[Local treatment of cancer of the breast].
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Breast Neoplasms↗
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Results for “Neoplasm Recurrence, Local”
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Intraoperative gamma detection probe with presurgical antibody imaging in colon cancer.
In this study, presurgical gamma camera imaging and an intraoperative gamma detection probe were used in 12 consecutive patients 6 to 22 days after infusion with indium 111-labeled anticarcinoembryonic antigen monoclonal antibody (111In-MoAb). In three of 11 patients who underwent laparotomy, clinical management was affected by the probe findings: localization of occult retroperitoneal disease, identification of an occult cecal lesion, and localization of residual disease at a site of local recurrence. Of all intra-abdominal lesions seen using any method, the probe identified 18 (86%) of 21, compared with 14 (67%) of 21 with the 111In-MoAb scan, 10 (48%) of 21 by computed tomographic scan, and 16 (76%) of 21 after surgical exploration. Uptake of 111In-MoAb in the portal (n = 3) and mediastinal (n = 3) lymph nodes was not associated with histologic findings of malignant neoplasms. For all pathologically confirmed extrahepatic and nonportal sites of cancer, the probe localized nine of nine, compared with five of nine by 111In-MoAb scan, two of nine by computed tomographic scan, and six of nine by surgical exploration. Important clinical uses of the intraoperative probe included occult lesion identification, localization of areas with 111In uptake shown with MoAb scanning, and verification of complete resection of areas with 111In-MoAb uptake.
Abdominal Neoplasms↗
DNA index as a significant indicator of lymph node metastasis and local recurrence of rectal cancer.
To confirm the prognostic significance of the DNA index (DI) in cases of rectal cancer, the nuclear DNA content of tumor cells was examined in 184 cases of rectal cancer treated with curative surgery, and the incidence of lymph node metastasis and recurrence of the cancer was analyzed. The incidence of lymph node metastasis was 43.9 percent in cases with aneuploidy (DI above 1.5), being statistically different from the 18.0 percent incidence in cases with diploidy (P < 0.001). Although the extent of lymph node metastasis was limited to adjacent lymph nodes in cases with diploidy, distant lymph node metastases were frequent in cases with aneuploidy, especially in those with a DI above 1.5. Furthermore, the incidence of recurrence of cancer, and especially of local recurrence, was significantly higher (P < 0.001) in cases with aneuploidy (DI above 1.5) than in cases with diploidy and aneuploidy (DI below 1.4). These findings indicate the significant value of the DNA index for the prediction of lymph node metastasis and local recurrence in patients with rectal cancer.
Aneuploidy↗
Pelvic recurrence after curative resection for carcinoma of the rectum.
Cases of carcinoma of the rectum have been prospectively studied from 1971-80. Two hundred and ten patients had curative resections and 25 of these developed clinical pelvic recurrence in the period of follow-up which ranges from one to eleven years. The rate of recurrence is found to be dependent on the level of the lesion and the degree of its local and lymphatic spread. Results from other papers are discussed. Measures to minimise local recurrence are discussed.
Aged↗
Malignant melanoma prognostic factors 3: surgical margins.
Narrow margins of excision for melanomas less than 0.85 mm thick neither shorten the length of survival nor increase the local recurrence rate. Similarly, narrow margins of excision for melanomas greater than 0.85 mm thick do not adversely affect the survival rate. However, for thicker melanomas, the local recurrence rate increases when the surgical margin is reduced to less than 3 cm.
Humans↗
Merkel cell tumor with spontaneous regression.
Merkel cell tumor of the skin is now a well-documented tumor. We report on another tumor with local recurrence and skin metastases which spontaneously regressed.
Aged↗
The oncologic risks of skin preservation at mastectomy when combined with immediate reconstruction of the breast.
Most oncologic surgeons agree that removal of the nipple, the areola and any recent scar at the site of the biopsy is necessary during a mastectomy for treatment of carcinoma of the breast. There is less agreement about what should be done with the remaining uninvolved mammary skin. Its preservation facilitates the performance of immediate reconstruction of the breast and can lead to improved aesthetic results, but many oncologists fear that this practice could lead to an increased incidence of local tumor recurrence. To determine if that fear was justified, 87 patients who had undergone unilateral or bilateral mastectomy with immediate reconstruction for treatment of early carcinoma of the breast were studied. Preservation of uninvolved skin was used in all instances. All patients had a documented follow-up study of 12 months or more; the average follow-up time was 23.1 months. One peripheral local recurrence was observed. This 1.2 per cent rate of early local recurrence is lower than that reported from several series using modified radical mastectomy without skin preservation or immediate reconstruction, and suggests that skin preservation does not confer additional risks of local recurrence of carcinoma of the breast in properly selected patients.
Breast Neoplasms↗
[Consequences of after-care in colorectal cancer].
Results of a computer supported follow-up-program on patients with colorectal cancer are presented. Between 1978 and 1985 1024 patients underwent these program, the drop-out-rate was 18%. 231 recurrences in 137 patients were discovered (40% local recurrence, 30% liver metastases and 30% others). 54% of patients with local recurrence and 43% with liver metastases were free of symptoms. Radical surgery was performed in 47% of local recurrences and in 24% of liver metastases. The three year survival rate after radical surgery for recurrence amounted to 28% for local recurrences and to 31% for liver metastases.
Colonic Neoplasms↗
[Immediate breast reconstruction following mastectomy for carcinoma].
Analysis of the psychic situation of the women after mastectomy. Most surgeons are against an immediate reconstruction of the breast, because the comparison to conditions before the amputation is usually too negative. The main argument against immediate reconstruction is the local recurrence which occurs in the first 6 postoperative months in 75% of the cases. In stage 0, no local recurrences were observed. If a mastectomy is performed in this stage, immediate reconstruction can be done. In stage 1 the number of local recurrences is 5% in the first postoperative months. In elected cases, if it is the expressed wish of the patient immediate reconstruction can be discussed. In stage 2 the local recurrence rate is already 13,8%. In this stage, an immediate reconstruction is out of the question.
Breast↗
Results of intersphincteric resection of the rectum with direct coloanal anastomosis for rectal carcinoma.
Between 1977 and 1987, 519 patients underwent operation for rectal carcinoma. Sixty-three patients underwent intersphincteric resection with direct coloanal anastomosis (CAA), and 77 had an abdominoperineal resection (APR). Curative surgery was achieved in 57 and 65 patients, respectively. Both groups were comparable regarding age, stage of tumors, and localization of tumors. During the mean period of 6.7 years (range: 3 to 13.6 years), all patients were examined according to a predefined follow-up plan. From those patients with curative surgery, 11% presented with pelvic recurrence and 33% with distant metastases after coloanal anastomosis; the rates of recurrence and distant metastases after APR were 17% and 35%, respectively. The corrected 5-year survival rates were 62% following CAA and 53% following APR. Eighty-five percent of the patients with CAA reported good functional results regarding anal continence. Our study demonstrates that the intersphincteric resection with CAA is a valuable surgical technique for rectal carcinoma with the benefit of preservation of continence. It is suitable for neoplasms with high- and medium-grade differentiation (G1 to G2) and a localization that allows a minimum distal clearence of 3 cm.
Abdominal Muscles↗
[The adequate operation, an essential element of interdisciplinary cancer therapy].
Operative treatment plays a dominant role in our effort for cancer control. The results, e.g. in breast cancer, cancer of the stomach and colon, malignant melanoma, malignant teratoma of the testicle, mixed tumours of the salivary glands, and sarcomas of soft tissues demonstrate that local tumour relapses and/or local metastases may be avoided by adequate, sufficiently radical operative techniques.
Female↗
Local recurrence of gastric adenocarcinomas after gastrectomy.
A study of 257 gastric cancer patients treated with gastrectomy and followed to their death showed that (a) the incidence of local recurrence in the field of gastrectomy was 25%; (b) from the three types of gastrectomy used, extended total gastrectomy resulted in the lowest incidence of recurrence, followed by subtotal and total; (c) recurrences were more common in patients with TNM stages I, II, and III tumors where extended total gastrectomy was proven superior (p less than 0.05); (d) early stage tumors tended to recur in the gastric remnant and the esophagus; (e) narrow surgical margins and margins involved by disease predisposed to recurrence; (f) not every patient with histologically invaded margins developed recurrence; (g) the risk of recurrence did not decrease with time; (h) the longer the disease-free interval the better the prognosis; (i) the more advanced the original lesion the longer the disease-free interval; (j) of all patients with recurrence only 19% had resectable lesions on reexploration; (k) the longer the disease-free interval the higher the resectability rate; (l) the median interval from recurrence to death was 2 months; (m) the same interval of those undergoing resection was 18 months. Patients with early-stage tumors treated with gastrectomy should be followed closely for local recurrence and should recurrence develop they should be reexplored if there is no evidence of metastasis.
Adenocarcinoma↗
Local tumour control and its effect upon survival of the patient.
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Animals↗
Blood transfusion and recurrence of colorectal cancer: the role of platelet derived growth factors.
Efforts to explain the possible effects of blood transfusion on the recurrence of colorectal cancer have been based entirely on the immunosuppressive effects of blood transfusion. However, the relationship between solid tumour development and the immune system is inconclusive. We have investigated an alternative mechanism involving the potential role of growth factors in this phenomenon. Using a human fibroblast: [125I]deoxyuridine uptake mitogenesis assay, the relative amounts of growth factor in the plasma of stored blood were measured. There was a progressive increase in mitogenesis from day 0 (n = 6) to day 28 (n = 6; P less than 0.001, Mann-Whitney U test). The effect of growth factors on the development of liver and intraperitoneal metastases was studied in Hooded Lister rats. Following an intraportal injection of 10(5) MC28 tumour cells, the experimental group (n = 25) received 2 ml of syngeneic serum intravenously for 4 days. Likewise, colonic anastomoses were performed on omentectomized rats and the peritoneal cavity seeded with 10(3) cells. The experimental groups (n = 20) received either 2 ml serum intravenously repeatedly or 3 ml serum intraperitoneally (n = 19). There was no significant increase in liver metastases or peritoneal disease following intravenous infusion of serum but serum delivered intraperitoneally resulted in a significant increase in tumour from 22 per cent in the controls to 89 per cent in the study group (P less than 0.01). Growth factors released from platelets following blood loss into the peritoneal cavity may be important in enhancing local recurrence of colorectal cancer.
Anastomosis, Surgical↗
[Prognostic value of histopathological parameters in epidermoid carcinoma of the vocal cords in T-1 stage].
In this paper are studied macro- and microscopically, 14 histopathologic parameters belonging to 37 patients suffering from vocal cord squamous cell carcinoma, stage T-la. All patients were submitted to cordectomy and followed up during a 5 years term, as a minimum. A discriminant analysis was performed in order to establish the relation between histopathologic parameters and local failure. Only two of them were statistically significative (p < 0.01): the structural type and the differential degree of tumor cells. The histopathological study allowed the prediction of 82 percent of local recurrences.
Carcinoma, Squamous Cell↗
Pattern of recurrences in endometrial carcinoma and their management.
During the period 1961-1971, 177 surgical candidates with clinical Stage I adenocarcinoma of the endometrium were treated. The pattern of recurrence according to the initial mode of treatment and the high risk factors predisposing to recurrence are presented. The incidence of vaginal vault recurrence was reduced from 7.4% with surgery to 1.2% by the use of adjunctive radiotherapy. Management of recurrence according to site is outlined. The local control rate for patients with local recurrence was 44% and the five-year survival rate after recurrence was 33%.
Adenocarcinoma↗
Mucocutaneous plasmacytomas in dogs: 75 cases (1980-1987).
Mucocutaneous plasmacytomas were diagnosed in 75 dogs. Medical records and communication with owners and referring veterinarians provided information regarding location and description of the tumor, clinicopathologic data, treatment, and postoperative status of the dogs. Males and females were equally represented, and most dogs were aged adults (mean, 9.7 years). Tumors developed most commonly in the mouth, on the feet or trunk, and in the ears. Plasmacytomas were confined to the skin and mucosa in 70 dogs. Two dogs had disseminated lymphoid neoplasia, and 1 dog developed cutaneous plasmacytoma during clinical remission of lymphosarcoma. Two dogs had multiple myeloma, which was diagnosed concurrently or within a few weeks of diagnosis of the cutaneous tumor. Multiple plasmacytomas were found in 10 dogs but were not associated with clinical signs of generalized disease. Tumors did not recur after surgical excision. Clinicopathologic values, when determined, were normal in all dogs with localized plasmacytomas.
Animals↗
Local control in rectal cancer. A clinical review and meta-analysis.
We reviewed the factors influencing local control of potentially curable rectal cancer in 106 patients. There was improvement in stage-adjusted local control associated with increasing use of adjuvant radiation therapy. A meta-analysis of the English-language literature through 1988 also supported the effectiveness of adjuvant radiation therapy in all but the lowest-risk patients. No effect on survival was identified in either analysis, but a reduction of up to 40% in local recurrence rates may be achieved with doses of 3000 cGy or more.
Humans↗