive patients. Optimal clinical results of the management of patients with malignancy are usually obtained by specialist centres, and laboratory tumour marker services should be established so that they are appropriate to local oncology specialities.

Biomarkers, Tumor↗
PubMed1975

Experimental surgery on the Cloudman S91 melanoma with the carbon-dioxide laser.

The continuous wave CO2 laser lacks a number of draw-backs of the pulsed Ruby laser, and seems attractive for tumor surgery. We compared the CO2 laser with conventional surgery in experiments on mice bearing the Cloudman S91 melanoma. We had the same rate of local recurrence and lung metastasis in both techniques.

Animals↗
PubMed1990

[Adjuvant radiotherapy of rectal cancer].

Evaluation and refinement of surgical techniques in rectal carcinoma have reduced the rate of local recurrences. Nevertheless recurrence it remains high at more than 20% in patients with extensive infiltration of perirectal tissues and cures are an exception. Overview of many years of experience with adjuvant radiotherapy shows that local recurrence rate can be reduced and survival the rate improved.

Combined Modality Therapy↗
PubMed1989

[Cause and surgical management of local recurrence of rectal cancer following radical resection retaining the anus].

Of seventy-one patients with rectal cancer after radical resection retaining the anus, 15 developed local recurrence with a recurrence rate of 21.1%. Local recurrence was correlated with improper safety margin from the lower edge of cancer to the anal end. There was statistical significant difference between 3 cm or more and 2 cm or less. The local recurrence was also related to the pathologic stage, histologic differentiation and implant of free cancer cells. It is suggested that the surgical indication of saving the anus be strict and without stretching, the safety margin from the lower edge of cancer to the anal end should not be less than 2 cm in early rectal cancer and not less than 4 cm in advanced lesions. During the operation, no touching tumor technique, thorough rinsing of the peritoneal cavity and pre- or post-operative radiotherapy are important for prevention of local recurrence. Early local recurrent rectal cancer can be detected by periodic examinations.

Adenocarcinoma↗
PubMed1981

The melanotic neuroectodermal tumor of infancy. Report of two cases and review of the literature.

The melanotic neuroectodermal tumor of infancy (MNTI) is a rare childhood neoplasm with an alarming but classical clinical presentation. It appears as a rapidly enlarging mass in the jaws of skull of infants and unless MNTI is considered in the differential diagnosis, the lesion can easily be mistaken for a malignant neoplasm. Although possessing an aggressive growth rate and radiographic appearance, the MNTI almost always behaves in a benign fashion and can be treated with local excision. However, recent reports of malignant behavior as well as of occasional recurrences make close follow-up important. Approximately 139 cases of the MNTI have been reviewed and tabulated with respect to age at discovery, sex, tumor location, length of follow-up, and whether recurrence occurred, 2 additional cases, 1 of which was in the mandible, are presented along with theories of origin and recommended therapy.

Diagnosis, Differential↗
PubMed1987

Evaluation of bone scan as a screening work-up in primary and local-regional recurrence of breast cancer.

To evaluate the use of radionuclide bone scan in staging patients with primary and local-regional recurrence of breast cancer, we reviewed the results in 265 patients with primary breast cancer who had the scan either preoperatively or within 6 weeks of surgery, and in 39 patients presenting with their first local-regional recurrence. All patients were clinically staged according to the revised 1983 criteria of the American Joint Committee for Cancer Staging and End-Results Reporting. None of the 92 with stage I and four of 95 patients with stage II had a positive scan. Eleven of 41 with stage IIIA and 13 of 37 with stage IIIB had a positive bone scan. In patients with their first local-regional recurrence, 12 of 39 had a positive scan. Follow-up scans were available in 61 patients with clinical stage I and II breast cancer who had adjuvant chemotherapy for pathological involvement of axillary node. There were six conversions observed in 61 scans obtained during the first year. Seven converted in follow-up scans in 47 patients in the second year. We conclude that although bone scans have a low positive yield in stage I and II breast cancer, their use in the preoperative setting and in the follow-up of patients with axillary node involvement detects early converters. Bone scans are justified in stage IIIA and IIIB breast cancer and in patients being evaluated for local-regional recurrence.

Adult↗
PubMed1985

[Locoregional recurrence following the operative treatment of rectal cancer. Basic principles of prevention and therapy].

The frequency of local recurrences has been observed in dependence on sex, tumour specific parameters (typing, grading, staging, macroscopical form of growth, level of primary tumour) and technical parameters (method of operation, distal margin of resection). In case of early diagnosis, there is a possibility of differentiating technically caused local recurrences from those caused by the tumour because of their localization. Recurrences caused by the tumour may proceed from incompletely removed primary tumours. Technically caused recurrences may be primarily due to insufficiently resected tumours, which could have been removed completely. Only technically caused recurrences make a curative second operation possible. If the criteria of radicality are strictly observed during the primary operation, there should be no need for the so-called 'surgically curative' local recurrences to be treated anymore.

Adenocarcinoma↗