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At least 19 recordsLinked to original sources

Surgical treatment of tendosynovial sarcoma.

Tendosynovial sarcoma is notorious for its high rates of local recurrence and metastases after surgical treatment. A retrospective study was made of 109 cases of monobloc wide soft part resection and amputation for primary tumors, and 29 patients who underwent resection of pulmonary metastases. Actuarial five-year survival rates after soft part resection was 70% for untreated, and 61% for previously treated, locally recurrent neoplasms. Corresponding rates after amputation were 47% and 64%. Local tumor recurrence developed in 18% of the primary soft part resections and 4% of the amputations, usually when some basic surgical principle had been violated. 35% five-year survival was achieved with judicious resection of solitary and multiple lung metastases in most cases without chemotherapy. Local control of a tendosynovial sarcoma can be achieved with properly executed surgical procedures which adhere to established tenets of cancer surgery. Resection of pulmonary metastases merits an important position in the management of these patients.

Amputation, Surgical

Quadruple renal neoplasia: bilateral renal tumors of dissimilar histogenesis.

Four separate renal neoplasms were removed from a 64-year-old man during a period of 8 months. A lesion was first identified in the left kidney and the nephrectomy specimen had 2 separate adenocarcinomas. A third adenocarcinoma and a papillary urothelial pelvic carcinoma were found subsequently and segmentally resected from the right kidney. The patient died 9 years later with local recurrence of the urothelial neoplasm but no evidence of metastatic carcinoma.

Adenocarcinoma

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

The dilemma of stage III breast cancer: a study of preoperative radiotherapy.

The results of treatment of 68 patients with Stage III breast cancer treated by preoperative radiotherapy and subsequent mastectomy have been compared with those in 68 patients treated by more conventional methods, matched individually for age, stage, and year of treatment. Preoperative radiotherapy delayed the time of the first local recurrence, but did not improve overall survival. It is concluded that preoperative radiotherapy may be justified in patients with Stage III breast cancer in an attempt to control local disease, but is unlikely to improve control of systemic recurrence.

Breast Neoplasms

Biologic determinants of tumor growth in healing wounds.

The morphologic characteristics of a scar may render it an "immunologically privileged site" providing fertile ground for tumor occurrence and growth. We sought to extend this concept and to determine the effect of different stages of wound healing on tumor occurrence. Syngeneic strain-2 guinea pigs and a methylcholanthrene-induced liposarcoma (MCA-2) were used. Incisional flank wounds were created at appropriate intervals such that at the time of tumor inoculation each group of animals had a sequentially aged wound which was a) acute, b) three weeks old, c) nine weeks old, d) 11 weeks old, e) created one week after tumor injection, or f) no wound. Wounds which were three, nine, or 11 weeks old consistently caused a significant increase in tumor growth rate following inoculation of a single cell tumor suspension (<.001). The delayed wounds, or those created following after tumor injection, and the acute wounds did not promote increased tumor growth. This study demonstrates that the ability of a wound to amplify or retard tumor growth may vary with its age. As a postulate we suggest that the relative paucity of lymphatic regeneration within scar tissue may render it an "immunologically privileged site" such that early recognition and destruction of tumor cells within the scar may be delayed long enough for the tumor to grow to a "critical size." Subsequent to this regardless of the host's immunocompetence the tumor can no longer be destroyed by an immune mechanism. The general lack of progressive growth of tumor cells placed in acute wounds suggests that they were not protected from immunocompetent cells and were destroyed by the ongoing inflammatory response to injury. Therefore, different biologic characteristics of a surgical scar are important in potentiating or retarding tumor growth. Variations in such factors may account for the local recurrence of cancer in operative wounds.

Animals

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

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

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

Enhanced survival of patients with colon and rectal cancer is based upon wide anatomic resection.

From 1966 through 1970 we performed resections in 216 patients with carcinoma of the large bowel. The relative five year survival for all patients was 65.5%. The relative five year survival for all potentially curable patients was 80.4%. Patients with positive lymph nodes and full-thickness penetration of their tumors had a five year survival of 70.5% and a 10 year survival of 60.5%. In performing this study we have tested the principles of wide anatomical resection and radical lymphadenectomy. For their specific influences on survival we have also examined stage, site, age, sex, race, margins, local recurrence, hypogastric lymph node dissection, serosal penetration and various aspects of nodal status. The information derived from these parameters has confirmed our hypothesis that survival is directly related to radical anatomical resection and lymphadenectomy. For rectal cancer, extensive resection also reduces the incidence of local recurrence. We are persuaded that the principles of operation for large-bowel cancer are valid and that they merit universal adoption.

Aged

Breast cancer and prostaglandins: a new approach to treatment.

The effect of the non-steroidal inhibitor of prostaglandin synthesis, flurbiprofen, has been studied on a transplanted mouse mammary tumour of spontaneous origin. Daily administration of 2.5 mg/kg flurbiprofen signficantly reduced the growth of this NC adenocarcinoma transplanted subcutaneously into the right flank of WHT/Ht mice. Histological examination showed that primary tumours excised at 3 weeks from treated mice tended to have a more prominent lymphocytic infiltration. There was a non-significant tendency for mice treated with flurbiprofen alone to survive longer after tumour excision and to develop less local metastases, although scar recurrences seemed unaffected. The effect of adjuvant chemotherapy and local radiotherapy on local metastases and survival time tended to be greater when flurbiprofen was also given. This work supports and extends the basis for prospective clinical trials to evaluate the role of prostaglandins in human cancer and the value of prostaglandin synthesis inhibitors in cancer therapy.

Animals

Granular cell tumor of the tongue.

The granular cell tumor has been and still is a debatable lesion in several aspects. The etiology and pathogenesis are still unknown. Granular cell tumors may occur everywhere in the body, but the oral cavity is a favorite location. The majority of the oral lesions are found in the dorsum and the borders of the anterior two-thirds of the tongue. Seven patients with a granular cell tumor of the tongue are described. The clinical and microscopic findings have been discussed. In all cases an excisional biopsy had been aimed at. In spite of incomplete excision in six out of the seven cases, local recurrences were noticed in only one patient. In one patient "metastatic" occurrence of granular cell tumors was noticed.

Adult