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At least 19 recordsLinked to original sources
PubMed1999

[Experimental studies on hyperthermic distilled water combining with saline and dextran for preventing intraperitoneal cancer recurrence due to neoplasm seeding].

In order to know the efficacy of hyperthermic distilled water combining with saline and dextran (DSD) to prevent intraperitoneal cancer from recurrence due to neoplasm seeding, we carried out the experimental studies, including an observation on inhibiting cancer cells from implantation in vivo by abdominal cavity lavation, cytotoxic test and attachment test in vitro. The results of the tests in vitro showed no viable tumor cell exposed to 45 degrees C distilled water for 20 minutes in the tissue culture wells, meanwhile, dextran-40 partially blocked attachment of B16-F10 cells to gelatinized wells. In vivo test, DSD effectively prevented neoplasm seeding of B16-F10 viable melanoma cells in C57BL/6j mouse abdominal cavity and had no obvious toxicity. The efficiency was 70%; when cisplatin was added, the efficiency was enhanced to 88.9% with slight toxicity. These data indicate that the local application of hyperthermic distilled water combined with saline and DSD may prevent intraperitoneal neoplasm from recurring.

Animals↗
PubMed1999

Long-term consequences from bladder perforation and/or violation in the presence of transitional cell carcinoma: results of a small series and a review of the literature.

PURPOSE: Perforation of the bladder during transurethral resection is a worrisome complication for most urologists. Little is known about the consequences of seeding of tumor cells into the peritoneum or retroperitoneum. We reviewed several hospital patient databases as well as the literature to determine the outcome of such situations. MATERIALS AND METHODS: We performed a local multi-institutional case and MEDLINE review using key words, such as bladder neoplasm, neoplasm seeding, perforation, rupture, transurethral resection, peritonitis and tumor. We also contacted several urologists and oncologists at major cancer centers in the United States and Europe regarding the incidence and followup of perforated/violated bladder cancer cases. RESULTS: There were 16 bladder violations in the presence of transitional cell carcinoma, including 2 partial cystectomies that had negative margins and no subsequent metastatic recurrences, a bladder tumor that was detected during suprapubic prostatectomy and perforations during transurethral resection (extraperitoneal in 4 cases and intraperitoneal in 9). Two patients died of sepsis and existing metastatic disease, respectively. The only recurrence among the remaining 11 patients developed after intraperitoneal bladder perforation during transurethral resection for Ta grade 2 tumor. Several anecdotal reports discussed local and distal tumor recurrences, suggesting that even superficial transitional cell carcinoma can behave aggressively if grown in an environment outside the bladder. However, these reports are rare. Any benefit of prophylactic chemotherapy was not proved. CONCLUSIONS: While perforation of the bladder during transurethral resection for cancer and the possibility of tumor implantation are matters of concern, our review demonstrates that few patients return with an extravesical tumor recurrence either locally or distally compared to those with a nonruptured bladder after resection. Although our patient sample is small and there are a limited number of reports in the literature, the risk of recurrence still exists and the urologist should be aware of its possibility. Since recurrences are usually rapid, they may easily manifest to the urologist at followup. However, one should also consider chest x-rays and/or computerized tomography to rule out recurrences that are not clinically obvious.

Carcinoma, Transitional Cell↗
PubMed2000

Pathophysiologic interactions in skeletal metastasis.

BACKGROUND: This review summarizes evidence that the formation of bone metastases is the result of multiple synergistic cellular and molecular interactions between metastatic cells and the unique microenvironment in bone. METHODS: Molecular technologies have been used to detect cancer cells in bone and to define their genotypic and phenotypic properties. Bone organ cultures have been employed to analyze the ability of tumor cells to modulate bone resorption and to study the effects of resorption products on the phenotypic properties of cancer cells. Experimental models of bone metastasis provide the ability to examine the effects of modulating specific host or tumor properties in vivo by quantifying their effects on the formation of bone tumors. RESULTS: By means of the blood stream, cells from many common neoplasms seed bone marrow as an early clinical event. The subsequent growth of these cells into clinically significant metastatic lesions is associated with their ability to stimulate bone resorption through osteoclasts and macrophages or through a direct action on bone. In turn, the products of bone resorption, which include matrix-derived growth factors, act on the tumor cells to stimulate the expression of properties that promote their metastatic competence. These include the induction of integrin adhesion molecules, the stimulation of cell motility and chemotaxis, the enhanced expression of matrix metalloproteinases, and the stimulation of tumor cell growth. CONCLUSIONS: The interdependency of tumor cells and bone was recognized by Steven Paget over 100 years ago, and it provides a rational basis for the development of current therapeutic strategies against bone metastasis.

Bone Neoplasms↗
PubMed1995

Tumor cells in blood shed from the surgical field.

OBJECTIVES: To analyze blood shed from the surgical field during oncologic surgery for tumor cells and to assess functional characteristics of these cells. DESIGN AND PATIENTS: Series of 61 patients with cancer who underwent surgery for an abdominal, orthopedic, urological, gynecological, or head and neck malignant tumor, and blinded comparison with 15 patients with benign diseases undergoing surgery. SETTING: A 500-bed tumor center and a tertiary care hospital. MAIN OUTCOME MEASURES: Tumor cells were isolated from intraoperatively salvaged and washed blood by density gradient centrifugation. They were identified in cytospin specimens by their content of cytokeratins and nucleolar organizer regions with a sensitivity of 10 cells in 500 mL of blood. Clonogenicity was tested in a cell colony assay; invasiveness, in Boyden chambers; and tumorigenicity, in nude mice. RESULTS: In 57 of 61 patients, tumor cells were detected in the blood shed during oncologic surgery. They demonstrated proliferation capacity, invasiveness, and tumorigenicity. The total number of tumor cells identified ranged from 1 x 10(1) to 7 x 10(6), with no close correlation to the amount of blood loss. Circulating tumor cells were demonstrated in only 26% of these patients and in small numbers. CONCLUSIONS: Malignant cells identified regularly in the blood shed during tumor surgery and different from circulating tumor cells are of concern, since at the surgical site they may cause local tumor recurrence, or in the salvaged blood they may cause hematogenic metastasis after retransfusion. Therefore, the contraindication of intraoperative autotransfusion in tumor surgery is strongly supported, and a review of surgical procedures and adjuvant therapy may be indicated, as the passage of the identified cells to the shed blood is yet unknown.

Blood Loss, Surgical↗
PubMed1996

Effect of intraperitoneal chemotherapy and fibrinolytic therapy on tumor implantation in wound sites.

Failure of surgical treatment for gastrointestinal cancers is often caused by recurrence of the tumor in traumatized peritoneal surfaces. This study examined the effect of intraperitoneal administration of doxorubicin and recombinant tissue plasminogen activator (rt-PA), a fibrinolytic agent, on incidence and volume of postoperative tumor implants in peritoneal wounds. Prior to randomization, a surgical wound was created on the right parietal peritoneum of 110 BDIX rats and 6 x 10(5) DHD/K12 colon cancer cells were inoculated intraperitoneally (ip). The control group was given an intraperitoneal injection of saline. Five groups received 1 mg/kg of ip doxorubicin at different times postoperatively: at the end of surgery (D0), 3 hr after surgery (D + 3), postoperative day 1 (D1), postoperative day 3 (D3), and postoperative day 7 (D7). In a second set of experiments, five groups of rats received, in addition to postoperative doxorubicin, 5 mg/kg of intraoperative ip rt-PA. Incidence and volume of tumor implants in peritoneal wounds were assessed for each group 20 days after the tumor inoculation. All rats of the control group (incidence = 100%) developed tumor implants in peritoneal wounds. Mean (SD) volume was 16.2 (4.7) mm3. When administered at D0, D + 3, and D1 intraperitoneal doxorubicin reduced significantly the incidence and volume of tumor implants in wounds. Postoperative administration of doxorubicin at D3 and D7 did not affect significantly the incidence and the volume of tumor implants in peritoneal wounds. When rt-PA was administered intraoperatively, ip injection of doxorubicin at any postoperative timing decreased significantly the incidence and volume of tumor implants. In conclusion, ip doxorubicin administered before postoperative D3 may act on tumor cell implanted in peritoneal wounds. Delayed (D3, D7) ip administration of doxorubicin does not prevent the development of tumor implants in peritoneal wounds. Intraoperative administration of rt-PA may significantly increase the efficacy of delayed ip chemotherapy.

Animals↗
PubMed1998

Local treatment of abdominal wound reduces tumor implantation.

BACKGROUND AND OBJECTIVES: Pneumoperitoneum increases the trocar-site tumor implantation rate using a human colon cancer cell line in a hamster model. The purpose of this study was to determine whether local treatment of trocar sites with potential tumoricidal agents can inhibit tumor implantation after pneumoperitoneum. METHODS: GW-39 human colon cancer cells (0.5 ml of 2.5% v/v; 8.0 x 10(5) cells) were injected throughout the abdomen of 133 Golden Syrian hamsters through a midline incision. The animals were randomized to receive either untreated 5-mm trocars in each abdominal quadrant (group I control, n = 49), trocars dipped in 10% povidone-iodine (group II, n = 53), or trocars coated with 1% silver sulfadiazine (group III, n = 51). The midline wounds were also coated with the respective agents before closing. Pneumoperitoneum was then maintained at 10 mmHg for 10 min, after which the trocar wounds were closed. In group II, the trocar sites were treated with a coat of povidone-iodine after the trocars were withdrawn and before closing. Gross and microscopic tumor implants were analyzed at 7 weeks postoperatively. RESULTS: The rate of tumor cell implantation at trocar sites was reduced from 93% (172/184) in the control group to 75% (126/168) and 78% (141/180) in groups II and III, respectively (P < 0.0001). Fewer palpable tumors were detected in groups II and III (40% and 23%, respectively) than in the control group (72%, P < 0.0001). Mean tumor mass in group III (0.4+/-0.1 g), but not in group II (1.0+/-0.2 g), was significantly less than that in the control group (1.3+/-0.1 g, P < 0.01). Overall tumor involvement of the larger midline wound was similar for all groups (I = 80%, II = 79%, III = 71%). However, palpable tumors were identified more frequently in group I (67%) than in groups II and III (43%, P < 0.05; 22%, P < 0.01, respectively). CONCLUSION: Pretreatment of abdominal wounds with povidone-iodine or silver sulfadiazine can reduce tumor implantation after pneumoperitoneum in a hamster model.

Abdominal Muscles↗
PubMed1999

In vitro tissue effects of a combined Ho:YAG/Nd:YAG laser: sprinkling of tissue fragments by Ho:YAG laser light may be problematic for oncological interventions.

BACKGROUND AND OBJECTIVE: Surgery of soft tissue, for example, of the tongue or the liver, requires a cutting and coagulating device. Therefore, a combined Ho:YAG/Nd:YAG laser providing the laser beam of both systems together in one bare fiber seems to be useful. STUDY DESIGN/MATERIALS AND METHODS: We studied the effect of such a laser system in vitro on tongues of pigs. RESULTS: Combined application of both lasers results in vitro in a thicker coagulation zone in soft tissue (tongue). Tissue fragments possibly containing vital cells are sprinkled by the pulsed energy of the Ho:YAG laser up to a distance of 20 cm. CONCLUSION: Using the pulsed Ho:YAG laser for oncologic interventions seems to be problematic. Combined laser effect in vivo may result in better hemostasis.

Animals↗
PubMedDate not supplied

Pneumoperitoneum in the cancer patient: advantages and pitfalls.

The use of pneumoperitoneum to create a working environment for laparoscopic surgery may have both beneficial and detrimental effects in cancer patients. Studies suggest that immune mechanisms are protected when laparoscopic procedures are used and this does not seem to be compromised by the use of gas in the abdomen. Potential pitfalls in the utilization of pneumoperitoneum include the effects of hypothermia, cardiovascular consequences, hypercoagulability with associated deep-venous thrombosis, and the possibility that trocar-site recurrences may be produced by using a pneumoperitoneum. No concrete evidence of either beneficial or detrimental effects from pneumoperitoneum in cancer patients currently exists. Studies utilizing animal models and humans should be supported in this extremely important area.

Animals↗
PubMedDate not supplied

Port-site metastasis in the abdominal wall: fact or fiction?

Port-site metastasis (PSM) following minimally invasive surgery (MIS) is discussed and four points are addressed: 1) the occurrence of PSM; 2) the occurrence of PSM as part of distant metastasis, and the need for more studies to confirm that it can occur purely as implantation metastasis; 3) the preliminary experimental evidence suggesting that carbon dioxide might have a role in PSM and that viable cells can be dispersed by pneumoperitoneum (with more experimental work and clinical studies needed to confirm these observations); and 4) some studies showing an increased incidence of PSM after MIS compared with open surgery. Prospective randomized studies with adequate follow-up are needed to establish the validity of such reports.

Abdominal Neoplasms↗
PubMed1999

Port site recurrences after laparoscopy for malignant disease.

Reports of recurrent malignant disease developing at laparoscopic port sites has created considerable controversy among surgeons. Many have implicated the technique of laparoscopy as a cause of metastases and this has led to condemnation of laparoscopy in malignant disease by many surgeons. A review of the case reports, as well as animal studies, reveals the problem to be considerably more complex. Based on experimental models, reported cases, and our experience at the University of Texas M. D. Anderson Cancer Center, we have arrived at some substantive conclusions regarding this phenomenon. Port site recurrences (PSRs) after laparoscopy for malignant disease can occur as the only site of recurrence, but this is an extremely rare event, and the incidence does not appear to be significantly different from the development of wound recurrences after open laparotomy for malignancy. It is likely that port site recurrences reflect the underlying biology of the malignant disease, rather than an effect of the technique of laparoscopy.

Animals↗
PubMed1980

Percutaneous fine-needle aspiration biopsy. I. Its value to clinical practice.

From the experiences in dealing with 2591 cases of transthoracic and transabdominal fine-needle aspiration biopsies (1967-1978), we present our views on the value of this relatively new diagnostic method to clinical practice. Virtually any accessible localized lesion in any organ of the body can be investigated by fine-needle aspiration biopsy, which is considered most useful in patients with suspected malignant disease. Transthoracic and transabdominal fine-needle aspiration biopsy may provide information otherwise obtainable only by thoracotomy or laparotomy. It is an inexpensive and safe method with high accuracy for obtaining a pathologic diagnosis, and can impart some practical significance to clinical practice, especially in clinical management. The pitfalls in cytomorphologic interpretation, which often cause unsuccessful attempts, can be readily avoided with increased practical experience, as indicated by the increase in detection rate of lung cancer by fine-needle aspiration method from 82.8% in 1967-1968 to 93.4% in 1976 at the Toronto General Hospital. The accuracy of cytologic diagnosis plays a major role in spreading this still relatively unfamiliar but excellent diagnostic method. We believe that the method deserves widespread clinical application and when this happens, it will bring about great savings in health care resources.

Abdomen↗