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PubMed1990

[Etiopathogenetic considerations on local recurrence after excision of rectal carcinoma].

A series of 77 cases of rectum carcinoma observed in a six year period, is presented. Sixty-one patients underwent radical operation and 57 of them have been regularly followed up. The incidence of local relapses has been 12.28%, with a majority of perianastomotic forms. It turned out to be proportional to the aboral distance and to primitive neoplasm staging, but not to histologic differentiation degree. Staplers were used and therefore the choice between resection or amputation was determined by the degree of loco-regional infiltration of the neoplasm. The frequency of local relapses turned out not to be related to the type of operation, but the impossibility to the exeresis of perirectal tissues involved by neoplastic process.

Adult↗
PubMed1989

Preoperative staging techniques for soft-tissue neoplasms.

Preoperative staging studies need not be limited to one of the techniques discussed since each has its own specific advantages and disadvantages in the overall evaluation of soft-tissue neoplasms. Among orthopaedic oncologists, however, it is apparent that MRI is becoming the preoperative staging study of choice. It is by the careful, judicial use of one or all of these techniques that optimal diagnostic information is obtained and the patient given the best treatment alternatives.

Angiography↗
PubMed2000

Non-Hodgkin's lymphomas involving the uterus: a clinicopathologic analysis of 26 cases.

Non-Hodgkin's lymphomas (NHL) involving the uterus may be either low-stage neoplasms that probably arise in the uterus (primary) or systemic neoplasms with secondary involvement. In this study, 26 NHL involving the uterus are reported. Ten cases were stage I(E) or II(E) and are presumed to be primary. The mean age of patients at presentation was 55 years (range, 35 to 67 years), and abnormal uterine bleeding was the most frequent complaint (six patients). Nine of 10 tumors involved the cervix. Histologically, eight were diffuse large B-cell lymphoma (DLBCL); one was follicle center lymphoma, follicular, grade 1; and one was marginal zone B-cell lymphoma. At 5 years of clinical follow-up, five of six patients were alive after treatment. In 12 cases, uterine involvement was part of a systemic disease at diagnosis, either stage III(E) or IV. The mean patient age at the time that uterine involvement was detected was 58 years (range, 22 to 75 years); 6 of 12 had abnormal uterine bleeding. Six tumors involved both cervix and corpus, four corpus, and two cervix. Six were DLBCL; two were small lymphocytic lymphoma; three were follicle center lymphoma, follicular, grade 1 (two cases) or grade 2 (one case); and one was precursor T-cell lymphoblastic lymphoma. At 5 years of clinical follow-up, two of seven patients were alive after treatment. Four DLBCL arose in patients with incomplete clinical information; therefore, stage is unknown. We conclude that low-stage (presumably primary) uterine NHL are most commonly DLBCL, predominantly arise in the cervix, and cause abnormal uterine bleeding. High-stage NHL are a heterogeneous group of B-cell neoplasms that can involve the cervix or the corpus.

Adult↗
PubMed1993

[Transurethral echography in the staging of bladder neoplasms].

Forty vesical neoplasias in various stages and which were treated through transurethral resection followed by chemotherapy, in accordance to the currently accepted approach, were studied using transurethral ultrasound techniques. A histochemical correlation is established based on the proposed U.I.C.C. grading (T.N.M.). Such correlation coincides in 88.2% of cases for the "unified" Ta-T1 stage; 70% for T2; 88.8% for T3; and 100% for T4.

Adult↗
PubMed1980

Angiography in the diagnosis and staging of pelvic neoplasms.

The efficacy of arteriography in the staging of pelvic neoplasms was examined in 447 patients. It was found to be most useful in defining advanced neoplastic disease, improving accuracy of staging in these patients by about 18%. In patients with early pelvic neoplastic disease, arteriography reduced the number of false positives.

Angiography↗
PubMed1995

Clinical aspects of risk in women with endometrial carcinoma.

Carcinoma of the endometrium is the most common gynecologic malignancy, expected to account for 33,000 new cases and 6,000 deaths in 1995. Most endometrial cancers occur in postmenopausal women and produce abnormal vaginal bleeding. Some women exhibit the premalignant changes of atypical endometrial hyperplasia before developing an overt carcinoma. Identified epidemiologic risk factors include obesity, diabetes mellitus, use of unopposed exogenous estrogens, estrogen-secreting tumors, and a reproductive history characterized by prolonged estrogenic predominance. Diagnosis can be readily established by outpatient endometrial biopsy. Because clinical estimates of disease extent and spread are subject to substantial error, endometrial cancer is now a surgically staged neoplasm. A well-defined set of surgicopathologic risk factors have been incorporated into the staging scheme. Women with extrauterine disease comprise about 20% of cases and are at greatest risk for tumor recurrence and death from disease. Within the much larger group of women whose tumors are limited to the uterus, recurrence risk can be stratified by cytologic grade, cell type, depth of myometrial invasion, and extension to the cervix. About two-thirds of women have low-risk disease confined to the uterus when these criteria are employed, while the remaining one-third have high-risk subtypes. Recent areas of investigation have focused on molecular and genetic markers. Two clinical observations currently being examined are the poorer survival of Black women with uterine cancer and the apparent association of endometrial lesions with chronic tamoxifen suppression in women with breast carcinomas.

Biopsy↗
PubMedDate not supplied

[Critical evaluation of preoperative instrumental staging of rectal tumors. Research on the adequate use of US, CT and MR].

Both traditional exams (rectal exploration, rectoscopy, barium enema, CEA) and advanced imaging (31 US, 40 CT and 11 MR) were performed for preoperative evaluation of rectal carcinoma in order to assess the accuracy of radiological imaging in the T and N staging. The results obtained have not been considered satisfactory and it is felt that US, CT and MR should not be employed routinely for rectal staging. Indeed accuracy of US, CT and MR is respectively 64%, 75% and 81% in the T evaluation and 64%, 70% and 64% in the N staging. In order to evaluate the effective usefulness of these three latter imaging techniques a double therapeutical choice was proposed. The first treatment option was suggested on the basis of traditional staging while a second choice was given considering US, TC and MR data also. Operatory findings subsequently allowed a definitive judgement on the influence of the different techniques on treatment selection. US has furnished useful data that could have allowed us to modify treatment in one case while in 5 other cases diagnostic error would have influenced treatment negatively. CT was useful in 5 cases while in 7 cases it would have influenced treatment choice negatively. MR would have been useful in one case and harmful in another. It is concluded that only patients with large neoplasms (stages T3 and T4) benefit from CT and MR staging with the exception of those cases that have tumors above the peritoneal fold or in strict relation with the sphincter structures. US was useful only in evaluating relations of neoplasms of the anterior rectal wall with nearby pelvic structures.

Adult↗
PubMed1986

Direct coronal and direct sagittal CT of abdomen and pelvis: an approach to staging malignancies.

Direct coronal and sagittal CT images are of high quality and are applicable to a majority of patients in daily practice. Because of the fact that transverse scans alone can be misleading, direct CT images in two or more different planes greatly enhance one's capability to stage neoplasms that are complex and extensive. The integrity of the margins of an organ, in the presence of tumor, is best determined by coronal or sagittal scanning. Lesions of the adrenal and kidney and retroperitoneal processes with possible extension into liver or other adjacent organs can be evaluated best using the combination of transverse and coronal or sagittal scans of the upper abdomen. Depending on the origin of pelvic lesions, the radiologist must consider in every individual case the performance of either direct coronal or sagittal sections or both. This judgment is based on the findings on the transverse scans, understanding of anatomic relationships of the pelvic viscera and knowledge of staging systems and their implications with respect to therapeutic decisions. In such a tailored approach, multiplanar CT facilitates improved presurgical evaluation. In some cases, the true extent of the lesion can only be seen in the coronal or sagittal planes. A potential new role for direct multiplanar CT is that it may be used as a sort of "gold standard" for the analysis of multiplanar ultrasound and MRI studies.

Abdominal Neoplasms↗
PubMedDate not supplied

[Genitourinary soft tissue sarcomas located outside bladder and prostate in children treated according to the CWS-96 protocol--report from the Polish Paediatric Solid Tumours Study Group].

AIM: Analysis of therapy efficacy in non-bladder/prostate genitourinary sarcomas in children treated from I'1997 to VI'2003 with CWS-96 protocol in Poland. MATERIAL AND METHODS: 19 children (M/F: 15/4, age: 3m-17,5y; median 7,2y). Histopathology: RMS - 15pts (RME-13), non-RMS- 4. RESULTS: Primary site: testes - 9 patients, paratesticular region - 6, uterus - 2, vagina and ovary-1 of each. 63% presented with low stage neoplasm (I - 7, II - 5). Primary tumour exceeded 5cm and/or invaded surrounding tissues in 7 patients (37%). 3 patients had regional, 2 patients--distant lymph nodes metastases. Primary excision: complete in 7 patients, incomplete - 12 (microscopically - 5, macroscopically - 7). Six of 7 patients with macroscopic tumour residues responded to chemotherapy (CR-4, GR-2). One patient (stage III triton tumour of uterus) did not, respond but obtained complete remission after mutilating delayed surgery. No other patient required delayed tumour resection. Radiotherapy (23,5-54 Gy) was given to 8 patients. 3 children developed local relapse, 3 patients died (16%): 2 due to neoplasm progression, 1 of neutropenia-related sepsis. 16 patients are alive (84%) with mean follow-up 48 months. The only permanent complications result from mutilating surgery. CONCLUSIONS: 1) prognosis in children with non-bladder/prostate genitourinary sarcomas is favourable despite incomplete primary excision of the neoplasm. 2) chemotherapy and radiotherapy were accompanied by severe but transient myelosupression in the HR group.

Adolescent↗
PubMed2000

Staging of bone neoplasms: an orthopedic oncologist's perspective.

The process of staging bone tumors is complex. The goal of staging is to define the type of tumor and its extent. Like staging for other neoplasms, it stratifies patients into groups based on prognosis and established treatment protocols. Staging is a multidisciplinary effort involving orthopedic oncologists, musculoskeletal radiologists, and orthopedic pathologists. The diagnosis is often suggested on clinical examination and review of the radiographs. The biopsy usually confirms the clinical and radiographic impression. However, biopsy is difficult and leads to errors in diagnosis in nearly 20% of cases. These errors may make limb salvage impossible and adversely affect survival. For this reason, staging and especially the biopsy should be done in the institution where definitive treatment is planned.

Adult↗
PubMed1998

Radiation treatment of glottic squamous cell carcinoma, stage I and II: analysis of factors affecting prognosis.

PURPOSE: At least in some European Countries, there is still considerable controversy regarding the choice between surgery and radiotherapy for the treatment of patients with early laryngeal-glottic carcinoma. METHODS AND MATERIALS: Two hundred and forty-six patients with laryngeal-glottic neoplasms, Stage I-II, were treated with radical radiotherapy. Before radiotherapy the patients were evaluated to determine the surgical procedure of choice. Either 66-68.4 Gy (33-38 fractions) or 63-65 Gy (28-29 fractions) of radiation therapy (RT) were administered. The overall disease free survival was determined for each subgroup of patients. Univariate and multivariate analyses were performed to determine significant prognostic variables. RESULTS: Five- and 10-year overall survival rates were 83 and 72%, respectively. At a median follow-up of 6 years 204 patients are alive and disease free. No patient developed distant metastases. One patient died of a large local recurrence, 38 patients died of causes unrelated to their tumor, and 3 patients were lost to follow-up. The multivariate analysis confirmed that performance status (PS), macroscopic presentation of the lesion, and persistence of dysphonia after radiotherapy are significant prognostic factors. CONCLUSIONS: According to the multivariate analysis, the patients with PS > 80 and with exophytic lesions are eligible for radical RT. The surgical procedure proposed for each patient was not found to be an independent prognostic factor.

Adult↗
PubMed1978

Value of liver scintiscan in staging of testicular neoplasm.

A nineteen-year retrospective study of the usefulness of liver scanning in the staging evaluation of germinal cell testicular neoplasms was undertaken at the National Naval Medical Center. Of 94 patients, 90 (96 per cent) demonstrated accurate correlation between liver scan and histopathologic diagnosis.

Adult↗
PubMed2006

Depressed-type (0-IIc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer: A cross-sectional study.

AIM: To investigate the correlation of depressed-type (0-IIc) colorectal neoplasm and family history of first-degree relatives (FDR) with colorectal cancer (CRC). METHODS: This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types (0-IIc vs non 0-IIc). Odds ratios (OR) and 95% confidence intervals (CI) were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC. RESULTS: The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 (95% CI: 1.31-2.61, P = 0.0004), that for non 0-IIc neoplasm was 1.71 (95% CI: 1.22-2.41, P = 0.0017) and for 0-IIc colorectal neoplasm was 2.78 (95% CI: 1.49-5.16, P = 0.0031). CONCLUSION: Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type (0-IIc) lesions.

Aged↗
PubMed2003

[Magnetic resonance tomography in the staging of uterine neoplasms].

Diagnostic significance of MR imaging used for cervical carcinoma staging was established during the examination of 71 patients with verified tumors stage I-III. These findings were compared with the clinical and surgical data. MRI procedure proved highly effective in detecting uterine body involvement, identification of hydroureter caused by the ureters being squeezed by parametrial infiltrates as well as reliable exclusion of parametrial infiltration of bladder wall invasion. It is instrumental in assessing involvement of tissues around the uterus and regional lymph node condition.

Adult↗
PubMed2005

[Expression and amplification of steroid receptor coactivator-3 gene in colorectal carcinoma and its clinicopathological significance].

OBJECTIVE: To investigate the expression and amplification of steroid receptor coactivator- 3(SRC- 3) gene in colorectal carcinoma (CRC) and its clinicopathological significance. METHODS: Immunohistochemistry and fluorescence in situ hybridization (FISH) were used to detect the expression and amplification of SRC- 3 gene in CRC, and its association with patient's clinical pathological features was analyzed. RESULTS: A total of 60 patients with CRC were studied. SAR- 3 proteins were overexpressed in 23 cases (38% ). There was a significant association between SAR- 3 overexpression and neoplasm staging (P< 0.01). SRC- 3 protein was overexpressed in 62% of patients with Dukes C or D stage, whereas SRC- 3 protein was normally expressed in 74% of patients with Dukes A or B stage. As for FISH study, 47 cases were informative. High- level amplification of SRC- 3 gene was detected in 6 cases(13% ) and all showed overexpression of SRC- 3 protein. Low- level amplification of SRC- 3 was observed in 9 cases (19% ). Overexpression of SRC- 3 was detected in 6 cases. The remaining 9 of 32 patients(28% ) without amplification of SRC- 3 gene were observed with overexpression of SRC- 3 protein. In addition, 91% patients with CRC were found overexpression of SRC- 3 as well as overexpression of P53. CONCLUSION: The abnormal expression of SRC- 3 gene might impact on the function of P53 and development of CRC. There might exist some unknown mechanisms other than gene amplification of SRC- 3 to regulate its encoded protein expression in CRC.

Biomarkers, Tumor↗
PubMed1985

Pre-operative staging of rectal neoplasm and its impact on clinical management.

A sophisticated staging technique (extended staging, ES) employing modern technology has been compared prospectively with conventional clinical assessment (initial staging, IS) in 45 patients with low rectal carcinoma (less than 12 cm from the anal verge) to determine its potential merit and its impact on clinical management. ES consisted of computerized tomography of liver and pelvis, ultrasound scan of liver, measurement of serum concentrations of carcinoembryonic antigen (CEA) and acute phase reactant proteins and multiple superficial and deep biopsies to determine not only the histological grade of the tumour but also its DNA cellular content as measured by flow cytometry. ES proved statistically superior to IS in the assessment of local spread and dissemination. Although histological grade proved to be more accurate on ES than IS this was only true when one specialist pathologist interpreted the slides. When several pathologists were involved interobserver variation made interpretation unreliable. Assessment of DNA content using flow cytometry, being quantitative, was more accurate and perhaps should be used in the future as a prognostic indicator. The improved accuracy of ES would have altered both pre- and intra-operative clinical decisions. It would have prevented some patients receiving inappropriate adjuvant therapy as well as selecting patients more accurately for the correct treatment.

Adult↗